Keeping fluid level gains as low as possible between dialysis treatments will minimize the risk of congestive heart failure, pulmonary edema, and hypertension. Cramps, headaches and breathing difficulties are short term side-effects of fluid overload, and whilst not as dangerous as the long term effects, these should be heeded as a pointer to fluid overload in dialysis patients.

Whilst every dialysis patient has their own special method of keeping their fluid levels in check, I thought it might be pertinent to explain some of the methods that I have found (relatively) successful.

1/ Buy a bag of ice. I have a large chest freezer in my kitchen; I buy a 5kg (approx 11lb) bag of ice chips from the service (gas) station, place it in the freezer, and suck on ice chips throughout the day. Make sure the freezer is in a convenient place, so you can reach it quickly to grab a few small pieces of ice, so you can avoid the temptation to fill a glass with ice. (In which case you might as well have that mug of coffee you wanted in the first place!)

2/ Get a GOOD set of digital scales. I have a set which measures with an accuracy of 200grams (don’t we all wish we could afford the scales at the dialysis unit which measure to 50grams?!?), which is accurate enough to get a good idea of where you are at with your fluid gain. Work out the difference between your dialysis centre scales, and your home scales, so you can get an accurate reflection of your fluid gain. I weigh myself first thing when I get up in the morning (you’d be surprised how much weight you lose over a warm night!), as soon as I get home from work, and whenever I have a drink.

This method is great in two ways: 1) you never (well, rarely, anyway!) get a nasty surprise when you arrive at dialysis and jump on the scales. And 2) you don’t get the opposite surprise of getting to dialysis with only 1kg of fluid on, thinking: “Damn, I wish I’d drank more! A?? (I often find myself in the ridiculous situation of forcing myself to have another cup of coffee before I leave for dialysis, as there’s no bank for fluid, once you’ve had that dialysis, the opportunity to have that drink is gone forever!)

3/ Save up your drinks if you’re going to need them. If you know you are going to an event where the temptation to drink more fluid that you should will be strong, save up your drinks beforehand. For example a??if you get off dialysis at lunchtime on Wednesday (meaning that you go back to dialysis on Friday Morning), and you have a function to attend on Thursday night, try to drink as little as possible between Wednesday lunchtime and Thursday evening, telling yourself that your reward will be the fact that you will be able to drink (nearly) as much as a “normal" person at the function.

4/ Keep yourself busy! Any dialysis patient will tell you that when they’re busy, they’re not thinking about drinking. It could be a gentle walk, send an email to a friend, jump on the phone, or play with your kids. It doesn’t matter, as long as it keeps your mind occupied.

5/ Frozen water. Freeze a bottle of water, containing the amount you have allowed yourself to drink that day, and drink it as it defrosts. This has the benefit of the drink being ice-cold, as well. The down-side of this is that if your bottle melts too quickly, you could find yourself at 3pm, with all your water gone!

6/ Spray bottle. Get yourself a spray bottle, and fill it with water (maybe with a little lemon juice or mint flavoring), and spray it into your mouth when you feel the urge to have a drink. Whilst this won’t completely sate your desire for fluids, it may help you wait a little longer before indulging!

7/ Mints and toothpaste. Try sucking a strong mint, or even brushing your teeth. The feeling of a clean, fresh mouth will often lessen the desire to blow your fluid limit. (This method will make you nicer to kiss, too!)

I hope that these suggestion will help you in the dialysis patient’s eternal quest to keep their fluid gain under control. But remember, life is for living too, and we, as dialysis patients more than most need to adhere to this edict. So whilst keeping your fluid gain under control is important for both your immediate and long term health, remember that if you’ve blown your fluid this time, there is always next time, so keep trying!