Today’s reading: 207/188.

That’s not a typo. It’s the kind of number that makes the dialysis nurse pause, the machine blink, and me wonder—how do we balance the scales when the treatment itself reshuffles them?

I live with a directive from my renal consultant: no blood pressure medication before dialysis. The reason is sound—if my pressure drops too low during treatment, the machine can’t safely remove fluid. It’s a known risk, and one I’ve felt in my bones. Dizzy spells. The slow slide into hypotension. The machine’s quiet refusal to proceed.

But the flip side is this: without that morning tablet, my blood pressure can soar. Not just a little. Not just “keep an eye on it.” We’re talking dangerously high readings that feel like a pressure cooker behind the eyes. And still, the machine must run. The fluid must come off. The balance must be struck.

This isn’t a complaint—it’s a reality check. A reminder that dialysis isn’t just about sitting in a chair for hours. It’s a dance of numbers, timing, and trust. It’s knowing that what works one day might wobble the next. It’s listening to your body, your team, and the quiet wisdom of lived experience.

I share this not for alarm, but for awareness. For anyone navigating the same tightrope. For clinicians who might not see the full picture. For fellow patients who wonder if they’re the only ones feeling like a balloon about to burst.

You’re not alone. And your numbers matter—not just on the chart, but in the story they tell.