Rocking the boat

"How long will I need to be on dialysis?"

It had been three months since I was put on dialysis. My toxic levels in the blood had risen to alarming levels. The doctors at the Washington Hospital Center had taken one look at them and rushed me into dialysis (dialysis is the mechanical removal of waste from the blood stream that would usually be processed by the kidneys if they were properly functioning ) A few of the doctors were pessimistic that this renal failure could be reversed. Two of then had even mentioned hospice as the next possible stage.

But the initial dialysis had worked and the numbers- bun (or blood urea nitrogen), creatine measures   measure how well your kidneys are working, and GFR is a measure of renal function)  had all retreated to relatively safer zones though not yet out of danger.

It had now been three months and the three times a week, three hours a session were getting to me. After each session I was so fatigued that I could do little but lie around the house.

My expert nephrologist, Dr B, looked at me reflectively and, after a pause, said: 

"You are recovering nicely from the serious toxic levels you have been through. In my view we should continue these sessions, and maybe even increase them to four hours a session which is the norm for dialysis patients."

"So how and when do I finally return to a more normal life? Can we not gradually reduce the frequency or the duration of the sessions?"

"So you think I should be on dialysis indefinitely?", I asked despondently.

"No" he replied," all I am saying is that but we have reached and are now on a safer plateau. All seems to be going well. And I am a "don't rock the boat" kind of guy."

Interestingly my GP. Dr S, had made the very same comment a week earlier.

But I still persisted, eager to exhaust all possible options.

"No" replied Dr B, "I have found that reducing the frequency does no good to your system but rather puts an extra strain on your heart." And he went on to explain the reasons for it. "We can play around a little bit with the duration of each session but not by much."

"So there is no way of getting off dialysis according to this analysis."

"Yes, there is," he replied. " We can go "cold turkey". We could just stop the dialysis completely and see if your body can tolerate the shock and live with it. But of course there is a danger that the older toxic levels will return."

"But if they do start going up, could we not restart dialysis?", I ask.

"Yes, we could. But the risk* remains." 

"Well," I told him , " I was not a "don't rock the boat" kind of guy." I glanced at my wife, who had borne the burden of the constant ferrying to and fro to the dialysis center every three days. 

So we had a choice- go "cold turkey" or be on dialysis for the rest of my life.

"Its your decision" she said.

 "All right then, let us stop the dialysis and see what happens."

Dr B agreed and so we stopped the dialysis three weeks ago. But we took the precaution of doing a blood test every week and he would review each result carefully before deciding to continue the experiment for another week.

So here I am back to near normal life. So far the gamble has paid off. No one knows for how long. But so far so good.

It is too early to state whether my insistence on this course was foolhardy or a risk worth taking.

But I figured it was my life and my decision.

"Play with life, laugh with life,

dance lightly with life,

and smile at the riddles of life..You don't have the power to make life "fair,"
but you do have the power to make life joyful." (Jonathan Lockwood Huie)

"The wise man looks back into the past,

and does not grieve over what is far off,
nor rejoice over what is near;
for he knows that time is without end" ( Lao Tzu)

Happiness is a accepting what is.

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*Since your kidneys cannot filter out the potassium, it will cause your heart to beat irregularly. If you have lost the ability to produce urine, your vascular system will become flooded with fluid and your heart won't be able to keep up with the increased volume. The increased volume will also collect in your lungs making it difficult to breath, depriving your heart and brain of oxygen. Your kidneys cannot filter out the urea your body produces, which will result in toxemia, rapidly damaging your heart, brain, and other vital organs. But dialysis prevents all the above life threatening effects by removing the harmfull toxins in your body.