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“I feel like this is Bangkok and my kidneys have been stolen.” That was my response two years ago when I woke up in the hospital. The day before, I had been diagnosed with end-stage renal disease (permanent kidney failure). I had also learned that I only had one kidney and, two years later, the cause of my kidney failure remains a mystery.

That mystery bothered me for most of the last two years. But six months ago I slowly came to realize that the why really didn’t matter; my kidneys were gone and they weren’t coming back.

Now I rely on a machine that removes toxins and fluid from my blood to keep me alive.

As life-changing events go, this was a big one. Two years ago, my blood pressure was through the roof, probably because my kidneys had shut down. I was put in the hospital and the doctors brought my blood pressure down so fast that I probably should have stroked out. But I was a newbie at all of this and didn’t know.

I’ve pretty much settled into a routine that I hope remains pretty mundane. I leave for dialysis every Monday and Friday at about 3:00 PM, dialyze from about 4:00 PM until about 8:00 PM, finish bleeding about 8:15 PM and I’m usually back home no later than 8:30 PM or so. It’s a big chunk of time, but I’m fortunate in that I’m the only patient at my dialysis center on a twice-a-week plan. Everyone else uses the more common three-times-each-week schedule. I’m able to do this because I still have about 6% kidney function and watch what I eat and drink pretty closely.

Each month my blood is drawn and shipped off to a lab for analysis of how my body is dealing with not having kidney function. Four main aspects of blood chemistry are measured: potassium, phosphorous, anemia, and adequacy of dialysis. These are problem areas for all dialysis patients.

Too much phosphorous blocks calcium and leads to bone deterioration. All renal patients have to watch their intake of phosphorous very closely and most take a drug that binds with the phosphorous to keep it from being absorbed into the bloodstream. Me, I just take a couple of Tums with high-phosphorous meals.

Too much potassium can make anyone’s heart stop. One of the functions of healthy kidneys is to regulate the flow of potassium throughout the bloodstream. When the kidneys fail, this regulation no longer takes place. My residual kidney function, so far, seems to be keeping potassium from being much of a problem for me.

Another thing kidney patients have to monitor is weight gain. I’m XXXL to start and it’s not unusual for my weight to fluctuate by two kilograms a day. When you no longer pee, most of what you drink stays with you until it’s dialyzed off. I usually go into the dialysis center about three kilograms over my dry weight, and it’s not a pleasant experience to lose that weight over the course of four hours.

Anemia is, for me, the biggest bugaboo of kidney failure. One of the jobs of the kidneys is to control the body’s creation of red blood cells. In my case, I have less than half of the normal amount of red blood cells. I take a drug—epoetin alfa—that tricks my bone marrow into creating more red blood cells, but the best I can muster is about half of what you have. The result is that I get tired pretty easily and am unable to do a lot of what I used to do.

The medical staff can’t figure out how I’ve managed to retain some function; they all say I should have lost it by now. Here’s the secret: I see a Chinese medicine man at least four times each year. Steve’s not Chinese, but he studied medicine in China for years after a devastating motorcycle accident. I’m too sick for him to do any acupuncture or other body work with me, so his treatment is limited strictly to diet. And some of it is admittedly weird—guacamole, peanut butter, and burnt rye toast, for example to temporarily increase my urine output—but it’s all about achieving balance.

A few months ago my lab reports indicated that my phosphorous levels were dangerously high. Convinced that this was the beginning of the end, the medical staff insisted that I would have to have more dialysis. I went to see Steve who mumbled a little, asked some questions about diet and sleep patterns, consulted his books and charts, mumbled a lot more, consulted more books and charts, took my pulses, and diagnosed that I needed more copper in my diet. The prescription: four ounces of chocolate each day for a while. The dietician at the dialysis center was apoplectic: chocolate is one of the foods highest in phosphorous. Like magic, when the next labs were drawn, my phosphorous levels had returned to normal. It wasn’t a problem of too much phosphorous; it was a problem of not enough copper.

In some ways, the disease has been oddly liberating. When faced with the possibility of our pending demise, most of us tend to get things in perspective really quickly. I’m dumber than most, so I’m still working on it, but I’m getting there. I’ve gotten really careful about how I spend my time, for example, and “no” seems to come much easier. For the first time in my life I’ve somehow wrangled permission to control where my attention goes. If something doesn’t hold my attention, I’m off to something that does. I’d like to say that I’ve become much more tolerant of my own deficiencies and of those around me, but I haven’t. Maybe next year.