BIG TENT ATTRACTION:  Dialysis or Death

On Tuesday I was hit with the cold hard slap of reality.  It was my first visit to the dreaded dialysis clinic.  It was an awareness and information session, and by the end of the session I would need to make a decision on the type of dialysis I was going to have.  Tim my dialysis nurse was lovely however quite direct.  Within 15 minutes upon my arrival he delivered a dose of reality with impressive force.

“Fiona the sooner you accept that it is either dialysis or death the better off you will be”

Slap.  Dialysis or death.

Ok so what is option three?  I don’t want dialysis, I don’t want death, I take option three.  What is option three?  According to Tim there is no option three, and by the look on his face he wasn’t messing around.  It was time to get real.  It was time to accept and start dealing with my new ordinary and Tim was determined that it was going to happen then and there.

As Tim worked through his presentation tears flowed and I became aware of the stench of sickness in the air.  It was suffocating me.  I couldn’t breathe.

“Fiona are you ok?’

“I can’t breathe”

“Would you like the door open?”

“Yes please”

I stared at the door.  I wanted to run out the door and never come back.  I wanted to run and keep running until I reached a far off land.  A far off land far far away from diagrams of tubes and sick people.  A far off land of white beaches and crystal blue waters.  A land where my days are spent relaxing  and my biggest decision is whether to have champagne or a mojito.

But taking one look at Tim all my hopes of escape faded.  I had a feeling that I wouldn’t make it half way across the room before Tim  would rugby tackle me back to reality and my chair of doom.  So  I decided against my great escape to a far off land.  Instead I pulled myself together and tried to absorb the information that is going to form part of my everyday life.  My new language, my new ordinary.

What does dialysis do?  When your kidneys fail, dialysis keeps your body in balance by:

• removing waste, salt and extra water to prevent them from building up in the body
• keeping a safe level of certain chemicals in your blood, such as potassium, sodium and bicarbonate
• helping to control blood pressure

What are the dialysis options?  There are two types of dialysis –hemodialysis and peritoneal dialysis.

What is hemodialysis?  In hemodialysis, an artificial kidney (a machine) is used to remove waste and extra chemicals and fluid from your blood. To get your blood into the artificial kidney, the doctor needs to make an access (entrance) into your blood vessels. This is done by minor surgery to your arm or leg.

Sometimes, an access is made by joining an artery to a vein under your skin to make a bigger blood vessel called a fistula.

However, if your blood vessels are not adequate for a fistula, the doctor may use a soft plastic tube to join an artery and a vein under your skin. This is called a graft.

At the start of each treatment two needles are then inserted into your veins and you are hooked up to a machine.  This treatment will be done three times a week, in a hospital or clinic for about four hours.  The whole treatment might take up to six hours.

What is peritoneal dialysis?  In this type of dialysis, your blood is cleaned inside your body. The doctor will do surgery to place a plastic tube called a catheter into your abdomen (belly) to make an access. During the treatment, your abdominal area (called the peritoneal cavity) is slowly filled with dialysate through the catheter. The blood stays in the arteries and veins that line your peritoneal cavity. Extra fluid and waste products are drawn out of your blood and into the dialysate.

You do this dialysis yourself three to four times a day.  The process takes about an hour each time.

Will dialysis help cure the kidney disease?  No. Dialysis does some of the work of healthy kidneys, but it does not cure your kidney disease. You will need to have dialysis treatments for your whole life unless you are able to get a kidney transplant.

Is dialysis uncomfortable?  You may have some discomfort when the needles are put into your arm.  The dialysis treatment itself is painless. However, some patients may have a drop in their blood pressure. If this happens, you may feel sick to your stomach, vomit, have a headache or cramps.

No more that is enough!  I get it, I get it.  I have read all of this, I have seen the pictures, I get it.  Decision time.  Tim I am getting there.  I can still feel the lingering sting of the slap….I can’t breathe.

Dialysis or death…..I choose….champagne or mojito?