06/29/2001

In the Last Analysis

Two people in my family have suffered kidney failure and had to go on dialysis (mechanical filtering of the blood to remove impurities and toxins.) Being kept alive by a machine dramatically changes one's life, both physically and psychologically.

My sister-in-law was in her late 40s when she had open-heart surgery. Her kidneys didn't react well to the dyes used during the surgery, causing her kidneys to fail postoperatively. Dialysis saved her life but was terrifying. She thought it meant machine dependency for the rest of her life. Luckily, after three months on dialysis, her kidneys resumed functioning and her health stabilized.

My father wasn't so lucky. He, too, had a surgical procedure on his heart -- called angioplasty -- and reacted badly to the dyes, also leading to kidney failure. He was 85 and had been healthy and independent all his life, so finding himself dependent on a machine to sustain his life was quite an adjustment.

It's now two years later. He goes for dialysis treatments three times a week for about three hours each time. Afterward, he's usually tired and needs time to rest.

Dialysis patients must watch their diets carefully in order to maintain the proper balance of nutrients and fluids. A dietician at the dialysis center meets with Dad regularly to answer questions and monitor his nutritional status. Fluid balance is especially important, something Dad found out the hard way. He wasn't keeping track of the exact amount of fluid he drank when taking medications, drank too much and went into congestive heart failure. Emergency dialysis treatments brought him out of it and re-stabilized his fluid balance. (At least this is my understanding of what happened. I'm not a doctor, so this explanation may not be 100% accurate.)

Little by little, my dad has faced the realization that he probably will live out the remainder of his life dependent on dialysis. Circulation problems have ruled him out as a candidate for a kidney transplant.

But that doesn't mean that he is forever homebound. Not at all! There are dialysis centers all over the world. As long as he makes arrangements in advance, he can receive dialysis treatments almost anywhere. Our son was married in Maine last September, and Dad decided to make the trip. He was quite nervous about it, but the dialysis center where he had lined up treatment "on the road" turned out to be brand new and was staffed with friendly, capable professionals. He was so relieved, he relaxed and slept through the entire treatment. He was then able to enjoy the rest of the weekend with the whole family. We were thrilled that he had the courage to make the trip, and that it all went so smoothly for him.

Advances in medical science have made it possible to sustain life today in situations that would have meant certain death years ago. My dad knows this and is thankful that a medical miracle has given him additional precious years. One of the visiting nurses who helps with home care on occasion was required to ask him, "If you go into cardiac arrest, do you wish to be resuscitated?"

"Yes, definitely," he said. "As long as I am clear-headed and can use my mind, my life is well worth living." Dad never imagined that he would be asked to make decisions about his own life or death. But now that he has thought about it and lived for two years on borrowed time, he takes every day for the gift it truly is.

LINKS

Kidney Dialysis

Dialysis Finder

Please send questions or comments to bbruno@snet.net.