Monday, September 28, 2009

Another Crisis

Curiously, one of the problems I've faced piecing this memoir together is figuring out when things happened. I remember images and scenes from events but putting them on a time line is surprisingly difficult!

One clear memory is being in the hospital when the Texas Rangers were in the hunt for the playoffs (that's so rare it's easy to pin down!) and Frankie Francisco threw their fading chances along with a couple of folding chairs into the stands in Oakland. Michael was in town taking a semester off from school and we watched the games together in the hospital. So there you have it, the time was fall of 2004, several months after the ankle episode. I was still wearing the damned walking boot.

The pain began the same way as my kidney stones and the bleeding cyst, a stitch in the side that wouldn't go away. By Sunday afternoon, the pain was getting serious. I felt really bad and was vomiting. I felt the need to urinate, but could not produce any urine. Susan called the doctor who told us to go to the emergency room. What I remember most are the morphine injections and the warm blankets. I lay there, barely conscious wrapped in a dark, warm, velvet cocoon; the kind of pleasure that totally explains addiction to narcotics. They did x-rays and scans and there was talk of a possible kidney stone, which is what the pain felt like. But evidently kidney stones didn't explain the vomiting and the lab results which showed acute kidney failure.

I guess I need to back up a little. At this point I was in the early stage of chronic kidney failure. I don't remember discussion of numbers or stages, but even going back 6 years to the first nephrectomy, clearance numbers were out of the normal range and through the intervening years my kidney function had been in a very shallow rate of decline. The hospital visit showed a big spike in the level of toxins, which indicated acute kidney failure, not stones. Of course the kidney was enlarged and distorted by the cysts, small stones would be difficult to see.

Eventually I was moved out of emergency and into a room. Frankly I don't remember much. I remember being told I was going to have surgery and I have a brief memory of being in the operating room, but the morphine makes memories fuzzy. Evidently what had happened was that pressure from the size of the polycystic kidney had blocked the ureter so that urine could not pass from the kidney into the bladder. Urine backed up in the kidney, causing the kidney to fail, along with pain and vomiting. The solution was to insert a stent into the ureter to keep it open and allow the urine to flow. I will leave it to the reader's imagination as to the point of insertion (or not, as the reader wishes!) I found myself back in my room with a catheter hooked up to a bag of bloody urine. The stent worked, and after several days my kidney function improved to the level it had been before the crisis. 

My nephrologist told me it was time to start making preparations for dialysis. A vascular surgeon came to see me to make plans for the creation of a fistula in my arm. The fistula is created by connecting a large artery to a large vein to make a high-speed loop to carry the high volume of blood necessary for hemodialysis. It takes 6-8 months for a fistula to mature to a point where it can be used, so it's best to have it done before dialysis is actually necessary. Of course all of this news came as a total shock to me, as I had been totally denying the possibility of this eventuality for years. (See earlier post on Stubborn Stupidity.

I had other plans. I was scheduled to go on a company trip to visit wineries in Napa Valley (I wound up not going due to the surgery.) The holidays are the busiest time of year for wine sales and busy days with long hours were just ahead. There was certainly no time to schedule vascular surgery in November or December as the doctor suggested.  

We did go to Hell's Backbone in the Canyonlands of Utah for my sister's wedding. Travis flew to Las Vegas and spent the night sipping bourbon and grading papers in the bar at the Bellagio where we picked him up and and drove through Zion and Bryce Canyons and had an amazing weekend.

At the end of the holidays, after a long New Year's Eve in the store, I threw the walking boot into the trunk of the car and resolved never to wear the damned thing again, no matter how bad the pain. I was sick of being sick. I was sick of being hurt and disabled.

In February we went to New York and spent the weekend with the boys wandering through Christo's fabulous Gates in Central Park in the snow. After a long weekend walking the sidewalks of New York, through museums, up and down stairs in Subway stations, and through Central Park, I was walking and feeling better than I had in a year. 

And I never made a followup appointment with my nephrologist. I didn't see the vascular surgeon. In fact, I didn't see a doctor for the rest of the year. 

Mind over matter. You don't mind, it don't matter. An old friend, Dr. Karma told me that in about 1971.

No comments:

Post a Comment