“YOUR serum creatinine is 409,” the doctor told me during my quarterly medical review recently.
Creatinine level in the blood indicates how well the kidneys are functioning. The higher the number, the more impaired they are.
I turned to look at my wife Wuan. She was standing at one corner in the small consultation room. Our eyes met. There was a look of alarm on her face.
Over a span of 13 years, my serum creatinine has risen steadily. This current result indicates my renal function is at 14 per cent only. I am now at Stage 5 kidney disease, also known as end stage renal failure. I will require dialysis for the rest of my life or a kidney transplant to survive.
During previous consultations, the nephrologist and I have discussed the options available to me. I had chosen continuous ambulatory peritoneal dialysis (CAPD) over haemodialysis because I foresee difficulty in going to the haemodialysis centre three times a week. CAPD also allows me to be more mobile without having to be hooked up to a machine for hours as required in haemodialysis.
As the severity of the situation sank in, the advice a urologist gave me in 2004 came flooding back. I went to see him when my blood test indicated a problem with my kidneys. He did an ultrasound scan which showed my kidneys were shrunken.
“You should take good care of your kidneys,” he had said. “It will cause hardship to your family if your kidneys fail and you have to go for dialysis.”
I took that advice seriously. Since that day, I have never missed a medical appointment. I have done as much as I could to delay the decline. I have been following the low-protein and low-sodium diet the dietician prescribed. Wuan cooks those meals for me every day before she goes to work. On top of that, I empty my bladder every three hours to prevent the reflux of urine back to the kidneys.
Despite all that effort, my renal function continued to deteriorate. This is not something unexpected. It was a matter of time. The hope was that I could outlive my kidneys. At the very least, I thought I have a few more years before needing dialysis. Unfortunately, the inevitable the urologist warned me about came sooner than anticipated.
I would be lying if I say I am not sad. This disease needs a lifelong commitment to treat and maintain. There are risks associated with dialysis. Infection is a major concern. A lot of things have to be changed from now on. Wuan and I have to rearrange our lives around the dialysis routine. The exorbitant cost of the treatments will be a drain on our financial resources.
But I am not grieving over this impending tribulation. That I have done a long time ago. I had wept when I leaped from Stage 3 to Stage 4 within 12 months after I was first diagnosed. I was only 39 years old then. The relationship with Wuan was going well. We had promised to grow old together. I had feared the downhill spiral of my health would rob us of that.
I still have that same fear this time around but I am more worried about how it is going to impact her work and routine. As it is, she is working full time and at the same time helping me with my daily activities in many ways. She spends a major portion of her annual leave to accompany me for blood tests, ultrasound and scheduled medical reviews. The additional needs of my dialysis procedures will burden her even more.
The day after getting the grim result from the doctor, Wuan and I sat down to discuss how we were going to deal with it. We have been talking about the things we were going to do when we both retire. This sudden development has thrown a spanner in our plans.
“I am sorry for putting you through this,” I apologised to her.
“It is all right,” she consoled me, “we will do this together”.
Although she did not show it, she was more worried for me than she was willing to admit. I tried hard to hold back my tears as we continued with the heart-to-heart talk. We have gone through a lot together but there was without an iota of doubt this will be the greatest challenge we have ever faced as husband and wife.
She should not have to endure what she is enduring on my account. My heart hurts thinking of the adversities I am putting her through. I wish I could give her a better life. On the contrary, she is the one who is making everything work for me. Her calmness and strength in the face of all this edifies me. Truly, her love for me is unconditional and boundless.
Even though we are fraught with anxieties as we move into unknown and unfamiliar territory, we are determined to approach this with a positive attitude. It is the only way for us to move forward. Dialysis can potentially extend my lifespan and afford us a little more time together. All we are wishing for now is a safe surgery to insert the peritonal catheter and subsequently dialysis processes that are free from complications. At this juncture, we will settle for small mercies and anything that eases us into the next chapter of our lives.