THE hospital finally gave me a date for the surgery to insert the Tenckhoff catheter. This is to allow me to do peritoneal dialysis to remove waste and fluid from my blood. The date is tentatively fixed for Dec 26. There are about 30 patients waiting in line before me.
Before putting my name in the list, the nurse asked if I celebrate Christmas. I told her the surgery will be a present for me. I expect to feel better with more toxins removed from my blood through dialysis. According to her, there is no urgency for me to get it done earlier. If there is a need, she would slot me in higher up on the list. Otherwise, I can get it done at the private wing of the hospital at my own cost.
Prior to that, a chronic kidney disease nurse educator went through the dialysis options with me. Seeing that I may have difficulty connecting the dialysis tubes by myself because of my poor hand function, she said that my wife would have to help me. Another person should be trained as backup just in case my wife is indisposed or unavailable.
We discussed going on automated peritoneal dialysis (APD) where the procedure is entirely managed by a machine while I sleep at night as opposed to continuous peritoneal dialysis (CAPD), which has to be done manually four times per day. Whichever option we choose; we have to first learn the manual method just in case the machine is unusable or breaks down.
Affordability is another factor that has to be taken into account. CAPD is RM700 per month while APD, which includes rental of the machine, is RM4,000 per month. I will have to bear one of these amounts as long as I am on dialysis. I prefer APD but the cost is prohibitive. I will decide nearer to the date. I was also asked to consider haemodialysis as another option.
As to whether I can tolerate the amount of dialysis fluid without triggering autonomic dysreflexia, we can only know when I begin dialysis. This is a potential life-threatening condition where blood pressure rises rapidly. Without prompt treatment, it may lead to seizures, stroke, and even death. I earnestly hope peritoneal dialysis works out for me without any such complication.
I had asked the nurse educator about the pros and cons of delaying dialysis as I am currently asymptomatic. My feet are not swollen and my appetite is still hearty. She said it would be better to begin as recommended rather than wait for my health to deteriorate. When that happens, they may have to perform emergency haemodialysis on me. Moreover, it could be difficult to bring my health back up to a desired level at that juncture as other organs may shut down and fail as well.
There is no point in me resisting or delaying the treatment after listening to what the nurse educator said. I am more or less prepared for the insertion of the catheter and dialysis. As much as I wish to not reach this stage, dialysis is the way to go to prolong my life and make me feel better. That is what matters.
Nevertheless, I am troubled by the drastic lifestyle changes I have to make. I must keep to a strict routine to ensure my dialysis is effective and to prevent occurrences of infection. I understand they are vital and for my own good. It grieves me that movements of the three cats living with us have to be severely restricted because of that.
The felines are kept indoors for their own safety and hygiene. They have a free run of the entire house. Cheeky, a white domestic shorthair and the oldest, has been with us for nine years. He usually accompanies me on the bed when I take afternoon naps. We enjoy each other’s company tremendously.
After the surgery, I have to take extra precautions to keep the catheter and its exit site clean. Subsequently, the entire process of dialysis has to be as sterile as possible. Pets like cats and dogs carry bacteria that can be passed on via handling and their fur. They will not be allowed in the same room when I am performing dialysis to minimise the risk of infection.
Likewise, to prevent contact with random strands of fur, Cheeky and the other two cats must be barred from the bedroom and the room where the supplies for dialysis are stored. Cheeky and I will have to stop taking naps together. I am certain we will both be very sad when that day comes. I have to work out a plan to make sure that he won’t feel neglected. In the meantime, we are enjoying every moment we have.
The countdown has begun. Being assigned a date has not reduced my anxieties and fears. I am not exactly looking forward to December but have accepted it as a necessity and even a lifesaving procedure I must go through. I have learnt to see it from a positive perspective and the corresponding impact it will have on my wellbeing. All I can wish for is a smooth and safe surgery, and a comfortable recovery afterwards.