My moment of truth

“ARE you still interested?” the person on the other end of the line asked.

She introduced herself as the staff nurse of the hospital’s CAPD (Continuous Ambulatory Peritoneal Dialysis) unit.

“Yes, I am,” I replied. My voice was shuddering.

“Your date is 13th July. Come for a blood test tomorrow and see the doctor the next day,” she continued.

This was the call I had been waiting for. It was to confirm the date for the insertion of the Tenckhoff catheter into my peritoneum for me to perform dialysis. In the procedure, a small incision is made in the lower abdomen for the placement of the catheter.

After the exit site for the catheter has healed, the dialysis is done by using the peritoneum as a filter. The peritoneum is filled with dialysis solution for a predetermined duration to draw out toxins from the blood. The used solution is then drained and replaced. This is repeated four times a day.

There is usually a four-month wait for the surgical procedure at the hospital. I was in the queue for December last year. The slot was assigned to another patient, who was in more urgent need of it. My turn was deferred two more times for the same reason.

During the last check-up, the nephrologist was alarmed by the rapid deterioration of my renal function. He decided I could not wait any longer and got the nurse to firm up on the date for my surgery.

He also advised me to go to the Accident and Emergency Department for emergency haemodialysis if my condition declined further and I felt unwell. As I listened to him, I silently hoped I would not have to come to that stage.

My hands were shaking by the time the call ended. I sat in a quiet corner, trying to calm myself down while slowly absorbing the reality. I had wished the surgery would not happen so soon. July is a busy month. I have received invitations to several major disability-related events and have committed to a couple.

This is all very sudden. One week is too short to put all my affairs in order. It is not a good time to be out of action. Surgery means I would have to spend two weeks recuperating. I then have to spend the week after that undergoing training to perform dialysis. I may have to be home-bound for a while as I will need to get used to the new routine and work my schedule around dialysis.

After considering my options, I called the nurse back with the intention of asking for a one-month postponement. I wanted to fulfil all the commitments I had made before I go for the surgery. Unfortunately, she told me that if I gave up that slot, the next earliest one would be in November.

As much as I tried to ignore the very obvious symptoms of my poor health, the signals from my body have been very telling. My mind is sluggish most of the time. My legs and ankles are swollen. If I am not working, I would practically be in bed sleeping throughout the day.

I do not think my kidneys can last a few more months seeing how lethargic I have been lately, and reluctantly I agreed to the assigned date. Work will have to wait. When and if I get better, I can continue, I consoled myself. But that is my biggest fear. What if I cannot go back to work after I begin dialysis?

Work is the reason I wake up early every morning even though getting ready is quite a task now as I’ve become progressively weaker. The cheery faces of the participants and their eagerness to learn is the motivation for me to travel the 60 km by train to the airport to conduct the training four days a week.

Regardless of my hesitation, the surgery will go on. The blood test and ultrasound scan of my abdomen show I am fit for it. However, like any medical procedure, there are risks. The surgery will be done under local anaesthesia. I will be sedated but awake and aware.

The doctor who is going to perform the surgery also ran through the list of complications and made sure I understood them. Bleeding, rupture of the peritoneum and difficulty in inserting the catheter may cause the procedure to be abandoned. In that case, I may need to go for another surgery under general anaesthesia.

I also need to be aware of peritonitis, the inflammation of the peritoneum caused by bacterial infection, infection of the catheter exit site, and displacement of the catheter due to constipation after the insertion. All these sound very intimidating but there is nothing much I can do except to pray for a complication-free surgery and a quick recovery thereafter.

The one thing I am looking forward to is to be rid of this constant tiredness. I have so much going on for me lately that it is such a waste I neither have the strength nor vigour to do them. It has been so long ago since I felt healthy. Hopefully, after I begin dialysis, I can become more active and regain some independence. Hopefully then, I will be able to go back to work, do some travelling, and enjoy life a little more.

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