The beginning of another journey

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THE surgery to insert the Tenckhoff catheter into my abdomen went on as scheduled last week.

This is to allow me to perform continuous ambulatory peritoneal dialysis (CAPD).

It was supposed to be done under local anaesthesia but I was totally knocked out right after I was sedated.

An extra dose of sedative was administered because I had complained of strong spasms in my abdomen and legs while I was in the operating room. The spasms were caused by my spinal cord injury. The doctor had warned that if they became too strong and interrupted the procedure, it would have to be abandoned.

Fortunately, the surgery went well. I was back in the nephrology ward three hours later. There was some soreness in my lower abdomen when I regained consciousness. The discomfort did not bother me much. The doctor came to check on me later and allowed me to be discharged in the evening.

He did not allow me to drive back because I was still drowsy. He said that if I insisted on driving, he would only discharge me the next day.

My wife was not up to that task. She had not driven for a long time and was exhausted from not sleeping well the night before. An old friend kindly offered to send us back in our car.

On the following day, I got woken up by a full bladder and pain in my entire abdomen. It felt like I was being cut from the inside by knives.

The pain was exacerbated when I had spasms or coughed. As much as I tried to avoid taking painkillers, I had to give in because I could not bear the agony. I also took a dose of anti-spasmodic medicine earlier to tone down on the spasms.

I had to go back to the nephrology day care clinic twice to have the dressing changed. On the first visit, the pain from cleaning the wound triggered very strong spasms. They did not subside even after I have left the clinic. I only found some relief after taking another two painkillers.

The second visit was even more alarming initially. The nurse noticed some redness around the catheter exit site. I have been experiencing pain in my abdomen in the few days prior to that and feared it could be an infection. After consulting with her colleague, they decided it was not a major concern.

She proceeded to test if the catheter was working properly by filling my peritoneal cavity with 500ml of dialysis solution and then draining it immediately. It worked perfectly. She was pleased with the flow rate both ways. That was good news to me too — I have crossed another hurdle.

It is slightly over a week now after the surgery. It has not been an easy one. There were times when I was so overwhelmed with fatigue that I was in bed drifting between sleep and stupor the entire day. I questioned if the pain and discomfort would ever go away. The fear of aggravating the surgical wound severely restricted my movements.

My wife, worried that I could not cope by myself, took leave from work for an entire week to help me with most of my daily routines. I felt that I had become even more impaired after the surgery. I grieved at my loss of independence.

Because of that, I have been mired in a sense of despondency on most days.

As the days go by, the reality slowly sinks in. I have embarked on another journey – one that is even more challenging than being severely paralysed. Dialysis will practically keep me alive. There is no question of slacking off once I have started.

And I have dragged my wife along into it.

It has not been easy for her. The turmoil I was going through was emotionally and physically draining for her as well. She has to take on an even larger role as my sole caregiver. She has to help me with the entire peritoneal dialysis process because I do not have the hand function to perform the procedures by myself.

The thought of the strict regimen we have to keep up with after I begin dialysis intimidates me. This is one thing we have to do for the rest of our lives. At times, I was so crestfallen that I wondered if I had made the right decision in choosing this path.

But she has steadfastly stood by me, never wavering in her support. The times that I faltered, she gently encouraged me to move forward. I know she is worried for me inwardly but showing a strong face outwardly. I could not have made it this far if not for her.

For this alone, I am truly blessed beyond measure.

As I sat there trying to make sense of what we were going through and would have to go through, I realised there was no escaping from the reality if I wanted to feel healthier.

Dialysis is the way to go for me. My wife has accepted it a long time ago. I have to do the same now somehow.

I am consoled by the fact that I have gone through one test after another in my 34 years of being paralysed. I have triumphed over most of them.

This too I shall overcome by taking baby steps, one step at a time. I just need to weather whatever storm that may come my way and look forward to better days.