Life on the edge


VISITS to the hospital are humbling experiences for me. Seeing sickly people with an anguished demeanour is a stark reminder of my own mortality.

For that reason, I used to dislike going to the hospital. I still do. The smell and the long wait for consultation with doctors are the other major pet peeves.

These visits are necessary for me nonetheless. My kidneys are in bad shape. The periodic check-ups are to ensure that I get proper medical care should there be any change in their condition.

Kidney failure is one of the leading causes of death for people with spinal cord injury. I have been living in the shadow of that fear long before I was diagnosed with it. Many friends in similar condition have succumbed to this disease.

How I came to discover my kidney problem is a story worth telling, however far-fetched it may sound.

I was half-asleep when I heard a familiar voice telling me in Hokkien, “If you don’t take care of yourself, you will not live longer than two years.”

Those words alarmed me. I opened my eyes to look around.

The curtains fluttered in the cool breeze blowing in from the open window. Street lights basked the room in a warm glow.

There was no one else. I was alone in the room. That was my mother’s voice. And she had passed away a few months earlier.

I wanted to dispel that as another dream but those words lingered at the back of my mind, nagging me until I finally got a blood test done a couple of months later.

The results indicated anaemia, unhealthy cholesterol levels and impaired renal function. The damage to the kidneys had progressed to Stage 3 Chronic Kidney Disease.

My serum creatinine level was 188 umol/L. Creatinine is a waste product of muscle activity. It is removed in the kidneys. When the kidneys fail, the creatinine level in the blood rises.

Kidney disease is categorised into five stages. At Stage 1, kidney function is normal with signs pointing to kidney disease.

Stage 5 is also known as End-Stage Renal Failure. Kidney function is severely impaired. Treatment options at this stage are either dialysis or kidney transplant.

At Stage 3, my kidney function was moderately reduced. The urologist put me on medication to relax the overactive bladder that was pushing urine back to the kidneys and advised me to continue with intermittent catherisation.

He then sent me to see the dietician to learn about a low-protein diet. I had to limit my meat and sodium intake. This was to slow down the damage to my kidneys.

Had I not started on the low-protein diet and adhered to the regiment prescribed by the urologist, the condition of my already damaged kidneys would have quickly deteriorated.

A urinary tract infection one year after the diagnosis nudged me into Stage 4. I had to reduce my protein intake even more.

From that day onwards, I was very cautious of what I eat. Each mouthful could potentially damage my kidneys further.

My most recent trip to the hospital was last Monday. It was my first visit to the nephrologist there. Blood test result showed that the serum creatinine is at an all-time high of 301 umol/L.

I have been displaying some of the classic symptoms of severe kidney disease like chronic fatigue, itching and difficulty in concentrating for some time already.

The nephrologist explained that at some point in time I will need dialysis. He prepared me for that eventuality by elaborating on the two options that were available to me other than kidney transplant.

Haemodialysis is the first option. I have to be hooked up to a machine to draw out waste from my blood. Each session takes four to five hours and has to be done three times a week.

The other option is peritoneal dialysis. A catheter is used to fill the abdominal cavity with dialysis solution. The solution draws waste from the body using the membrane in the abdomen called peritoneum as a filter. The waste is then drained away through the same catheter.

With haemodialysis, I have to travel to the centre and spend half a day there. Peritoneal dialysis can be done at home or while I am travelling.

Whichever option that is suitable for me will be assessed by the nephrologist when the time comes. I certainly prefer one that does not restrict my time and freedom for other activities.

I was more saddened than shocked as I listened to the nephrologist. This is an outcome I had expected although I fervently wished it would not happen so soon. I am living on a thin line now. This makes me appreciate life and the people around me even more.

Last but not least, was that my mother coming back to warn me that night? I want to believe that it was so because the blood test prompted by the ‘timely advice’ and subsequent preventive measures in all probability gave me a longer lease on life.

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