Sunday, February 15, 2009

Bad Dreams

For three years I was a kidney hemodialysis patient, before thankfully receiving a transplant. It is a period of my life that I remember and can speak about in emotionless terms, because I have moved on. It is best not to think of how terrible it was, or how close I came to not surviving it. The memories of that time rarely haunt me at all. Last night was an exception. I have always had vivid dreams. A few years ago, during a sleep study, I found out that I never came close to entering the deepest stages of sleep, which means that my mind is active through the night. I generally wake easily and often during the night, and in the morning find myself more exhausted than when I went to bed. It's cool to have an exciting and memorable dream life (mostly), but sometimes it really wears me out. Last night, is one of those times. I spent much of the night dreaming about my experiences with dialysis; reliving the pain and the sickness. I decided to get up and confront these moments. I pulled out some writing I did during those years and read through my thoughts as it was happening. Much of it was surprisingly funny and focused on my singular focus of trying to get myself a transplant and my paranoia of missing the call, once I made the transplant list. Very little was about dialysis itself. Here is an excerpt of something I did write during a day off:

It was one of those days at dialysis yesterday afternoon. Luckily, I was spared all of the tragedy, save for having to witness the disasters that were going on around me. The old woman in the corner with the bald spot took a spill last week. She literally missed the chair when sitting down. She mumbled to me a few days later, as she gimped by, that she had broken her pelvic bone from the fall. I felt bad for her; however, if she didn’t always act like such a tortured soul, I would feel worse for her. When she talks to me, she talks with some sort of failing voice and a look of pain. It is misery being at dialysis. Everyone there has to deal with it. I don’t know why she talks to me anyway, because she cannot hear a thing. If I even bother to respond, she won’t hear or understand what I’m saying. I just resort to shrugs and nods while contorting my face in various ways. Today it was time for her to lose a needle. If you don’t know anything about dialysis, all you need to know for this story is that the technicians stick two large needles into the patient’s arm or leg (repeated approximately 312 times a year). They stick these needles into either a fistula (a surgically combined artery and vein) or a graft (an artificially lined vein and artery), in order to remove blood from your body and, after the dialysis machine performs its secret magic, it pumps the blood back into your arm all fresh and clean (“so fresh and so clean clean”). When a needle comes out, pressure needs to be held against the fistula or graft in order to clot the blood, otherwise blood will literally spray across the room like a pump action squirt gun, or like one of those sprinklers that is a flat strip full of holes. Her needle came out accidentally. Blood was soon everywhere and the nurse and the techs had to rush to stop the bleeding and to clean up the mess. The old woman is so tiny, that any loss of blood must drop her blood pressure to unreadable levels. Her little white sweater, which she wears even when the summer temperatures reach 100 degrees, was saturated and she had spatter all over her face. She will blame the staff for this disaster as she did when she whiffed on the chair the week prior. She will show me her sad face next session.

Meanwhile, during the blood incident, the old man next to me, who sits hunched in his chair shaking, yet never uttering a sound or changing his completely blank expression suddenly blurted out a cry for help. This shriveled old man wears a giant baseball hat - the kind with the huge bill and the foam stuffed bridge like The Clash’s Mick Jones used to wear - was cramping. You see, the dialysis process removes fluid from your body, since failed or missing kids take away a person’s ability to piss. Because this process is done over a three to four hour period three days a week, too much fluid taken off too quickly can cause severe cramping in all parts of the body’s muscles. The old blank man lost his hat from the violence of the cramping. Then a patient across the way joined in with the cramping, and then another. The nurse and techs were running around trying to take care of everyone at the same time. It was near total chaos. I was fine. I was listening to music on my disc-man trying to ignore the suffering. I couldn’t ignore it. It is everywhere in that place. Suffering is in the air that you breathe.

No one ever talks about missing patients. You spend three days a week, every week, with the same people, until someone simply stops showing up. It could be that they received a much sought after transplant. It could be that they moved away, or are on a trip, or it could be that they’ve died. The patients have no memory. It is the only way to survive the ordeal of each session. If last session ended in a blood bath, as the old bald woman’s did, next time, she’d better not remember that incident. She will though, and that is why she suffers so badly.

There is another piece that I wrote while going through a session. It was a letter that I never sent, because it was so bitter and so angry. Having been forced into dialysis because of a genetic syndrome that ravaged my kidneys with cancerous tumors, I was there because I had my kidneys removed to survive. Otherwise, the cancer would have spread up the renal vein and into my lungs and spine and then, well, it would not have been good. So many of my fellow patients were there, because of adult onset, rampant diabetes, brought about by horrible diets and extreme obesity. In most of those cases, they could have avoided dialysis simply by living a healthier lifestyle, but what ate at my gut during those days was the fact that they continued to eat a normal diet and drink fluids excessively (a dialysis diet essentially means you need to avoid any food rich in nutrients, as well as the normal unhealthy stuff and pretty much any fluid). They were killing themselves, while the rest of us were fighting to survive and make the best of our horrific situation. Here is an example of how resentful I would sometimes get:

Every other day it's the same shit. Surrounded by suffering. Surrounded by pain. The air smells like vinegar. Most people suffer in quiet - putting on a brave face - maybe genuinely believing that there is hope - that one day this routine will change. For most of them, the only change will be further disintegration and death. The rest of them are the ones who put themselves here through their rampant consumerism. They all have the same chances, but they don't deserve the hope. They cruise in on their rascals loaded with snacks and gallon sized plastic cups from some mini mart. They bring boxes of donuts and bags of chipsssss. Sometimes they bring steaming shit in microwavable containers, so they can shovel the contents into their fat pale faces with their bare hands. They are here for only one reason. They are not justified for sympathy. I hate them all. I hate having to see their puke and hear their complaints as they receive all of the attention of those caring for us.

Okay, I think it's now out of my system. Time to move on again. Thank you for the indulgence.


  1. Does that really happen, the people who are on dialysis but keep eating like that? How can they do that to themselves? How can they not be held accountable?

    I didn't know you had both of them removed. What do you have to do to maintain a transplant?

  2. I want to buy a rascal and chase you around with it, while I eat potato chips and throw things.
    You are the man.

  3. Ammogirl, maintaining a transplant is pretty easy. It's amazing! I take a bunch of crazy pills every day, but otherwise, I live a pretty normal life. I don't know what to say about how people would treat themselves during dialysis. We all have our self-sabotage stuff. I find it remarkable at how angry I was during that time!