In the Chair

As I’ve written, somewhat extensively, my health struggle in the past year has been a resistance to realigning my identity to better match my reality as a sick person. There are plenty of good reasons for this resistance, and in some ways I have benefitted from it. I believe that I am more active and have continued to live my life as I want to live it due to my insistence on conceiving myself as a healthy person circumstantially compromised, rather than a sick person getting by. I am biking (sometimes to and from dialysis!), finishing my license and continuing my PhD coursework. C and I are buying a house, working on renting ours, and making plans for our future. However, my resistance to “being sick” does not and cannot ameliorate the daily anxiety and attention toward managing my body.

Managing my body can look like a lot of different things, many of which I’ve written about already. I am attentive to my dialysis access several times per day, ensuring that it is open and working well. I am attentive to my diet and fluid consumption (this becomes more of an issue the more degraded my kidney function becomes). I am attentive to scheduling my life around my dialysis – while I am able to do some reading, my concentration is limited by the environment at the clinic. I set aside work for this time, reading and online grading, and try to work for the first chunk of my three and a half hour run.

While the dialysis techs who “stick” me to hook me up to the machines are about my age and fun to chat with, most of the other dialysis patients are like a family I can’t bring myself to identify with. They tend to be older and much sicker, though most are very friendly. The set up isn’t conducive to much conversation, and while we have kidney failure in common – no small thing – people tend to keep to themselves. 

Occasionally someone struggles, somehow, which is very hard for me to watch. The other day a man, maybe in his 40s? didn’t swivel enough to move from his dialysis chair to his wheel chair. He is missing the lower half of his left leg, something that might have happened relatively recently, and struggles to move on his own. He didn’t fall, he just sort of slumped while Duke, the tech, supported him under his arms. Duke calmly asked for some help. The guy started moaning, something was hurting him, his shirt was pulled off his back. After a moment another tech helped him into his wheelchair. He was fine, the moment passed. Yet it has become a powerful memory for me, relentless. I was sitting in the chair next to him. It was hard to watch, and it was hard to not watch. I wanted to help him, but in another way I was him. I envision myself in that position, and it is a struggle to accept that - slumped on the floor, my back and belly exposed - with grace. 

Another patient, an older guy who started treatment here after I did, came in with a New Yorker magazine and a good sense of humor. He has struggled. Now he asks the techs a lot of questions, about his blood pressure, about his flow rate, about his access. The techs are starting to give him a hard time. It's good natured and I can't blame them, it's got to be a terrible place to work. I guess - I wish I could join them, but I know too much of what he is facing. His repeated questions, his anxiety about his treatment and his future, that's all way too real for me.

One more story. Another old guy, this one probably in his eighties, walks with a stooped shuffle. He doesn't read or watch anything and is hard of hearing. The staff yell to be heard by him. He's still driving - though he obviously shouldn't be - and hanging on to that. Two weeks ago when I pulled up in the parking lot he was face down on the sidewalk, bleeding from his face and his thumb. He was alright, but couldn't get himself up. I tried for a moment by grabbing his forearm. I felt strength in his arm as he tried to push himself up. He kept saying his car was right there. I told him to stay still while I got help from some folks inside. Two techs got him to sitting and they called an ambulance, which he didn't want. He was back in the clinic two days later and has seemed fine. He still just sits during his run - three and a half hours. I've always felt sympathetic towards people facing the loss of that freedom, but even watching him get into his car as I'm getting on my bike, his resistance resonated profoundly.

There are lighter stories which color my visits as well, but they do not persist as these do. 

Yesterday, Friday, I came into the clinic a bit heavier - extra fluid that dialysis would pull off - because I had missed my dialysis run on Wednesday. I'll explain why in another post. I usually weigh in at 75 kilograms or so and weigh out at 73.5 kilograms, my "dry weight." This time I came in at 77.5 kilograms. I hadn't had that much pulled off before and was a little nervous about cramping and feeling dizzy. I asked that the tech pull a bit less than the full amount. She suggested we pull three. If your math is sharper than mine was, you realize that that is the full amount. As much as she had joked with me or winked about another patient, I was more her patient than her peer. I am in the chair - not facing it, not walking by.  Thanks for reading.