Biopsy!

C and I showed up at Abbott at 10:45 and I was admitted to unit 44 - a daytime unit used for overflow and short inpatient procedures.  My blood pressure was a bit high, even after I doubled my metoprolol for good measure.  So after they got an IV in and checked and rechecked BP, we got bumped in the radiology line and didn't have the procedure until 2:30 (it was scheduled for 11:30).  

C and I passed the time with conversation, some reading and a nap.  At this point I was undressed and in my hospital 'gown.'  90% of my stay was lying in a bed - doing nothing, needing to do nothing, and feeling fine.  But just wearing the clothes of the sick and lying in a bed that automatically adjusted to my movements and hearing the soft voices from the hallway was a lot to handle.  I think what got to me was the atmosphere, what the place felt like.  My caregivers were attentive and well-intentioned, but in their absence a person is almost oppressively IN a HOSPITAL without any recourse to leave.  It is this state of suspension, removed from the movement of the world, from the weather, from the normal passage of time that wore me down yesterday, along with my anticipation first of the procedure and then of the results.  The biopsy trip reminded me of what had been so inexplicably hard that first time through ten years ago.  

My Doc put the kibosh on pictures, which is too bad because as C told it, there were some neat images from the procedure.  The biopsy was an 'ultrasound guided biopsy,' which meant that a radiologist (or assistant of some kind) held the ultrasound while my Nephrologist poked in the needle.  The ultrasound is a standard thing - the same used in all ultrasounds and seen in movies - where there's the handheld bit and the grayish projection on the computer screen along with the goop that conducts the ultra sounds.  The needle used in biopsies is a real doozy.  It has a cylindrical handle with a big button on the top and a needle end about eight inches long, about the diameter of a metal coat hanger.  While it is pretty menacing, it doesn't necessarily feel like much as they numb the hell out of the belly area where they go in.

Because the transplanted kidney is in the front of me, located where you might rest your hand if you put it just inside of your pants.  The biopsy, consequently, was about two inches below my belt line.  The helper person, a female John C Riley, located the spot with the ultrasound where my doc would go in and he numbed it up with some lidocaine, which is ironically the most painful part of the process.  A short pinch and he let it set for about 2 minutes.  He then inserted the mega needle saying 'pressure is normal, pain is not.'  I did feel a bit of pressure, but the insertion was remarkable smooth.  I could feel the needle catching my skin on the way out a bit, not to mention see C's face, but I was totally numbed up and could only feel the movement.  

I have to take a brief aside here to say that my first transplant biopsy, in the spring of 2002, was thoroughly awful experience.  I was biopsied by a resident who shook, sweated and needed to make a second excursion into the barely permeable expanse of my belly.  Each journey of the needle through the layers of my abdomen were jerky and hesitant; he struggled to get the needle through and kept telling me to relax.  I'm not sure what kind of patient I was at the time, but I am grateful beyond words for the professionalism and sure hand of my current doctor.  The procedure, from cleaning to band-aid, took about five minutes.  Easy peasy.  

We now wait for the result.  It could go a few directions - everywhere from staring over to nothing changing at all.  I continue to attempt a balance regarding the impact and scope of this episode.  It brings up a lot for me and I'm working through that stuff, here mostly.  But I'm also well aware of how much worse everything could be.  My basement has some water in it after all this rain, but it's nothing compared to Duluth.  

Thanks for reading!  

Numbers

So I got the numbers and as I had expected they were about the same - 2.2, so game on biopsy!  To be honest I'm kind of excited to be able to write and post photos of the biopsy stuff.  C will be around the the procedure and I'm hoping to get some fun pictures with my Kidney Doc.  Mad Doctor stuff.  It is a grab bag of emotions for me right now - not all bad but certainly some difficult feelings in the mix.

I got lunch with my mom on Thursday - I talked to my mom about Slavoj Zizek, the Slovenian philosopher.  He's kind of a side-show youtube sensation, famous for proclamations about what toilet design can tell you about a culture.  Well he has some slightly more serious talks on the true functions of organic fruit (to comfort the buyer) and one that struck me about how in a permissive society, as we live today, in a permissive society a person feels guilt for not actualizing all of their desires - for not being everything to everyone all the time.  Old fashion guilt, he says, came from our unspoken transgressive desires, which we had purged from us in psychotherapy, or expressed in art as Aristotle would have it.  We used to feel guilty for wanting things.  Now that we can want anything, we feel guilt when we do NOT want things!  And we suffer a crisis of impotence.  We cannot possibly enact all of our desires - physically or emotionally or pragmatically so we must not be enough.  Permissiveness does not make us happier we only feel guilty for different things.

I carried on for some time on my unsuspecting mother but there was a reason and I remembered it; when I enter a health crisis this guilt or inadequate feeling dissipates - as though it were never there.  I was waxing on about the abstract benefits of a health crisis.  And it's true - in a lot of ways kidney failure was one of the best thing that happened to me.  I have clear memories of the weeks after the hospital when the world was spread out before me, new and ready, everything but my next few days stripped away.  My life was the equivalent of a near death experience in a safe clinical environment every few weeks!  At least it was in 2002.  It never took long to lose perspective and get bogged down in the stupid shit of everyday life once again (namely my insecurities and my resistance thereof).

My first reaction to hearing the high creatinine level was a kind of calm focus.  What I had to do next was clearly laid out in front of me, prioritized and simple.  And I did not have control over the outcome, which meant I couldn't do anything wrong.  That was a welcome feeling after years of my future outweighing my present.  I never once wondered why it had happened, or why it had happened to me.  I was never angry about it.  The wounds feel quantified to me; they are mine and I know them.  I wouldn't trade them for anyone else's scars or naivete.

Yet I'd still rather not go through this - especially again; it is something that given the choice I'd rather not happen to me.  My curiosity and even tracking my experience here feels like a kind of masking, intellectualizing the hurt to damped it.  I mentioned to C that I hoped I could remain productive should I be laid up again - that in 2002 when I was going on dialysis I moped about, played Civilization III and ate impressive sums of chocolate chips.  I didn't even read much.  I was attending to myself at the time but that too was a loss I did not understand, even though I felt it.  It is a challenge to plot a course among the centers of my emotional well-being.  The lessons of clarity of purpose (not dying) remain elusive to me.  Joy and suffering create meaning and it seems like it might be my turn for some of the latter.  But really, given the choice; no thanks you know?

Thanks for reading!