Two cuter kidneys

Wednesday, June 19, 2019

As I sat in my hospital room, lights low, I filtered this information - but slowly. Terrance, who had gone home for the evening, would need telling and I needed to do that gently.  He gets deeply rattled when I am truly sick, for I am never truly sick.  Even when I was diagnosed with diabetes I soldiered on, diligently taking on the task of glucose monitors and medications and tons more doctor visits.  When a mammogram came back sketchy, I soldiered on, soothing him with the statistics of this being a scare and not a true problem.

Later, a good friend described the moment when he appeared at the desk of our Admin Assistant to share that I was being admitted to the hospital and I would not be back to teach classes for the foreseeable future.

"I've never seen a human look like that.", she said.

I've just been told that I am in very bad shape - far worse than I thought and well beyond my optimistic assessment that I would be out in a day and we would all laugh because I'd just been dehydrated and I could go back to teaching by Thursday.

Terrance called a bit later and I braced myself for his barrage of questions. When he is scared or upset he can revert to his lawyer training, peppering you with a barrage of questions that you can't quite answer.

"Hi Hon. The nephrologist was just here." I pause. We both know that the nephrologist should not have been there at 9 p.m.

"It seems that I am in acute renal failure. We don't know why. We just have to wait and see what the fluids will do and if my creatinine comes down."

His questions come fast - does this mean dialysis? When will we know for sure? Why did this happen?

I don't know, I don't know, I don't know.

"Don't tell Emily yet. I don't want to freak her out. She is in the middle of final exams and she is already freaked out about my being in the hospital."

This, readers, is an understatement. My daughter is positively violet with fear and worry. I get texts every 5 minutes begging for updates. I refuse video chats because if she sees me in the hospital bed, hooked to an aggressively beeping and humming IV, she is going to absolutely lose her shit. She is in New Hampshire. She will be home in a week. She needs to focus on her final exams.

"This is my worst fear", she says later. "Like, Mom. I have had nightmares about this - not being able to get to you and you are dying and I can't get there."

I soothe her too.  I am fine. I am being taken care of, there is nothing she could do even if she was here. I am in the best place for me to be in this situation. Focus on her final exams. Everything is fine.
This is the mantra of most mothers. Things are all right. Nothing is unsolvable. Our unflappability is an anchor for our children. We are their herd leader. Our fear becomes their fear and they do not need to fear.

I am not fine, of course. I am shaken.  On the day I am turning 49, I was unknowingly beginning to die - quietly and slowly but the path was actively being constructed.  As it was my first real brush with my mortality it is deeply disquieting. I mean, sure, we all consider our mortality, but it is abstract even when it encompasses the deaths of family members or friends or acquaintances.  We all hope for deaths that are predictable coming when we feel as if we have had enough time to be on the earth to accomplish everything we had hoped to accomplish.  We want a clean death, pain free and not messy. A sneaky death that you don't see coming? No.  I have been snuck up on by my body and I do not like it.

I sleep fitfully. Hospitals are terrible places to sleep and even my sleeping medication is not keeping me asleep.  Not to mention that the VAST amounts of saline being pumped through my system demands that I empty my bladder every 20 minutes.  When I sleep for a little over an hour, I am amazed to see that I urinate 20 OUNCES of fluid. Nearly a whole water bottle full of urine. I had no idea my bladder was so robust. In the end, I have about 7 gallons of saline moved through my body.

By the morning, my creatinine is dropping. Slowly but surely. There is a smidge of movement in the right direction. The doctors look happier. I ask - for the last time - when I can go home.  They look at me sternly and make no promises.  It is clear that I need to accept that I am in here for a while.

I become accustomed to the routine - unhooking the IV, wheeling to the bathroom, coming back, replugging the IV and getting back in bed, careful to not tangle the lines or displace the needle. I take a shower, an extensive plastic sleeve covering the IV port, and trying to wash with one hand. It wasn't awesome, but it helped.  Visitors come and stay for awhile. I am deeply grateful for the distraction. I read, I manage panicked freshman who are registering from afar. I plan for how my classes are going to finish their last week and a half without me, how presentations are going to get done and how good enough is fine.

The following morning my nurse is pleased. "Have they told you your numbers?" No, I hadn't seen anyone yet that morning and I had actually slept in a bit. My creatinine numbers are continuing to decrease nicely.  It seems that the massive push of saline into my blood had woken my kidneys up and they were operating again. That meant no biopsy. No more white blood cells in my urine.  I am eating some small meals.

A final day, it is decided, to make sure my numbers continue to decrease and hold. The IV is slowed and then taken out. I am wildly grateful to have the use of both arms again. Later, the bruises will bloom up and down both arms, flowers of purple and blue planted in haste.

I cry again as I am given advance directive paperwork to complete.  These things are concrete and final. I am being asked to not only consider my death, but to plan in advance for the eventuality.  I am controlled until the question about "Is there something you want to say to someone in the even you are unable to speak?"  I sob. SOB.

Yes. Yes. Yes, but it can not be contained on this paper. I can not commit to this question. It is too big, too amorphous. It is beyond my human capacity to distill into words.  I leave that section blank.

The rest I read aloud to Terrance, getting his consent to the things I ask him to consider.  How I want to die, what parameters I can control and his possible role in facilitating those wishes is a conversation we have never seriously had in the course of our relationship. While necessary, it is unnerving for both of us.

When I am released from the hospital, I am unsteady. While now deemed physically OK, I am more emotionally fragile than I knew.  I have a panic attack that evening, convinced that my kidneys are shutting down again and I won't know and die.  Simultaneously, I know this is a reaction that is in my mind and not my body.

It's been a bit over a month now. I am doing well. The medications that could have caused this have been removed from rotation. No ibuprofen or naproxen ever again- Pour one out for my beloved Liqui-gels. I mourn them. Metformin was taken away, then reintroduced at a much smaller dose.  No more Prilosec or its cousins.  My blood sugars soar and we have to do a different medication to eventually get it under control. We do another creatinine test because we always do more creatinine tests.  I am .88. Perfect kidney numbers.

I joked that I now know what kidney failure feels like. Terrance does not find this funny. He monitors me closely and when I don't feel well, he asks a litany of questions to assess if this is a passing thing or the prelude to something more serious.  I drink water, so much water.  I am still a little slower than I feel I should be at this stage in the summer. I get a bit more tired. I try to be more gentle with myself when I don't get as much done as I'd hoped, reminding myself that I was very sick even if I don't admit it. I travel alone, for the first time post hospital, and find myself in a hotel room worried that I am feeling pain in my kidneys and terrified that I will be away from home and go back into kidney failure.  There is a bit of post traumatic stress that, while disconcerting, is also perfectly normal.

I wish I had a grand pronouncement, but I don't.  Listen to your bodies, my friends.  We are more fragile than we realize, especially as we move solidly into middle age with all of it's accompanying insults, aches and pains. (Ask me about my rando aching knee!) Make sure you are peeing. Drink water. Don't take too much ibuprofen, they aren't kidding about the kidney thing.

Take care of yourselves. I would miss you if you were gone.

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