My Father's Health, Part 2: Nephrology

Nephrology is the branch of medicine that deals with the kidneys. It is not the study of dead people, which is what I always think of when I hear it. That's necrology. Anyway, the kidneys are responsible for a lot of things that generally all relate to cleaning out your system. This means urine, blood, electrolytes, etc. Wikipedia has a pretty good page about it if you're interested.

My Dad suffers from kidney failure. The term "failure" had always given me the impression that it was an all-or-nothing proposition, but instead it is more a matter of degree. We have two kidneys, which is generally more than we need. This is what allows kidney donations and transplants. Also, when kidneys stop working, sometimes they just need a break to recover, after which they start right up again. In the mean time, patients with kidney failure get to endure dialysis.

In the simplest terms, dialysis is just hooking up to an artificial kidney three times a week and letting it do the kidneys' work for it. In some cases, this gives the kidneys the break they need to regain functionality. In most cases, this is a procedure that will continue the rest of your life. The process varies in length based on the individual, but for my dad it lasts about three and a half hours.

When he first began the treatment, he was still in the hospital and still suffering from dementia. Most of the time he was able to sleep through it, but on occasion he would become quite ornery and insist on leaving. Later, after he came home, we went to a local dialysis clinic (more on that in a minute). He needed constant supervision for the first month or so, but now he's able to handle it by himself. I spent many sessions with him trying to keep him distracted, and failing. His favorite pastimes seemed to be eavesdropping and staring at the clock, neither one of which is very conducive to passing the time.

He never believed anyone when they told him how long he'd been there, or how much time he had left to go. One time, I thought I would be clever and help him. I started a countdown clock with him at the beginning (while he was still lucid) for 3 hours, 30 minutes. An hour later, he's sure we've been there too long already. I showed him my watch, and without hesitation he said, "Yeah, see? It says we've been here 2 1/2 hours already." Of course he didn't realize the clock was counting backwards.

But all of that is behind him now. He still dreads dialysis more than anything about his current situation, but he's finally learned to accept it. It does help, after all, and cleaning out his systems had certainly helped his mental state.

But let me take a minute to describe the dialysis clinic. You might think that a facility designed to have out-patient medical procedures would be fairly nice. Sadly, that is not the case. First, it is located in strip shopping center where the corner anchor is a sports bar. When you enter the dialysis room, it looks like a blood clinic from the '50s, or, for those of you who fell on hard times in college, like a plasma donation center. There are several rows of green vinyl reclining chairs that would look more at home in a dentist office. TO compliment that look, on the right side of each of these chairs is a large metal crane arm, such as a dentist would use for x-rays. However in this case, the arm contains a small television instead of a camera. On the left side of every chair is the dialysis machine itself. This is an interesting contraption of contradictions. It is about the shape of a small refrigerator. It has two rotating dials on the front that circulate the blood in and out, and look almost like a reel to reel tape deck. Above that is a very high tech touch screen computer monitor. But in sharp contrast to the monitor, the very top of the machine there is a tri-colored lamp that beeps and flashes either red, yellow, or green depending on your status. I cannot describe this light well enough. It looks like something you'd be more likely to see on an end-cap advertising a special at Wal-Mart than on a medical device.

The television comes with headphones, and (if it's working) you can watch any of several broadcast shows. My Dad usually starts dialysis at 11:30. Do you have any idea what kind of quality television is on in the middle of the day? Even he can't stand watching it. My sister brought him a portable DVD player, and that has worked very well. He watches a movie for a couple of hours, and that really takes his mind away from the time.

There are other, closer dialysis places, and we're currently on the waiting list for one. However, I haven't toured it myself, so I have no idea if it is any nicer. At least this other one is next to a grocery store instead of a saloon.

Today I have been on the phone with a cardiovascular surgeon in order to set a date for my Dad to have yet another operation. This one is not as serious or invasive, and hopefully can be done quickly. I have forgotten the term, but they will insert a device in my Dad's vein to facilitate dialysis. Currently, he uses a catheter in his upper chest that was inserted at the hospital. Supposedly, with the intravenous method, it can shave an hour off of the dialysis time. So of course, my Dad was all for that, and I don't blame him.

One thing that has pointed out how different we are during his adjustment to dialysis is his preference for passing time. He loves to do yardwork, he likes to be active and productive. Even though he could (and did) sit on the couch and watch Fox News all afternoon, he can't stand just sitting and watching TV during dialysis. He doesn't care to read, either. I'm nearly the complete opposite. For me, this would be like a dream situation. I could sit in that chair three times a week and do nothing but watch movies and read? For three hours? Sign me up!

Of course, it's easy for me to say that from the outside. I know that the process is tedious and unpleasant, and it wipes him out for the rest of the day. Basically, the four days a week when he doesn't have dialysis are about the only times he feels as though he's really living. He has become stronger every day, walking frequently without even a cane, and yet every other day he has to be chained to this chair for hours to make him "better." It's interesting to me how our modern medical wonders still haven't made obsolete the phrase "the cure is worse than the disease."