Monday, August 4, 2008

Six years of normalcy - Peritoneal Dialysis Part 1

March 2006, Chennai, India

"We're here to meet Dr. Georgi Abraham."

"Doctor has not yet come, sir. Please wait. You're the sixth in the list."

"Sixth!", I thought to myself. After he comes, it would be a good one hour atleast. My dad and I settled down in the waiting area on one of the upper floors of the Madras Medical Mission Hospital at Mogapair in Chennai. The hospital was called 'Triple M Hospital" and was one of the centers Dr. Georgi Abraham visited.

As we waited for Dr. Georgi to arrive and pass his verdict on my condition, I reminisced about the last few years of my life. How different they had been from the two years before that. The last six years passed by like lightning. It was an almost normal life.

I could almost see it happening in front of me. March 1999. Kamineni Hospital, Hyderabad's dialysis unit. It had been a few weeks since my graft nephrectomy (removal of the transplanted kidney) because of HUS recurrence. My transplant had failed and the kidney was causing a few problems. So, it had to be removed. I was by then, back on thrice a week dialysis.

I had heard about Peritoneal Dialysis (PD) and also read about it on the internet. This was a modality of dialysis where a catheter is inserted into the peritoneal cavity of the body. The peritoneal cavity has a semi permeable membrane and is surrounded by blood. So, dextrose solution is filled into the cavity by means of the catheter. Movement of impurities and excess fluids in the blood happens through the semi permeable membrane into the peritoneal cavity.

After a few hours of residing in the peritoneal cavity, the now saturated dextrose solution is removed through the catheter and fresh fluid is infused for a fresh cycle of cleansing to happen. The process of removal of the old fluid and infusion of fresh fluid is called an 'exchange'.

It sounded quite promising. Diet and fluid restrictions were minimal. It could be done at home. Many people were able to lead quite a normal life with it.

PD was very rare at that time. About 5% of the patients who needed dialysis did PD. But I had decided that I wanted to try it. I badly wanted to regain my life.

One day, I decided to ask the nephrologist treating me, Dr. Shastry about it. For some reason I was sure he would say no and that would be the end of it. So, I lay in bed, the needles in my left arm, going about the routine of pulling out the impure blood, passing it through the dialysis machine and then returning it into my body, unmindful of the anxiety in my mind.

Part 2

2 comments:

shailu said...
This comment has been removed by the author.
Manis said...

Kamal,
I came across your blog while doing some research on Peritoneal dialysis.

My mom has been recommended a kidney transplant. That, I'd like to be the last option.. because of the invasive surgery and the immuno suppressants. Would it be possible for you to spare some time to talk to my dad about PD? I'm most interested in finding how to get the solution for my mom. I understand it's expensive, but there seems to be an option to get a lifetime supply of the solution if you pay 3-4 lacs?
Please let me know if you will be able to help.
Manivannan_shanmugavel at yahoo