Tuesday, November 24, 2009

What's going on with me...

Several people have asked about my recent surgery, and what it's all about. In lieu of repeating myself multiple times to explain my surgery and why I did it, I decided to talk about it here.

For about 7 or 8 years now, I have had chronic kidney disease. It started with a completely unrelated visit to my primary care doctor, who called me back after bloodwork to say that I had protein in my urire. "Is that bad?" I asked. He advised that I make an appointment with Dr. Kirti Shah, a nephrology specialist (kidney doctor). At that time, they said I had about 60% of normal kidney function. I started taking various medications, hoping it would just pass. After putting it off for a couple of years, I had a biopsy done about 6 years ago, The biopsy produced the diagnosis: I have something called "Gouty Nephropathy". Gout, as you may have heard, is a condition where uric acid builds up the bloodstream and crystallizes in joints, often in the toes and ankles. I have had attacks of gout from time to time, and they are PAINFUL. At its worst, I can't walk. I haven't had a gout attack for couple of years now, but it appears that the "gout of the kidney" I have is a bit more permanent. Why I got it, I don't know for sure. My best guess is that I had undiagnosed, untreated blood pressure for some unknown number of years.

Last week I had surgery to put a fistula in my left arm. A fistula is a place where the surgeon connects a vein to an artery in your arm. This causes the blood vessel to expand, which makes for an easier access point for a large bore needle such as is used for kidney dialysis. It takes 2-3 months to "mature" and be ready for use. It's best to get it done sooner than later. Otherwise, if dialysis is needed and you DON'T have it, they would have to put in an intrusive and infection-prone "central line" in a vein near your neck.

Why now? Well, it comes down to this: As of my last appointment with Dr. Shah in mid October, I am down to about 12% kidney function. As a general rule, kidney patients are put on dialysis when they get down to 10% kidney function. So, it's best to be prepared.

To be honest, I don't FEEL like I have kidney disease. I take medications and check my blood pressure regularly, but I don't have any other physically apparent symptoms. I urinate normally and regularly, and the only way you'd know I have kidney disease is to look at my lab report. I was as reluctant to get this fistula as I was to get the biopsy in the first place. It interrupts my work and life schedule. It's an ugly 2-inch set of stitches on the inside of my left arm next to my wrist, and I hate it. In a way, it represents to me a path that I don't want to go down. But I have no choice. Here it is. It's real, and it's in my face. I don't know what the near future holds. I'm starting the process of getting into a kidney transplant program. Those near me assure me of God's ability to hear miraculously, and I don't doubt it. But I will plan for the worst as I hope for the best. Any and all prayers are appreciated as I travel down what could be a fairly rocky road in the coming years.