Regaining My Religion

I have grown lazy. Well, maybe not lazy so much as complacent.

Where my daily Peritoneal Dialysis (PD) sessions are concerned, anytime a person does the same thing seven days a week for the better part of a year, it's way too easy to start cutting corners. Maybe I don't do the full-out, 45-second, official DaVita Hand Wash every time before beginning my fluid exchange (see "Washing My Hands of Everything" from last February), or wear a surgical mask when I want to begin dialyzing quickly. Hey, what's wrong with just holding your breath, huh?

Well, I received a double-barreled dose of reality and reprimand today during my monthly checkup in Champaign with my kidney specialist, Dr. Abdel-Moneim Attia. We went over my bloodwork results for the previous month and Dr. Attia beamed at how well I continue to respond to my PD regimen. All my significant markers – calcium, potassium, phosphorous, albumin – are at or above their recommended levels. My mountain of medications are in no need of adjustment. "You are doing very good," the doctor praised in his warm accent. "There is nothing I need to do for you."

Or so we thought. Since this appointment basically had turned into a conversation, my lips got loose and I let it slip that I'm probably not as cautious or meticulous about my dialysis preparation as I was when I first started. Got skill and experience now, you know.

Dr. Attia looked at me aghast. He then commenced to regale me with Halloween weekend horror stories about patients who were doing spectacularly on PD until they got cocky and stopped washing their hands or using surgical masks and hand sanitizer while preparing to dialyze. "There are more germs on your hands than anywhere else on your body," he chided, "and you're using them to prepare solution that will go inside of you."

That does sound right, I thought sheepishly.

It only takes one nasty microorganism to get inside your peritoneal lining, he warned, and within five hours you've got a million of his cousins bouncing around your belly. Excruciating stomach pain, vomiting and diarrhea typically follow with peritonitis, he said; the infection won't kill you, but you'll wish it would.

And danger can come from the unlikeliest of sources, Attia added. He had one patient, a young woman who lived alone, who was performing splendidly on PD until she decided she needed a companion. She got a kitten. "The cat chewed through the tubing, and its germs got into the solution," he said. He shook his head. "And she was doing so well...."

"All right! I get it! I won't be sloppy again!" I squealed. The good doctor had worn me down. When you've got a catheter embedded inside you, tales of how it can go bad and force you to adopt the dreaded vampire-blood-sucking hemodialysis instead are scarier than any ghost stories I'm likely to hear this Halloween. Or ever.

I'm wearing my surgical mask while I write this. Don't want to accidentally breathe on my hands while I'm typing, since I'll be doing my daily exchange soon. Don't worry, I'll become less militant in a few weeks or so, but I have no intention of backsliding again. Like the U.S. Marines, when it comes to dialysis exchanges Semper fidelis will be my motto from now on.

Always faithful.