A common Republican theme is the need to reduce the Federal deficit. In fact, they were willing to shut down the government and default on our financial obligations over the issue (at least that became the big stalking horse after the “defund Obamacare” ran out of steam.
Deficit reduction should be a priority—but a long term one. Keynesians argue that governments (including central banks) should be counter-cyclical to the business cycle. Austerity in boom times-deficits in recessions.
But the Republicans have proved very poor stewards of the economy. They squandered the surpluses inherited from the Clinton boom years in ill-conceived tax cuts while launching wars (kind of reverse war bonds). They left the economy a smoking hole in the ground at the end of the last Republican administration.
Now, in times of recession and slow-growth recovery, they are insisting on government austerity. They believe this, in spite of very recent experiences in Europe. Go here for the Irish experience. Other countries in the Euro zone had (or are having) very similar experiences. It is Bizzaro World economics.
It is hard to imagine why they are not only so insistent on fixing the deficit right now, but why they are so obsessed with it. Inflation in the economy is 1.7% (below the Fed’s target of 2%) the US dollar is still the world’s reserve currency, and most of the debt is owed to ourselves. And any speculation of moving away from the US dollar as the word’s reserve currency is motivated, not by our deficits, but because of the crisis-to-crisis management of our economy caused by Republicans.
But there is a way to satisfy the Republican obsession with immediate deficit and not ruin the economy. This is an appeal to the right-wing core beliefs of superiority of the self sufficient, paying your own way, and their natural disdain for what Mitt Romney called the “47%” in the last election.
There are some States that pay more in Federal taxes than the benefits they receive. Lets call those the Maker States. On the other hand, there are some States that receive more in Federal benefits than they pay in Federal taxes. Lets call those the Taker States. There a total of 18 Maker States that are paying the freight for the Taker States. Traditional Republican thought would hold the Makers in high esteem, and the Takers would be regarded with disdain.
So, let’s start with the premise that the Maker States should be in charge. That should be an idea that the Republicans should love.
One idea is that Federal spending should be reduced across the board in the Taker States until all States contribute at least the amount of the benefits they receive. The advantage to this is that it would result in an immediate and dramatic reduction of the Federal deficit. The problem with this idea is that it would further impoverish the Taker States and perhaps condemn them to a permanent, welfare class. The goal, after all, it is to take all the Takers and turn them into Makers. The elimination of Social security payments, Medicare supports, SNAP assistance would hurt only the already poor. Elimination of farm subsidies and defense contracting would hurt the already rich.
Another, more compelling idea is this: Only the Representatives of the Maker States could cast votes in Congress. The Taker States could still send their Representatives to Congress, they could still make speeches, sit on Committees and press their cases. They just could not vote.
What could be more conservative than that? Only the ones paying the bills get to decide stuff.
But here’s the rub for Republicans: It turns out that 17 of the Maker States are Blue (they voted for Obama in the last election). Only one is Red (voted for Romney in the last election). Most of the Representatives and Senators who are in a dead panic about the deficit are from Taker States.
A reconfigured voting Congress would like this (presented in order of relative fiscal contribution to the nation):
| House | Senate | |||
| Dem | Repub | Dem | Repub | |
| NJ | 6 | 6 | 2 | 0 |
| NV | 2 | 2 | 1 | 1 |
| CN | 5 | 0 | 2 | 0 |
| NH | 2 | 0 | 1 | 1 |
| MN | 5 | 3 | 2 | 0 |
| IL | 12 | 6 | 1 | 1 |
| DL | 1 | 0 | 2 | 0 |
| CA | 38 | 15 | 2 | 0 |
| NY | 21 | 6 | 2 | 0 |
| CO | 3 | 4 | 2 | 0 |
| MA | 9 | 0 | 2 | 0 |
| WI | 3 | 5 | 1 | 1 |
| WA | 6 | 4 | 2 | 0 |
| MI | 5 | 9 | 2 | 0 |
| TX | 12 | 24 | 0 | 2 |
| FL | 10 | 17 | 1 | 1 |
| OR | 4 | 1 | 2 | 0 |
| RI | 2 | 0 | 2 | 0 |
| 146 | 102 | 29 | 7 | |
The immediate advantages to this are apparent:
- The number of votes in the Senate to break a filibuster would be 22. Problem solved.
- The grown ups are back in charge and partisan gridlock disappears. This Congress wishes to raise the debt ceiling or extend unemployment benefits, or not default on our obligations, then they have the power to do it. After all, who is paying the bills?
- If the Taker States want a voice in the affairs of the nation, it will become obvious quickly that they need to unshackle themselves from the Tea Party and the Religious Right. They would have to stop spending so much time and energy on inconsequential issues like gay marriage, women’s right to choose their own health care options, and easing gun control laws. They could either focus on economic development so that they can get their economies into a Maker status (this is the key to deficit reduction) or they continue as wards of the State, forever imprisoned by the Tea Party.
It is hard to know what the Takers would choose. My hope is that rationality would prevail.
If the Virginia Republican Party wanted to lose the 2013 elections, they were faced with an urgent problem.
At the top of the ticket they would be facing off against Terry McAuliffe, the glad handing, ethically challenged slime ball money man of the Clinton political machine. Who, by the way, had never held elective office in his entire life, and, who was running in what is essentially a conservative state.
How do you lose to a guy like that in a state (OK—a Commonwealth. Save your hate mail for a more worthy cause.) like Virginia?
So here’s the plan.
Start by not selecting your candidates in a state-wide primary, where a more moderate and reasonable Republican could emerge who might have a chance of peeling off some votes in the hated liberal precincts in Northern Virginia. Instead select your candidates in a closed convention that could be dominated by the most extreme, most hateful, and the most regressive elements in your party.
Check.
Then you offer candidates that could have been endorsed by Mullah Omar (See my prior post on this topic. No need to rehash it here.) Start with Ken Cuccinelli for Governor. The Cooch is anti-science, anti-academic freedom, anti-women’s right to choose their own health care options, pro-medically unnecessary transvaginal ultrasounds, wanted to make oral sex between consenting adults, including married couples, a felony, climate change denier, and an opponent of expanding Medicaid under the ACA. Did I mention that he was also caught up in the Governor Ultrasound corruption stink-show by accepting cash from the magic tobacco pill guy and not disclosing it? Not only is that not going to play well with educated voters who actually live in the 21st Century (aka ”Northern Virginia”), but it makes it kind of hard to raise ethical issues about your opponent, doesn’t it?
Check.
It gets better. The next step in the plan is to nominate Bishop Jackson for Lieutenant Governor. This is a man who believes that Planned Parenthood is worse than the Ku Klux Klan (after all, the Klan never offered mammograms or screenings for cervical cancer. Or something.), gay people are sick and twisted as well as “icky”, and the unamended Constitution, including the provision to count slaves as 3/5s of a person was actually an anti-slavery manifesto. We were even treated to a television interview when the Bishop, when confronted with his own repulsive statements, tried to deny he said those awful things. When you try to live in the 18th Century, you often lose your grasp of some essentially modern things—like digital recordings of nearly everything a public figure says. If you want to run away from your past, then you have to do better than just lie your way out of it. We have the tape.
Check.
The last stroke of genius in the master plan to lose the election is to nominate Mark Obenshain for Attorney General. Mr. Obenshain is noted mostly for introducing a bill in the Virginia legislature that would have required women to report miscarriages to the police. Or go to prison. Small government and freedom for old angry white men—police state for women.
Check.
So trot out this lunatic trifecta from Right Wing Nutbagistan and you will lose to the Democratic slime ball, even in a conservative state. And lose they did—0 for 3. To be fair, Mr. Obenshain could still pull this off in the recount that is coming. A recount, by the way, that will be subject to oversight of the sitting Attorney General—the Cooch himself.
The Virginia Republican corruption stink show continues.
Postscript
I previously intended to end this series with the five parts previously posted. However, I recently received a letter from my donor. Not only do I want to share this message from this amazing person, I want to share it with all of you who have been following my story. I think this is the perfect end to this series, as there is nothing else I can add.
So here it is, edited slightly to preserve confidentiality:
Hi. I’m so happy to hear from you! Even happier to hear that you are doing so good!!! What a thoughtful note; incredibly kind and straight to the point. I understand if you would not like to know too much about each other and will joyfully respect that that resolve if I am not to hear back from you after you receive this. As for me on this end, I have absolutely no qualms about exchanging mail from time to time, or just once a year on that faithful August 15th…because it means so much to me to hear that you are well and continue to be well. You were not told, it was obviously not known, that my kidney WAS just to help you directly.
Let’s start with this, I am not a religious person either. Or rather, I am obviously not, a religious person. I notably heard about living kidney donation somewhere around 7 years ago, on NPR. A guy told a story about listening to NPR himself and hearing a story about living kidney donation and knowing, somehow knowing that moment, that he he was going to do it to. And honestly, something dawned on me that moment as well! And it was then, that you and I started our invisible line toward each other.
It took me a while to finally be in a place where it fit, all the tests and finally the surgery…but I thought about you often…my person…we didn’t know each other-bound for each other…that thought made me fell connected to something larger, than very large things!
I have two children and an amazing husband who I couldn’t be in love with more (except I find that I am! In love with more almost daily). But you were a different large thing. You were me connection to man. Nothing to do with a god or a good deed or karma…Just us. People. We don’t care for each other enough. We knee-jerk. We judge. Once I committed to a donation, I knew I had to accept my recipient for exactly who they are. This was not hard. In my mind, you were dying…you were a person with potential, who was dying. That’s all I had to accept.
And I could help.
You ended your note to me saying your wish for me and my loved one to have days filled with joy adventure and love…you had no idea that you were wishing yourself that, you and me-because you are the “loved one.” You were the reason that I donated my kidney. They call it altruistic donation, I like to think I was donating to you. And the joy, adventure and love? It shall be done!It has already begun, no doubt.
I can’t tell how relieved I am that you are doing so much better, and further, I am so happy that you are happy!! Happy with new life and eager to live it with explosive exuberance! I must thank you as well-I now know something that few people do. I have learned something that will change and grow me in a brand new new wonderful way. I am incredibly humbled to have been able to help you. I made no sacrifice friend, it must be some other way around…we seem to sacrifice so much of ourselves for such petty things…it’s no sacrifice to help someone live…that is an honor. Maybe there are no words for some things.
Live. Live well. I will do the same.
The very best to you-
Prior Installment: By the Numbers
My very existence is a fluke of scientific progress. I was born in 1952. Only 30 years before was the start of the first experiments using insulin extracted from dogs to treat, what was known at the time, as Juvenile Onset Diabetes (now known as Type I). Before that time, people who were born with this genetic misfire simply died young, and died miserably. Because evolution works slowly, this anomaly was not yet weeded out of the human gene pool.
I was first diagnosed 1n 1963, which was only 41 years removed from the first experiments with insulin therapy. 41 years is not even a blink of an eye in the entire course of human history. Yet by 1963, animal-extracted insulin was widely available for the treatment of Type I.
Lucky me.
Research on dialysis for the treatment of renal failure started in the Netherlands in the early 1940s. This research was done on the sly with stolen materials and done at great risk because the researchers worked under close scrutiny of the Nazis. The first patient successfully treated with this therapy was in 1945.
After the war, the researchers moved their operations to the United States where they encountered serious opposition, especially from the religious zealots of the time who declared it an “abomination”, not dissimilar to religious opposition to stem cell research today. Yet they pressed on.
Only 68 years after the first patient, I would need dialysis to stay alive. Again, a mere blink of an eye.
Lucky me.
The first kidney transplant occurred in 1954. The donor and recipient were identical twins, thus alleviating the rejection issues. Unfortunately, the recipient did not live long, but it was the first step.
Rejection remained a persistent problem. It was not until the 1986 that truly effective anti-rejection drugs were widely available. There have been steady improvements in anti-rejection therapies ever since.
Only 27 years passed between the first effective anti-rejection drugs and when I needed them. Again, a mere blink of an eye.
Lucky me.
To paraphrase National Lampoon’s Deteriorata: I am a fluke of the universe. I have no right to be here.
To sum up my lessons:
- Renal failure is a crappy way to die.
- Much of renal failure is preventable, through control of diabetes and hypertension.
- The need for the treatment of this condition is great, and the resources available are shockingly inadequate.
- Living donors are essential to the alleviation of untold suffering. If one is looking to make a difference, one should look into becoming a living donor.
- I have amazing friends who went to great lengths to help me when I could scarcely help myself.
But the most important lesson that I learned is this: I learned how to receive. I am alive and healthy today because a great number of people devoted an almost unbelievable effort to get me here. They did this knowing that there was no way I could ever repay them.
First of all, is the donor who saved my life–a person that I do not know and may never know. The English language does not have the words to describe this gift. From August 15th forward, every day that I am not only alive but more importantly, not sick, is due to this person, whoever they are.
There is my courageous and steadfast wife of 21 years, who gave up a kidney so that I could get one. Organ donation was not part of our wedding vows, but when she got the call she answered without hesitation or fear (at least that I could see).
My brother interrupted his Costa Rican sabbatical to stay with us and serve as our primary caretaker while my wife and I were recovering. He was here nearly a month-I am not sure what we would have done without him.
The nephrology genius, Dr. Chi Hsu, who had all the right answers at the right time. Keeping someone in my state healthy enough for transplant is no easy task.
The entire staff at Wellbound, who played a critical role in my care when I was undergoing dialysis. They were professional and caring, and most importantly, they were wise enough to let me believe that I was in charge. In fact, I was only following orders.
Dozens of friends cooked for us and brought us food because it would have been very difficult for us to prepare meals during he first month after surgery. There were many more who sent cards, flowers, and prayers. All of this helped get us through some very dark times.
For the first time in my life, I believe that I will live to retirement and beyond. To everyone who made this possible: you know that I am indebted to you and it’s a debt that I can never repay. No amount of thanks will ever suffice for what you have given me. However, I can make you this promise: Whatever extra time that you have given me will not be wasted.
I would like to close this series by putting a human face on what all of this means: My wife and I had the great honor of actually meeting the new owner of my wife’s kidney. It was a genuinely transformative experience.
Here is a photograph of the two of them when we met (my wife is the blonde):
Last Installment-The Big Show
By the Numbers
The researchers at UCSF estimate that 40 million Americans are in some stage of renal failure. Most people in this group do not know it. The major factors contributing to this are diabetes and high blood pressure.
Diabetes can lead to high blood pressure as well as renal failure. High blood pressure is a contributing factor for renal failure, and renal failure is a contributing factor for high blood pressure.
90% to 95% of all diagnosed diabetes are Type II. 79 Million Americans have undiagnosed diabetes or pre-diabetes.
These conditions, undiagnosed or treated, sets up a downward spiral that just feeds on itself. While many of these people go on to die of renal failure or diabetes outright, many more go on to die of heart disease.
Demographically speaking, it is easy to see that there is trouble coming.
There are about 5,000 people waiting for kidney transplants at UCSF alone. UCSF does, on average, 315 transplant surgeries a year. That makes an average wait time about 14 years, assuming that everyone lives long enough to receive a transplant.
The average wait time to receive a kidney is three-to five years. The difference between 14 years and 5 years is the number of people who will die waiting for a kidney transplant. About 5,000 people per year die while on kidney transplant list.
The annual costs of treating patients in the US with End Stage Renal Disease (ESRD) was $40 billion as of 2009. The individual cost of a kidney transplant, including pre-surgery prep, the actual surgery, and the first 180 days of post operative care are about $263,000.
For people like myself, who are lucky enough to have excellent employer-provided health care insurance, these costs are of very little concern. However, those less fortunate who need to rely on Medicare, the gaps in coverage can be not only a real burden, but financially devastating.
ESRD will continue to grow as our population ages. This will place increasing upward pressure on our health care costs. New programs, such as the Affordable Care Act, will help. However, no program or combination of programs will come close to matching the growing need. We are rapidly approaching a state where only the affluent will be able to afford this treatment. We can expect to see the annual mortality rate of people waiting for transplants to increase, perhaps dramatically, in the coming years.
What to do? First of all, we need to realize that the very best treatment is prevention. We need to aggressively control the conditions that lead to renal failure, especially diabetes.
Much, although not all, Type II diabetes is controllable, if not preventable. If you know someone with Type II diabetes or is at risk for it, for God’s sake, intervene. This may be uncomfortable, but take it from someone who has walked this path—renal failure is no joke. Save a life.
Be aware of, and control other behaviors that can lead to renal failure, Including hypertension. Control dietary choices—including a low sodium diet, avoid high fructose corn syrup, most processed foods. Make good nutritional decisions, including fresh vegetables, and reduce red meat consumption. Renal failure is no joke. Save a life.
Consider becoming a living donor. You do not have to be an exact match, but can paired with another in need through the national Kidney Registery. A healthy and long life can be experienced with one kidney. I was on the transplant list for about a year, not the 3-5 year average. The difference? I was lucky to have living donors. Renal failure is no joke. Save a life.
To the extent you can, support advanced kidney disease research, like the implantable artificial kidney being developed at UCSF. Renal failure is no joke. Save a life.
I know this last part became a little preachy, but the need is great, and the resources to meet that need are shockingly inadequate. Renal failure is an especially bad way to die. Everyone who can should do their part.
Renal failure is no joke. Save a life.
Next Installment-Lessons Learned and Closing Observations
Prior Installment: Dialysis Days
The Big Show
By the spring of 2013, paired exchanges with other donor/recipient pairs, including me and a non-matching donor, began to appear.
A paired exchange is something simple in concept, but very difficult in real life. It requires a person who does not match their recipient but does match a complete stranger to donate their kidney to the complete stranger in order for their recipient to receive a matching kidney from another complete stranger. Some of these pairings (called “chains”) can be quite long and complicated and often involve pairs from all over the country.
Paired exchange chains are quite fragile. Any number of things can cause a chain to be broken, which means we have to start over. Final cross-tissue matches can fail, a donor or recipient can change their minds, and because the recipients are often quite ill, a recipient can die.
Between May and July, we had two exchange chains break for one reason or another-we were never told why, just that the chain was broken and the coordinators will keep working.
The third week in July, we were entered into a chain that had nine donor/recipient pairs. Obviously, the more pairs involved, the more likely things are to go wrong. The final tissue cross match takes a couple of weeks, which was probably the longest two weeks of my wife’s life.
Just as the final cross tissue match was completed—a glitch. Less than a week before the surgeries were to begin, my donor’s recipient received a cadaver kidney which meant that this donor no longer needed to donate. Good for him, very bad for the rest of us.
Three days before the surgeries, the chain was repaired. Instead of receiving a 52 year old kidney from Maryland, I was to receive a 41 year old kidney from Colorado. Younger kidney—and closer. This worked out just fine but it was a close call.
Further complicating the situation is that of the three living donors willing to give on my behalf, it was my wife who got the call. That meant that both of us would be in long post-op recovery at the same time. During the first three weeks of recovery, there would be very little we could do for ourselves.
My brother interrupted his Costa Rican sabbatical to come to California to serve as our primary caretaker during our recovery. Our neighbor organized and mobilized a vast network of friends to bring meals during our recovery. Almost everyone we know contributed what they could (our dog walker took care of Auggie and refused to take money, for example).
The day of our surgeries was undoubtedly the longest day of our lives. My wife’s surgery was scheduled for 7:30am, which means she had to be at the hospital at 5:30am. My surgery was tentatively scheduled for 4:30pm that same day.
I stayed with her and walked with her gurney to double doors that led to the operating suites. They wheeled her through the doors and the doors closed and she was gone. Now beyond any ability I had to protect or comfort her.
I never felt so alone in my life.
The next three hours seemed like 30 years. At 11:00am her surgeon reported that she was fine, a perfect patient and her kidney was on its way across town to save a life. The relief was something beyond my ability to describe. Knowing that she would be OK brought me peace of mind that, again, I cannot describe. Nothing else mattered now. I felt absolutely no apprehension about my upcoming surgery.
Unfortunately, by the time I would be allowed to see her, I would be in pre-op prep myself. We just got word that my kidney was on its way to the Denver airport. Show time was just around the corner.
By 2:00pm I was checked in and in my hospital room. We just got word that my kidney was in the air and on its way (every kidney in transit has a GPS tracker so the surgical team knows where it is at any time).
At 4:30pm the kidney landed at SFO. At 5:00pm the kidney was on its way by courier to UCSF. Time’s up. Now we go.
As I was being wheeled to the elevator that would take me to surgery, another gurney was coming my way. It was my wife who was coming from the ICU. We had a moment when we were allowed a moment to hold hands. It was a magical moment that I will never forget.
But it was a short moment. Time and tides wait for no man.
As I lay on the operating table, with everyone buzzing around me I could muster some last words of advice for the team: “Think clearly. Cut straight. Wake me when its over”. I could swear I could see one of the surgeons roll his eyes. The mask went on my face.
Then I was in the ICU/Recovery. I opened my eyes and the chief surgeon was there. He reported that the surgery was text book, the kidney was beautiful, and it was it was making urine even before he connected it to the bladder. I choose not to think to much about that.
As I drifted back into my drug-induced haze, I only had two thoughts: I wanted to see my wife. And the journey back starts now.
Next Installment: By the Numbers
Previous Entry-Introduction to Renal Failure
As 2011 progressed, I was becoming very ill with the effects of renal failure. I was putting off the dialysis decision as long as I could, because I had not yet decided if I wanted to put up with the serious life compromises that dialysis would entail. I was unsure if life on dialysis was worth living.
We all die. If this was my time, then so be it.
I was adamant about not asking anyone to be a kidney donor. No one owes me anything, especially not something like an organ. Yet the donors started coming forward and entering the UCSF screening. It occurred to me that if someone volunteers, that is another story altogether.
It turns out that I do not have a particularly easy blood type to match, at least in my donor pool. Non-matching blood types can still be a donor, but it must be through a paired exchange through the National Kidney Registry (there will be more on this later)
In October of 2011 a good friend stepped forward and offered to donate his kidney to me and he was a blood type match. For the first time since I became sick, I began to feel hope.
Once passed the preliminary screening, the real testing began. I was astonished at how difficult it is to be a donor. Donors face a battery of testing that is rigorous, time consuming, and, at times, uncomfortable. The only testing I was subjected to was to make sure that I would survive the surgery. Piece of cake, really.
The screening is a complicated and time-consuming process. But in every step of the way, this donor passed with flying colors.
Until the last step.
This donor was screened out just before we were to schedule the surgery. The reasons are not important, and I am not allowed to know because of confidentiality requirements.
My choices now were simple and stark. I could die, which would not have taken long at this point. Or I could accept dialysis and hope for a paired exchange with one of my non-matching donors.
It turns out that hope is a hard thing to kill.
There two kinds of dialysis-hemodialysis and peritoneal dialysis.
I choose peritoneal. It could be done at home, and most of the heavy lifting would be done overnight while I was sleeping (at least theoretically). This would allow me to continue working and allow me to have some independence from being on a strict schedule dictated by the dialysis centers, which I consider dreadful.
This type of dialysis requires careful management, due to the constant risk of infection. A catheter is surgically implanted in the abdomen which opens a portal to the peritoneal cavity. Since white blood cells never access this cavity, the risk of infection is real and it is persistent. Peritonitis is not only a constant threat, it can be fatal.
My catheter was placed on May 10th. By May 23rd, the incision had healed enough for me to start using it.
I started with manual fluid exchanges (4 per day and overnight). Within a few weeks, a machine called a “Cycler” arrived. This would allow all of the necessary fluid exchanges to be done overnight. Whether manual or automatic, the rhythm of my life became dominated by the “drain, fill, dwell” cycle.
Peritoneal dialysis requires careful management because of the constant risk of potentially fatal infection. Every time the portal was exposed (a requirement to accept and drain the fluid) required an exacting disinfectant routine. Also, the site where the catheter left my abdomen required constant care to avoid infection at the site and prevent damage to the catheter itself. I spent at least an hour a day with these procedures.
The overnight fluid exchange presented its unique challenges. The Cycler was programmed to provide for a nine hour cycle. Since I needed to be up at 5:30am in order to go to work, the cycle had to start relatively early. This meant I needed to be attached to the machine no later than 8:30pm every evening. My friends soon got used to me exiting all manner of social engagements long before anyone else. Even when people were visiting my home, I had to excuse myself before the evening was over.
The machine itself was a challenge. Any number of things could cause its alarms to go off. Some of the alarms were easy to resolve and some were quite mysterious. All resulted sleep interruption.
What did I get for all of this labor and sleep deprivation? My mind cleared and most, but not all, of the effects of renal failure were mitigated and I could continue working. This was my life for a year. Was it worth it? Absolutely. Would I do it again if I had to? Without a doubt.
I and one living donor went on the paired exchange program on August 13th. A second living donor was added in the winter, and third living donor was added in the spring.
Now we wait.
Next Installment: The Big Show
This will be a departure from my usual political rants. Eventually, I will get back to that—so those of you who are annoyed by me and especially those who enjoy taking shots at me will have to wait a while. Keep your rounds chambered-it won’t be long for the sport to resume.
But none of that seems important now. Those of you who have ever faced a life-threatening crisis will find this familiar territory. Those of you who have not-it is my sincere hope that you will never will.
Some things about me for the sake of context: I am a 61 year old male with Type I diabetes.
This is the type of diabetes that is not a result of lifestyle choices. Rather, it is a genetic misfire that caused my immune system to mistakenly react to the cells that produce insulin as foreign material and attack and kill those cells. I have been dealing with the effects of this disease for 50 years.
Well-managed diabetes is a remorseless disease that kills one slowly (diabetes not well-managed is another story altogether). The physical degradation can be slowed to the point that one can achieve a near-normal life. But it is always there: it never takes a day off, it never gets tired, it never loses focus and is relentlessly committed to killing me.
I have held this disease at bay for half a century. I have had a life filled with adventure, amazement, professional success and the love and support of my friends and family. If I died today, I would have the satisfaction of knowing that even though I was dealt a bad hand, I played it well.
But my grand prize for this astonishing longevity: renal failure.
The kidneys provide a vital function that sustains life. They are a natural organic filter that removes toxins and waste from the blood stream and provides a mechanism to remove that waste from the body. Most people are born with two kidneys—but a healthy life can be sustained with only one.
Outside of trauma or certain diseases, kidneys, when they fail, fail slowly. My kidneys started to lose efficiency in the late ‘90s. Certain therapies, drugs and lifestyle choices can slow the degradation of kidney function. During the long deterioration I told my doctors that our goal was to keep my kidneys alive long enough so that I could die of something else. They failed to see the humor.
During the Christmas holidays in 2010, I came down with a viral infection that among other things, accelerated the deterioration of my renal function. My kidneys, along with the rest of me, began to circle the drain.
I did not experience all of the symptoms of Chronic Kidney Disease (CKD), but the symptoms I experienced, I experienced in spades. 2011 was the year of dealing with those symptoms in an effort to stay healthy enough to keep working. This by far, was the most difficult thing I have ever done. And the most futile.
I developed Obstructive Sleep Apnea, Restless Leg Syndrome, terrifying and painful cramping in my legs and feet, persistent insomnia, involuntary muscular twitching, loss of appetite (especially in the evening), constant upset stomach and nausea, and the loss of energy or interest in the things that gave my life meaning (especially photography). I could no longer focus for more than a few minutes or even think clearly.
But the worst part, by far, was that my wife and the absolute love of my life, got to stand by helplessly and watch me die.
Next installment-Dialysis Days and Waiting for a Transplant.
bigdogdancer 