Why I Chose Peritoneal Dialysis

When most people hear "dialysis," they think of being hooked up to a machine that pumps out dirty blood, cleans it, and pumps it back into the body. This is hemodialysis and is done at a medical clinic. Patients generally go into the clinic for treatments three times a week, four or five hours each time.

The advantages of hemodialysis are that someone else does the treatment and all you have to do is sit back and relax; you don't have to keep any supplies in your home; you only receive a treatment every three days; and you are able to have a pet in the house.

The disadvantages are that you have to rely on someone else to perform the treatment; you are restricted in your travel to large urban areas that might have a clinic that could accommodate you; you feel weak and tired between treatments since the toxins are building up in your body on the days without dialysis; you have to allow two large needles to be stuck in your vein each time; and you are vulnerable to the unsanitary environment that is unfortunately the norm at most hospitals and clinics.

The alternative is peritoneal dialysis. It is done four times a day, using the peritoneal membrane as a natural filter. Each exchange of fluids--clean in, dirty out--lasts about a half hour. It is done at home or in some other clean place.

The advantages are that the patient has control of the treatment; travel is not restricted to large urban areas that have clinics that can accommodate your travel plans; and, since the system is being cleaned four times a day rather than only once every three days, the patient feels better and has more energy.

The disadvantages are that the room in which the dialysis is to be performed has to be kept sterile, dirt- and dust-free; the patient is responsible for treatments; a lot of space has to be devoted to storing dialysis bags and other supplies; and dogs and cats in the home are highly discouraged as the hairs could contaminate the system and cause a serious infection.

I stewed over this for a while, wondering which way to go--hemodialysis or peritoneal. At last I decided on peritoneal because it is better for my body and my overall well-being. The whole thing about not being able to have a dog--something I have long wanted but have been unable to have because I have lived in apartments with pet restrictions--made me pretty sad. But I don't know what the future holds, and it could hold a transplant--and a dog.

It's been a little over a year since I started wearing an insulin pump. That was difficult enough, and the insulin pump's infusion site is changed every three days, so if I really wanted to keep my pump a secret--like when having sex with someone who may not know me very well--I always have the option of removing it for a few hours. But that isn't the case with the dialysis catheter. Having something else emerging from my abdomen doesn't thrill me in the least.

But when the alternative to dialysis is death, I realize I am really limiting myself if I go with the death option. A Jewish saying comes to mind: "Take care of your health. You can always commit suicide later."

The rejoinder to that, of course, is "But if I commit suicide now, I will never have a chance at health."

Off to London Tomorrow!

As soon as I began to accept the fact that dialysis was my destiny, I began to look ever more earnestly at the world map on my shower curtain. Where in the world should I go for my perhaps-last big adventure? A daunting question.

I immediately thought of New Zealand. How often I have heard wonderful things about New Zealand! Actually, I've never heard a bad word about the place or its people. I bought a guidebook and began to make plans for three or four weeks in a camper van, tooling about either the north or the south island. But a travel agent wondered if I had really thought this through. I'd be a very long way from home, without family or friends. I was already having a rough emotional time of it, wouldn't traveling solo exacerbate my sadness? What if I had a sudden decline or medical emergency? Would my insurance cover me in a foreign country? Who would help me?

Then I thought of taking a road trip in the U.S. One last camping trip. (I'm told camping is still a possibility for peritoneal dialysis patients, but what is meant by that is RVing--definitely not my kind of camping.) But then I thought of how cold it is throughout the country at this time of year. And how much colder it would be sleeping inside my truck, what is essentially a metal box!

About this time, I received an email from Virgin Airlines, touting a hotel-and-airfare deal to London. I asked Aaron if he thought he might be able to get a week off from work, given the circumstances. He spoke with his boss, and she said yes. So I booked the trip--with trip-cancellation and health insurance.

Of course it is impossible to say what the future may hold. I could be fast-tracked for a transplant. I could be the first stem-cell-kidney-replacement patient. I could drop dead tomorrow. I could be fully restored to health. Who knows?

But with peritoneal dialysis, travel is far less spontaneous, as the dialysis supplies are quite cumbersome. A month's worth of dialysis solution and tubing takes up the space of three four-drawer filing cabinets. And the places I would travel would have to provide a sterile environment in which I could conduct the dialysis. So though London may not be my very last trip, it may very well be my last trip without all this excess baggage!