Tuesday, November 15, 2016

Year six of dialysis

In the flurry of the US presidential election, I didn't even realize that I have crossed the five-year mark of my dialysis. I've now entered the sixth year. So, how are things going?

The good
I'm still in very good shape for a 52 year old guy with kidney failure. On a good day I can do 200 pushups, on a bad day 100. I regularly skip rope, ride the stationary bike in the gym, lift weights, do body weight training and Iaido. I go for longish walks, either with my wife or alone. Overall, I end up spending quite a bit of time on exercise, maybe an average of 50 minutes to one hour a day. This seems like the bare minimum. If I do anything less than this, I start to lose muscle mass very fast, probably to do with the dialysis sucking out so much protein from my body. I have to accept that there is no way I can build up more muscle mass than I currently have (which is not much), and have to settle for just maintaining strength and endurance at a steady state.  It's not that I want to bulk up like those poor bozos in the gym whose brains have settled into their biceps; they have so little brain power left they have to randomly walk around the gym trying to find out where their locker is. But I wouldn't mind having a bit more muscle. My doctors are pretty amazed that I exercise; it seems I am the only one under their care who does.  They keep telling me vaguely to "take it easy", without really defining what that means, so I just ignore them.

Another good thing is dialysis in Germany. Despite the recent cut-backs in dialysis funding, the system hasn't yet become a totally dysfunctional one. There is now such a scarcity of narrow tape for taping up the needles during dialysis that nurses have to rip up a wide tape lengthwise to get the right width. Even the tubing has become much shorter, so that I have to have the dialysis machine extremely close to me when I sleep. I believe the nurses are also getting paid less. Nevertheless, I am lucky not to be living in any of the following countries: USA, France, Netherlands, Austria, Sweden. Did I mention the US? After the recent amazing discussion about how dialysis patients should be just allowed to die because they cost so much,  I want to add Japan, but maybe not just yet. Germany is still better than most of these countries. I feel very lucky to get night dialysis so that I can lead a near-normal life.

The bad
I can't think of anything bad at the moment. Oh yes, my shunt is narrowing and will need regular treatment at the hospital (every three months). They will have to regularly stick in a balloon catheter into the shunt to widen a narrowing in my armpit. It isn't much fun, but I guess things could be worse. Here too, the only really annoying thing about the procedure is having to spend a night in the hospital with other patients, who loudly talk their way through their hospital stay (see below, The Ugly).

The ugly
That's a no-brainer. It's the typical (dialysis) patient in Berlin. The typical patient in Berlin is basically an animal with no ability to think about what effect their behavior has on other people. TV: on at full volume. Music: the same. Walk around the dialysis center touching the water bottles and glasses while holding on to one's urine container. Playing the guitar loudly, singing a weirdly demented version of Stairway to Heaven at the top of their lungs. Talking loudly to fellow dialysis patients while dialyzing despite the fact that many other patients are sleeping. Jesus, who the fuck are these people? I'm trying to recall where I have seen this kind of behavior in Berlin. Oh yeah, everywhere! The definition of Berlin is Rücksichtslosigkeit. If there were a polar opposite to the consideration people show in Japan to each other, it is Berlin.

So now I have some five more years of dialysis to do before I get a transplant. I must say I am now totally willing to risk another transplant to squeeze out another 10 or so years of near-normal life.

Monday, November 14, 2016

The worst thing about dialysis in Berlin is other dialysis patients

In the last five years, I have now dialyzed all over western Europe, Japan, and the US (just two weeks or so there).  One striking difference between dialyzing in Berlin vs any other city I have been to is the sheer obnoxiousness of dialysis patients. They will either turn their TV headphones to full blast and put them on the table so they don't have to put them over their heads, or talk loudly to each other even when other patients are sleeping, talk loudly on the phone, or all of the above at the same time.  I have seen doctors sometimes try to get patients to be more considerate, but in one particular case I saw, the patient told the doctor that there is nothing the doctor could do to stop the patient from talking loudly.  In my dialysis center, one guy actually brings his guitar and walks around all over the dialysis center loudly singing and strumming his guitar. What's so special about Berliners? Why are they such assholes?