Monday, February 1, 2010

PART TWO: The Conversation I Had With My Kidney


The Dynamics of Dread, the Power of Pain, and the Conversation I Had With My Kidney


Part One


(Out of the Blue, Vortexia) -- My New Year’s resolution for 2010 was that life would return to “normal” after a year of sickness and death in my husband’s family. But, on January 4 – having never experienced a serious illness in my life -- I discovered blood in my urine and knew with sobering certainty that my life would be anything but normal for awhile; maybe forever.


“Tests show no sign of infection,” my doctor announced. “Even though you’re not experiencing any pain, I’m ordering an ultrasound to check for kidney stones.”


Two days later, he called back. “Well, the good news is the ultrasound showed no stones in your kidneys. The bad news is, we need to take a different test to see the inside of your bladder. I’m referring you to an urologist.”


Having done my homework on the Internet, I knew that heavy bleeding without pain was symptomatic of bladder cancer; ergo, the thought of waiting two more weeks to have the next test was unbearable. A dear friend who “happened” to work for a premier urological medical group came to my rescue. He set up an appointment for me with a first-rate urologist immediately. Miracle Number One.


I know, it’s futile to worry, but telling someone being tested for cancer not to worry is like telling a dog not to cower from fireworks on the 4th of July. I succumbed to an endless mental litany of “what-if’s” and “if-only’s”: What if I do have cancer? Maybe that’s why God arranged for me to get seen so quickly. What if it’s advanced? Untreatable? If only I had gone to the doctor sooner. If only I had watched my diet more. If only I hadn’t snapped at my husband the other day…


Later, listening to my urologist tell me the test on my bladder was negative for cancer, I scolded myself. Silly girl.


“See?” my husband beamed. “You’re going to be just fine.”


The urologist, however, wasn’t so convinced. “Something is causing the bleeding,” he said, noting that during the test he had located the source. It was my left kidney. “I want you back in two days for a CAT-scan,” he ordered. “We need to get to the bottom of this.”


I should interject here that I am notoriously leery of being over-exposed to x-rays. When I told my eldest daughter, a medical professional, of my intent to cancel the CAT-scan appointment because I was sure everything was ok and the urologist was just over-reacting, she had a fit. “Don’t you dare cancel that appointment,” she shrilled. “That’s your old 'hippy-head' talking mom!”


I indulged her, grudgingly, but not without telling the technician who did the scan that I was in mourning because my “virginal kidneys were about to be violated.” A joke, of course.


The joke, as it turned out, was on me. A half-hour later, as my unsuspecting husband and I sat with the urologist in front of the computer displaying the first of my CAT-scan x-rays, we heard the dreaded words: “See this shadow here in your ureter….and this spot on your left kidney? I’m concerned. I’ll be honest with you, I’m afraid you could have a rare form of kidney and/or ureter cancer. There’s no way to know for sure unless we do a ureteroscopy. If it does turn out to be cancer, I think we may have caught it early enough to simply remove the kidney and avoid any chemo or radiation, but we need to schedule the procedure as soon as possible.”


On the way home I broke down and told my husband that my two greatest regrets in life – if I were to have cancer – were that I might not live to see my grandchildren and that I’d surely have to bless him to marry someone else. “You’re too young to be widowed for 30 years,” I choked, failing miserably at feigning both humor and courage.


He wouldn’t hear of it. I was being “premature” he cautioned. I was going to be “fine,” he said. Nevertheless, this pragmatic, type-A personality, former Girl Scout, was determined to be prepared for the worst. At the same time, I was equally determined to keep everything in perspective so as to prevent despair from swallowing me alive.


Rolling out the carpet of the mind; a typical reaction to fear, isn’t it? The length and breadth of life unfurls, expanding into eternity, revealing the stark sum of our past and the imminent sentence of our future existence. It’s an inescapable reality check; a virtual checklist of personal foibles and misappropriated affections. Why had I wasted so much of my life burdened with trivialities and spent so little time really living? Suddenly, I see my husband as unsurpassingly beautiful, perfect. My children are precious beyond belief. Nothing else matters.


The following day a 7.0 earthquake devastated Haiti. There’s perspective for you. Lying on the operating table, ready to go under general anesthesia, I told the surgeon and the anesthesiologist, “I can’t stop thinking of the poor Haitians trapped in buildings, suffering such unspeakable pain with no food, no water, no doctors, no medicine. I almost feel guilty being here.”


The next thing I knew, my husband was holding my hand telling me that my kidneys were perfectly healthy, that I was cancer free – Miracle Number Two --and that the doctor had found a small kidney stone in my left kidney and removed it.


The procedure effectively ended my fears of cancer, but gave birth to a week of excruciating pain unlike anything I had ever experienced. Of course, I couldn’t have known that then, sedated as I was, intoxicated with thankfulness for my clean bill of health.


If ignorance is bliss, I was blind, deliriously so, to what the future had in store for me.

Part Two


Searing Pain: Unnatural, suffocating, a ruthless exercise in faith and self-control. If fear expands one’s scope, pain retracts it, reeling in the panoply of life so that nothing exists but the pain itself. Time stops; there is no past, no future. All that is left, all that exists, is the brutal reality of “now.” Worse yet, no amount of reasoning, comfort, cajoling, distractions, or positive thinking can alleviate it. In essence, nothing – absolutely nothing -- matters anymore but the numb hope that the pain will go away and never return.


You think, perhaps, that I’m referring to the pain of torture, of childbirth, or of a broken bone, or a mortal wound of some sort. No, I refer to the pain of passing a kidney stone.


During my surgery the doctor had to insert a stent through my bladder and ureter and into my kidney. It was necessary, he told me, to keep the kidney draining correctly for awhile. It was tolerably painful (with pain medication), and after four days of immobility and walking about like Quasimodo, I was primed to have it removed. Removing the stent was a simple matter, the urologist assured me. His staff agreed that I would feel great immediately and that I would “bounce right back” to health.


Well, I left his office that morning in excruciating pain, assuming it would subside during the hour-long drive back home. A half-hour into our drive, writhing in pain, I shouted at my husband to pull off the interstate. Nauseous, light-headed, breathing shallowly, my heart racing, there was no position I could get into that would lessen the pain. Finally, thanks to my husband’s wisdom and sensitivity, we somehow made it home.


Shortly thereafter, my husband broke the news to me – hesitantly, as though I’d bite his head off -- after he talked to the doctor’s nurse on the phone. “She says you must be one of the very few who react this way when a stent is removed,” he said. “Your ureter is going through spasms as though it’s passing a stone, even though there’s not one there. She says you’re in for a rough 24 hours and after that it will get better.”


There are times you don’t want to stand out from the crowd, when you want to be like everyone else. Unfortunately, this was one of the them.


I spent the next 24-hours having “stoneless” kidney attacks every five hours. The pain meds the doctor had prescribed didn’t even begin to touch the pain. When the attacks continued after 24-hours the nurse told my husband that “sometimes they can last longer; up to five days.”


Are you kidding me?


They prescribed an anti-spasmodic medication to control the spasms, instructing me to take them along with the strong pain medication I was still on. They provided no relief whatsoever. The screaming pain brought me to my knees -- unbearable, incapacitating. It was like being stabbed in the kidney over-and-over every two or three seconds for up to an hour at a time. During an attack, I couldn’t talk, move, be touched, or listen to anything. All I could do was focus on enduring and mastering the pain.


I began to despair. People were praying for me, I knew, but the peace I felt when I wasn’t in pain fled the moment the attacks started, and each one progressively left me weakened physically and mentally. I felt like a Russian wooden nesting doll, as though the real me was shrinking inside of myself…as though I was looking at myself from the inside out. As a result, I began relating to the pain in an almost clinical way. It would start as a dull ache in my left kidney and go from 0-10 (10 being unbearable pain) in five minutes, where it would remain for 30-minutes or so, and then begin to fade at varying rates depending on my ability to relax.


Here’s where it got dicey. If the pain didn’t recede to an absolute 0, the spasms would start up again and I’d go through the cycle all over. It took every ounce of strength and concentration for me to subdue the pain at that point. I knew I had reached a 0 level of pain when I was either, 1) so relaxed I couldn’t feel the left side of my body or, 2) I fell asleep.


On the third day, during another attack, my despair turned to desperation. The peak had passed, but I was still struggling at about a stage 2 level of pain. I tried to think of sounds that I found calming and immediately thought of the Italian language; it has always had a soothing effect on me. As I tried to remember waking up in Italy to the voices of Italians in the street, a voice inside my head said, “Your prayer language has the same effect on you, you know.”


It was a eureka moment for me, and as I began to breath the tongues of angels my pain vanished. Just like that.

I had prayed that would be my last attack, but still they continued. The following evening I suffered two back-to-back. Writhing in agony, I suddenly envisioned the film The Passion of the Christ and my heart broke with the most rudimentary understanding of what a battle Jesus must have been engaged in with His pain. How could He carry on a conversation with the thieves on the cross? How could He care about His friends and family or anyone else for that matter, while he hung there on the cross?


I was so wasted at that point I couldn’t concentrate enough to even pray anymore. Then out of nowhere I had a mental picture of our new kitten, Bo. Spoilt rotten, she had kept us up several nights whining and crying, scratching incessantly at the door because she wanted to be fed and coddled. Delirious with pain, I placed my hand on my back over my contracting kidney/ureter and began to speak to it.


“Kidney,” I said, “I get it. You’re mad. You’re throwing a fit because you’ve been messed with. You just want to be held. Well, here. I’ll massage you until you calm down.”


“It’s pointless for you to continue like this,” I continued. “You’re stuck with me and I’m stuck with you. We’re in this together, like it or not, and as long as you’re not happy nobody’s happy. So go ahead and keep throwing a fit because you’re just hurting yourself.”


Immediately, the pain began to subside. I kept rubbing my back, speaking to my kidney until I felt the spasms stop. I was too exhausted to marvel – or even care -- at what had just happened. It had been the worst attack yet and had left me feeling nearly paralyzed on my left side. I even wondered for awhile if I had suffered a stroke during it. Desperate times had called for desperate measures.


It was my last attack. Miracle Number Three.


As I write this, a week later, I am a different person. Pain, and facing the inevitability of death in a visceral way, have left me enormously grateful. Grateful, because unlike thousands of others every day, I was spared a positive test result for cancer. Though I dodged the bullet, I was left with a fresh reminder of my mortality. And the next time I’m waiting in an emergency room or hospital lab, surrounded by bedraggled, unkempt people who look distant or worried, I won’t entertain smug thoughts of how I would never go out in public wearing my pajamas and slippers with my hair uncombed because, indeed, I would have during one of my attacks. Instead, my heart will break for them. Miracle Number Four...the greatest miracle of all.