Before I begin, I should point out that I do know I have nobody to blame other than myself. Perhaps the French...no, mainly me.
It was the pear cider that did it. On Saturday afternoon, Coops and I sat in Soho Square amongst a plethora of very good looking young men drinking pear cider and soaking up the sunshine. As soon as they remove your buggered kidney, the doctors teach you two things:
1) alcohol is de-hydrating and will make you thirsty
2) the sun is de-hydrating and will make you thirsty.
Having imbibed a couple of ciders, I subsequently sweated it out in the staggering afternoon heat and proceeded to make-up for the shortfall by gulping down too much water (plus, over the course of the weekend, a glass of wine, a three course meal and McDonalds' cheeseburger).
As a consequence of all this gluttony, I squelched into dialysis this afternoon three kilos over my dry weight. Tipping the scales at 51.8kg came as no surprise: I could feel the fluid and I saw it in my cheeks; after two and a half years of dialysis, I am now adept at guessing my own weight - I am both sideshow and punter at my very own little freaky fairground attraction. Instead of carefully calculating the exact amount of fluid to come off (pre-dialysis weight, minus dry weight, plus 0.7 kg), I nonchalantly surmised that 3.5l ought to be enough to get me safely back to dry weight.
Unfortunately, I cannot tolerate a reduction of 3.5 kg very well and I should admit: this is not something I was entirely unaware of before today. 3.2 I can manage, 3.3 at a push, if it's a one-off. The last time I tried 3.5, my blood pressure bottomed out and I spent the next hour upside-down in an effort to force the blood to literally run to my head. Then the nurses made me chug orange squash like I was being inducted into a rugby squad. However, the brain is not wired to remember pain and my brain is especially skilled at superseding any lingering memory with a militant impetus to: get thin! At any cost!
The session started quite merrily. It was blissfully cool, at least: I could have tanned during Friday's offering. I read Marie Claire then flicked through the In Style that had accompanied it for an extra one pound fifty. I ate some biscuits; I watched "Crash" the third time...then I ate some more biscuits (alarmingly, not at odds with my incessant desire to be thin). I started a new book and by the end of the third hour, I was quite pleased at how the afternoon's session was progressing; I patted my gradually shrinking belly contentedly, a happy little Buddha.
The first, second and third hour of dialysis are not the ones with which the patient should concern themselves, however; it is the fourth hour that has the sting in the tail. Traditionally, my fourth hour is characterised by lethargy; languid and laconic conversation; slowly descending eye-lids...and I can get pretty grouchy. The fourth hour is when I hit the wall and have to slog it out until the finish line; it is a slow and gentle counting down of minutes. Today, I experienced all of these tell-tale signs, except my mammoth over-reach, fluid-wise, had now bestowed upon me every dialysis patients' nemesis: cramp.
It began in my toes. It is not uncommon and if I'm going to cramp my toes will get hit first, but this afternoon, it would not fucking go away. My toes looked arthritic, stuck at obscene angles and stubbornly stiff. I tried to ease my right foot by rubbing it with my left, only for the toes on the latter (you guessed it) to seize up themselves. I tried to massage my feet with my one free hand, but it made scant difference. I resorted to holding my toes in place, but the minute I eased the counter-force they vibrated back into an excruciating, un-natural position.
After ten minutes, I was writhing around like a snared trout trying not to say c**t too loudly. If this doesn't seem ridiculous enough, let me explain what I was wearing. Having been unable to do any washing at the weekend, my wardrobe choice that morning had been severely limited - the problem being compounded by the fact that any work attire must cover up my repulsive fistula for fear of scaring the kids. I had consequently managed to put together an ensemble that was vastly inappropriate and yet, somehow, frumpy: a strapless red cotton dress that allowed an impressive sighting of my strapless black bra when I took my black , woolen cardigan off. When paired with heels, the dress just about works. When worn in addition to flat, black pumps it takes on a middle aged air. Now I was flailing about, puffing, swearing and grasping at my feet with my one free arm whilst simultaneously trying to maintain some modicum of decency and not flash my last remaining pair of clean knickers to passing porters.
When the cramp started to travel up to my thigh, I conceded defeat and leapt at the chance to come off a whole nine minutes early. As soon as the machine stopped and the fluid was no longer being sucked out of me, the cramp began to ease and I experienced the euphoric sense of calm that occurs when intense pain finally eases. We flushed the needles through, and Alicia (my heavily pregnant Russian nurse) took them out. Blood had dried and caked around the top one: it stung like a bitch when it came out. Then the bottom one got caught on the tape. Yowzaa.
I felt the hot prick of tears in my eyes. I bit my lip and urged myself not to cry, firstly, because I didn't want to look like a pussy and secondly, crying at dialysis usually triggers some major psychological intervention and a STAT page to the psychologist because my nurses (bless their sensible shoes) seem to find it untenable that anyone might ever find dialysis painful or distressing in any way. I didn't want to cry because I had to hobble on my (still) cramp-ridden, aching trotters to the scales or because my arm would not stop bleeding after fifteen minutes; I didn't want to cry because my needle sites stung, or because I queried my ability to get home without passing out on the tube. I didn't want to cry at all; it was just that, after four hours, I was spent: sucked dry as a bone because of my own idiocy and desperate to get home. I leave dialysis sessions wondering how the hell I am going to make myself come back for the next one, but by the time it swings around a day and a half later, I'm always there. Its not that I forget what that last hour is like, but I recoup enough chutzpah inbetween sessions to know I can get through it. By Wednesday, I'll be fat - and ready to do it all again.
It was the pear cider that did it. On Saturday afternoon, Coops and I sat in Soho Square amongst a plethora of very good looking young men drinking pear cider and soaking up the sunshine. As soon as they remove your buggered kidney, the doctors teach you two things:
1) alcohol is de-hydrating and will make you thirsty
2) the sun is de-hydrating and will make you thirsty.
Having imbibed a couple of ciders, I subsequently sweated it out in the staggering afternoon heat and proceeded to make-up for the shortfall by gulping down too much water (plus, over the course of the weekend, a glass of wine, a three course meal and McDonalds' cheeseburger).
As a consequence of all this gluttony, I squelched into dialysis this afternoon three kilos over my dry weight. Tipping the scales at 51.8kg came as no surprise: I could feel the fluid and I saw it in my cheeks; after two and a half years of dialysis, I am now adept at guessing my own weight - I am both sideshow and punter at my very own little freaky fairground attraction. Instead of carefully calculating the exact amount of fluid to come off (pre-dialysis weight, minus dry weight, plus 0.7 kg), I nonchalantly surmised that 3.5l ought to be enough to get me safely back to dry weight.
Unfortunately, I cannot tolerate a reduction of 3.5 kg very well and I should admit: this is not something I was entirely unaware of before today. 3.2 I can manage, 3.3 at a push, if it's a one-off. The last time I tried 3.5, my blood pressure bottomed out and I spent the next hour upside-down in an effort to force the blood to literally run to my head. Then the nurses made me chug orange squash like I was being inducted into a rugby squad. However, the brain is not wired to remember pain and my brain is especially skilled at superseding any lingering memory with a militant impetus to: get thin! At any cost!
The session started quite merrily. It was blissfully cool, at least: I could have tanned during Friday's offering. I read Marie Claire then flicked through the In Style that had accompanied it for an extra one pound fifty. I ate some biscuits; I watched "Crash" the third time...then I ate some more biscuits (alarmingly, not at odds with my incessant desire to be thin). I started a new book and by the end of the third hour, I was quite pleased at how the afternoon's session was progressing; I patted my gradually shrinking belly contentedly, a happy little Buddha.
The first, second and third hour of dialysis are not the ones with which the patient should concern themselves, however; it is the fourth hour that has the sting in the tail. Traditionally, my fourth hour is characterised by lethargy; languid and laconic conversation; slowly descending eye-lids...and I can get pretty grouchy. The fourth hour is when I hit the wall and have to slog it out until the finish line; it is a slow and gentle counting down of minutes. Today, I experienced all of these tell-tale signs, except my mammoth over-reach, fluid-wise, had now bestowed upon me every dialysis patients' nemesis: cramp.
It began in my toes. It is not uncommon and if I'm going to cramp my toes will get hit first, but this afternoon, it would not fucking go away. My toes looked arthritic, stuck at obscene angles and stubbornly stiff. I tried to ease my right foot by rubbing it with my left, only for the toes on the latter (you guessed it) to seize up themselves. I tried to massage my feet with my one free hand, but it made scant difference. I resorted to holding my toes in place, but the minute I eased the counter-force they vibrated back into an excruciating, un-natural position.
After ten minutes, I was writhing around like a snared trout trying not to say c**t too loudly. If this doesn't seem ridiculous enough, let me explain what I was wearing. Having been unable to do any washing at the weekend, my wardrobe choice that morning had been severely limited - the problem being compounded by the fact that any work attire must cover up my repulsive fistula for fear of scaring the kids. I had consequently managed to put together an ensemble that was vastly inappropriate and yet, somehow, frumpy: a strapless red cotton dress that allowed an impressive sighting of my strapless black bra when I took my black , woolen cardigan off. When paired with heels, the dress just about works. When worn in addition to flat, black pumps it takes on a middle aged air. Now I was flailing about, puffing, swearing and grasping at my feet with my one free arm whilst simultaneously trying to maintain some modicum of decency and not flash my last remaining pair of clean knickers to passing porters.
When the cramp started to travel up to my thigh, I conceded defeat and leapt at the chance to come off a whole nine minutes early. As soon as the machine stopped and the fluid was no longer being sucked out of me, the cramp began to ease and I experienced the euphoric sense of calm that occurs when intense pain finally eases. We flushed the needles through, and Alicia (my heavily pregnant Russian nurse) took them out. Blood had dried and caked around the top one: it stung like a bitch when it came out. Then the bottom one got caught on the tape. Yowzaa.
I felt the hot prick of tears in my eyes. I bit my lip and urged myself not to cry, firstly, because I didn't want to look like a pussy and secondly, crying at dialysis usually triggers some major psychological intervention and a STAT page to the psychologist because my nurses (bless their sensible shoes) seem to find it untenable that anyone might ever find dialysis painful or distressing in any way. I didn't want to cry because I had to hobble on my (still) cramp-ridden, aching trotters to the scales or because my arm would not stop bleeding after fifteen minutes; I didn't want to cry because my needle sites stung, or because I queried my ability to get home without passing out on the tube. I didn't want to cry at all; it was just that, after four hours, I was spent: sucked dry as a bone because of my own idiocy and desperate to get home. I leave dialysis sessions wondering how the hell I am going to make myself come back for the next one, but by the time it swings around a day and a half later, I'm always there. Its not that I forget what that last hour is like, but I recoup enough chutzpah inbetween sessions to know I can get through it. By Wednesday, I'll be fat - and ready to do it all again.
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