A chronic illness can become debilitating if not managed properly. But a 75-year-old East Texas woman has not only coped with her condition well, but she also serves as an example of how to overcome life’s bumps by simply living it.
Beside her bed in her East Texas home, Mrs. Howe keeps a computer-sized cycler used to remove wastes and excess water from her body as she sleeps. This is the normal function of kidneys. She is among the 36,000 Texans who are on dialysis.
It takes her about 15 minutes to prepare the machine. She wears a mask as she completes this process nightly and all of her tubes and other supplies must be sterile to ward off infection.
For the last three years, at-home continuous cycling peritoneal dialysis has become a routine.
“It tells you step by step,” she explained as she pulled out tubes and turned the monitor on.
A catheter was implanted in her side and the tube goes into the peritoneal cavity, which ends in her lower pelvis. The catheter is her lifeline.
“I just hook up and I get in the bed and watch TV,” she said.
A cycler runs fluid in and drains it out, dialyzing while the fluid is inside. Unlike hemodialysis, no blood is exchanged.
Mrs. Howe had been diabetic for 25 years. Her mother and all five siblings had diabetes as well.
Her health took a turn for the worse when she became riddled with fatigue. When she saw her doctor, she was admitted into the hospital with severe anemia — a complication of end stage renal failure. She was immediately placed on dialysis.
“I didn’t see it coming,” Mrs. Howe said.
She didn’t know much about dialysis or kidney disease before it happened to her, but she learned in a hurry.
Mrs. Howe said managing diabetes had not been difficult in past years.
“I was doing pretty good with oral medication,” she said. “But it seems like when my husband died with cancer everything kind of went berserk. I had to go on insulin. We just couldn’t get it organized then and I also had high blood pressure.”
Mrs. Howe is not on the waiting list for a transplant because of her age. She’ll live with dialysis the rest of her life.
“Transplants are not a cure,” Ms. Bearr noted. “It’s just another treatment modality. It’s more natural because you have a natural kidney in there versus an artificial means of doing dialysis. But you still have to take a lot of medications.”
Depression is common with people who suddenly find themselves on dialysis. Their employment, living arrangement, finances and physical and emotional health may be changing.
The first six months may be the hardest, Ms. Bearr noted, as patients adjust to new arrangements, which for many include dialysis three times weekly.
“It doesn’t mean that after you’ve adjusted, later in life that depression doesn’t become a problem again,” she said. “You’ve dealing with a chronic illness and there will be some times later in life that you may have those ups and downs.”
Mrs. Howe recently began taking a mild medication for depression.
“All of a sudden, it just hit me,” she said, describing the impact of her medical condition. “Everything was closing in.”
There is counseling available and support groups for patients who need help. Mrs. Howe’s support team consists of her family, doctor, nurse, social worker and dietitian. She also relies on her religious faith.
“You go into this and you have to have a lot of faith,” she said. “Me and God have done a lot of talking. My faith is very strong and I just depend on him.”