Sunday, January 27, 2013

I'm Not in Denial: Reflection on The Kidney Incident



Yet I am not silenced by the darkness, by the thick darkness that covers my face. (Job 23:17)

I suspect in some instances my friends who visit me and see me in high spirits and bubbly think that I'm in denial of my situation. You see I have End-Stage Renal Disease more popularly known as Chronic Kidney Disease or CKD. And for me to be seen thankful at life is just a bit suspicious. The truth is I'm just thankful. Simple as that. Thankful.

Being grateful when one is sick may cause some people to roll their eyes. It’s understandable. There are many instances when a person suffering a major tragedy in life would sink into a state of denial and create an illusion of detachment. All one has to do is to deny that the tragedy never happened and that one lives a normal life.

Some might think that seeing the blessings of God in a living nightmare is just plain denial. It might be true, but not always. Unlike the person in denial who refuses to believe difficulty has befallen one, the truth of the matter is I know that my life is a cautionary tale. My life right now is travail compared to many a regular life. I rise before the dawning of the morning and cry for help that my body won't deteriorate the entire day. Every morning I still cut my Carvedilol into two and organize them in a pill box along with the Amlodipines, Ferrous Fumarates and Calcium Carbonates. Every three days I still go the National Kidney Transplant Institute to go through four hours of hemodialysis. A machine as big as a small refrigerator sucks blood from me, cleans it, and then pushes it back to my jugular vein through a plastic catheter that is buried inside my collar bone 8 inches down. Every time I complete a dialysis, I still get 4000 units of an Epo shot on my right arm to ward off anemia by buttressing my hemoglobin production. I am currently nursing a fistula on my left arm. A fistula is like a USB port for blood. Later doctors would remove my catheter, sew the opening up and stab my fistula with two big needles for my dialysis. Every session I have to shell out 4500 (that's 45,000 a month!). Add to that, everyday, I have to measure my salt intake and avoid eating oily foods and food cooked in coconut milk or gata (I’m a Bicolano and this is probably the worst of all!). Everyday I have to watch my blood pressure and avoid stress (50% of “Chronic Kidney Disease” or CKD patients die of heart disease). Me, in denial? No way!

My outlook nowadays is that my life will never be the same again. CKD is a game-changer. My present prescription tells me that I have to have dialysis for the rest of my life and that a kidney transplant must be in my future plans to save money and life. And even after I get a transplant I will still be regularly monitored by the doctor, be careful with my eating and take a good dose of medications. Everyday I have to fight off the dangers of depression, worry, fear, and anger and overwhelm them with enthusiasm & zeal for life. That last part though “enthusiasm & zeal for life” is a gift from God. While “depression, worry, fear, and anger” are my own doing, “enthusiasm & zeal for life” are gifts of God. To make things clearer: think of these two groups as having two different sources – one self-generated; the other graciously given.

 These were my reflections as I pondered on a Bible book that exemplifies living without denialsOne would wonder why the writer of Lamentations wrote these perplexing lines:
 I remember my affliction and my wandering,
   the bitterness and the gall.
I well remember them,
    and my soul is downcast within me.
Yet this I call to mind
    and therefore I have hope: (3:19-21)
 Why would remembrance of “affliction” which certainly created in the writer a “downcast” feeling and yet he has “hope”? John Calvin asks the same question in his commentary to this passage. He asks,

How can despair produce hope from itself? This would be contrary to nature. What then does the Prophet mean here...? Even that being oppressed with evils, he was almost lost, and was also nearly persuaded that no hope of good anymore remained.

Being “downcast” many understand is a bummer. Many people think that being “downcast” is a source of depression and may lead to many medical issues such as heart disease, stomach and psychological problems. But I would suspect that that is the same number of people who would believe that hope has a role in recovery. In a landmark study on the role of hope on cancer patients PhD and RN authors, Dr. Tone Rustøen, Dr. Bruce A. Cooper and Dr. Christine Miaskowski in Cancer Nursing: An International Journal for CancerCare (Jan/Feb [2013] 36.1) most specifically in their article “The Importance of Hope as a Mediator of Psychological Distress and Life Satisfaction in a Community Sample of Cancer Patients,” their study concluded that “hope is an important resource for oncology patients that impacts their quality of life.”

Now I have a recurring struggle with cynicism. I question a lot. A question that comes to my mind for readers would be that I am just saying this to alleviate my suffering and create an illusion of calm and serenity. Actually I don’t want to repeat myself. I have already stated above the difficulty I face not only on a daily basis but all the time. The more I deny that reality, the more incapable I am of adapting to the situation. That’s why I try to avoid living in denial.

A person-in-denial’s life is a life that is grounded on an illusion. When one creates a life that is not there, what one creates is oftentimes grounded on an illusion, if not always. Hope for it to be hope must be grounded on nothing but the Ultimate Reality, God Himself. Calvin is best to explain what I’m talking about in his commentary on Lamentations 3:21:

As then he would recall this to mind, he says that he would then have new ground of hope, that is, when he had recourse to God; for all who devour their own sorrows, and do not look to God, kindle more and more the hidden fire, which at length suddenly turns to fury. Hence it comes that they clamor against God, as though they were doubly insane. But he who is conscious of his own infirmity, and directs his prayer to God, will at length find a ground of hope.
 Perhaps this was in the mind of the authors of the Westminster Confession of Faith when they wrote “a true believer may wait long and conflict with many difficulties before he be partaker of [infallible assurance].”

Now that is a long and winded way to explain yourself that you are not in denial. Please forgive me.

If you'd like to know more about this Hope I'm talking about and how to begin a life in Christ -- the "ground of hope" (most especially those going through tough times), drop me a note at jmpesebre@yahoo.com.

Kidney Edward beside a mechanical Bea.

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