Managing your Life with Kidney Failure
II. The Emotional Effects of Kidney Failure
Kidney failure will cause many changes in your life. It will affect your daily schedule, and may also have an impact on your closest relationships. Adjusting to these changes will be a challenge you never dreamed of. Some of the changes will be difficult, while others will be easier.
Some may even have unexpected positive rewards. The keys to surviving and making the most of this challenge are:
Be prepared
Ask for help
Here are some of the most common emotions kidney patients and their loved ones experience after a diagnosis of kidney failure. You may feel all, some or none of them--but it's important to know that each one is normal.
When you first hear that you have a chronic kidney disease, or even kidney failure, you may not believe it. You may not go for treatment right away because it just doesn't seem possible that you could have chronic kidney disease. Many kidney patients feel so shocked by the news that they have a chronic illness that they ignore it.
Unfortunately, denial can be harmful. The earlier you treat your kidney problems, the sooner you'll feel better, and the more likely it is you'll live a productive life. If you don't seek treatment your health problems will get worse and could even lead to your death. If you really doubt your diagnosis, get a second opinion from another doctor, or go for further testing. But don’t ignore the warning signs. They are there to save your life.
It is not unusual for someone to feel sad, unhappy or "blue" when a loss or an illness occurs. Even if you don't actually feel depressed, from time to time you may have some of the typical symptoms of depression like irritability, loss of appetite, decreased interest in sex and difficulty sleeping.
When you're feeling depressed, it often helps to talk about your feelings and to try to find the causes. Your family and friends, doctor and social worker can be important sources of support and help you find solutions. If your depression continues and even becomes severe, however, you should seek other professional help. Severe depression can interfere with your ability to follow your kidney treatment and stay healthy. Besides, you have no reason to suffer. Depression--like kidney failure--can be treated.
Nobody "deserves" kidney failure. You may have times when you feel resentful and angry. These are perfectly normal reactions. They may even be necessary before you can begin the process of acceptance and emotional healing. Facing your anger directly is important. If you try to hide your anger, it will only come out in more destructive ways like arguments with your loved ones, depression, headaches, stomach problems, and not following your prescribed treatment. Your doctor, social worker or an outside counselor can help. It’s important to keep reminding yourself that while you can’t control your feelings, you can control your actions. Taking your anger out on other people, or on yourself, will only make matters worse.
Anxiety is a feeling of worry, uncertainty or fear. It is a common emotion most of us have whether or not we have a chronic illness. Remember your first date, a final exam, a job interview or something else in your life that was really important to you? Anxiety may be caused by fears about what will happen in the future. A certain amount of anxiety and worry is normal. However, too much anxiety may impair your ability to function. If you find that your anxiety won't go away, or that it's taking over your life, you should seek help. A friend, family member, your religious leader or social worker can be good listeners and help you put things in perspective. Relaxation exercises may also help.
It’s normal to feel a certain amount of fear before you begin your first dialysis treatment or before a kidney transplant. You may be afraid that the treatment or surgery won't work, or that complications may occur, or even that you might die. Fear of the unknown is something that anyone can experience, and it is quite understandable in the case of kidney patients.
You may have learned about chronic kidney disease and its treatments through books, on television or at the movies. These images can be frightening, and they are not always based on fact. They often give people the false idea that kidney failure is a terminal illness where you have to spend the rest of your life in bed hooked up to a kidney machine! Or, if you get a transplant, it probably won't work.
The reality is that kidney failure is not nearly so awful. You don't have to spend all your time hooked up to a machine. Transplantation is a routine operation with a high success rate. You don’t have to give up your hopes and dreams for the future, either. People with kidney failure can live a reasonably normal life, working, getting married and raising a family.
The best way to ease your fears about the treatments is to learn as much as you can about them. Here are some tips that have helped others:
- Visit other patients (and their family members) who have been through the same type of dialysis or a transplant operation, to find out how they coped.
- Visit your dialysis (or transplant) center before your first treatment to meet the personnel and to see what the equipment looks like
- Ask for booklets, videos and other materials about kidney failure and its treatments .
- ASK QUESTIONS! No question is too dumb to ask.
- Always ask for help if something is bothering you.
You are likely to feel sorrow or grief over the loss of kidney function and the changes it brings to your life. While it may feel painful, grief over your losses can be a healthy step toward accepting your life with kidney failure. As with the other emotions we have discussed, you don’t need to face your grief alone. Talking with your social worker and with others who have experienced kidney failure can give you the support you need to move forward with your life.
When you are first diagnosed with kidney failure, you may feel like everything you’ve worked hard to have in your life is slipping away. You may fear that you’ll lose your independence, or become a burden to those you love. Such feelings can be frightening, and they may lead to some of the emotions discussed above, like anger and depression.
However, you will always have control over certain aspects of your life. For instance, you can control what you eat, which will affect how you feel. You can control how you treat others, which will affect the quality of your relationships. You can control how well you follow your treatment plan and take your medications which will affect how much extra energy you have to devote to work, hobbies and other activities. With some planning, you can also have some control over your daily activities, including working, traveling and going to school. Learning to recognize the things you can control and working to accept those you cannot are important parts of the coping process.
With all of the changes and challenges that kidney failure brings, it’s easy to feel overwhelmed. However, thousands of people have already met the challenges of kidney failure and its treatment and returned to a reasonably normal lifestyle. The important thing is to learn to face the challenges one by one. If you deal with each situation as your strength and motivation allow, your victories will accumulate. Don’t try to accept and adjust to everything at once--your treatment schedule, medications, and diet, for example.
Most importantly, you need to remember that you aren't alone. Help and support are available to you. Every dialysis and transplant patient’s health care team includes your doctor, a social worker and nurses and dietitians with special training in the care of dialysis and transplant patients. Your social worker can provide counseling for you and your family members and refer you to other services in the community as needed. Remember, that help is available, but you have to ask for it.
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