No Peeing, Or Beer: 6 Realities Of Life Without Kidneys
Kidneys are pretty important in the grand scheme of bodily functions. They let us pee, filter poisons out of our bloodstreams, and they're one of the few organs in our body that travels with a partner for backup, in case something goes horribly wrong. But what happens if something goes horribly wrong, leaving you with zero kidneys rather than two?
"You die" is probably what most people assume, and that's a totally understandable conclusion to arrive at. But believe it or not, it's entirely possible to live a full(ish) life without a single kidney in your body. We talked to one man who lost both of his kidneys to a rare disease and has spent most of the last decade living a kidney-less existence, and he told us that seemingly little things we take for granted suddenly become incredibly difficult once two of your vital organs fester and die inside your abdomen:
Yes, You Can Live Without Kidneys (For A While)
I live in Japan, but I'm not a native speaker. So when I say "I have no kidneys" in Japanese, most people assume I'm screwing up the language. When I say it in English, people eye me suspiciously and say, "Uh ... I thought you couldn't live without kidneys."
"He must not know English. Ask him again, in Japanese."
Well, yes, in theory. You're not supposed to be able to live without kidneys. But thanks to the miracle of modern medicine, dialysis three times a week, and a fanny pack full of drugs, I can "extend my survival." You see, I have an affliction called polycystic kidney disease (PKD), which made my kidneys swell up to the point that they were crushing my OTHER organs and I looked like Arnold Schwarzenegger in Junior. For reference, this image should give you a basic idea of the Hulkamaniacal monsters my kidneys became:
Unfortunately, when your kidneys mutate to that size, surgery isn't actually an option. The inside of your body is a pretty tightly packed place to begin with. Having kidneys several times larger than they are meant to be squished everything together like cheap luggage, and I was told that a normal nephrectomy would be too dangerous: Scraping two basketball-sized kidneys out of my torso carried a high risk of damaging one of my normal-sized, bullied organs, as well as a sky-high risk of infection.
Leaving the monster kidneys in wasn't an option either. They still worked a little, but they were also actively trying to destroy me. My doctors claimed my kidneys would keep swelling until my insides turned into a GO-GURT tube. So my kidneys clearly had to go, but they couldn't be surgically removed. Thankfully, my doctors had a more cunning plan ...
They Slowly Kill Your Diseased Kidneys (And You're Awake The Whole Time)
Now I'm more or less the complete opposite of a medical professional, so I'm not even going to try to remember the names of all the drugs my doctors pumped into me. They shot me up with so much stuff that I figured I'd be drifting off in a cloud of euphoria by the time they got around to assassinating my kidneys, but instead I remained fully conscious, apparently because they needed me to be awake in order to ask me questions and monitor me. This becomes important in a moment.
The surgeons started by opening up a vein in my right leg, which actually didn't hurt. Then, one at a time, they squirted 99 straight platinum wires into my bloodstream that got caught right before reaching my kidneys and coiled up, creating an artificial embolism that blocked the blood flowing to my kidneys. That part hurt like demon's dick.
When each wire reached its target and coiled up, pain exploded in my abdomen. My body writhed while I struggled to keep my right leg still, and I begged for more pain medicine. The doctor said, "Quit fidgeting." This makes me wonder why they bothered to keep me awake in the first place, if they were going to ignore helpful feedback like that. By the 99th coil, I was delirious and half-conscious. I don't remember the gurney ride back to my room.
Those blood-blocking wires killed my kidneys the rest of the way, and they slowly wasted away to nothing over the next year. But before my kidneys went away forever, they had one last gift to bestow upon me ...
I Peed Black For An Entire Year, And Eating Fruit Will Kill Me
As my kidneys atrophied, the dead and dying tissue was gradually released in a decreasing amount of urine. This is another way of saying that my pee got blacker and blacker throughout the year until I just stopped peeing at all. I haven't peed in six years, and boy do I miss it.
Obviously, this inability to pee comes with some problems. I can't have more than 4 liters of water in my system, so that limits a lot of what I can eat or drink. For instance, lots of foods are really high in water, like fruit. So, goodbye fruit, pretty much. Oranges, melons, bananas, dates, nuts, potatoes, and tomatoes are also high in potassium, meaning too much can stop my heart like a Cessna choking on its last fumes. Eating out is basically not an option, because restaurant food tends to be really high in sodium, which makes you retain water. Sometimes I live on the edge and eat a whole peach or drink tomato juice.
Any liquid I drink goes into my blood and just stays there until my next session of dialysis removes it. The extra water raises my blood pressure dangerously high, especially right before dialysis. Consequently, most drinks, such as beer and even water, are out of the question. Luckily, I can and do still get drunk. I've learned to love whiskey and rum, which fulfill their intended task without filling my system with too much unpeeable water, but I sure do miss beer.
But hey, lots of people have weird, specific diets. For instance, I hear some folks don't drink any kind of alcohol at all. Unfortunately, I've experienced a few side effects that are much more unique to the un-kidneyed peoples of the world ...
There Are Some Horror Movie Side Effects
I have a huge fistula on my left wrist that throbs. Audibly. Visibly. It's just an artery pushed up close to the surface of my skin and U-turned to act as the access point for an outgoing dialysis tube, but it creeps people out. You don't need to check my pulse, because as long as my hand-bump is pulsating like the spawn of some alien parasite, you can be pretty sure my heart's beating. I tell people to touch it sometimes, because you've got to find entertainment where you can in this life. They tell me it feels like there's a motor inside of my bump.
I have to be careful not to cut myself in general, because I have anti-coagulants coursing through my veins at all times to prevent clotting in the dialysis machines. So much as a nick or a scratch and I could wind up bleeding out like the son of a Russian tsar. This means I must pay special attention to my throbbing fistula, because cutting that open would result in a B-movie geyser of angry blood.
I also have to keep track of about 20 different prescription drugs: some for my blood pressure and heart rate, some to lower phosphorus and potassium, some to reduce itching over every area of my skin (a symptom for most dialysis patients), and then some to ease the stomach pain caused by eating all of these drugs on a regular basis. Consequently, I'm constantly popping pills like Dr. House, which can either be a good thing or a bad thing, depending on how you identify with that character.
Dialysis Isn't So Bad, By Comparison
Dialysis is a process that can essentially be described as "the nightmare of having your blood sucked out by a machine, cleaned, and shoved back in." No part of that sentence is hyperbole, and it is exactly as fun as it sounds.
But like anything, you get used to it surprisingly fast. At first I would get nauseous and sick, and it was really miserable, but now I'm so used to it that I can just fall asleep really peacefully. It takes about five hours, three times a week, so I've had to work my schedule around the fact that having my blood washed is basically a part-time job. However, since I've learned to sleep during dialysis, I'm not really missing anything. I just get stuff done while normal, full-kidneyed people are sleeping, such as writing articles about my stygian pee.
Dialysis even has some upsides. Since it takes all of the bad shit out of your body, you can walk into a dialysis appointment with a hangover and walk out as pure as a monk. And while it's easy to become malnourished on dialysis, because you're getting good stuff removed from your blood along with the bad, recently I've actually gained weight. The procedure leaves you really drained, so I'll often go get dialysis and then pound down a cheeseburger afterwards to make up for it. I've always been really skinny and had to eat a little bit more than most people, but last winter for the first time in my life, I started getting a little bit fat.
You May Not Be Able To Get A Transplant (For Some Very Weird Reasons)
Getting a transplant in any country isn't easy, but it's especially difficult in countries like Japan, where people are very particular about what can and can't be done with dead bodies. The Japanese believe that a dead body should remain intact for spiritual reasons, and since most living people are pretty attached to their internal organs, donors are hard to come by.
For a long time, transplants were only legal in the case of a brain-dead donor, and then only if both the donor and his family had given consent. That was troubling, because brain-dead people generally aren't very communicative, and children can't consent at all, so basically no organ donations for sick kids. Luckily, the laws were recently relaxed for exactly those reasons.
Even so, the supply of organs remains low and the reluctance to perform transplants remains high. While 68 transplants are performed every day in the U.S., kidney transplants are only performed 10 times a year in Japan. The waiting list is 15 years long, and people often have to leave the country in order to get the life-saving transplants they need -- that is, if they can afford it. My situation is a bit less dire, but still, I'm on a waiting list in Japan to get a kidney transplant. I want to pee again.
I could travel to China for an organ transplant, which is a storied pastime among sick Japanese people, but that basically requires you to be OK with the fact that you're probably going to be taking organs from some executed prisoner. I don't want that on my conscience. So for now, it's 15 hours a week of dialysis naps, peppered with vague, wistful dreams of being able to urinate.
Seriously, treasure your ability to pee, my friends. Treasure it.
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