Bob's Blog 11-3-12: In a Sense, Dialysis Causes Nonsense

Bob Here.

Dialysis treatments obviously take a physical toll on our bodies, but we don't generally talk about the funky things it does to our minds.

I mean, we know that kidney problems can also affect the heart and lungs, but there isn't much focus on another part of the body.

The brain.

I don’t know if you all agree, but sometimes during treatment, it doesn't feel like my brain is exactly firing on all cylinders. This can result in some behavior that could graciously be called unusual.

Now, when I discuss a subject like this, I like to categorize my thoughts. This symmetrical method of thinking is no doubt the result of a 30+ year career in the Finance industry, where we didn't discuss any subject that couldn't be summarized in a nicely arranged spreadsheet with clearly defined rows and columns. It got so bad that I couldn't even eat a meal without carefully arranging the plate, silverware, napkins, condiments, placemat, salt, and pepper so that the meal would flow according to a meticulously planned sequence that often made my wife want to crown me with a frying pan or have me locked away somewhere far from possible human contact.

Anyway, when I consider about how dialysis treatments affect our minds, I think in terms of three broad and eclectic categories that may sound alike but are different yet related.

How about: Senses, Scents, and Sense.

I think just about all of the whacko things that happen to us during and after our treatments can all fall into one of these groupings, and we can agree to argue later about whether my examples are correctly classified.

I'm sure I'm not the only one who feels like my senses are, shall we say, dulled during dialysis treatments. That's kind of a nice way of putting it. A lot of times, it would be more accurate to say that some of us are semi-coherent while being dialyzed. I know my regular behavior is a little oddball at times, but I know I'm not the dimwit that these treatments make me.

Since retiring, I started having my treatments first shift. So my session typically starts at five-o-nothing in the morning, which could at least partially explain my empty headedness behavior. But I'm putting the rest on dialysis.

Some of the effect on my "Sense" is apparent in some simple things. I like to do crosswords on my iPad and normally whiz through most puzzles with no trouble at all. But when I'm dialyzing, sometimes I want to beat my head against the wall when I can't come up with answers that I would normally consider to be a piece of cake. Seriously, the problem reminds me of the old adage, "He's so dumb he couldn't spell 'cat' if you spotted him the 'c' and the 'a'." I know the issue is related to the treatment because when I look at the incomplete puzzle later, I know the answer instantly. I'm like, "Duuuuh." And while I'm in this mental limbo while I'm still on the machine, I get frustrated to the point of wanting to fling my iPad across the room like a frisbee.

The assault on my 'sense' also manifests itself as forgetfulness.

A couple of weeks ago, I was fanning on people's names. These are people I've known for a couple of years. People who I interact closely with three times a week.

I had started my treatment when a technician who works in the center came over.

"Hey Bob. How you doing this morning?" he asked.

Now, again, I've known this guy for years, but when I looked at him, I drew a complete blank on his name.

I stammered, "Hey....how you doing?"

He just looked at me a little strangely and then moved on. Thing is, his name didn't come to me until they unhooked me from the machine.

That can't be a coincidence.

Later that morning, I saw the dietician walking around and remembered that I needed to ask her a question. I said to the nurse, "Would you ask Mary to come over for a minute?"

Now she was just looking at me.

"Who's Mary?" she asked.

Then I realized I couldn't come up with the dietician's name either.

I pointed in the dietician's general direction, grit my teeth and proceeded to go through about every female name that I knew of.

"Sorry I meant...Sue, Nancy, Donna, Jane, Barbara...I mean...Ah...just ask...WHATSERNAME to come over here. The dietician."

The nurse, who knew that I had worked closely with this dietician, just gave a little laugh. "Sure Bob. No problem."

On the 'scents', I don't know if I'm the only one this happens to, but things smell differently when I'm on dialysis.

I began to notice shortly after beginning treatments that I suddenly liked the smell of cleaning fluids being used in the center, up to and including the bleach they use to wipe down the machines. Only when I was on treatment. Afterward things would go back to normal.

And, hey, you don't have to drop a building on me. I picked up on the coincidence right away. Dialysis was doing a number on my sense of smell.

I was seriously wondering if my glue had completely melted, but decided to confide in the dietician to see if she could shed any light on this phenomenon.

When I told her about it, she asked if I knew about a condition called pica, which most dialysis patients know is a sensory disorder with some unusual characteristics.

I had already been clued in on pica, so I said, "Oh yeah, that's where we get the urge to eat dog food, right?"

She said, "Well, that's one way it could manifest itself, yes."

Then Evil Bob took over and I went into a fit of fake (and unusual) hiccups.

"Don't worry...<woof> 'scuse me...as far as I know...<woof> 'scuse me...I don't have any...<woof> 'scuse me...symptoms of that disease...<woof>..."

She was just looking at me, shaking her head.

"...'scuse me," I said.

She just laughed and walked away, saying, "Why do I bother talking to you?"

"It's a mystery to me too," I said.

I know my thought process is affected as well. My reference to 'sense' above is as in "Not in his right sense of mind." I admit it. That's me when I'm on dialysis.

Unfortunately, we occasionally have to interact with others while we're being treated. Not the most ideal of circumstances when our brains aren't functioning normally.

I was talking to another staff member recently, when she mentioned that her son was with her in the center that day. We had talked about her son a lot and I knew that he was born with a hearing problem and that they communicated largely through sign language. So, brilliant me, I thought it would be a nice gesture to learn something to say to him in sign language, and asked her to teach me something simple.

She agreed, apparently unaware of the reduced mental faculties of someone undergoing treatment. So she was showing me how to say a fairly simple, greeting, something along the lines of "Hello. How are you? Good to see you today."

We went through the signs, and I was sure that I had it down pat. Then she went to the back room to get her son.

She brought him over to my chair and introduced me.

Then it was my big moment. I was sure I remembered clearly how the sequence of signs was supposed to go. I went through my signs, thinking how impressed this young man was going to be that I was conversant in sign.

When I finished, the kid pursed his lips like he was keeping from laughing out loud. The he reached over and shook my free hand and walked back to the associate lounge.

I looked over at the staff member, who was looking at me with a smile.

"Huh, that wasn't the reaction that I was expecting," I told her.

She said, "That's because you told him he was shaped like a kumquat."

"Huh? How can that be? I did exactly like you showed me."

"Bob, those signs looked nothing like what I showed you."

"Well, where did I get those then??"

She said, "That's a good one. If you ever figure that out, let me know, will you?"

From then on, I learned to keep my interactions with others when I was being dialyzed very basic. If anyone asks a question with any complexity, I give them an:

"I'll get back to you on that."

So if you're a dialysis patient and it seems like your thinking is a little off while you're being treated, don't worry too much. It's a normal part of the process.

Thanks for reading. I hope all your treatments are good ones.

Take care.