Detrusitol 2mg tablet – Page 3 – Peter Tan

Where Do I Go From Here?

After the rain.
Photo by Wuan.

The damage has been done. There is absolutely no possibility of reversing the condition. Vesicoureteral reflux is one of the main causes of my chronic renal failure. Other contributing factors include several episodes of acute and chronic urinary tract infections, diet, travelling and stress. What is certain is that my kidneys will continue to fail up to a stage where I will need dialysis. That is the prognosis.

Accepting the condition, no matter how bleak the prognosis, is the only way to move on. I am one who likes to work with a lot of slack but this is not giving me much space to manoeuvre. Each time I think about it, I could feel the noose tightening around my neck. Living with so many restrictions, especially in my diet and the need to catheterise every three hours, is difficult but not unachievable. Adjustments have to be made.

Trips out have to be carefully planned. If need be, there must be food outlets nearby that are willing to cook to suit my diet or serve food that are suitable. Meals have to be taken at appropriate times to accomodate my medication. Clean accessible toilets have become even more important now. Water intake has to be regulated in order not to over or under-hydrate.

Those routines must be strictly adhered to from now on. Detrusitol must be taken one hour before food twice daily. The three doses of Ketosteril have to be spread out to optimise absorption. In between that, intermittent catheterisations have to be performed three-hourly. I am gradually getting used to this regiment. It is imperative that I abide by it to slow down the progression. This has become a do-or-die routine and I have chosen to live a little longer.

Where do I go from here? I asked myself that question a while back when I was struggling with housework and trying to maintain my diet. The weeks of soul searching after those weeks of depression has made me realise several things. The situation is neither as bad or as hopeless as it seemed. What I needed to do is to continue moving. Whether I like it or not, if I allow myself to wallow in the depths of despair, the world will continue to march on, with or without me. It is either that I keep up or be left behind. The competitive person that I was and still am, I dislike being a back marker.

This is one of those potholes in life. Sometime all is smooth. Sometimes it is a bumpy ride. I have survived twenty two years. I pray for another twenty to accomplish the things that I have set out to do. Knowing my own melancholic nature, depression will be a constant companion, more so when I can hear the seconds of my life ticking away loud and clear. There is a need to balance my emotional volatility in these areas. Keeping the occasional anxiety attacks at arm’s length will not be a simple task

However, I know for sure that Wuan will always be there to give me that little push from behind to keep me going. She is heaven-sent – an angel who is always there to brighten up my days. I have prayed for and have been bestowed with a purpose in life. I believe that when I bring hope for others, I am bringing hope for myself. There may be kinks along the way to slow me down but which of life’s major journeys do not? Despite what I have lost I can still count my blessings. There is only one way for me to go now. That way is forward, undoubtedly.

My Failing Kidneys

Outside Hospital Pantai Indah, Pandan Indah – 4.15pm.

My kidneys are failing. That is an irrefutable fact. Their condition will only worsen with time. There is no way to determine whether the deterioration will be gradual or sudden. All I can do is to continue to be aware with the dos and don’ts of chronic renal failure and hope that their decline will be arrested.

When I was back in Penang recently, I did not have time to go for my scheduled check-up due this month. Since Wuan is on leave today, we spent almost the whole day at Pandan Indah. In the morning, I got my blood tested and had an ultrasound of my abdomen. In the afternoon, we saw Dr. Lim, the Physician and Nephrologist at Hospital Pantai Indah.

My serum creatinine had risen to 271umol/L from 258umol/U when it was tested in February. Although the calibration of the testing equipment of different laboratories varies, the serum creatinine count still shows an increase. My protein intake has to be further reduced in order not to strain the kidneys further. The three portions of meat that I was allowed is further reduced to two now.

Protein is needed to build, maintain and replace the tissues in the body. Protein provides the body with essential amino acids for such purposes. My low-protein diet, if not properly managed will result in protein depletion. This will cause a host of health problems from anaemia to osteoporosis. Symptoms for both are manifested in my blood tests and rippled finger nails called koilonychia.

Ketosteril was prescribed to supplement my low-protein diet with essential amino acids and Sangobion for my anaemia. Those are expensive drugs. One month’s supply of Ketosteril and Sangobion costs nearly RM600. That is not inclusive of Detrusitol that I am taking to relax my spasmodic bladder which is the cause of my renal failure in the first place. One month’s supply of Detrusitol costs RM170.

To cut down on the expenses for Ketosteril, Dr. Lim has suggested a “drug holiday” where I go without Ketosteril for Saturdays and Sundays. To maintain my protein intake, I have to increase it from 29gms of protein on weekdays to 36gms of protein on weekends. 36gms of protein will allow me three portions of matchbox-sized meat.

This progression is not something that I did not expect. Because of my spinal cord injury, I knew full well that renal failure will be one of the problems that I will have to come face to face with. Nevertheless, the thought that my kidneys may totally fail one day in the future is extremely unsettling. When that day comes, dialysis will be the only solution. That will be an expensive therapy and one that will restrict many aspects of my life. I pray that that day will never come.

Wisdom of the Domesticated Wild

Pets are more than mere companions. Over the years, Mum had kept dogs and cats. They were great teachers especially on instinctive survival at its most basic. They never ever whimpered or howled incessantly when ill. They would seek out their favourite spots and recuperate quietly there.

They seldom needed to see the veterinarian. One that did died. She was hale and hearty when we sent her in to have her ingrown nail problem treated. The vet gave her an injection and she went to dog heaven afterwards. He gave some lame excuses about her having a weak heart and all. Truthfully, it was more like she died of an allergic reaction to the antibiotics.

Pets are great teachers because they still listen to their own bodies. By observing them, I learnt a lot. Their domestication had not taken away those primal natures that are essential to their continued existence. They eat when hungry, sleep when tired and do everything else in between. I thought how wonderful it would be if I could listen to my own body just like them.

Emulate them I did the past week. I have been seeking my favourite spot to recuperate – my bed. I have been taking long naps in the afternoon. Those extended siestas were refreshing. I woke up with a slightly less dull mind and more vigour to carry me through to dinner for my next energy boost. The only drawback is that I have very little time for anything else.

In time, I hope my body will adapt better to Detrusitol and the diet. The side effects have become less apparent. I am slowly getting used to taking less meat and more meals. I am performing my intermittent catheterisation diligently and according to schedule. I have done my part. That is all I can do. The rest, I leave to God’s Providence.