My mother was diagnosed with diabetes in her 40's. By her 50's, she was suffering from peripheral neuropathy and could no longer wear the heels she so loved because of the danger of falling. But her shoes still defined her style that was anything but sensible. She started to develop diabetic retinopathy that caused her to quit driving for fear of being in an accident because of her sight problems. And, around the time I was going to graduate from medical school, she was told her greatest fear. That she was going into renal failure and should start planning for dialysis.
We talked at great length about what this would mean, and she asked me what it would take to stay off of dialysis. I talked to her about medications that would help to remove the buildup of impurities and electrolytes (especially potassium) in her body. I talked about low protein diets and drinking plenty of fluids. I talked about exercise and doing whatever the doctor told her to do. She went to her kidney doctor then and told him in no uncertain terms that she did not want dialysis, and that she was willing to do whatever he told her even if it included killing puppies, making them into milkshakes and drinking them on a daily basis. (Momma and I have a warped sense of humor)
He laid out a pill regimen (about 9 different ones) and told her that they would check her blood on a regular basis. And so it went. From 2003 to 2013, she continued the plan. You couldn't get her to take a bite of anything that wasn't good for her. She's a low meat, water-drinking, no sweets seriously disciplined patient. And, her kidney function didn't worsen.
Over the last 6 months, however, the doctor told her that he's starting to see some changes in her lab work that concerns him again that she might be approaching the need for dialysis. Again, we talked about it, and she says she doesn't want it. Her kidney doctor told me to talk her into it. And, I told him I have to respect her wishes. I am sad to think I might lose her sooner without it, but proud and supportive that she wants to live life on her own terms. Like she has always done. And which inspires me on those days when I just want to throw away my salad and have a stack of pancakes, or french fries, or a Starbuck's caramel macchiato or any of the other 100 foods I love that I can't have right now.