How anger can complicate dialysis treatments

It happened again at dialysis-- I watched a patient across the aisle from me be disconnected from her machine and sent to the hospital to have her dialysis catheter de-clotted. This woman had just spent the morning having the catheter cleaned out, and now it needed to be done again, just five hours later. She was justifiably upset-- but her anger may have contributed to the clot formation that was disrupting her dialysis treatments.

This woman is a very angry person-- angry at being kept waiting, angry at being on dialysis, angry that nurses won't drop everything and put her on the machine before other patients. What's amazing is that this is not a new patient-- she's been on dialysis for several years. Usually patients have an 'attitude adjustment' within the first six months of starting dialysis, as they accept the fact that there are other patients in the unit, and a "me me me" attitude won't get you very far. Somehow, this woman never passed through that stage.

A certain amount of anger is natural-- dialysis is an invasive procedure, and not something a human being normally has to undergo. Anger can be a motivating force, allowing a patient to continue to fight for life despite numerous medical problems. But anger can also be destructive-- it can increase the amount of angiotensin in the blood, which can promote clot formation. I've seen this at work personally, both in myself and in other patients. I was an extremely angry person for the first few years of dialysis, and I had numerous clots that had to be aspirated-- sucked out with a needle-- that caused incredible pain and pushed me to the point of almost quitting dialysis. I've seen other patients clot their grafts and be sent to the hospital, only to have the graft clot up again within weeks or months. No amount of anti-clotting medication seems to work for these people.

Eventually, after doing some reading on the subject, I realized that my 'poor little me' attitude might be the cause of my clots. It wasn't easy, but I slowly shifted my focus off of myself and onto the other patients, talking to them and trying to help them. Within a few months, my clotting problem disappeared, and my attitude became much more positive. Even the nurses and social worker at my unit noticed the change; I've been recruited to become a Peer Mentor, someone who is undergoing dialysis and talks to other patients who are having a hard time adjusting to dialysis. This is proof that a bad attitude CAN be changed, and can improve your health... and if I could do it, I'm pretty sure anyone could! I was deeply entrenched in it, but I slowly dug my way out. It's like any other bad habit-- thousands of reasons why you feel justified in continuing it while you ignore what it's doing to you.

The toughest part of dialysis is the sheer amount of time spent waiting: Waiting to be called into the unit, waiting to be hooked up, waiting the 4 hours for the treatment to be over, waiting to be taped up, waiting for your ride home. The process can take six hours, which is enough to irritate even the calmest person... especially when you perceive that someone else is being given preferential treatment! But there is always a good reason for someone else going ahead of you-- I've learned this from watching the nurses and listening to their conversations. Other patients often have longer treatment times and must be hooked up before 'regular' patients-- and it does no good to get mad about it. As one of those patients walks into the unit ahead of me, I just think about how lucky I am that I'm 'only' there for 4 hours.

I've been able to transfer this attitude to other areas of my life, such as waiting in lines in stores. It amazes me that people can lose their cool in a grocery store line-- how long will you stand there, maybe ten minutes, tops? I'm used to waiting for 4 hours at dialysis, so a 10-minute wait barely registers on my Annoyance Scale.

It's a paradox that dialysis preserves life while using up much of that life in the dialysis unit. Our time is precious, and many dialysis patients resent having to waste so much of it waiting for this, that, and the other thing. But getting angry about things not under our control doesn't help us, and will only create more problems. We might not be able to control the situation, but we CAN control our response to it.