Sure-shot dissimilarities were noticed between the last leg of these mega-events where all eyes on Google-earth were glued on fireworks demonstrated by the Big-Boys before ACCEPTING to seal their fate in 2016 vs. in 2020 when voters in the United States (US) got wooed by their 46th Presidential candidate. This article comes in the catalogue of some unpredictable moments with a touch of nostalgia as my fate was also sealed in 2016 when I anticipated to be in the best health-equity but God was using an inevitable ink-color to re-write my story.
I still remember that evening when this foursome-effect changed it all for me being diagnosed with a rare medical condition, Isaac Syndrome (a diverse disorder as a result of muscular hyperactivity), Membranous Glomerulonephritis (a slowly progressive disease of the kidney), Lymes (a bacterial infection that can be spread to humans by infected ticks) and Glaucoma (an eye conditions that damage the optic nerve often caused by high pressure) and the journey still continues……Easy said than done but only Accepting this hurricane blowing off, my cards-of-health was the only option.
As I grew up living alone post graduation, I realized that self-responsibility teaches some of the greatest life-lessons, realizing early not to hypnotize life as it takes seconds for the glory of the past to consign into flames of the present. After all the evil-symbolizing tantrums of life, it left me with little but no choice to accommodate and make room for the ”ACCEPTANCE PRESCRIPTION”.
Initially it was like a grenade launched from a power-packed missile but slowly as time graduated, the ‘A’cceptance of God fishing for something new got evident as differences between the performing spirits of the past vs. demonic losses of the present bought me face-to-face with my reality and the courage to re-work on life.
Since 2016, a 180 degree shift initiated my unworried world slip into virgin territories when the illegal immigration of health-damage set it’s foot by unleashing the changed format being the new law of life. In a jiffy my health cover seemed insufficient, travelling for leisure appeared farfetched, daily jogs & cycling diverged to weekly walks, consuming carton of medicines was a daily practice, compulsive attendance with doctors than friends was the new normal etc.. At a point in life I was scratching the surface, not peeping inside with the fear of being declared defeated but ‘A’cceptance is all about finding our own Ikigai (Japanese term, the relevance of which exaggerates to its closeness with ‘A’ccepting life situations, focusing on overall up-liftment & wellbeing to contentment).
All of us have our unique stories:-
Recently I took the liberty of watching ”The Pursuit of Happiness” a journey of a life-hero being homeless & then a millionaire, ‘A’ccepting failures & living through his personal catastrophe to succeed. The movie has the right ingredients in the light of performance where it took only one conversation to seal Mr. Gardner’s future forever.
This was one of the epics that inspired my ways to challenge limits & re-discover perceptions whenever the symptom-mystery deepens enacting as a scorpion sting engulfing the relations between my bones & muscles experiencing torn pieces between frequent medicinal changes & technical comfort graph.
1) For me Acceptance is not merely Parroting the ‘A’ word instead submit to addressing my zeal to recovery where the word zeal denotes happily agreeing to offers made by life
2) I can feel the difference in attitude since I was touched by the art of ‘A’ as its taught me to handle uncertainties, better
3) ‘A’ is one of the key therapies that acted like a vastu-tip sublimating my brain-waves towards the truth of the moment becoming another synonym for inner peace
4) This art tested my tolerance to sail through ‘n’ number of undesired encounters
5) ‘A’ is very helpful in providing a safety net defeating the intensifying peer group competition
6) ‘A’ inched me from a black-board to a smart-board with a baseline making necessary timely amendments in my daily routine creating a fight-back aura
7) ‘A’ is living in the moment instead of planning the future, a step forward surrendering to the omnipotent.
CRUX :- The emotional quotient needs to be well-balanced while sailing through any crisis, if handled with ‘A’cceptance becomes a positive emotion. During my journey I realized that this art cannot percolate within us until there is a strong reflection of spirituality accompanied with significant essence of faith.
As only a Golden vessel is equipped to hold Lion’s milk until the pH is altered similarly God chooses his special vessels to handle certain humanitarian crisis and therefore I end by urging my peer-group to create an aura around the art of ‘A’ceeptance as even these hard times of Covid recites the same mantra to the world.
Though I admit my target & target-points shifted places but the need of the hour is to mute the background music & surrender to these new algorithms, expecting that someday these lost-dark-years would surface back in the form of wisdom. Currently the only thing that echoes my mind is to ACCCEPT the fact that I haven’t come this far for a casual walk.
I wish to hear from my readers, if I have collided with fatigue by merely Accepting my today ??
End-Stage Renal Disease (ESRD) – Diagnoses, Progression, Tre
End-Stage Renal Disease (ESRD) – Diagnoses, Progression and Treatment (Title)
Brief Epidemiology of End- Stage Renal Disease (ESRD)
End-stage renal disease (ESRD) is the final stage of kidney failure that affects at least 230,000 individuals in the United States (Blake, Toker, Dickerman & Dunn, 2002). Some of the primary causes of ESRD include #Diabetes (34.47%), hypertension (25.1%), #Glomerulonephritis (16.4%), Cystic Kidney (4.69%) and 16.39% are due to unknown or miscellaneous causes (National Kidney Foundation, 2016). With older age additional age-related comorbid diseases also come into play (Brown and Johansson, 2011).
Disease progression and treatment
ESRD is the final stage of kidney failure. There are two types of ESRD treatment: dialysis and kidney #Transplant. Dialysis treatments consist of the removal of toxins and extra fluid from the body (Billington, Simpson, Unwin, Bray, & Giles, 2008). The NKF (2016) reports that more than 193,000 patients currently living in the United States have had a kidney transplant. Although a kidney transplant is the most desired type of Replacement Real Therapy (RRT), kidney donors are generally limited with the organs typically “reserved” for the healthies of ESRD individuals (Billington et al., 2008). To add to that, there is also a very high rate of failure averaging 61% (Billington et al., 2008).
Since obtaining a kidney is not a viable options for all patients, a hemodialysis treatment have been one of the most commonly used approaches for individuals diagnosed with ESRD to maintain their conditions over time (Billington et al., 2008). The National Institute of Diabetes and Digestive and #KidneyDisease (2016) reports that from the 398,861 patients who suffer from ESRD, the vast majority undergo hemodialysis (HD) treatments at a clinic as compared to those who employ peritoneal dialysis (PD) and home HD treatments combined. Brown and Johansson (2011) bring attention to the fact that even though the default treatment approach to chronic kidney disease is an in-center hemodialysis treatment, research has found that peritoneal dialysis has shown better results especially with the elderly population. Patients who are under peritoneal dialysis are able to travel, they are able to have their treatments at their convenience in their own home, and they skip the trips to the hemodialysis clinics and generally enjoy an active social life (Brown & Johansson, 2011).
Patel, Peterson and Kimmel (2005) described the limitations that patients undergoing hemodialysis treatments experience. For instance, patients are unable to work and travel, and they also have limited interactions with family and friends (Patel, Peterson &Kimmel, 2005). Additionally, the same authors also point to correlations between social support, #Depression and mortality rates, and the patient’s compliance with their medical treatment (Patel, Peterson & Kimmel, 2005). Wells and Anderson (2011) argue that ESRD clients whose results rate high on social support and self-efficacy have the potential to improve their health outcomes and are better able to cope with the stressors caused by ESRD. When it comes to ESRD, compliance with treatment is indeed crucial (Wells & Walker, 2012). Research shows that older adults tend to be more adherent to treatments especially regarding intradialytic weigh gain (IDWG) and potassium levels (Wells & Walker, 2012).
Knowledge of human behavior and the social environment
When clients are diagnosed with ESRD there are typically in shock and denial. Being diagnosed with a ESRD is a traumatic experience, there’s no question about it. Individuals are already in frail conditions, and admit that thoughts about possible death plagued them for a while. Feelings of hopelessness and helplessness for a long period of time after the initial discovery are also common. It is not surprising to hear that during that stage, patients feel drained from the constant worry about their future, children and loss of job income.
As typically occurs with patients who have been diagnosed with a debilitating condition, once the shock and denial phase passes, clients are able to adjust their life to a point where they are able to accept their situation. From not wanting to discuss their hemodialysis treatments with friends or family, a topic already addressed by Nicholas, Picone and Selkirk’s study (2011), patients do overcome their feelings of fear and hopelessness. Some of them even become advocates, able to encourage and motivate patients who are newly diagnosed with ESRD.
It is not uncommon for patients to give up their businesses or leave work as the disease makes it impossible for them to perform daily tasks. The three hemodialysis’ treatments per week are very exhausting, with clients feeling extremely sick and unable to cope not only with the treatment itself, but also with the dietary and fluid restrictions. And in fact, ESRD is a brutal disease leaving patients wondering if they would be better off without treatment. Hackett and Watnick (2007) report that the third leading cause for mortality in the dialysis population has been found to be the withdrawal from medical treatment. This holds true for some patients who report that at times they did not believe they could make it and has had to “lean on” their families for courage and support.
Theoretical framework for those individuals diagnosed with ESRD
The self-regulation theory is based on the famous Leventhal’s Common Sense Model (CSM). According to Jansen, Heijmans, Rijken and Kaptein (2011) when people are faced with a health related threat, they make cognitive representations relating to that threat. These cognitive schemas include several categories such as the name and related symptoms of the illness; what causes the disease and how long it would last, and what the personal consequences would be for both the individual and his or her mate (Jansen et al., 2011). The cognitive schemas created by patients influence how they will be able to cope with the illness not only psychologically but also emotionally.
According to the Self-Determination theory (SDT), individuals function at their prime level when autonomy drives them to fulfil desired goals and it also brings psychological health (Jansen et al., 2011). When an individual’s sense of autonomy is being deprived, feelings of loss and low-self-esteem come in to play and their self-worth being questioned (Jansen et al., 2011). Autonomy is an important factor when dealing with patients on dialysis. Research has found that patients on dialysis feel limited autonomy due to the fact that they do not have the freedom to engage in activities they would like to do because of their condition (Jansen et al., 2011). Indeed, hemodialysis treatments are not only time consuming (4 hours treatments, three times per week) but also lead to patients feeling drained and washed out with little energy to stay active.
Social support is critical, when patients feel supported by family and friends they generally are more adherent to their dialysis treatment, which in turn may stimulate their sense of autonomy and self-worth (Jansen et al., 2011). Having a healthy support system is indeed important. Low, Smith, Burns, and Jones, (2008) draw the parallel that even though it is known that caretakers who are in a healthy state of mind positively affect patients suffering from ESRD, little to no research has been done to address this relationship.
The final theory that helps us to better understand patients suffering from ESRD is the Social Learning theory by Bandura. This theory is based on the foundational strategies of self-efficacy and expectation of outcomes (Jansen et al., 2011). Patients have the potential to change negative thought patterns and maladaptive behaviors by using modeling, self-monitoring skills and problem-solving techniques (Jansen et al., 2011). This is especially crucial for ESRD patients in areas such as finding a job and feeling productive.
For this and more information regarding dealing with ESRD, please stay tuned. Part 2 will be posted next week.
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Atkinson, M. A., Neu, A. M., Fivush, B. A., & Frankenfield, D. L. (2008). Disparate outcomes in pediatric peritoneal dialysis patients by gender/race in the End-Stage Renal Disease Clinical Performance Measures project. Pediatric Nephrology, 23(8), 1331-1338. doi:10.1007/s00467-008-0832-z
Billington, E., Simpson, J., Unwin, J., Bray, D., & Giles, D. (2008). Does hope predict adjustment to end-stage renal failure and consequent dialysis?. British Journal Of Health Psychology, 13(4), 683-699. doi:10.1348/135910707X248959
Blake, A., Toker, S., Dickerman, R., & Dunn, E. (2002). Trauma management in the end-stage renal disease patient. The American Surgeon, 68(5), 425.
Brown, E. A., & Johansson, L. (2011). Epidemiology and management of end-stage renal disease in the elderly. Nature Reviews Nephrology, (10), 591.
Chilcot, J., Wellsted, D., & Farrington, K. (2010). Depression in End-Stage Renal Disease: Current Advances and Research. Seminars In Dialysis, (1), 74.
Crews, D. C., Charles, R. F., Evans, M. K., Zonderman, A. B., & Powe, N. R. (2010). Original Investigation: Poverty, Race, and CKD in a Racially and Socioeconomically Diverse Urban Population. American Journal Of Kidney Diseases, 55992-1000. doi:10.1053/j.ajkd.2009.12.032
Cukor, D. P. (2007). Use of CBT to Treat Depression Among Patients on Hemodialysis. Psychiatric Services, (5), 711. doi:10.1176/ps.2007.58.5.711
Duarte, P. S., Miyazaki, M. C., Blay, S. L., & Sesso, R. (2009). Cognitive–behavioral group therapy is an effective treatment for major depression in hemodialysis patients. Kidney International, 76(4), 414-421. doi:10.1038/ki.2009.156
Hackett, A. S., & Watnick, S. G. (2007). Withdrawal from Dialysis in End-Stage Renal Disease: Medical, Social, and Psychological Issues. Seminars In Dialysis, 20(1), 86-90. doi:10.1111/j.1525-139X.2007.00249.x
Hughes, J., Wood, E., & Smith, G. (2009). Exploring kidney patients’ experiences of receiving individual peer support. Health Expectations: An International Journal Of Public Participation In Health Care & Health Policy, 12(4), 396-406. doi:10.1111/j.1369-7625.2009.00568.x
Jansen, D. L., Heijmans, M., Rijken, M., & Kaptein, A. A. (2011). The development of and first experiences with a behavioural self-regulation intervention for end-stage renal disease patients and their partners. Journal Of Health Psychology, 16(2), 274-283. doi:10.1177/1359105310372976
Kovacs, P. p., Perkins, N., Nuschke, E., & Carroll, N. (2012). How End-Stage Renal Disease Patients Manage the Medicare Part D Coverage Gap. Health & Social Work, 37(4), 225-233
Low, J., Smith, G., Burns, A., & Jones, L. (2008). The impact of end-stage kidney disease (ESKD) on close persons: a literature review. NDT Plus, 1(2), 67-79. doi:10.1093/ndt-plus/sfm046
Nicholas, D. B., Picone, G., & Selkirk, E. K. (2011). The lived experiences of children and adolescents with end-stage renal disease. Qualitative Health Research, 21(2), 162-173. doi:10.1177/1049732310382789
Nicholas, S. B., Kalantar-Zadeh, K., & Norris, K. C. (2015). Article: Socioeconomic Disparities in Chronic Kidney Disease. Advances In Chronic Kidney Disease, 22(Socioeconomics, Disparities, and the Kidney), 6-15. doi:10.1053/j.ackd.2014.07.002
Patel, S. S., Peterson, R. A., & Kimmel, P. L. (2005). The Impact of Social Support on End-Stage Renal Disease. Seminars In Dialysis, 18(2), 98-102. doi:10.1111/j.1525-139X.2005.18203.x
Wells, J. R., & Anderson, S. T. (2011). Self-Efficacy and Social Support in African Americans diagnosed with End Stage Renal Disease. ABNF Journal, 22(1), 9-12 4p.
Wells, J. R., & Walker, C. A. (2012). Factors Influencing Adherence in African Americans with End Stage Renal Disease. Journal Of Theory Construction & Testing, 16(2), 52-56.
Williams, A. W. (2015). Article: Health Policy, Disparities, and the Kidney. Advances In Chronic , 22(Socioeconomics, Disparities, and the Kidney), 54-59. doi:10.1053/j.ackd.2014.06.002