Seize the Day: Coping With Dialysis

By Loretta Bosch, MSW, ACSW, LCSW

Coping with Dialysis

As a social worker in a renal care unit, I witness people on dialysis living happy and productive lives despite difficult challenges. These people understand the meaning of Carpe Diem (Seize The Day).

Confronting a Crisis
There comes a time in everyone’s life when we are forced to reflect on the meaning of our existence. At times, we feel victimized by the circumstances that present themselves on this journey through life. Somewhere in the drama of living we are faced with a crisis that turns our lives upside down. We seek answers to such troubling questions as: What went wrong? How could this happen? Why me?

One such crisis is a diagnosis of kidney failure and the realization that ongoing dialysis treatments will be necessary. We struggle and rage that life is unfair, that this setback was not part of our life plan. The foundation of our life has been shaken. What was stable, secure, and predictable is gone. Nothing feels right anymore.

“Change Can Be Exciting”
But remember that life is full of change. Change is essential. Unfortunately, many people have the mistaken belief that they can control everything around them, but that is an illusion. Attempting to control other people, circumstances, and things will leave us feeling exhausted and isolated. It is to our detriment to hang on to the old when the new is knocking on the door.

Change can be exciting. Embrace the spirit within yourself and open yourself to embracing the spirit in others. Get on with your life. Spark that inner light. It does not depend on outer circumstances. Take an inventory of current habits and start to make choices that will positively affect the outcome of any situation in your life.

From Bitterness to Healing
Rather than taking steps towards healing, some people cling to what they perceive as hurt and bitterness. They hang on to what was and stay stuck in a familiar time and place. In doing so, they block the potential for new life opportunities. Rather than becoming better, they become bitter.

The problem with this approach is that bitterness kills the spirit. It creates barriers and keeps people at a distance. The most important gift we can give to ourselves and to the world is to keep growing through difficult times. Healing from any loss takes time. Healing isn’t about pain: it’s about learning to love. The natural byproducts of healing are glimmers of hope, pride, and satisfaction.

Facing a Health Crisis
It is common for negative thoughts and feelings to surface when a person has a setback. A health crisis forces us to examine life. These setbacks can cause us to lose touch with the good things about ourselves. A medical crisis can trigger fear leading to self-doubt and uncertainty.

To overcome these setbacks we must put our hearts into that which we desire. Look at life from a different angle. There is a purpose and a plan for your life that takes into account your needs, wants, desires, talents and abilities.

Every human being has problems. It is important to look beyond the problems to the solutions. The first step is to deal with one issue at a time. Do you have a passion for something? Gardening? Stamp collecting? Art? Painting? Writing? Biking? Compose a list of activities that gave you pleasure prior to starting dialysis. Read articles about people who receive dialysis treatments yet continue to engage in life with gusto. Join a support group. Visit someone who is just starting dialysis and offer your experience, strength, and hope.

Tools For Feeling Better
Now that you are on dialysis, it is imperative to forge a more gentle, loving relationship with yourself. There are specific tools you can use to help you feel better about yourself:

  • Change internalized negative messages.
  • Each time you feel bad about yourself or think a negative thought, try to isolate the thought or event that set off the feeling.

Ask yourself:

  • When did I start feeling this way?
  • Did I have a disturbing conversation with someone?
  • Did I get a disturbing phone call or letter?
  • Did something scare me or make me angry?
  • When did I stop feeling good about myself?

Silencing the Negative
Whenever you start feeling bad about yourself, identify and silence your inner negative voice. Pay attention and discover the roots of your negative thoughts. In doing so, you will dramatically interrupt your tendency to feel bad about yourself.

Here are some other things you can do to silence your negative voice:

  •  Make a list of all the things you would like to do.
  • Ask your friends what they like about you.
  • Listen and take notes.
  • Ask your friends to accentuate your positive qualities.
  • Save those notes and review the list on days when you are feeling bad.

When you will feel out of sync and off balance, it is important to get active. Take on a manageable task. This helps you get planted in the present. When you feel miserable, reach out to someone else who is hurting.

Nourish the Positive
An important part of creating a healthy self-image is being with people who mirror you in a positive way, people who believe in your strengths, your goodness, and in your ability to manage your own life. It is of great importance that you remain in contact with people who respect you, who value you, and who take you seriously. Nourish relationships with people who respect and understand you.

You create what you believe to be true. You attract what you fear. Embrace the spirit both within yourself and others. Train yourself to hear and incorporate into your being the positive things that people say to and about you.

Dealing With Stress
In today’s hectic world, stress is a fact of life. There are many situations that push your stress buttons. Like change, stress can be either positive or negative. Unfortunately, when stress is constant, your health and wellness suffer.

Stress may be the anxiety that you feel when faced with a new and challenging situation. There are many things in life you cannot control, but there are few that you can learn to manage.

“Laughter is a Tool”
Laughter is a tool. It soothes the soul and is contagious.

Here are some things you can do to find the lighter (humorous) side of life.

  •  Read cartoons and jokes. Post them where you can review them every day.
  • Be positive. Find someone doing something right and praise that person.
  • Find positive opportunities in negative situations.
  • Share your troubles with close friends or loved ones. Tears and laughter heal the soul.
  • Seek humor for balance and perspective.
  • Laugh at yourself.
  • Schedule the time to play or it won’t happen.
  • Smile! A wide grin warms the environment and is beneficial to the ecology.

Finally, remember that renal social workers are there to support you both before and after you start dialysis. They are highly educated and trained to help patients and their families by providing support in a number of important areas, including emotional, financial, occupational, and lifestyle adjustment.

Perhaps the social worker’s main duty is to help patients and their families cope with the diagnosis of kidney failure. They can advise you on adjusting to the necessary changes that come with dialysis or a kidney transplant. They can help you:

  • Discuss your emotional needs;
  • Enhance your coping skills;
  • Learn about kidney disease and transplantation;
  • Strengthen your family and other support systems;
  • Adjust to treatment plans and diet changes;
  • Locate community resources for transportation, home health services, nutrition, and insurance;
  • Get and maintain employment;
  • Set future goals; and
  • Arrange for dialysis when you travel.

Remember that your social worker is an advocate for you and is there to help you. Feel free to discuss with him/her any issues you may have regarding dialysis or receiving a transplant.

Coping with DialysisAbout the Author
Loretta Bosch, MSW, ACSW, LCSW, is a Social Worker with the Palm Bay Kidney Center, Palm Bay, FL, and the Harbor City Kidney Center, Melbourne, FL. She is also a member of the Academy of Certified Social Workers (ACSW). She has worked in the social work field since 1978. Bosch was also an assistant faculty member at Eastern Virginia Medical School’s Department of Behavioral Sciences.

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