Lithium and Dialysis

Author: Natalia Beiser

At the age of eighteen, I experienced my first full blown manic episode. I was not diagnosed with bipolar disorder at that time; it is not uncommon for bipolar patients to be misdiagnosed with schizophrenia.

In 1990, there were few treatment options, and they were dismal.  I was placed on Haldol, which caused me to have a zombie like affect, as well as weight gain and dystonia.  I lost countless friends due to my behaviors surrounding that time, as well as my puffy, pale, zombielike appearance.

I was morbidly depressed and I thought that was normal.  I spent as much time as I could asleep so that I could escape my reality.  I would not complain about my mood to anyone because I was afraid of going back to the hospital with the bars on the windows and the stainless steel bathrooms.

I would not go to the support group that they recommended for the schizophrenics because I was afraid the facilitators would see something in me that I did not and I would end up back in the psych ward.

A few years went by, and I again find myself in a psychotic way in a new city where they recognized my symptoms as bipolar disorder.  There still were not many choices in the treatment cocktail.  While being floridly psychotic, the nursing staff at the hospital tried to dispense Haldol and I still had enough mental capacity to refuse to take it.

Lithium was introduced, and I did not know anything about it, other than life was getting better while was taking it.  Navane was used to augment Lithium because I refused Haldol, but I had past positive experiences with Navane.  Little did anyone know how Lithium would affect the rest of my life.

I have tried practically every concoction on the market, but have been unable to go without Lithium.  As the mood stabilizers also known as anticonvulsants began to be used, they were helpful.  In spite of all of the efforts of my medical team, I could not remain stable on mood stabilizers or any class of antipsychotics without Lithium in the dosage schedule somewhere.

Six years ago, I was devistated to learn that I had chronic kidney disease, enough so that much care had to be taken when prescribing medications so that my kidneys would not suffer.  I took this news very hard, and knew that the Lithium played a huge part in this situation.  I was told that there was a significant chance that I would need dialysis in the future.

I have had countless doctors ask me why I still continue to take Lithium if it is doing so much damage to my body.  It’s easy.  I enjoy my sanity.  I enjoy life.  When I am not taking Lithium, I am off balance and no one enjoys being around me.

Developing renal cell carcinoma and a nephrectomy and put a glitch into the situation and sped up the inevitable.  My emotions over the circumstances have changed over time, regardless of how adamant I have been that I am not going to partake in dialysis.  I have done my homework.  I am not scared to die.  I am just not ready to do so if I do not have to.

I worry about what people will think.  I have been on disability for many years, but have continued to hold a job and be a taxpayer.  However, as a dialysis patient, I will cost the system even more money that could be used to feed the hungry or house the homeless.   I wonder if I will feel better or worse on dialysis.

I have an appointment with a vascular surgeon to have a fistula placed for dialysis in a few weeks.  I am frightened of the pain surrounding the surgery, of the physical therapy needed after the surgery, and will I still be able to cross stitch?  Will my left forearm be an ugly mess?  Will people stare at it?

The nephrologist walked into my last appointment as he always does and suggests lightly that I should quit taking Lithium.  Why now?  The damage is done.  I have nine percent kidney function.  What good would making me a psychotic mess do me now?

Losing renal function is exhausting and painful.  I am scared of dying naturally without trying dialysis because most pain medications that would be used to conquer the pain also make me psychotic.

The good news is that some people do not experience the side effects of Lithium as I have.  I have literally had every side effect of Lithium and continue taking it because it keeps me out of hospitals.

I am trying with due diligence to find the silver lining in all of this.  Hopefully my words resonate with people and I am able to help in this format.  I pray every night that I am doing something to better the life of someone else, whether I am aware of it or not.  I ask God that if I can no longer be of benefit to others in a positive way that I be taken to meet him.  That’s my silver lining.

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