I have been living with chronic diseases for most of my life

My last name is Zhang, I am 78 years old this year, you can call me Lao Zhang. I am a retired professor, or according to the old custom, you can call me Teacher Zhang. I have been "coexisting" with chronic diseases for most of my life.

1

I have suffered from high blood pressure for many years. When I was teaching at school, I was in my early 40s, in the prime of my life, and I devoted myself to work and did not take my health seriously.

One time, I was standing on the podium, writing with chalk, when I suddenly felt dizzy and my neck was tight. I endured it and finished the class, then went to the infirmary of my school to measure my blood pressure, which was 180/110 mmHg. After visiting the hospital, the doctor said it was primary hypertension, and it was severe. He told me to pay attention to a low-salt diet, take antihypertensive drugs on time every day, and measure my blood pressure regularly. After a long time, my blood pressure finally stabilized.

I have been doing this blood pressure treatment for more than 30 years. Many people have recommended to me folk remedies for lowering blood pressure, such as acupuncture, bloodletting, and medicinal pillows, but I just laughed them off. When it comes to treating illnesses, just trust the doctor and trust science.

I teach accounting, so I apply some accounting principles, such as objectivity, comparability, clarity, and timeliness, to my daily blood pressure management and medication records. Every time I go to the hospital for treatment, I hand over the compiled information to the doctor, so that all the data is clear at a glance, which not only helps the doctor understand the condition, but also saves time. The doctor says I am a "model patient."

2

Time flies, and I retired. I was born in Changsha and worked in Shaanxi all my life. I finally returned to my hometown. The first thing I did was to find a suitable hospital, Hunan Provincial People's Hospital, and see a hypertension specialist regularly; second, although I could no longer go for the physical examination organized by the company, I still insisted on arranging my own physical examination every year to understand my physical condition.

After another ten years of peace of mind, in 2015, when I turned 70, I discovered new changes in my test indicators: my urine protein rose from 1+ to 2+, and my blood creatinine reached over 100. The doctor who examined me told me that there was something wrong with my kidneys.

I started to go to the nephrology department for treatment. After the nephrology doctor learned about my condition in detail, he determined that my condition was chronic renal insufficiency caused by hypertensive nephropathy. He still emphasized that I should eat a low-salt and high-quality low-protein diet, and asked a nutritionist to help me develop a diet and adjust the blood pressure reduction plan. My blood pressure control was stricter than before, and I changed to antihypertensive drugs that can both lower blood pressure and protect the kidneys.

3

Chronic kidney disease doesn't really reflect on my body. I was pretty stable for a few years after the diagnosis. But time is not forgiving, and things started to change.

Especially at the beginning of 2021, I started to experience lower limb edema. There was a deep pit when I pressed on my ankle. Moreover, I couldn't breathe after daily activities, and I had to sit up when I woke up at night. I went to the hospital for treatment, and the doctor diagnosed it as heart failure and required hospitalization.

The first two hospitalizations were relieved by infusion. In the next few times, when the disease flared up, I sweated profusely, felt extremely stuffy, and felt like I was going to die. I've heard people talk about the "near-death feeling" before, and I think this is the experience. Every time I was sent to the emergency department for rescue. The most serious time, I had to place a catheter in my neck and use a machine to remove excess water from my body. Even so, I finally recovered, but within ten days or half a month, the previous symptoms came back and I had to be hospitalized again. I spent most of 2021 in the hospital.

4

The hospital organized a large-scale consultation and diagnosed my condition as cardiorenal syndrome, which means that kidney failure induces heart failure, and heart failure leads to worsening kidney failure. In short, my body is in a vicious cycle.

The nephrologist suggested that I establish an arteriovenous fistula and prepare for hemodialysis. This was a major decision in my life. To be honest, I couldn't accept it at first, but I believed in the doctor's judgment and didn't want to go through that life-threatening process again. After a fierce ideological struggle, I decided to have the surgery.

The operation went smoothly and was completed in about an hour. The effect was good. At the end of 2021, I started to receive hemodialysis through an arteriovenous fistula. About two weeks later, my edema subsided, my breathing became smoother, I felt much better, I could eat, my physical strength improved significantly, and I felt like I was back to the way I was before. When the weather was sunny, I could go downstairs for a walk.

5

Life is not always smooth sailing. My blood vessels are not in good condition, and it is not easy to draw blood through veins. A few months later, my dialysis lifeline, the arteriovenous fistula, had problems. According to the doctor's request, I would touch my blood vessels every day. Usually, I would feel a "flushing feeling" when I touched them, but that afternoon, I suddenly found that this feeling disappeared.

I rushed to the hospital, and the doctor diagnosed acute thrombosis. What should I do? My lifeline was cut off, was my life going to end? Looking back now, I really thought too much. The doctor performed a balloon dilatation on me in time, and within an hour, the fistula was reopened. I resumed dialysis, and my quality of life has improved.

I now insist on dialysis twice a week. After all, I am old and need to be picked up by my son. I still follow my old habits, keep good records, pay attention to diet, and try to stay in the hospital as little as possible or not at all, so as not to cause trouble to my family. If I were to talk about my experience in dealing with chronic diseases, it would be to learn to get along with doctors and make friends with them. This is an extra benefit brought to me by the disease.

Doctor's comments

I invited Ms. Zhang to share her experience of "coexisting" with chronic diseases over the past few decades because her story covers the entire course of chronic kidney disease from stage 1 to stage 5. It is estimated that the prevalence of chronic kidney disease in Chinese adults is 10.8%. Considering China's population base and aging, the prevention and treatment of chronic kidney disease is a long and arduous task. In clinical practice, I have encountered many patients whose renal function is already very poor when they come to the hospital for treatment, and they have missed the best time for treatment.

For such patients, I always remind them to remember these few sentences: First, chronic kidney disease has no symptoms in the early stages, but it can be detected early through simple urine tests and blood tests to check kidney function; second, patients with chronic kidney disease live with the disease, so we should accept it and not be pessimistic; third, dialysis is for living, not living for dialysis; being able to take care of yourself means that life still has dignity.

Narrated by: Teacher Zhang

Compiled by: Cao Wei and Wu Jing

Comment: Luo Xun, chief physician of the Department of Nephrology, Hunan Provincial People's Hospital

Planning: Tan Jiayu Yunxi

Host: Liang Jing

Editor: Yu Yunxi

Submission email: [email protected]

Source: Healthy China