Update on Minga: A Range of Emotions

Minga has been the soul of cooperation and gracious accommodation to her difficult new dialysis routine — until last night, when she suddenly blew up. That’s rare for her. Some of my readers have met her and can attest to the fact that she is normally quiet, reserved and unassuming, but warmly welcoming with twinkling eyes and open arms.

Some of my readers — Katie, Eileen, and Emily, who have professional expertise from the perspectives of nursing, social work, and psychotherapy — have far more experience with this than I do, and I’d welcome any or all of you weighing in with a comment. But here’s what makes sense to me: I can well imagine Minga having a rush of good feeling after she feared she would die, and then didn’t. I imagine, after her initial three dialysis treatments in the hospital, that she felt better than she’s felt for a long time, maybe years. She heard stories of people whose kidneys had spontaneously started to work again, and she felt that such a miracle might be granted to her. Even without a miracle, she thought that going  home and getting treatment near the village was a realistic option.

There has to be a huge emotional thud as she realizes after five weeks that her life  as a dialysis patient is what it is, and that nothing much is going to change or get better than it is right now. As friend and psychotherapist Emily pointed out to me in an email, at the very least Minga’s sleep patterns are totally disrupted and she must be exhausted. That exhaustion taints everything.

I have plane reservations to go to Panama in mid-November, to be with Minga. While I’m pretty much flailing in the dark about treatment for kidney failure and about the public health system in Panama, I’m getting support and information from friend and regular reader Dawn, who has a family member undergoing dialysis, and from my brother in law Paul, who is an ER doc.

There is no easy path here, and I’m not a big believer in miracles. I hope to provide comfort for my dear friend, and perhaps some practical advice and encouragement for her family. Sometimes the best we can do is patch together things that make life a little better. I’m not hoping for much more than that.

Visiting Minga is not, of course, only about what I might be able to do for her. On point also is how this visit is important for me. More on that tomorrow.

2 thoughts on “Update on Minga: A Range of Emotions

  1. Now that Minga is a few weeks into dialysis she is likely disappointed that her kidney function hasn’t returned. While dialysis has saved her life it has also profoundly changed it. It is unlikely that her kidneys will improve. In fact, the patients that I’ve seen regain kidney function have had acute, sudden kidney failure due to an assault from an agent, such as CAT scan due or strong antibiotics. In those cases, once the agent is stopped the kidneys rest and often recover. This is not minga’s case. She had chronic renal failure.

    Minga has a chronic illness that requires 3x a week treatment and dependence on a machine at an inconvenient hour away from her home. The realization of chronic illness can cause anger, disappointment and even rebellion. I’ve even seen people with insulin dependent diabetes, who depend on insulin to live, stop insultin because of anger. This is life threatening.

    Minga has a chronic illness. Her life as it was has changed. But it can be OK. While Minga’s hope of kidney function return is likely not realistic, she needs hope. Perhaps hope of getting an earlier appointment. One day she may get a slot in the program near her home. She now has a job: going to dialysis. Although she has to be in Panama City, she is blessed with loving family in Borge Panama City and Rio Hato.

    How family and you can help are giving her future things to look forward to. Hope looks to the future. Your going in November gives her something to look forward to. When you leave I still the hope of your return in January. Family can create hope by sharing the joy of even simple celebrations to look forward to. She will always need “#the next thing “ to look forward to. Family should be empathetic but avoid “Que pastime” pity. Reinforce that slwhile her life has changed, it can be ok and it can still be happy and joyful!

  2. for Katie: Thanks for this thoughtful and insightful answer. I think those of us who love Minga are all struggling to find the right path forward. Focusing on giving her hope for short term enjoyable things is certainly do-able. I look forward to being able to sit with her for a quiet conversation to see what she feels is most difficult, so we can perhaps focus hopeful moments around that.I agree that adding to the sense of “isn’t this terrible” doesn’t help. Thanks for sharing your expertise here — you’ve certainly seen more of people struggling with life-altering medical conditions than most of us have.

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