As much as we pay attention to the physical health of a kidney patient, it is important to pay attention to his mental health as well. Clinical studies have shown that 30 to 40 percent of kidney failure patients, dialysis patients, and kidney transplant recipients suffer from mental health problems. I was transferred to Thanjavur Medical College in 1984. The chemicals required for dialysis there have to be brought from Chennai. I visit Chennai every week. So I took permission from higher officials that I am buying it myself. Accordingly, every week when I come to Chennai and go to Thanjavur by train, I carry 2 cans of that solution. I go to sleep with two black cans on my head. The ticket inspector on the train who had noticed this often asked me directly one day. What are you carrying in the can, sir.. I have seen it many times, he said. Then I told him that I am a urologist and this is a chemical for dialysis for kidney patients. It was like a great miracle for him to see me and talk to me. This is because he has undergone 16 surgeries for his kidney problems. He has undergone various treatments for urinary incontinence, urinary tract obstruction, and kidney stones. Finally one kidney was surgically removed due to septicemia. He told me all this and from that day he became like a friend to me. After that he started coming to me for treatment. At one point he had to undergo dialysis. Dialysis should be done three days a week. For this, the passenger train from Thanjavur to Sengot will leave at 8 pm and reach Chennai at 4 am. He gets off at Tambaram and takes an electric train from where he reaches Kilpakkam Medical College at around 6 am. He will be the first patient to start dialysis at 9 am. Dialysis ends at 1 pm. After that at 4 o'clock he will again catch Senkot passenger train to Thanjavur. He continued to receive treatment from me. Not only was he treating me, but he became like a friend to all the nurses and medical assistants working in that ward. Everyone was supportive of him coming back to work immediately after undergoing dialysis. Suddenly one day he did not show up for dialysis. I called the nurse and asked why she didn't come. The information they gave then gave me a big shock. It was reported that he had attempted suicide and was being admitted downstairs for treatment. I went there and saw him. Then the comments he made to the point of desperation left an impression and embarrassment on my mind without even knowing it. I have to show all the 18 bottles of medicine that he kept with him for kidney treatment and I have to take all these medicines, sir... Worrying about how much is more painful than what will happen. A lot of money is spent every week. I am not at peace with my family either. The future of my children and wife is seriously affected financially. I can't bear this pain and family trouble sir... he said while crying. I consoled him. That's all I can do. In those days there were no insurance facilities like now. All expenses are borne by the patient. Kidney patients suffer psychologically from enduring so much hardship. The first thing that happens to them is stress. They will not speak properly thinking this. They will not eat. Various confusions arise in the mind. At such times they need psychological counseling as well. Mainly, the patients who come for dialysis every week become friends with their fellow patients. Similarly, the nurses and medical staff working in the ward will get close to everyone. Many people can see that they are talking like one of their family members. 6 people are coming every week. One would not have come suddenly. When we inquire what is wrong with him, we get the information that he died at home. He went to sleep at night and did not wake up after that. It is said that life is separated in sleep. After hearing that, the fear of death comes to mind without others knowing themselves. Will this happen to us next? They fear that. This will create huge stress in them.
First-time dialysis patients lie in the dialysis machine for about 4 hours. Sir, when I wake up after dialysis... my breathing has slowed down considerably. Vomiting has stopped. Getting hungry. The leg swelling has also reduced significantly. They will be happy that I have been rehabilitated because of this machine. It's like bowing down to that machine. But the same patient comes back after 3 months with difficulty in breathing, swollen leg and vomiting. Then he gets a grudge. They will be disgusted, "What is this coming back?" At that time they get angry with everyone. The nurse will deliberately accuse the technicians of not doing dialysis properly. That is why they complain that it has come back. Sometimes they complain about doctors. Seeing people around them happily smiling and talking makes them jealous. Especially when they see the young nurses and doctors talking and laughing with each other during dialysis, the patients get very angry. So I often tell my co-workers to avoid laughing and talking in the room where the dialysis patients are. If their mental problems are not diagnosed and given proper counseling, they will choose suicide. Generally, if we detect stage 1 and stage 2 kidney disease, we will advise them on strict dietary restrictions. Do not add too much salt. But even that restriction can be somewhat off-putting to these types of patients. Diabetics are told not to eat sweets. It is said that if you have heart disease then avoid oil polykarams. When dialysis comes to kidney transplant, the financially concerned families will face a huge crisis. I've had many people open up about their family situations and feel overwhelmed. I have sold and spent all the jewelery I had put together for my daughter's wedding. My son wants to study medicine in America. But due to kidney problem I could not make him study. There was little space. It would be sad for us to hear that we have sold that place and spent it and are now living in a rented house. More importantly, the condition of those working in private companies is very bad. The company started assigning him to dialysis three days a week. They will start looking for other people to answer him. You can no longer work. They will directly tell you to take rest. When faced with this kind of crisis, the guilt of not being able to save the family and burdening the family begins to overwhelm them. No proper sleep. There is a kind of fear, fluttering in the mind, constant mental confusion and forgetfulness. When faced with such a crisis, they get frustrated in life and seek the solution of suicide.
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