By Mary Heisick, MSW

Ah, the holidays. Why do they bring on the blues? I posed this question to James Call several years ago. James was a close friend, a chronic kidney disease (CKD) patient and a renal social worker. He viewed this lack of holiday cheer as a reaction to the life changes that accompany CKD. For many, the diagnosis is catastrophic. As in any catastrophe, there are losses. I found I identified with a few of the losses he described.

The loss of one’s physical well-being due to anemia, nausea, surgeries or hospitalizations can diminish stamina. This, in turn, may create a loss of mental well-being. Feelings of depression, fear or anxiety may occur. It becomes a challenge to get through a regular day’s activities. Some may find the demands and expectations of the holidays to be exhausting.

Some patients experience a job loss, or an early, unexpected retirement. The cost of living, as well as medical, prescription and insurance fees, could create financial worries. Thinking about holiday expenses may dampen spirits and cause a reluctance to join in the traditional spirit of giving.

The loss of one’s independence becomes apparent as patients slowly become dependent on their spouse, family and/or significant other to help with daily routines. They find themselves relying on doctors and nurses, as well as machines, wheelchairs, walkers or other devices. A sense of frustration accumulates over their inability to do what once was natural.

CKD patients often sense a loss of control as they realize their body needs constant maintenance. For example, if hypertensive, one must limit sodium and check blood pressure. A diabetic patient must face dietary changes, check blood sugar regularly, and if needed, inject insulin. Patients are prescribed an assortment of medications, some with unpredictable and uncomfortable side effects that need to be addressed. If on dialysis, a patient must adhere to a treatment regimen along with food and fluid restrictions.

The result of experiencing one or more of these losses is bound to make one feel blue. Memories of past holidays and the losses now being mourned due to CKD can seem overpowering. It is important to remember these are normal feelings.

It is also important to recognize each loss and allow time to grieve each one. Permit yourself time to experience thoughts and feelings openly to yourself and your loved ones. Acknowledge and accept all feelings, both positive and negative. After the initial shock, most CKD patients do come to understand these changes can be managed and eventually they will be able to regain control.

It does take deliberate action to ease the trauma of the holiday season. Let your supporters know your feelings. Limit the amount of gatherings you attend. Inform your host of your special needs. Ask for help if you are hosting an event. Use the Internet for errands and shopping. Lean on your healthcare team. Doctors and nurses are concerned and want the best for you. Dietitians can help you make delicious “renal friendly” holiday menus. Social workers are ready to listen and offer solace and support.

One way I resolved my holiday melancholy, and life with CKD, was by joining an AAKP Chapter. It’s where I initially met James. Group members shared fears, regrets and accomplishments. They provided tips on how to live with CKD. Together we devised coping skills. Friendships developed. We began our own annual holiday tradition for children at a local dialysis unit, The Santa Delivers Project, an event guaranteed to restore holiday spirits to all who participate.

It has been several years since James died. I think of him often. If he were here today, I would hug him and offer him this holiday greeting: “Cheers, my friend”!

Mary Heisick, MSW, is a transplant recipient and a member of the AAKP Board of Directors.

This article originally appeared in the December 2007 edition of Kidney Beginnings: The Magazine.

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