By Jerome A. Bailey

Susan Braun knows first hand what a wide range of health professionals are starting to recognize and pet owners have known for years: pets can be good for our health!

The 52 year-old has been battling health problems for more than half of her young life. In 1984, doctors diagnosed Susan with multiple sclerosis (MS). MS is a chronic, potentially debilitating disease that affects your central nervous system, which is made up of your brain and spinal cord. Multiple sclerosis is widely believed to be an autoimmune disease, a condition in which your immune system attacks components of your body as if they’re foreign.

A little more than 10 years later, Susan learned she had hydronephrosis, brought on by a previous diagnosed neurogenic bladder.1 Hydronephrosis happens when the kidneys swell with urine. Normally, urine flows out of the kidney at extremely low pressure. If the flow of urine is obstructed, urine backs up in the small tubes of the kidney in its collecting area (renal pelvis), swelling the kidney and increasing the pressure on its internal structures. The elevated pressure from obstruction may ultimately damage the kidney and can result in loss of kidney function.

Although the hydronephrosis was caused by the neurogenic bladder, Susan was surprised to learned this past Spring that hydronephrosis was a form of chronic kidney disease. According to Susan, a misunderstanding between her and her physician led to her disbelief. “All I heard for the past two years is that if I don’t keep the catheter in so that my bladder empties out, I would eventually go into chronic renal failure, acute renal failure or die. The words chronic ‘kidney’ disease did not come up until March, two years after the diagnosis of hydronephrosis.”

Susan also admits she did not always follow the doctor’s orders. “There were many battles between my physician and myself over the need for the indwelling Foley catheter and it was frequently taken out by me and left out for weeks on end many times.”

Today Susan is determined to be an active participant in her healthcare. She is learning all she can about her kidney disease. 2Symptoms of hydronephrosis depend on the cause, location and duration of the obstruction. When the obstruction begins quickly (acute hydronephrosis), it usually produces renal colic—an excruciating, intermittent pain in the flank (the area between the ribs and hip) on the affected side. Partial obstruction may reduce the rate of urine flow. A total stoppage of the flow of urine most often occurs with complete blockage of the ureters from both kidneys or complete blockage of the urethra.

People who have slowly progressive (chronic) hydronephrosis may have no symptoms, or they may have attacks of dull, aching discomfort in the flank on the affected side. Sometimes a kidney shifts downward, causing temporary overfilling of the renal pelvis or temporary blockage of the ureter and producing painful hydronephrosis that occurs intermittently.

The last 23 years have been tough for Susan. She’s spent a lot of time by herself. She focused a lot of time on furthering her education. However, in 1984, she became very sick and was not able to return to work, nor continue her education. The combination of her illness and her being forced to stop her schooling has led to bouts of depression. She is getting professional help. She is also getting help from her cat, Missy. According to Susan, “Whenever I don’t want to get out bed, Missy talks to me in her own way. She’s my shadow. She is truly my life line.”

Susan also volunteers her time as a feline adoption counselor for the SPCA Tampa Bay. “I show cats to people who want to adopt a cat. And when I’m not showing them, I’m socializing them, playing with them and cuddling with them.” Susan says she has found great satisfaction in her volunteer work. “I’ve always loved animals. I find cats to be good natured and very loving.”

Susan encourages all patients to have a conversation with their healthcare team and to make sure they understand what is being said to them. Susan wants to encourage doctors to talk to their patients in “plain English.” She believes if she had understood what her physician was telling her before she was diagnosed with CKD, many of the problems she is facing now could have been avoided or delayed.

Effective communication between the healthcare provider and the patient is vital. It could mean the difference between a productive life and death.

Reference:
1. Walsh PC. Campbell’s Urology. 8th ed. St. Louis, Mo: WB Saunders; 2002. <http://www.nlm.nih.gov/medlineplus/ency/article/000506.htm>
2. The Merck Manual of Medical Information, Porter, Robert S., MD, 2004
http://www.merck.com/mmhe/sec11/ch148/ch148b.html

Jerome A. Bailey is the Editor of aakpRENALIFE and Communications Manager for AAKP.

This article originally appeared in the November 2007 issue of aakpRENALIFE.

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