"So, you're Karen?"

Those were the first words I heard from this smiling, gentle-voiced man who came and sat at the end of my hospital bed. I could tell he was surprised by ...what? My age? I was 28 at the time - young compared to most of his patients I was to find out - with long auburn hair down to my elbows. Or maybe the fact i was sitting upright, cross-legged in the middle of my bed, holding a stuffed toy pig? I could see him looking curiously at me through soft brown eyes and wondered if he was a social worker or diabetic counselor; someone in that realm of expertise i was sure of it. Early forties, plaid shirt and khakis with brown loafers, combined with the most astonishing aspect of his manner: he was in absolutely no hurry. After confirming that I was indeed Karen - or K as I was going by then - it was my turn to be surprised by his introducing himself as my nephrologist. I did not want to admit to him I was not sure what kind of specialist a nephrologist was much less why I needed one. "Kidney doctor." Put simply by him but I knew then that this was an intuitive man who could read people instantly and diplomatically and could tell I did not want to admit my ignorance. I liked him instantly and knew that from that moment on I would do whatever he said i needed to feel better.

I must admit that at the time I did not absorb it all. I knew that I was going to have to go on blood pressure medication but kidney problems? I had never discussed that with any doctor in my many years as a Type I, juvenile onset, and insulin dependent diabetic. Maybe they all just thought I had enough to deal with just being a diabetic. Maybe none of them thought I would live long enough for it to be an issue. I choose to believe that the reasoning was, I was not displaying any overt signs of kidney disease so why bring it up? It could have been many things including me not going to the doctor as regularly as I should have in recent adult years. I suspect this whole stint in the hospital was a culmination of all the influences finally taking their toll.

As Dr. Steve sat there quietly explaining to me how my life would be irrevocably changed, I had already begun to try to blame someone or something. The first target, as I mentioned, was me, and my not being a good steward of my own health care. Then came all the stress factors - so many and all so close together in their progressions. Moving out of state from my home of Texas to Reno, Nevada was a monumental one. I left close family ties and friends and an established business to move with my spouse. I cannot say he was much of a husband; I take that term very seriously now. He did not bring out the best in me, that was for sure. I was trying to work at a new job, deal with in-and-out of the house step children with all manner of psychological problems, a Mother, sister and nephew who missed me terribly, an alcoholic, gambling, abusive husband and my swollen feet hurt. Who needed serious health problems to deal with in addition to all that?

I felt pretty sorry for myself in between trying to place blame and practice denial. What I did glean from Dr. Steve's speech was that I would need dialysis eventually. Okay, then what? I still did not get the picture. So ignorant of all that terminology it didn't sink in that I would be forced to sit in a chair four hours at a time, three times a week, connected to a machine that cleansed my blood, however successfully, by I.V., just to start. He did not go into all of the details at the time; the most important issue at this time was my skyrocketing blood pressure. Would I still be able to work? Yes, with medication. However, I found out that I would only work a few more weeks. Because of the fatigue, breathlessness and the onset of vision loss, I had to give my notice at work. I felt trapped in a city where I knew virtually no one; I had only been there a few months. No job and from what I could envision, no way to get out of the discouraging situation I was in. Dialysis loomed in the future.

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