I Must Be Dreaming; Pinch My Kidneys

Uncle AndrewUncle Andrew
Filed under: @ 11:32 am

I go in for a renal biopsy tomorrow. Will the fun never fucking cease?

During my last routine physical my doctor found an unusual amount of protein in my urine. We ran some other tests and determined that I am shedding many, many times the normal amount of protein an otherwise normal human male should be. Basically, with what I’ve been passing, the toilet should have been full of Ball Park Franks (although I rather suspect I would have noticed if that had been happening; the phrase “HEEEEEEYAAAAAAAAAUUUUUGHHHH” comes to mind).

Now normally, when a diabetic is peeing away a bunch of protein the diagnosis is a cinch: diabetic nephropathy. Basically, the presence of unhealthy amounts of sugar in the blood and tissues has eaten holes in the glomeruli of the kidney, compromising the filtration system and allowing stuff to get through that ought not. However, this typically only happens in poorly-controlled diabetics, and my sugar control is damn near perfect. On top of that, in diabetic nephropathy the loss of protein through the membranes of the kidney should also be accompanied by the buildup of toxic metabolites in the blood. A kidney that is perforated enough to allow protein to escape through the urine should also be compromised enough to allow things like creatinine to make it back into the body. But my creatinine clearance is excellent; better than the average healthy human male my age. This has left my doctors a little puzzled. My brother-in-law the trauma nurse came up with an excellent analogy: it’s as if you had a colander whose holes were so big that it couldn’t hold a batch of cooked pasta, yet simultaneously so small that they could filter the salt out of the water in that same pot of pasta. Don’t make no sense.

So, the next step is to take physical samples of the kidney via needle biopsy and see what can be seen. I go in tomorrow down at Saint Peter in Lacey, after which they’ll keep me overnight to make sure my abdominal cavity isn’t filling with blood from my ruptured organs, leaving me to explode in a cataclysmic font of Roo juice like Violet Beauregarde in Charlie and the Chocolate Factory. I made Margaret promise to get me a pizza from The Old School as long as we’re in the neighborhood; pfui the hospital food.

I have to say, I’m more than a little worried about the outcome. Not the surgery itself, really: despite the apocalyptic prose found in most pre-surgical releases, this kind of procedure is totally run-of-the-mill these days. The surgeon has multiple CT scans taken in advance so that (s)he knows exactly where the ideal extraction site lies. The biopsy itself if said to be a bit painful, but I’ll be seriously medicated although awake….I have to be sufficiently conscious to hold my breath on command during the actual pinch.

But I’m not at all thrilled to contemplate what they’ll find. Right now, about the only things we know with near-complete certainty are that it isn’t diabetic nephropathy and it isn’t cancer. That’s great, but it does leave me and everyone else wondering what the fuck it actually is. I worry that I might have some other form of autoimmune disorder. I worry that protein may be leaching from some other source in the pathway between my insides and my outsides: some weird bladder or urethral problem. I worry that I have some sort of totally unique condition for which there is no cure. Even weirder, I worry that I may have some totally unique condition that will inspire the folks at Saint Peter to harvest my renal cells and patent them, selling them to a biotech firm for three billion dollars, of which I will never see one thin dime (sorry, I just finished rereading Michael Crichton’s Next).

I swear to God, if they perfect the cybernetic wiener in my lifetime I am so outta this body…

I’ll let you all know how this turns out.

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