Permission to Thrive—Part 3: Grieve Your Diagnosis

By April McGraw, RN. NOTE: April has taken the time to compile her experiences and life lessons as a nephrology nurse and person on dialysis into a book that she shares with the renal community free of charge for download. She has given MEI permission to serialize the book once a month in KidneyViews—and we hope you will share the link with others who will benefit from her wisdom, compassion, and empowerment. A course and workbook are in progress as well, so watch for those!

I encourage my clients to work through the five stages of grief when they receive a chronic illness diagnosis. Denial, anger, bargaining, depression, and acceptance are the five stages of grief. For me, this was by far the most difficult of steps. One of my theories is because you can’t say, “I will grieve for 2 days, and then I am done.” Everyone processes differently, and everyone grieves differently. The duration of grief depends on the mindset of the individual. A good mindset is important for overall coping with a chronic illness.

Now, be careful and watch for signs of depression as this will impede your progress. As a 13 and 15-year-old, I did not understand if or when I went through the grieving process. As an older adult, I definitely did after my first and second transplants failed. The second transplant, which lasted a little over 8 years was the hardest. I had accomplished so much during that time off dialysis. I completed nursing school and had been working as a dialysis RN/Administrator for the last five and a half years. I had a new life in Virginia, a new man, and life was good!

I was fortunate to have a wonderful physician and care team that had been propping up this transplanted kidney for the last year at my first signs of rejection. I hobbled along as long as I could to stay off dialysis. The day that she sat me in her office to tell me that I had to resume dialysis, I just went numb, and I clearly remember crying, despite knowing this was going to be my fate. I was losing the life that I had built during the time I enjoyed my transplant.

Then, I briefly went into denial. I did not give myself permission to feel whatever emotions that I needed to feel for a few days. I told myself and my physician that my fatigue was from the hours I was working as an acute dialysis nurse. My weight loss and my inability to take lunch breaks were due to the hours I worked. Every symptom I had, I blamed it on my job, which wasn’t the case at all. My kidney was failing, and I wasn’t ready to face that.

As I went through the process of preparing to return to dialysis, I was just plain pissed off. I knew enough about the process to know that this was going to happen, so my bargaining consisted of asking GOD to give me another week or two before I had to resume dialysis. Depression was present at each stage. In fасt, I had periods in which I gave uр hоре fоr a life I оnсе hаd. But going through the stages of grief taught me that I could асtuаllу соре, and live healthy аnd hарру еvеrу dау, оnlу if I was willing and rеаdу tо do so.

Fortunately, my support tribe allowed me to grieve as I needed. That was key for me. If I felt like crying, I cried. If I felt like throwing myself a pity party, I did. If I didn’t feel like being social during that time, I wasn’t. I simply worked through my grief as best I could on my own terms, eventually focusing on the positives and things that I could control. I advise anyone that is dealing with a chronic illness to seek some form of therapy or counseling, especially if your grief can result in derailing your health even further if not properly checked. Many employers have Employee Assistance Programs available to the staff that I was able to access. You can get a referral from your physician to work with a therapist, talk to a licensed social worker, or seek professional services through your insurance carrier, depending on your plan and coverage. This is the third step that I took in my coping journey that led me to my fourth step of accepting my diagnosis.