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I’ve had much reason to consider Dad’s kidneys as we’ve worked our way through specialists, medication options and potential procedures, and I’ve come to think of this matched pair of organs, cumulatively, as the quietly long-suffering wife and mother in the body’s family dynamics. They clean up the messes we create for ourselves, purifying the blood of toxins, and help keep blood pressure and electrolytes in balance. Sometimes, they just get fed up, and their resentment can take physical form, crystallizing into a small nugget of pain. However, once they’ve made us painfully aware of their presence, the kidneys put their heads back down and get back to work as the put-upon lynch pins they’ve always been.

The National Kidney Foundation has a great description of how kidneys work. The fist-sized organs are located just below the rib cage on either side of the spine, and each contains up to a million little nephrons. These nephrons each feature a filtering structure called a “glomerulus,” through which blood passes. Waste products are filtered and passed through a connecting “tubule,” eventually hitting the bladder and then – well, you know what happens after the bladder. According to the website, healthy kidneys filter 100 percent of a body’s blood supply every five minutes.

These Type A workers have a spouse, and their partner in marriage, ironically, is the heart – the equally hard-working, pressure-inducing star of bodily organs. These two entities, one the lord of the manor and the other its scullery maid, work in concert to keep us on our feet.

Each is dependent (or, for the fierce individualists among my readers, codependent) on the other for its own well-being. If the kidneys are unable to function efficiently, fluid can begin to back up, forcing the heart to work harder, eventually resulting in congestive heart failure. The resulting high blood pressure, in turn, batters against the nephrons like a storm surge during an astronomical high tide (fellow coastal residents will understand what I mean – for you landlubbers, just know a situation like this ain’t good for anything said tide might hit up against: water always wins).

Low pressure – which happens when we become dehydrated and blood volume decreases – can be just as damaging to both spouses, especially the kidneys. In this case, the kidneys receive too little of the nutrients even these long-suffering servants need to survive. And, with blood flow too weak to force fluid through the nephrons, toxins can begin to back up. This is when we can begin to think we’re in the hospital, when we’re really in our own comfortable bed, and that our son is the nurse we’ve been trying to summon with our plaintive cries of “help.”

Though typically hypertensive – that is, suffering from high blood pressure – Dad has lately been battling the complications of low pressures, as he seems to have become hypersensitive to his blood-pressure medication. Without the medicine, altogether, the pressure remains too high for the kidneys to sustain. But even the slightest dose can, alternatively, send that pressure plummeting if he hasn’t been drinking enough water to maintain a sufficient blood volume.

Analogies help me understand such complicated relationships, so I’ve come to see Dad’s heart and kidneys as one of those old, married couples who struggle on, on their own, each for the sake of the other. You read about them in the paper sometimes. Or, maybe, you see them gently bickering with each other as they totter through the supermarket aisles, with one, perhaps, barking out orders from the seat of a complimentary scooter. They fear calling for outside assistance with the knowledge that such an admission of weakness could well mean the separation that would be as good as – or even worse than – death.

I think of my grandparents, my mother’s parents, when I think of such a partnership – one out in the business world, hauling his family from East Coast to Midwest, several times over, and the other managing children and household. Each, however, remaining devoted to each other. Meeting in late childhood, they became a paired yin and yang in the lives of the family they created together. Meaning only respect when I say this, their relationship was every bit as symbiotic as that of the heart and the kidneys, as neither functioned without the other in mind. At the death of my grandfather, always her own heart’s strongest supporter, my grandmother lingered to clean up the bills and insurance issues before passing herself a year later.

It’s hard to say which of the true loves, heart or kidneys, supporting my father’s own existence will be the first to fail. However, given the current complications (and their recent 88th anniversary as a mutually supportive pair), it’s likely one or the other will be running out of steam sometime soon. And with that passing, the other soon will follow. But such an event is not to be seen entirely in sadness – we should all be so lucky to celebrate 88 years in marriage to a mate that’s helped us clean up our messes, and die within minutes of our true love’s last beat.