Kidneys
- “What does your energy level look like after dialysis?”
- “When are you actually at your Mac with both arms free?”
- “What makes this app section so complicated?”
From 10 Meters to 1.5 Kilometers
Eight weeks ago, I had open kidney surgery. After being bedridden for most of my three and a half week hospital stay, that final week felt like a triumph.
I’d graduated from assisted walking to making it down the hospital floor and back on my own. By discharge day, I was walking the entire floor independently. I felt confident. Ready to get back to normal life.
That confidence lasted exactly ten meters outside the hospital.
Ten meters from my front door, I needed a thirty-second break. Just ten meters. The same distance I’d been covering easily in the hospital corridors suddenly felt impossible. After feeling so capable walking those hospital floors, I felt like I’d run a marathon.
By the end of that first day home, I’d managed maybe thirty or forty meters total before admitting complete defeat. The difference between hospital walking and real-world walking hit me like a wall.
Here’s what I didn’t understand then. Hospital floors are designed for recovery. They’re flat, climate-controlled, with handrails and places to rest every few meters. The real world has curbs, uneven pavement, weather, and distances that actually matter. Walking a hospital corridor doesn’t prepare you for walking to your mailbox.
The medical reality is pretty straightforward, but no one really prepares you for the psychological whiplash. After weeks of bed rest followed by successful hospital walking, you think you’re ready. Then you discover that three and a half weeks of lying still, even with that final week of corridor walking, has fundamentally changed what your body can handle.
Those first few days home were a study in humility I never wanted to take. Each day I’d try to walk a little further. Some days I managed it. Other days I didn’t. The frustrating part wasn’t just the physical limitation—it was accepting that my hospital confidence had been completely misplaced.
I started tracking my progress. Not with meters or fancy apps, but with houses. How many houses down the street could I make it before needing a breather? Before I had to turn around? These landmarks became my measuring stick. When my confidence was shattered, making it one house further was concrete proof I was still getting better, even if it didn’t feel like it.
The breakthrough came gradually, then suddenly. Around week four post-surgery, I realized I wasn’t counting steps anymore. Week six, I was walking around the block. Week seven, I made it to the local park and back.
Yesterday, I walked 1.5 kilometers in thirty minutes without stopping once. I held a conversation the entire time. Eight weeks after surgery, four and a half weeks after that humbling ten-meter reality check.
What strikes me most isn’t just the physical progress. It’s how hospital walking creates false confidence that real-world recovery quickly corrects. Before surgery, walking was just transportation. Now it’s proof that my body works outside controlled environments. Each step feels like a small victory over both the surgery and that initial confidence crash.
The research says most open surgery patients don’t hit these milestones until week ten or twelve, especially after extended hospital stays. That feels good to hear, but it also makes me realize how misleading hospital walking can be. Your real recovery timeline starts when you leave the building.
If you’re starting your own walking recovery after major surgery and hospitalization, here’s what I wish someone had told me. Hospital walking is just the beginning. Don’t let that final week of corridor confidence fool you into thinking you’re ready for the real world. You’re not, and that’s completely normal.
Track everything once you’re home. Write down distances, times, how you felt. After that initial confidence crash, the numbers become your proof of progress when your brain tells you you’re moving backwards.
Don’t compare your home walking to your hospital walking. They’re completely different activities requiring different energy levels and skills. Hospital floors are recovery training wheels. Real-world walking is the actual test.
Consistency beats intensity every single time. I walked every day after discharge, even if it was just to the mailbox. Those tiny daily efforts compound faster than sporadic longer attempts. Your body needs to relearn movement in real environments, not just controlled hospital corridors.
Bad days will happen. Last week I had a terrible walking day where everything felt harder than usual. I questioned whether I was actually improving or just fooling myself. The next day I walked further than ever before. Recovery after that kind of confidence crash isn’t linear.
The mental side of this recovery taught me things I never expected to learn. Humility, for one. Hospital walking had made me feel capable. Real-world walking reminded me I was still healing. Both were necessary parts of the process.
It also taught me to celebrate ridiculously small victories. Making it to the corner without stopping. Walking up three stairs without getting winded. Holding a conversation while moving. After that ten-meter wake-up call, these became genuine achievements worth acknowledging.
Looking ahead, I’m still technically in the recovery window. Open surgery patients don’t hit full recovery until month three. That means I’ve got another month of potential improvement ahead of me. The thought is both exciting and surreal.
My new goal is two kilometers by week ten. Then maybe three by month three. But honestly, I’m less focused on the numbers now. The real victory is that walking feels normal again, even outside hospital corridors.
Recovery from major surgery isn’t just about getting back to where you were. It’s about developing a completely different appreciation for what your body can do in real environments, not just controlled ones. Every day I can walk 1.5 kilometers is a day I don’t take for granted.
Eight weeks ago, that confident hospital walking meant nothing when faced with ten real meters. Today, 1.5 kilometers feels routine. That’s not just physical healing—that’s rebuilding trust with your own body one step at a time, in the real world.
This post documents my personal recovery experience. Always follow your doctor’s specific instructions for post-surgery activity and recovery timelines.
The Productivity Conversation I Didn't Expect to Have
I sat down to write about productivity. Instead, I accidentally solved my productivity problem.
It started with a simple request. I wanted to turn my struggles with overwhelm and chronic illness into a blog post. Multiple interests pulling me in different directions, dialysis eating up twelve hours a week, YouTube consumption replacing creation - the usual productivity paradox.
You read more about it here.
But something unexpected happened during the conversation with my AI writing assistant. What began as research for a blog post became a real-time case study in how productive conversations actually work.
The Original Problem
The setup was familiar to anyone who’s ever felt overwhelmed by their own interests. I love coding, cooking, RPGs, fitness, reading. My wife has projects that need my support. I’m supposed to be working on an iPad app for her. But instead of making progress on any of it, I find myself watching YouTube videos for hours.
I’d even found a video that perfectly explained the problem - how our brains get hijacked by consumption, how creation provides more sustainable dopamine hits, how shifting from consumer to contributor changes everything.
The Habit that forces your brain to stop consuming
I understood the theory. I just couldn’t implement it.
The Conversation That Changed Everything
“What’s your top priority right then?” came the question.
“Probably the iPadOS app, since finishing that would help my wife greatly.”
Simple question. Clear answer. But then something interesting happened.
“Those twelve hours of dialysis per week? That’s actually prime iPad development time. You could queue up iOS tutorials, work on app wireframes…”
“Well, there’s no Xcode for iPad,” I replied. “And my left arm is completely blocked with needles. I can’t move it.”
Sudden silence. Then: “Right, of course there’s no Xcode for iPad. That was a pretty big oversight on my part.”
What Made This Conversation Different
Most productivity advice fails because it’s generic. It assumes everyone has the same constraints, the same energy levels, the same physical capabilities. The conversation became productive the moment my real constraints got acknowledged.
No judgment about not being able to code one-handed during medical treatment. No generic advice about “just managing your time better.” Instead: “What can you realistically do one-handed on an iPad for four hours?”
The questions kept getting more specific:
Each question revealed another layer of reality that typical productivity advice ignores.
The Lessons Hidden in the Dialogue
Assumptions get corrected quickly. The Xcode-on-iPad suggestion was wrong, but it got corrected immediately instead of becoming the foundation for useless advice.
Constraints clarify priorities. Once we established that dialysis time wasn’t coding time, it became clear that the real development work had to happen during my four productive in-between days.
Specificity beats generality. “Work on the app” is overwhelming. “Identify the next three concrete actions for the app” is actionable.
Questions matter more than answers. The breakthrough didn’t come from advice. It came from questions that helped me see my situation more clearly.
The Meta-Lesson
Here’s what I realized: the conversation itself was demonstrating the productivity principle I needed to learn.
Instead of consuming more productivity content, I was actively working through my specific situation. Instead of generic advice, I was getting targeted questions. Instead of feeling judged for my limitations, I was finding ways to work with them.
The conversation was creation, not consumption. It was collaborative problem-solving in real time.
The Breakthrough Moment
The real breakthrough came when we identified that the missing section of the app wasn’t just technically complicated - it was “lots of different pieces.” Suddenly the overwhelm made sense. It wasn’t one elegant problem to solve, but fifteen mini-features that all needed to connect.
“What if you just listed all the different pieces first? Not designing them, not coding them - just creating an inventory.”
That’s when it clicked. The paralysis wasn’t about not knowing how to code. It was about not knowing where to start when everything felt connected to everything else.
What This Means for Productivity
The best productivity hack might be finding someone who asks better questions.
Not someone who gives you a system to follow. Not someone who tells you to eliminate distractions. Someone who helps you see your actual constraints clearly, then works with those constraints instead of ignoring them.
Generic productivity advice is like generic medical advice - it might work for some people, but it’s useless if it doesn’t account for your specific situation.
The real productivity breakthrough happens when you stop trying to fit your life into someone else’s system and start building a system that fits your actual life.
The Ironic Ending
I started this conversation wanting to write about my productivity problems. I ended up actually solving them.
The blog post was supposed to be about the problem. Instead, it became about the solution.
Sometimes the most productive thing you can do is have a better conversation.
Ze:ro Praxen. 📍
Just drove in for a quick two hour emergency dialysis. Apparently my potassium was too high. So I had to weight my options. High risk of a heart attack in the night or two hours of dialysis. Though choice really. I hope I picked the right option.
Ze:ro Praxen. 📍
Another day, another dialysis session. And once again four hours of lying still in the heat. You can believe that I’m drenched in sweat afterwards. 🙁
Trading Freedom for Efficiency: My Journey from PD to HD
After my kidney surgery, everything changed. I had to switch from peritoneal dialysis (PD) to hemodialysis (HD). PD is the type where you dialyze at home through your abdomen. HD is what most people picture - sitting in a clinic hooked to a machine.
I didn’t have a choice in this. The surgery made the decision for me.
What I Miss Most About PD
I miss my nights. With PD, I just hooked up before bed. The machine worked while I slept. Eight hours of gentle, continuous cleaning. No alarms, no nurses, no commute.
I could roll over. I could get up for water. I could live.
Now that freedom is gone. PD was like a gentle stream cleaning my blood all night. HD feels like a pressure washer blasting through me. Both work, but one lets you forget you’re sick.
Understanding Ultrafiltration
Let me explain ultrafiltration. It’s just a fancy word for removing extra fluid. Your kidneys normally do this when you pee. Dialysis has to do it artificially.
With PD, I could remove about twice as much fluid. The peritoneum - that’s your abdominal lining - acts like a filter. Glucose in the dialysis fluid pulls water from your blood. It’s osmosis, really.
HD uses pressure instead. It forces fluid out through an artificial membrane. It works, but there’s a limit. Push too hard and you cramp. Your blood pressure drops. You feel awful.
The HD Reality
Four hours. That’s what HD demands from me. Four hours of complete stillness every two days.
Try lying perfectly still for four hours. Your arm with the needles can’t move. One wrong shift and alarms scream. Blood might leak. The nurses rush over.
My back aches after two hours. My legs want to stretch. My mind goes crazy with boredom. I watch the clock like it’s my enemy.
Some people sleep through it. I can’t. I just lie there, waiting.
What HD Does Better
I have to be fair here. HD removes phosphate and potassium like a champion. These minerals build up when your kidneys fail. Too much potassium stops your heart. Too much phosphate destroys your bones.
HD clears them efficiently. Three times a week, boom - levels drop. With PD, it was always a struggle. I took binders with every meal. I avoided certain foods.
So yes, HD has its advantages. But at what cost?
The Trade-Off I’d Make
Give me back my PD tomorrow. I’ll take the phosphate binders. I’ll skip the bananas and potatoes. I’ll manage the potassium myself.
What good is efficient toxin removal if it steals your life? I’d rather have good days with some dietary restrictions. HD gives me perfect labs and exhausting treatment days.
Quality of life matters. Being able to work matters. Traveling without planning around clinics matters. Sleeping in your own bed every night matters.
I’d make that trade in a heartbeat.
Looking Forward
My doctors say I might return to PD eventually. The surgical site needs to heal completely first. I’m counting the days.
If you’re choosing between PD and HD, think beyond the medical numbers. Consider your lifestyle. Value your independence. Ask about all your options.
HD works well for many people. Some prefer the structure. Some like not managing their own care. That’s valid too.
But for me? I just want my nights back. I want to wake up dialyzed, not exhausted. I want treatment that fits my life, not life that fits my treatment.
Until then, I’ll endure my four-hour sessions. I’ll appreciate what HD does well. But I’ll keep hoping for the day I can go home again.
Remember: every patient is different. What works for me might not work for you. Always discuss your options with your nephrologist.
Today is a bad recovery day again. I’m all tired and couch bound. All joints hurt when I try to move or get up.
After 3,5 weeks of hospital stay and now about 3 weeks at home I sat down at my Mac for the first time again and fired up the 3D printer. Feels good to something else then sitting on the couch again.
At the radiology department getting a thorax scan. The joys of regular checkups.
Getting an iron infusion today. Ah, the joys of failed kidneys. 🩸💉