Before the sun rises, I’m already awake. The house is quiet, the world still. I move through my morning routine like a ritual — gathering the things I’ll need: a blanket, my headphones, maybe a book I’ve read before but can’t quite finish. I take my morning meds with a sip of water I have to measure. Even water comes with limits now. This is life on hemodialysis — not something I chose, but something I’ve learned to live with.

At the dialysis center, the machines greet me with their steady hum. They are both enemy and ally. I sit down in the chair, offer my arm, and feel the sharp pinch as the needles go in. My blood begins its journey — out of me, through the machine, and back again. Three, sometimes four hours. I try not to think too hard about it, but some days, that’s impossible. I watch the tubes, the monitor, the numbers blinking like a foreign language I’ve come to understand. This machine is my lifeline — but it also takes so much from me.

Time in the chair stretches. I drift. Sometimes I sleep. Sometimes I stare at the wall or watch TV without really watching. Other days, I talk with the nurses or the person in the chair next to me. We don’t have to explain much — we all know. The fatigue creeps in slowly, then all at once. My muscles ache. I get cold. If they pull too much fluid, I cramp or get lightheaded. I sit still while the machine does what my kidneys no longer can, and I remind myself: I’m here. I’m alive. That has to count for something.

When the session ends, I’m free, but not really. I’m worn out. I move slower. I carry my tiredness like a second skin. I go home and rest, if I can. Some days, I sleep for hours. Some days, I push through. I eat carefully, weighing each bite against my lab numbers and fluid limits. I think about things most people never have to: how many milligrams of phosphorus, how much sodium, how many ounces I’ve had to drink. Everything is measured. Nothing is casual. But this is how I survive.

And still, life continues. I laugh. I cry. I sit outside and let the wind touch my face. I hold the people I love close. I listen to music, even on days when I’m too tired to sing along. I’ve learned to find beauty in quiet places — the kind you only see when you’ve slowed down enough to notice. Hemodialysis has taken a lot from me, but it’s also taught me how to endure. How to live in fragments and still call it whole.

Hope has changed shape for me. It’s no longer a dream of perfection or freedom. It’s in the little things now — a good lab result, a day without cramps, a meal I can enjoy without fear. It’s in the fact that I keep showing up, even when I don’t want to. That I keep rising, morning after morning, to face it all again. Weary, yes. But not broken.

A fellow patient