6/21/06

22) Postively Negative

June 20, 2006
Tuesday

El Milagro:
As I walked in to the center today, Marilyn the Social Worker stopped me to report that she has set up my visitor sessions in north Dallas for next month. I said thanks and somewhere in our little conversation asked how much my insurance is paying for these sessions. She replied that she didn¹t know; that insurance companies all have contracts with DaVita and pay different amounts. If I were to pay for it myself, it would cost $480 per session.

As I sat in my chair, Wilma and Eloy came up and one read and spelled my name off my dialyzer and the other verified they heard it before they even checked my blood pressure or listened to my chest. James cannulated my today, and had some difficulty getting a good draw in the arterial vein (the one that goes to the machine). He wiggled it around some and later, Herman came over and messed with it a little. Herman explained that sometimes the needle causes a kind of suction that collapses the vein and slows down the flow. In those cases you wiggle the needle around until it is in the center of the vein, where that collapsing is less likely to happen. While he was sitting there messing with the needle, he reported to me that the blood work from the other day (see Post # 20), when they got me in the wrong chair, was negative. I joked, "No, that¹s positive" and he replied, "I¹m positive it was negative."

Later, Jennifer the Dietician stopped by to give me my latest lab report and to visit. She started by letting me know she had read this blog and found it "interesting". We went over my lab report and basically, all the results are better than last time, although my phosphorous is still too high. She suggested that it is okay to take my binders either before or after meals and that I take my vitamins at bedtime rather than in the morning (since dialysis can flush them). She reminded me that I need to remember to take my sensipar after meals, because that will help my parathyroid balance calcium and phosphorous (see
http://www.sensipar.com/consumer/whatIsSHPT.jsp for more information).

Detailed Nutrition Report:
& My albumin (protein) was good; although I need to keep concentrating on getting more protein
& My HCT CALC(HGBX3) is really good (that¹s my red blood cell count btw);
& My IRON SATURATION is good;
& My FERRITIN is good (stored iron);
& My CALCIUM CORRECTED is good;
& My PHOSPHORUS is still high although it is getting better with each report
& My CAxPHOS CORRECTED is also too high. Calcium + Phosphorus = Product. Again: take the binders.


Jennifer and I also discussed briefly the ethical questions surrounding living donors and somehow got into a discussion about the recent violence in New Orleans and the loss of her grandmother¹s house in Katrina.

About 20 minutes before the end of the session, I began having cramps in my legs. Wilma came over and turned the machine off and shot in some fluid (which gets rid of the cramping). So, I actually got done a little early this evening.

Notes: In at 73.5 Kg, and out at 70.7 Kg.

1 comment:

Connie the Nurse said...

Jack, absolutely love your blog! Haven't read all of it yet but what I have is good reading. It's always good to see a situation from another perspective. It will only make us (dialysis personnel) better care givers. Keep up the good work.