202) Sunset over 2007

December 31, 2007

El Milagro:
I am just barely awake here at 5:55 am, waiting in the truck until 6 cause I’d rather wait out here in the parking lot than in the weighting room. I listen to the end of a news item on Marketplace, and grab my bag and enter. I weigh in at 76.1 and wander in to the room. Everyone looks way too bright-eyed and bushy-tailed to me. Rosie the Tech nods and smiles and I just give her a blank stare, it seems. I can't really tell how my demeanor strikes others as I am only 1/4 here. I get the chair in the corner this morning, and some little tech fairy has left three chocolate cookies and one strawberry filled wafer cookie.

I just want to sleep and my brain says, "Nice cookies... good... let's sleep" Margaret the Nurse comes to set my machine up in her businessy, no muss no fuss, way. She listens to me and reports that she hears some fluid in my lower back. Oh great! I don’t know what to say, so I just mumble about cedar allergies. Jackie the Tech comes over and sticks me quickly and before I know it, I am leaning my chair way back, putting on my head
phones for radio, pulling my hat down over my eyes, and closing them to the quietude of the interior of my head. Ah yes. Sleep. About 8 I wake up and look around. The place is still hopping and I look around observing it all move by. I notice that Jackie is looking at my machine and that my BP cuff is just now relaxing. Jackie has a frown and asks me how I feel. Well… “I feel like I’m just waking up… and, I’m warmish… and… did I say I just woke up?” She replies, “Well, your BP is 93 over 68… Margaret, she tosses over her shoulder, ...his BP is down so I’m turning him off, okay?

My wandering brain turns to my TV, which is announcing the news from a psychiatrist about why people break their New Year’s resolutions: “It takes 21 days to wire in a new habit.” He goes on to tell how to actually change habits, reporting that we should choose a small change we can handle and then find a habit we want to replace it with and then practice the new habit, to create new chemistry in the brain. Well, Duh! My b
lood pressure is now down to 80 over 43, so this guy is not getting me excited at all. Jackie says, “don’t go back to sleep”, and I think, “Darn! I want to just close my eyes and drift off into dreamland.” They decide to give me 200 ml of saline and keep my machine from pulling more weight off. So I end up the session getting saline and my BP finally comes up to 115 over 72 at the end. I am done, but I wonder how useful today's session is. Oh well. This is the last session of the year and I ponder that as I am holding my stick holes. Ponder Ponder.

hen Red haired John bounces in the door (picture Tigger) and wants to switch vehicles so he can take junk from his mom’s garage to the dump. He dashes out again, Jackie and I compare 23 year olds, and I continue to ponder the end of this year. I come out of my pondering with a sense that it was a difficult year adjusting to dialysis while working full time and having a family. Liz says that this next year we’ll get a kidney… so, I think that is a good idea. I am ready to move beyond dialysis. So it goes on this last day of 2007.

In at 76.1 and out at 74
.7 kgs.
* Photo is of sunset @ I-35 S., Moody, TX Exit.
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201) Back Home Dialysis

December 29, 2007

El Milagro: I am back at my center, weighing in at a hefty 79 Kgs! Boy, we eat a lot in Dallas; baked chicken, paella, bagels and lox, pancakes, and wonderful cheeses to nibble on with lunch sandwiches of roast beast. Yum Yum. Of course, I temporarily suspended my dietary restrictions for the cheeses… Oh yeah, and there were the nuts from the home-made cookies and peanut brittle.

I came in today at 2 and Jason the Tech sticks me. At first he can’t get a good flow, and we even think briefly he’s infiltrated me. But, there is no great pain or puffing up of my arm, so once he has untapped me and wiggled the needle around, I am all set.

Phyllis the Nurse comes by to listen to my heart and poke my ankles, saying that today is really her last day. She is moving up to the new dialysis center in North Austin, about 14 miles closer to her home. I frown and tell her I’ll miss her and won’t she please just stay? “NO.” I will miss Phyllis… who I have felt a special relationship to since the first day I came here. Phyllis is a veteran nurse who has this acerbic wit and the nephrology knowledge of many years of experience. I tell her I’ll come visit her up there sometime, and she invites me to call her if I ever have to dialyze MWF.

I was going to watch sports, but can’t find anything I want to see and as I am surfing I happen upon The Dirty Dozen and watch until it’s over. Then I read my new book (Bob Spitz’s The Beatles) for awhile and then catch the local News. I learn that UT lost again today; to Wisconsin. DARN! Well, I am happy I missed that one, since my day was pretty happy and wouldn’t-a-been if I’d seen the game.

Rosie the Tech comes by with a clip board and asks if I want to come in early on Monday. “Monday? “ She rolls her eyes and replies, “New Years!”Oh yeah…” I say, as if I knew all about it. “How early?”Six.” I roll my eyes and ask, “What’s the other choice?” “Three thirty.” “Okay; I’ll take six. Will you bring me breakfast tacos?” I can tell by her smile that she won’t be bringing me any tacos. I forget to report to her that I sent in the December newsletter today. Little late, don’t you think? Well… publisher’s prerogative I say to myself, as if anyone is listening. So it goes on a Saturday back in our Austin dialysis center.

Notes: In at 79 and out at 74.8 kgs.
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200) Annual Dallas Visit

December 26, 2007

We’re in big D visiting Liz’s mom and I am going to get my dialysis at a Davita center called “Dalla
s-East UT Southwestern Health Systems”. So I call and talk to Ed, who says I should come in between 2 and 2:30 to do some paperwork. To me, in this day of the electronic web, it seems dumb to do “paperwork” when all my records and approvals can be electronically sent from El Milagro.

UTSHS: I get to the facility, which is set up like your normal doctor’s clinic, with a waiting room of rows of chairs facing a Spanish-language channel on TV. On the left is a portal into the “treatment room” with sliding glass window, that Ed slides open to say, “Mr. Nowicki?”. I flash on the doorman from Wizard of Oz cocking his head as it pokes out the front door of the Emerald City, for some reason. “Just have a seat and we’ll call you” he continues.
I sit and read my Texas Monthly. About 30 minutes later they call me in and direct me to a chair. I look around for a little table to put my bag and coat on, but there are none, so I put the stuff on the floor next to my chair. Maybe they don’t have machine spills here that flood the floor with water. Carlos the Tech introduces himself and begins to make ready for the poking. The charge nurse, Clark, comes by with forms to sign giving them consent and signing away my ability to sue them if they screw up. This place has about 18 chairs, all organized in little nooks of chairs, rather than rows, like at El Milagro. Carlos takes my BP (113/72) and we talk a little while he deftly pokes me. I settle in to reading and observing this new place (this isn’t the facility I was in last year at the holidays).

A woman comes over, checks my approvals, my chart, and okays my Heparin. She reviews my last blood work and mentions the slightly elevated potassium and I explain my potassium blues. “It’s harder to compensate as we get older” she replies. I ask her who she is, and she replies that she is the PA from Southwestern. “Oh” I think. I had hoped for a name, not a job title. She is quite self-assured, attractive, brunette, with a pageboy cut that bounces when she walks. She looks like a “cute professional”… the look that Tina Fey has with her horn-rimmed glasses.

Sometime into the session, Clark stops by and suggests putting my feet up, since my BP is 117. “Okay” I am watching TV by now… the news. This place has a moaner somewhere behind me and to my left. I can’t see the moaner, but I do see staff making slight comments and chuckles, so it must be a nagging, bothersome moaner. This moaning goes off and on for about half the time I am in the chair. It doesn’t bother me… just reminds me of the old days at El Milagro, with the woman who says “help”.

I observe Carlos’ goings back and forth, since he is closest to my chair. He spends time talking to the patient across the way, leaning close to her and listening to her. He jokes with the other staff and generally has a good, positive attitude. I tell him about this blog and by the end of the session I feel close to him, which is surprising for one foreign session. My standing is 103/__, so I sit for awhile and then it is 115/65 and I am outa there, into the dark, cold night… and back to my vacation. The Dallas Dialysis is over for this year.

I drive back around the dark and shiny waters of White Rock Lake, thinking about the experience of going to a new dialysis center and how just one staff there can make me feel like it is a place that will take good care of me. I have heard so many bad stories about visiting centers, that I am usually a bit nervous about being in a new center, and when there is just one staff there that I feel a connection to, then it allays all those fears. Thanks to Carlos the Tech, this dialysis session is considered "safe" and "okay" in my little brain.

Notes: In at 77.4 and out at 74.9 kg.s
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199) X-Mas Eve Dialysis

December 24, 2007

El Milagro:
Here I am at 1:15 and I get a chair in the front of the store. Jason the Tech sticks me today with his customary careful conversation; “Is that feeling okay?” and “How’s that feel?”. This kind of patient concern and questioning is what we should all expect from our techs, I think. I settle in to reading the new Texas Monthly and listening to NPR. In the news, Oscar Peterson died* yesterday and so we lose an
other of the jazz greats. According to The Australian, “To jazz pianists, Peterson exemplified a level of virtuosity encountered only once before in the history of the instrument: in the work of an earlier piano god, Art Tatum, whose particular brand of pyrotechnics also proved inimitable.” I remember my introduction to Peterson, through Mary Lou Parker, who weathered the winter winds of Chicago to hear jazz. Mary Lou was passionate about jazz and it rubbed off; Peterson being one of the ones who, when I hear today, make me think of Mary Lou.

In the Texas Monthly the highlight is the Bum Steer awards, although none of them stand out for highlighting here. I only read about half before I decide to take a snooze (I stayed up until about 3 am last night after Liz’s birthday dinner to Shoreline Grill, making holiday cookies, and then got up at 9 and drove our Christmas gift bag down to Dad in San Antonio). I doze but not well and finally get up and cruise the channels, landing on an old movie on TV; The Man Who Came To Dinner, with Bette Davis and Ann Sheridan. This movie is reminiscent of Friday late night movies I watched through my formative years; giving me a sense that my life wasn’t real and that real life only happened on the silver screen. “Acting” stands out in this movie, as do the wacky antics of Jimmy Durante.

Amanda came by, all dressed in pink, and gently de-cannulates me as the movie is ending. She is excited about Christmas and we swap Merry’s and holiday wishes. Today as all the patients are leaving they yell out Merry Christmas to all, and to all a good night. I weigh out and rush out into the cold to drive home quickly and get ready to go to Michele and Michael’s Christmas Eve party.

In at 77.6 and out at 74.8 kgs.

* Oscar Peterson, jazz piano god, dies. Retrieved online from the Australian, http://www.theaustralian.news.com.au/story/0,25197,22970953-2703,00.html

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198) Texas Falls to MSU

December 22, 2007

El Milagro: I come in at 4 today so I can catch the Texas – MSU game on ESPN. Carol the Tech cannulates me and she says we can only take off a couple, since I’ll be back on X-mas eve. I doze until the game, listening to All Things Considered… especially a story interviewing Ross Baker* about the acrimony between Dems and Republicans, which seems worse than ever before. It’s not, but Baker thinks it’s pretty bad. I think it has to do with the basically different values between the two, and from my perspective, most of us can’t even talk to them about politics anymore. In a way that’s a loss, because when we could converse we both were able to hear each other’s ideas and we were even able, at times, to debate the issues. Those days, I’m afraid, are gone.

The game co
mes on and I get immersed in the game, worrying that even though we are unbeaten we lost to MSU last year and we are playing in their backyard… so, Tom Izzo might prevail. At half time I am really worried. In the second half, the Spartans are there, but where are the Longhorns… have we already headed back to Texas (to work on our ranch)? YIKES! By the end of the game I am depressed and not even Abrams shooting about 5 straight 3-pointers pulled them or me out. I tip my hat to your boys, Dad.

I’m on vacation for the n
ext couple weeks, so dialysis will seem even more of a chore than usual. Today I had to clean up and change clothes to go to dialysis. Yuck.

Notes: In at 75.6 and out at 75.0 kgs.
*Congress Ends Year with Disappointing Marks retrieved online from NPR, http://www.npr.org/templates/story/story.php?storyId=17551753
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197) Passage of The Living Kidney Organ Donation Clarification Act

December 20, 2007

Last night I was surfing the PKD list of blogs and catching up with other PKD folks' adventures. I found several items of interest that I want to add to my blog. First, The Living Kidney Organ Donation Clarification Act passed the House and Senate and supposedly President Bush will sign it. This legislation makes possible what we call paired donation; the ability for family members and close friends of people needing kidney transplants to sign up for paired donations. As the Alliance for Paired Donations explains it: “Kidney paired donation matches one incompatible donor / recipient pair to another pair with a complementary incompatibility, so that the donor of the first pair gives to the recipient of the second, and vice versa.”*

I picked up this bit of news from Team Teddy Bear’s blog** December 12th post, in which Bob describes how the bill with effect he and his wife, Jeanne. Liz and I too will be impacted, since we are just waiting for our Social Worker, David, to let us know that the paper streams and forms here in our catchment area are finalized so Liz can complete the necessary paperwork.

El Milagro: I walk in, weigh myself, and stroll into the big room saying “Hi” to various patients I’ve become friendlier with since putting out the newsletter, and run into Sherry the Social Worker and she asks if I’ve gotten her last emails about my Dallas trip and I thank her for all the rigamarole of getting a chair in a place.

My chair is still filled with a human body, so I return to the weighting room and eavesdrop on a telephone conversation about how a relative has been systematically ripping off the caller and how the family caught her and is getting her kids X-mas presents cause she is too self-absorbed, etc. etc…. and I think about how various and complicated everyone’s family stories are.

At some point, Rosie the Tech calls me in for my chair, and Carol the Tech is rushing around warning me not to sit down cause the chair is still wet from disinfecting… and she is like a hyper-mad woman, veritably flying thru the procedures and entering computer data with fingers-a-blur. “Carol… what’s the rush? Chill out.
I just don’t want you to be late like the other day. This time we are behind so I want to get you hooked up asap.” She bustles off and Rosie comes over and gets ready to hit me up while Dr. Rowder and his crew come by to do their weekly doctor’s ‘drive-by’. Jennifer the Dietician reports on my latest blood work and they all agree things are hunky-dory… my albumin is slightly down and Jennifer has some rationale for that. My potassium is slightly high and that’s okay too. I ask Rosie and Monica the Nurse to explain to the doc my recent BP crashing experiences and they all agree to raise my dry weight again and I quip, “for the holidays”. So, it is decreed across the land that Jack’s dry weight is now 74 Kgs (that’s 162.8 lbs, folks). The tribunal moves on down the row, and Rosie finishes sticking me and adjusting the machine to take off about 2 kgs.

My session tonight is spent reading Motivational Interviewing***, watching ABC News, The Simpsons, CSI Las Vegas, and Gray’s Anatomy. It's TV-city... There you have it, gang.

Oh; and BTW: The Walk for PKD raised 3 Million buckaroos for PKD research this year, according to an email I got today! That's a lotta money.

Notes: In at 76.2 and out at 74.9 kgs.

*The Alliance for Paired Donations online at http://www.paireddonation.org/
** Team Teddy Bear’s Blog on blogger at
*** Web-media-wire online at http://www.webmediawire.com/news/20071211130145.html
**** Miller, W.R. & Rollnick, S. (2002) Motivational interviewing: Preparing people for change, 2nd Ed. New York:Guilford
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196) Turning Down the Manic Knob

December 17, 2007

El Milagro: I arrive a little early today and of course, it’ll be another 20 minutes before my chair is ready… so, I shoot outa there and down to Waterloo Records* to buy a copy of the Texas Christmas Collection** for my Secret Holiday Pal at work. I’ve been in Houston (doing TA and Team-building) for two days, zooming back up here ala Ellinger’s excellente chopped beef sandwiches @ Peter’s BBQ. They’re GOOOD. Since I was off to Houston early Monday morning and back just a half an hour ago… it is difficult to buy my secret pal their last holiday gift. So, at work in our smaller than small business we do this holiday thing every year where we write up a bunch of stuff about our likes and treats and then Faith seals ‘em up and hands ‘em out and the only rule is you can’t get yourself or the person you got last year. Then, for the next four weeks or so, we secretly Santa-tize our secret pal with goodies from their lists. The whole thing winds up at the Holiday Party where we have a staff meeting, eat food, make silly conversation with each other for way too long, and give out the last secret gifts. Then everyone tries to guess who their secret pal is. It’s considered to be great office fun and the food is usually great! Even I like it okay.

So, that party is tomorrow and I’m not gonna be in a mood to shop after dialysis, so I zoom over to get my pal that CD. And… well… it takes me about 22 minutes there and back so now I’m late! Rosie the Tech says, “Hey. Where did you go?” and I sheepishly explain my CD Dilemma and we get to work hooking me up. I weigh in at 76.1 and they decide to take off about 3-something… and I am all tired-manic from being “on” for hours, facilitating folks… and that makes me talky and a little frazzled. My BP is up around 145 over something and it is gonna take some time for me to just chill out… You see: I do that facilitating stuff, drive outa the Emerald city as fast as I can and race down I-10 to Columbus thinking fast thoughts but not having anyone to talk (process) to. So I slam to a halt in my dialysis chair and now I have someone to talk to so it just pours out. Well, it seems like that to me.

So, I’m telling Rosie about the trip and she’s telling me about this new guy’s wife and how much she loves him… they bought a Harley just so they can ride around together and I’m thinking here’s another possible El Milagro Person for Interviewing. So I join her train of thought and say it must be nice that these guys have their wives not working so they can hang out here with them… like George’s wife. Well… turns out George’s “wife” is his neice, according to the latest gossip!

I been observing George and ‘his wife’ for about a year now… they always in here together and he always so laid back and she always seeming a little bossy and pushy and yet there is a strong attachment there you can tell… and, I always think it is interesting how two people work out the steps to their relational dance… blah, blah, blah, etc. etc. etc.

She’s his neice! WOW! I immediately fall back in my head and reel around in there thinking how our hallucinations can narrate whole stories that are based on our own fluff. I reply to Rosie something about maybe there’s something to be said for taking histories after all. Rosie in the wise-ness of 30+ years as a people person, cautions, “I don’t think it’s too good to know too much because then you tend to make judgments about them.” "Oh yeah... histories do not outweigh judgments". This, to my way of thinking, is a great concept to hold onto when working with people. Because, although my brain has created a whole story-life for George and his wife-niece... in reality, were I working with him, I would be working at sequestering that internal jury so as to do "client-centered" change work.

Just yesterday, in the consulting in Houston, I fell back into some NLP exercise strategy and made the ‘rule’ that the interviewees cannot tell the practice interviewer what the crisis is; only how it impacts them and what they want instead.

So we chat on and then she takes off to work on someone else and I write this post and start to actually turn down the manic knob and turn up the rest-now-quietly knob. I listen to All Things Considered and then start looking at the ’57 Chevy on my neighbor’s TV and then get interested in what these guys are saying as they stand around the Chevy… so, I turn off ATC and plug my earphones into the TV to hear these guys. They say "...this silver '57 Chevy mixes the old with the new; a Corvette LS1, and it is HOT!"*** Well, waddaya expect two guys hanging round a modified '57 Chevy would say?

Somewhere around 7:30 my BP drops to 105/90 and Rosie comes over and we discuss her theory that I have gained more weight and they need “to pull less off… change to 3 instead of 3.5” That sounds fine to me… I am a bit spacey now and beginning to feel faint. Further BP monitorings show it going down, down... Monica the Nurse comes over and repeats what Rosie has said… that I possibly have gained more weight, which makes it difficult for me to handle the pulls they’re doing. OKAY! Finally, with BP lowering, Rosie quits me completely and then even gives me some saline to get my BP back up. She offers me some “broth” but all of us ‘patients’ know about the broth. YUCK. Very salty… in fact, salty enough that is zooms your BP right back up. She also tells me that when my BP crashes at home, I can gulp water down and it’ll work to pull up the BP too. I look back at her with the eyes of a proselyte bowing to the wise curandera. So, anyway... I get the needles pulled, get patched up, and sit there for awhile waiting for time to pass until I can wander out into the Austin night. So it goes.

Notes: In at 76.1 and out at 75.? kgs.
* Waterloo Records online at http://waterloorecords.ypguides.net/
* The Texas Christmas Collection review online at Texas Music Roundup, http://texasmusicroundup.com/holiday.html
***Modified '57 Chevy Hdtp online at http://www.remarkablecars.com/main/chevrolet/1957-chevrolet-009.html

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195) Ruminations a la Bourgeois

December 15, 2007

El Milagro: I had called around noon and talked to Jason the Tech, who found out I could come in at 2 p.m. So I actually got here around 2:20 and got my favorite corner chair. Carrie the Tech sticks me today. She walks right up and starts talking about her allergies and how difficult it was for her to get up this morning. I respond with a comment on the wind kicking up the cedar, even though I am a little annoyed by her prattle. My brain is trying to figure out my annoyance and I came up with this: when staff here at the center talk about their own maladies in response to a patient’s inquiry (How are you doing?) or in response to the patient’s own description, then it is part of a conversation. We want the staff to have casual and friendly conversations because it makes this ongoing loathsome medical procedure somewhat more palatable. It doesn’t seem the same as when the staff walk up to us complaining about their own personal lives, including their allergies and sleeping habits. I am here to have my blood cleaned in order to continue some sort of ‘normal’ life, and the staff is complaining about allergies. That doesn’t seem right, to me.

Now, another part of my brain wonders if I am just being bourgeois? Do the traditional clashes of the conventions of the classes define this complaint too? Let’s see: I am a patient in a medical facility where a continuum of professionals care for me and my insurance pays an exorbitant amount for the care. These folks must have a doctrine that defines the parameters of their decorum in working with patients. And, I would guess that part of that doctrine cautions them from getting too personally involved with the patients. So,
I could argue that my annoyance is perfectly appropriate within the context of the patient / medical staff relationship. As a family counselor, I generally don’t bring up personal information except when asked directly by a client, or sometimes in order to reinforce something they have said, or in order to deliver a metaphor that relates to the goals of the counseling.

On the other hand, I could also argue that Carrie’s mentioning such innocuous information as her allergies and being tired are not even close to the kinds of personal information that would count as inappropriate, and that my reaction does reflect the thoughts and actions of class-to-class discrimination. From that slant we see Jack acting differently with and respecting more the staff with professional degrees and licenses, such as the nurses, social workers, and doctors. The others are the peons that can and should be ordered around without consideration of their humanity. After all, they have chosen their lot in life… or, worse yet, as in the Indian culture, they haven’t chosen their caste and are just placed in one by fate (or, karma). From this perspective, everyone should be judged by how high they have pulled themselves up by their bootstraps, and there is no reason what-so-ever that any person can’t raise themselves above their original position. They simply have to work hard. This is
the guts of the American Dream. And, it is a bourgeois philosophy.

Now m
y brain is trying to escape these ruminations… me dost think I think too much. Or, as Pepe le Peu says, “I stink, therefore, I am”. I actually think, in my little brain, that considering these ruminations is important for those of us who are involved with working with people and I offer them up to provoke you, dear reader, in a similar self-dialogue about your relations. And, I do believe that I accept and relate equally to the techs as with the docs. If anything, I think I knock the docs. And, some of my favorite people here are the techs (you know who you are).

So, I can’t listen to my radio (Folkways, of course) because the batteries are dead. I brought Shayna’s radio today and find her batteries are dead too. So, I flip the TV channels from Tiger golf to basketball and finally settle on some movie with Kevin Kline and Meg Ryan and the French countryside…

Then I find UT vs. TSU! This is the game daughter Katie is at today! And I get to see the guy she is dating (“He's not my boyfriend!”) play guard for TSU. This is really a neat experience; watching your daughter’s non-boyfriend play college basketball on TV! WOW. This is almost as cool as seeing your own kid playing sports on TV. When I see parents of college kids in the stands going crazy over their kids on the field (court), I can really understand their excitement. So, anyway, Katie’s non-boyfriend played pretty well, although in the second half UT pulled far out ahead of TSU.

Carrie comes over and pulls my needles and tapes me up as I watch the game wind down. The score is 87 to 70 with 4:12 left… and it looks like it’s in the bag for Texas*.

So, I drive home and Lizzie and I are going out on a date to Mike & Kris’ X-mas party, since Shayna is out at a friend’s for the night. But before we go, I must lay down since my BP is crashing. I check it several times over the next hour and it is hovering around 90 / 54. DAMN! As you might figure, we end up staying home and I crash and Liz watches a movie and makes a grocery list. So it goes.

In at 75.3 and out at 73.0 kgs.

*"Atchley leads No. 4 Men's Basketball past Texas State, 96-81" Read about it online at http://www.texassports.com/index.php?s=&url_channel_id=16&change_well_id=1
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194) Brains at Work

December 13, 2007

El Milagro: I am really late getting here today… after having to be in on a conference call at the office. Carol the Tech and I agree that it is weird that it seems that when I’m on time I have to wait for a chair, and when I’m late, like today, they have my chair ready at 3 o’clock. As Carol is cannulating me I notice that she has put the needles both up rather than one up and one down, the way I have always had them inserted. I ask about this and she nonchalantly remarks that she just decided to do it this way.

Now, I am famous for hating change so in my little brain I am having some difficulty with this and I feel like I should say something… but, what, really, could I say? “NO! Take it out and put it the other way!” Part of my rational brain says to my other brain, “Don’t be such a baby.” and my other brain can’t really think of a response, so it shrivels up in a corner and grumbles. Another part of my brain wishes I had been more aware of what was going on as she was sticking me, thinking it woulda been easier to stop her as she was about to stick me… and that part is now lecturing the other parts about paying attention… and it’s voice sounds suspiciously like my mother’s. “Enough of this!” yells the part from the corner… and I change the subject.

Once I’m hooked up I call Rosie the Tech over and ask about her research on the oldest patient. It’s Mr. Acama who’s been here since the day El Milagro opened, eleven years ago. He is an MWF mid-day, so we agree that Pete will have to interview him for the newsletter. I want to listen to All Things Considered but my batteries are dead so I turn on the tube and catch the early local news on KEYE, checking on Judy since I hardly ever watch her anymore. She looks fine and her news is newsy. Then I switch over to ABC for the national and stay there for the local-after-national on KVUE. Mostly the news focuses on the weather in Oklahoma and I think about Tom and Emily and imagine them navigating the weather and wishing they were back in Houston.

I doze until Survivor and watch; although I am less interested since my guy got booted. Now I don’t favor any of the final survivors really, although as I am watching, brain #2 is telling me I should pick one to favor, just so it is more fun to watch. So, I guess I would like Denise to win now… although Amanda seems worthy too. One or the other? Brain work. "ARGHHH!"

By 8:30 I have just checked the clock, thinking that I have another half hour, when Carol comes up with my glove. Oh yeah, when you’re as late as I was, they take you off at 8:30, even though you haven’t finished your 4 hours. I forgot that, but am happy to remember it now. It’s like getting out of class a bit early, and is always like a little perk in life. So it goes.

Notes: In at 75.3 and out at 73.5 kgs.
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193) On the Front Porch of the Di-Allysis Hotel

December 8, 2007

I call in and Phyllis the Nurse says I can come in at 1 and I negotiate down to 12:30, saying that tonight we have the relatives over for our Chanukah dinner.

El Milagro:
I weigh in and again find my chair isn’t ready. An old old woman is sitting in it and looks up at me as if to say, “I’m not moving until I am ready, buddy!” I return to the weighting room, passing the nurses’ station, where Monica the Nurse commen
ts, “I didn’t think we’d be ready by 12:30 when Phyllis negotiated that time with you.” “That’s okay” I say. I chuckle to myself about Phyllis saying okay to my negotiation, probably knowing that I’d have to wait. Today I brought an article I am late on reviewing, thinking I can catch up. I start finishing it while I’m waiting. Pretty soon Rosie the Tech wheels the old old woman out for final weighing and I watch her delicately and gently adjust her covers and set her near the window so she can watch for her ride. Then she comes over and quietly tells me that Amanda wants to cannulate me today, adding that she needs practice and that she is a bit nervous so I should be very supportive. So, of course I say “okay” to Amanda Ambrosia poking me! I can’t wait. So, I move in to my chair and pull my stuff outa my bag to set up. Kim the Nurse floats up like a balloon (her budding baby bulge leading the way) and listens to me and takes my temp. Rosie does my BP and I notice Amanda on the other side of the supply station moving back and forth nervously. Finally I can’t stand it any longer and I call out, “Aaamannnndaaaa…” and gesture her over by hooking my index finger. She smiles shyly, grabs some gloves, and comes around to my machine. I say,So, I hear you want to practice sticking people and I am happy to let you stick me.” She shyly mumbles something like thanks and very gently yet deftly wipes down my fistula and begins the process. I comment that she doesn’t have to learn this if she isn’t ready and she replies that she does have to learn it because she is studying to be a nurse.

As she is
pushing in the arterial needle, I encourage her by saying “push… good…” and, “that’s right” as it pops into the vein. She finishes up setting the machine and I watch Rosie walking by every few minutes, looking over Amanda’s shoulder, ensuring that she is on target with her adjustments. Afterwards I tell her she did good and she moves on to care for someone else. I am sitting beside John today and we begin a conversation that interrupts me from my normal TV focus and listening to Folkways. At some point Phyllis the Nurse drops by to say it isn’t a mistake that she sat us by each other. John and I discuss a variety of things from Austin restaurants closed down to great albums like Super Session, to Texas towns to books by Wierdos. Finally our conversation peters out and we both go back to our solitary pursuits of reading and watching sports… but it was a nice friendly good-ole-Texas-boy talk and I enjoyed it. We coulda been two guys jawin' on the front porch of the Di-Allysis Hotel.

Beginning and ending weights were recorded but forgotten by my swiss cheese brain… in memory of Hunter S. Thompson’s gravy brain.

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192) Getting Stuck in the ARM

December 6, 2007

El Milagro:
Today I walk right in and the machine isn’t ready yet but I can sit and watch the goings on until the machine beeps that it is ready for another customer. While waiting I hook up my earphones and listen to All Things Considered. Rosie the Tech comes over and we discuss last night… when Pete and I had our PAC meeting and then left and Joe showed up right afterwards and Rosie sent him down to where we were, not knowing we’d left… and how am I going to write up a newsletter on that? I ask if she knows which patient has been here the longest, cause I think we’d like to highlight that person for the December newsletter. She replies that she doesn’t know, but will call a tech who was here in the beginning to ask her.

Dr. Rowder, Jo the Nurse, and Jennifer the Dietician are making rounds and when they get to me I re-order my 3 month supply of allergy meds for the upcoming cedar pollen blitz that's supposed to be worse than ever, and we discuss my recent weight gain. Rowder approves updating my dry weitght to 73.1 --> or 161 pounds! Oh boy. All I can promise is that I will not wear a larger levi than 34" waist!

On ATC I listen to a report about Bush’s new democratic-style plan to bail out homeowners who were stupid enough to get into adjustable rate mortgages without considering how they would pay for the increase once their payments jumped. Now, as a good liberal, I must admit that there actually are uneducated or otherwise disenfranchised people who were sucked in to an ARM by unscrupulous lenders who probably shoved piles of papers over and said, “sign here, here, here, here, etc.” and “oh yes. This is the best deal you’ll ever get. Sign here, here, here,…” It is a good thing to help these folks keep their homes. I am surprised that the Bush administration would ride this horse, but I guess at this point those guys will do just about anything to get our minds off the war and their refusal to accept congress’ ideas on funding it. And, maybe the hidden agenda is not to help people but to help the investment bankers who have bought up these loans. It is notable that this saving of the poor people who took out these mortgages will only actually assist about 1/5th of those who will lose their homes… and that the bureaucratic rigmarole will cut out all but the most motivated of marginalized folk. Bush’s cronies would like, I’m sure, to help enough people to look good, if that goal is even possible for this administration anymore.

Tonight my BP is low. First reading when I arrived it was 90/86. We stood there looking at the machine and shook our heads “no”. So we took it again and it went up to 108/90. Throughout the session it stayed very low and who knows why. My brain whirls to figure it out. “I am very relaxed today. Maybe I took one and a half BP pills this morning. What else could it be?” and I ponder that for some time as a mental exercise. Also, my twitchy feet twitch a little so that takes some of my worry away from low BP… but actually the twitchiness is nothing like last time and by the middle to end of the session I notice myself noticing no twitching at all!

I watch and listen to the ABC News, turn down the next show, and then turn up Survivor, although I actually doze off for part of it. Then I wake up again and watch Gray’s Anatomy. Grays is getting so soapy I may stop watching, he said, eyes glued to Dr. McSteamy kissing a new intern. Tonight’s episode seems to be all critical surgeries with people flat-lining and the interns all kissing in the dark corners of he hospital. What a life.

Notes: In at 75.8 and out at 72.3
*Zaroli, J. (2007) What the mortgage deal does and doesn’t do. Retrieved Dec. ’07 online from the ATC website,
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191) Twitchy Feet

December 4, 2007

El Milagro: Today when I arrive Gabe the Tech says they aren’t ready with my chair yet so I sit in the weighting room, listening to two “cool” black men commenting on the news and weather. One is the patient: older, white-tinged hair, and blind; with sunglasses on and a cane. I suspect he is the victim of diabetes. He sits there and hears the TV talking and mentions what it says to no one in particular. “72° out. Didn’t think it was that warm…” I think it is his son sitting beside him, also looking cool in shades and neatly pressed slacks. Both of them look like they stepped out of a jazz movie to hang here in this space. Every once in awhile the son responds… “Yeah man”. They are in this room together, waiting for a chair along with me. We could be in a barber shop somewhere in South Philie.

Finally Carrie the Tech pops in, calls my name, and reports that she didn’t even know I was here yet. I smile and choose not to comment at all. She seats me and is yakking along about things that are important to her, I guess. Maybe she is just making conversation. She asks a lot of questions about cannulating me, as if she has never poked me… but, she has, so I am a little annoyed at her prattle. I do suggest she only “take off 3” since I had difficulties with cramping last time. She cocks her head as if to say something... and then just turns to the machine.

Monica the Nurse comes over to check me out, and I report to her the sad news about losing my last Clarinex prescription. I did get the one month from Walgreens but lost the one to be sent in to the mail order. Monica says she’ll call in a month’s worth and get Dr. Rowder to write me a new mail order prescription on Thursday. Whew. I would hate to run outa Clarinex right at the time the cedar is starting.

I listen to All Things Considered and watch silent golf on the TV… and drift off for a late afternoon nap, reminding myself that this is the reward for being on dialysis. Over the next month of holidays dialysis will become a bother at times; integrating it with going to Dallas, holiday festivities, and various trips out of town. But for right this minute all is well in dialy-land.

I snooze for awhile and notice that my legs are quite twitchy tonight… I alleviate the twitchiness by spreading my legs and clanging them together like a lateral jumping jack. When my heels smash together it somehow knocks out the twitchiness for a few minutes. Mostly this exercise keeps me from enjoying my snooze so I wake up and channel flip through the boring TV options. So it goes for the rest of my time here tonight.

Oh yeah... and for you of the tribe, Happy Hanukkah! Of course, I missed lighting candles for the menorah tonight.

Notes: In at 77.0 kgs and out at 73.2 kgs.

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190) Saturday of Cramps

December 1, 2007

El Milagro: So I am able to get in today at 1 pm in order to get out early for Steve’s Annual X-mas Party. Kim the Nurse assesses me, does my BP and sticks me. I am listening to Folkways on the radio, and so not paying close attention to her doings. She asks if I want to take off blah blah and I agree. When I am all hooked up she moves on and I settle in to my session.

Today I am reviewing LeShawn’s contribution to our writing assignment (more on this later) while listening to Folkways and Kevin Connor’s selection of music: laid back, mellow, and not-so-on-the-tip-of-your-brain artists, including Phil Ochs, Maggie Walters*, David Olney**, Mark O’connor****, and Cornell Hurd Band*****.

So, I’m listening listening listening, and glancing up at the TV too, keeping some track of the Tennessee / LSU game (poosh poosh poosh)… waiting for the Big XII big game tonight.

At about 4:15 both my calves start cramping and I am wiggling around trying to make these cramps go away or at least deminish a bit. I try moving my legs, bending them at the knee and then stretching them out… until I can no longer even move them. I call Rosie the Tech over and she decides to lower my goal a little. We set up my chair so I can put my feet on the floor and push, which also helps cramps sometimes. My calves de-cramp (about 4:15) and I settle back again and think about the difference between pain and no-pain.

When pain is there it is almost impossible to ignore it, although I 'understand' (as Bush would say) the idea of separating consciousness from pain thru meditation or focused awareness. And, I can in some ways just refuse to be bothered by the cramps… and when they really come on despite my refusal of acceptance, at some point the cramps’ calling my attention overwhelms my ability to ignore, overwhelms my West Texas gritting of man-teeth, and overwhelms my Eastern-leaning focused awareness on nada. Then I wiggle and wane and waffle and wimper… and call for the nurses three.

At 4:30 it starts again… this time in my right thigh first. I stretch out my right leg so I look like I am reaching for a pirouette. My foot is trying to escape my leg out under the sink to the right of my chair. I wince and Carol the Tech, Rosie the Tech, and Monica the Nurse all come over and discuss, in abstract dis-compassion my current situation. I hear them as if they are a small TV screen off to my left. Carol says, “when I saw that Kim had him taking off 5 I knew it was too much. I never have him take off more than 3.” Rosie responds, “I think his puffy self is gaining weight… he shouldn’t be cramping unless he gained some weight… blah blah…” and Monica chimes in with reflections on her notions about Jack’s cramps. All the while I am stretching and cringing and trying to ignore the beginnings of cramps in my left thigh, which is wanting in on the excitement. So, Rosie does some quick math on the clip board of my “plan” and shows me her figures, reporting, “You came in at Gauguin and we set the freebird as the what-cha dingle and see? There is the culprit right there in the subtraction of the parameters of Frankenheim! So, what we clearly have to do is cut off your legs and offer them up to Alah!

Actually her report is more full of numbers but no matter… I can’t listen rationally anyway. She concludes that my weight has probably gone up about 7 pounds due to holiday feasting, which makes me cramp when they take off any more than 3.4 kgs. Here I am cramping with more than an hour left in my session, which clearly indicates Kim set too high a goal. We need to up my dry weight and plan to take off less in dialysis. She smiles at the end of her report, saying, “So there ya go, Puffy!” and I smile weakly. They turn me off (on the machine) and I rest and feel slightly faint. The faintness is the conclusion of cramps… when your blood pressure drops. It drops only to about 108 over 70 something, so that’s not too bad.

By 5 o’clock all is back to normal and I drift along through the rest of my session uneventfully. So it goes.

I can hardly wait to get outa here, rush home to get the girls, and head up north to Steve’s party.

Notes: In at 75.8 and out at 72.3
* Maggie Walters’ new CD online at: www.americanarecords.com/ images/MAGGIE_WALTERS_ONE_SHEET.pdf
** David Olney online at: http://www.davidolney.com/
*** Mark O’connor online at: http://www.markoconnor.com/
****Cornell Hurd Band online at: http://www.cornellhurdband.com/

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