1/30/08

211) Calcium Bath Bulletin

January 29, 2008
Tuesday

El Milagro:
I’m here on time at 4 today and… they’re running about 30 minutes late. On my way back out to the weighting room, I stop by Dr. Rowder’s drive-by team, who are standing in the middle of the floor, not clearly visiting with any patient. I ask, “So, what’s the story?” to Jennifer the Dietician. She replies, “They had you on the wrong bath.” Dr. Rowder continues, “We’re gonna check your calcium today.” Sherry the Social Worker inquires about how I feel so I report that I have been puffy since Saturday; I walked out of here on Saturday weighing more than when I came in; and I have felt bloated since. Then I ask Dr. Rowder, “So, is this something I need to learn to check myself to make sure it’s done right?” He shakes his head and replies, “No. Its highly unusual for that kind of thing to happen. You don’t have to check it.” I feel like responding back with a list of the things that have been mistakes since I have been here, but realize they need to get back to their drive-bys and it isn’t really my turn to be talking to them, since I’m not even in a chair yet. (I probably will follow the advice of Bill P and be more aware of these things)

I scoot outa there and do a few errands and return to find a chair waiting for me. I weigh in at 80.7, even though I have concentrated on minimizing my fluid intake since Saturday. That has been easy since I get immediate feedback when I look at my puffy hands that I can’t really clasp together… like the Nowicki Doughboy. I was in Tyler yesterday doing a training and kept myself to one cup of coffee and one glass of water through the whole thing.

Kim the Nurse comes over and listens to my chest and feels my puffy hands. She listens to my story about Saturday and acknowledges that they probably gave me the wrong bath. My bath should be a “1 K 2 Ca” bath and Kim points it out on my poop sheet on the clip board and on the bottle on the floor in front of the dialyzer. She continues that probably what happened was they gave me a "0 Ca" bath, which resulted in the dialyzer filtering out all the calcium in my system without replacing any. When she checks my standing BP it is 163 / 83, so I am clearly upset about this whole thing. She and I determine that we want to try to take most of the gain off this session, so she sets the machine for taking off 5.4 Kgs.

I settle in and down and pretty soon Dr. Rowder drives his cart over and asks, “Is there anything else we need to talk about?”. I say “Yes. Is there a way to ensure this kind of thing doesn’t happen again… since it was not a really fun deal.” The Doc doesn’t have a succinct answer to that one but he does apologize and assures me that the event was unusual. In my little brain of brains, I wonder how many times mistakes really occur and if they do have internal procedures for correcting them. I hate to think that Amanda the Tech was the culprit of this… and when I think back, I actually don’t remember her being the one who set up the bath. Many times the tech who is cannulating me isn’t the one who sets up the machine, which includes getting the bath set up. In the past (see Post # 20, June 2006), when staff gave me the wrong dialyzer, the parties involved were suspended for a day. I wonder what they do for this kind of thing, if anything. Perhaps this is a question to bring up at the next PAC Meeting with the administration. Since there seems to be nothing else to discuss with Rowder and the team, I just acknowledge his apology and reflect that it pissed me off… to which Jennifer the Dietician throws back, “Wimp” as they walk away.

I’m thinking she’ll be back soon to share that that comment was a joke.

I listen to NPR and doze a little and check my BP after awhile and it is down to 120 over something, so I am calming down. One of the things that continues to gnaw at me is that on Saturday, even when staff realized I was on the wrong bath, they didn’t come up and acknowledge that their behavior led to my discomfort. Instead, I was in a situation of thinking that it was something to do with me. Somehow I had done something that led to my bottoming out. It seems to me that as soon as they figured out I was on the wrong bath they should have told me and then told me that they were doing everything they could to make it better. Now, it is true that in the state I was in I was not feeling well enough to have a long discussion about the whole event. But, I would’ve like to hear that it was their problem not my problem. I also would like to get a look at whatever they wrote in my record to document this event. Did they write something like, "Mr. Nowicki's calcium was low so we blah blah blah" which doesn't really identify that they gave the wrong bath... or, did they write something like, "we goofed and gave the poor patient the wrong bath, which caused his extremities and lips to tingle like a mild electric shock was pursing through them." Maybe I can get someone to share with me the documentation that was put in the record. Maybe it's really not that big a deal and I should count my blessings and go on with my life.

Oh well. There are always things that can improve in any enterprise. And, I know that many of the staff are doing the best they can and in the long run I do appreciate the care they take of me. So, who am I to gripe? It could be worse.

By the end of the session I am feeling better and happy to get outa there into the cold Austin night and head home to the family. A note on the cold night: I came in today in short sleeves with no jacket cause it was over 70° out and then on the news I found that the temperature is dropping by about 30°. So, I wrap myself in my Mexican blanket and head out to the truck. It reminds me of many years ago when I first decided to keep a down jacket behind the seat of my truck because of the wild weather shifts out in West Texas. As I am shivering on home, my memories go back to the time that Susie and I pulled off the road in our little VW square-back to sleep overnight and the next morning we were snowed into the car, with drifts up over the roof. We had to dig out and then slide back down the mountain on icy treacherous roads. That was in April in the mountains of northern New Mexico. What a great memory.

Notes: In at 80.7 and out at 75.8 Kgs.

1/27/08

210) Low Calcium Lip Tingles

January 26, 2008
Saturday

El Milagro: I’m here at 4 today, choosing not to call in for an early chair because UT is playing at 7 on a channel I don’t get at home. Amanda the Tech smiles over to cannulate me. She is getting more comfortable at sticking people and therefore doing it faster, and, at least this time, a little more painfully than usual. Slow down Amanda! Going slowly and cautiously is less painful for your victims. Jo the Nurse comes by to do the nursing assessment and I touch base with Ron the Head Nurse about ordering my Sensipar… he recalls he did, although he has a kinda worried look on his face that makes me hallucinate he might not be sure.

I am listening to NPR All Things Considered Saturday version as I wait for the game… interesting story about ice skating starting in Finland 4000 years ago, when they strapped horse bones to their feet to traverse the many frozen lakes. Picture that! Also a thing on nicknames and reports on the SC primary. I drift off. Rosie the Tech comes by to warn us all that she will be doing feet checks today.

For awhile I am feeling a little funny (not the kind Steve Martin talks about when he says "I put a piece of baloney in my shoe and when I walk out on stage... I feel funny!")… a kind of tingly feeling in my lips that is bothersome. I try to ignore it at first and then pay close attention to the feelings. As I do that, they grow and pretty soon I am feeling kinda faint, have tingly numb feeling lips, and my fingers on both hands are starting to tingle too. Something is going wrong. I can’t see my machine to determine what my BP is but I suspect it is going down. When Rosie comes up to do my foot check, I tell her, “I’m feeling weird… tingly lips and faint”. She checks my BP and it is down under 100 (why didn’t the machine beep?) She ups my saline intake and asks if I want some broth. Who ever wants broth? Well, I’m feeling so shitty I want broth. I feel like I can’t move much so I just nod okay. Then she leaves and Ron the Nurse shows up and studies my readouts and asks me about my tingles. “Do you hurt anywhere?” “Nope” “Any shortness of breath?” “Nope” “Nauseous?” “Not really” “Well, I think it’s low calcium… we’ll bring you some Tums and see if that helps.” I am relieved, I guess… although I have no idea how this low calcium thing starts, or what it means. Rosie brings the Tums and I gobble 4 or 5 and realize I have no spit to add to them so they become like a glob of cement in my mouth. YUCK. “Gubme tom watah” I mumble and Rosie laughs and brings a cup. When I’m feeling so badly, I don’t have a lot of energy to find out what this is all about… I just want to feel better.

I felt so badly it was difficult to pay attention to Rosie the Tech's foot check, which they always say they do regularly but this is the first one I've had since starting dialysis a year and a half ago. Rosie takes off my socks and feels all around my foot and it kinda reminds me of an acupressure session... I like it... although I really wish I was feeling better so I could ask questions, etc. about it. Next time I'll ask for a foot check... especially if they choose to wait another one and a half years...

After about 7 tums my lips begin to feel normal and I relax back to watch the second half of the UT / Texas Tech game. We end up smearing Tech and old beady-eyed Bobby Knight grumbles across the floor to shake hands with Coach Barnes. Later on I talk more to Rosie, who says she doesn’t know why folks end up with low calcium, but it does happen to others every so often. I’m left wondering how in the heck you can be just laying there dialyzing and all of a sudden your lips go tingly and it’s downhill from there. I guess I’ll have to do some research on LOW Calcium.

Sunday: In researching yesterday’s difficulties at dialysis, I look up low calcium and find that when it is related to high PTH, it can mean a vitamin D deficiency (My PTH was high last lab results). Well, yesterday was the first time I decided to follow the vitamin instructions on my lab result report that specify I should wait until after my dialysis to take my Renal Tab. I wonder if not taking the renal tab in the morning could have anything to do with the problem in dialysis in the afternoon? I will send this post to Jennifer the Dietician and see what she thinks. More to come.

Notes: In at 76.4 and out at 77.3 Kgs.
Calcium & Kidney Disease, retrieved online from Davita’s website, http://www.davita.com/diet-and-nutrition/c/595

209) Session of Memories

January 24, 2008
Thursday

El Milagro: I’m in the far corner today. Kim the Nurse sticks me after doing a nursing assessment. She is one of the few nurses who stick people. As she sticks me I am listening to Nancy Pelosi in my earphones saying we didn’t get as much as we wanted out of the “economic boost package” since the Republicans didn’t want the benefits to go to people on unemployment benefits and the people on food stamps. Seems like to me that if the idea is for folks to basically spend their boost checks on basic expenses those the unemployed and food stamp populations would be most likely to put the money right back in the economy. Oh well. Instead, taxpayers will receive a financial stimulus that they can use in any way they want. If Lizzie and I get a stimulus, we’ll pay down our credit cards, which won’t help the economy much, but it will help our personal economy. I can’t remember when in history the government has decided to send people money to boost the economy which has been screwed up by the govt. Is this part of the new modern govt.?

My mom’s birthday is coming up and I am thinking about her and my aunt Marilyn on my mom’s side. According to my dad (in a phone call the other day), my aunt is in the hospital with congestive heart failure and pneumonia and probably won’t make it through this. My aunt is about 89 and my mom woulda been 86 this year. As I am picturing my aunt laying in her hospital bed, I wonder what my mom would be like today if she had lived through these last 17 years. I can imagine Mom living with my dad at his USAA Towers condo and know she woulda loved those digs. She would be, in my imagination, wanting to go be with Marilyn, who she used to call Zaz. I never can remember where Marilyn got that nickname.*

As this older generation passes on we are left with memories of their best years. I remember Marilyn wrestling with Katie on the floor of the cottage when we went up for my mom’s funeral back in ’91. Marilyn spent a lot of time playing on the floor with Katie and her grandson who was exactly Katie’s age. Marilyn and my mom always seemed to share a private joke or communal consciousness with each other… I think they were of like mind in many ways, and as Marilyn approaches her own passing on, it is like another part of intricate system of Mom memories is disappearing. Marilyn is my closest aunt, mostly because she served as my second mom through much of my childhood summers at the family cottage on Christi Lake in central Michigan. She used to encourage me to behave and scold my uncle for using ribald language in front of us kids. She chased me around a desk at a doctor’s office once to give me a shot cause she was his nurse and I was probably running from her as my aunt… one of those situations where familiarity leads to a Rockwell-type visual image.

Another ancient memory pushes into my mind as I am relaxing here in dialysis: the memory of a conversation I had a number of years ago with Nan Stackhouse, one of my mom’s best friends. Nan was telling me about her friendship with my mom and she remembered my mom as glamorous in college in her unfashionably short hair… a tomboy, but also really strong willed and, according to Nan, liberal for the times. She was part of the impetus for Nan choosing to be an artist, encouraging her to follow her passion.

A radio announcement pops through my ruminations; home sales in Austin are down but not as much as other places… and the median price of a home in Austin today is 217 thousand. I wonder what our house is worth today and if we are at the median yet, or still below the median. Two hundred and seventeen K sounds like a ton of money to me and I wonder how in the heck people afford houses that cost that much. And the reporter follows with the fact that this is the first decline in home values on record! Also on the local news, Tonya Voss talks about the difficulties with getting state partner insurance when your partner isn’t an opposite sex person, and Dennis Kucinich is throwing in the towel and backing out of the presidential race. And so it goes.

Notes: In at 79.6 and out at 76.0 Kgs.
*1/31/08: My dad thinks Marilyn got that nickname from ZaSu Pitts. He asked her once but didn't get a definitive answer. I pulled up a pic of ZaSu Pitts, and think she does resemble my aunt.

1/24/08

208) Lab Report Day

January 22, 2008
Tuesday

El Milagro: I am 30 minutes late today because I fell into a big work project at work and lost track of time. Carrie the Tech cannulates me and says its okay that I’m late cause they’re running behind too. Dr. Rowder and crew are doing their ‘drive-bys’. Am I okay? Yup. Any problems? Nope. Jennifer the Dietician reports that my blood work looks good: Phosphorous (5.1) and Potassium (4.5) are within the normal range! ALRIGHT! (This feedback makes us dialysis folk very happy, since most of the time we are worried about our phoshorous) My Albumin is down to 3.6 so she says I need to eat more protein… I complain… and she replies, “Just eat a couple eggs for breakfast every day”. For you all who interested in lab results, the rest of the report is as follows:

NPCR – 0.96 – Low (eat more protein)
HCT Calc – 30.9 – Low (red blood cell count. Take your vitamins)
Iron Saturation – 25 – Good
Ferritin – 629 – Good
Calc Corrected – 9.1 – Good
CaxPhos Corrected – 46.4 – Good
PTH Intact – 383 –High (Remember your binders!)
Kt/V UKM Delivered – 1.48 – Good
Glucose – 112 – Good

Sherri the Social Worker came by to introduce a new social work intern from SWT (Now Texas State U.) who’ll be here for the semester. Rosie the Tech came by and said she is almost finished with the staff interview for the newsletter.

I listen to NPR, as usual, and watch the news. Later I doze and wake up and watch a great show about kids online on Frontline: Growing up online.

Notes: In at 79.6 and out at 76.0 Kgs.
Growing up online, retrieved online from the Frontline website: http://www.pbs.org/wgbh/pages/frontline/kidsonline/

1/20/08

207) INDEX

January 20, 2008
Sunday


Home:
I have been planning to update my Welcome Post (August 2006) for some time and decided to put in an Index for people who may be using this blog to find information on various aspects of dialyisis, ESRD, PKD, and other topics that can be found in the blog. The index allows you to find the month of the topic you want to read about, click it on the Archives column on the right, and then page down to find the Post # of the topic.

Jack’s Kidney Adventure: Index




















































































































































Topic







Mo & YrPost #
AV Fistula












May 2006# 8
Binders


































December 2006
# 79
Cannulation


































May 2006
# 10
Counseling




































July 2006, January 2007, July 2007, September 2007, November 2007,
December 2007
# 33,# 91,# 146, # 161, # 185, # 195
Cramping


































December 2007, September 2007, March 2007, September 2006, July 2006# 178, # 172, # 108, # 60, 59, # 33
Dialysis Power Loss


































March 2007# 109
Ethical Considerations


































July 2006, March 2007, April 2007# 26, # 119, # 120
Hallucinations


































July 2006# 33
High Phosphorous Foods


































May 2006
# 6
Heparin


































June 2006
# 24
Home Dialysis


































August 2007
# 157
In Case of Nuclear Attack






























July 2006
# 31
Infiltration






























April 2006
# 4
Infiltration






























April 2006
# 4
Kidney Advocacy






























September 2007
# 165-168
Kt/V






























April 2006
# 3
Low Blood Pressure






























April 2007, September 2007
# 122, 182
Meditations






























April 2006, August 2006, September 2006
# 2, 38, 52
Nutritional Reports






























May 2006, June 2006, October 2006, November 2006, October 2007
# 11, #22, # 66, # 76, # 178
Paired Exchanges






























March 2007, December 2007
# 104, # 197
Parathyroid Glands






























May 2006
# 6
Phosphorous & Fish






























July 2006
# 34
Phosphorous Itch






























July 2006
# 27
Phosphorous Levels






























April 2006, January 2007, February 2007, May 2007
# 6, 96, 102, 129
PKD Cysts






























April 2006
# 38
PKD Walk






























September 2006, 2007
# 55, 164
Potassium






























September 2006
# 56
PTH Intact





























September 2006, September 2007
# 51, 62
Thanksgiving Day Foods





























November 2006
# 77
Transplant Options





























June 2006
# 17
Transplant Physical





























January 2007
# 90
Urea Reduction Level





























April 2006
# 47
Weight Loss During Dialysis





























October 2007
# 184
WELCOME NEW READERS





























August 2006
# 47
Wrong Dialyzer





























June 2006
# 20

1/19/08

206) Adios La Alondra de la Frontera

January 17 2008
Thursday

El Milagro:
Got here at 4:30… which was good since my chair wasn’t ready at 4 anyway. Carrie cannulates me and Monica the Nurse checks my chest and ankles. Monica is leaving the facility to move back to the west coast to be closer to her family, so I wish her well and say we’ll miss her. I watch Oprah and see Dr. Chistine Northrup discuss menopause and am glad I’m a guy.


I am pondering the Patient Advisory Committee meeting we had yesterday and writing up the report for the newsletter. The meeting was on the gripey side; with the members having issues with nursing assessments, staffing on shifts, patients bleeding too much, Suzanne’s picking up trash, Moritz the doctor's not coming around to visit with folks, Moritz’s bedside manner, and the doctors' ‘drive bys’ being billed to insurance as visits when they only
last a minute or so. The administration, represented by Suzanne the Administrator and Marilyn the Social Worker responded to all these ‘issues’ and the meeting ended on a positive note, but now I have to write up a politically correct report about it all for the newsletter, and that will be a challenge.

Notes:
In at 76.9 Kgs and out at 75. Kgs.

<◊><◊><◊><◊><◊><◊><◊><◊><◊><◊>
January 18, 2008
Friday


El Milagro:
In at 4:15 for my 4 o’clock chair and the chair is ready. (I am here today so I can miss tomorrow for Mitch's House-warming) I ready my area by taking out my blanket, my pillow, and replacing the batteries in my radio. Carrie the Tech comes over to stick me again, saying, “Is it okay for me to stick you two days in a row?” I am okay with it and tell her so. As she is sticking me I notice that she changes gloves about five times during the process, so either she is a bit germ-a-phobic, or obsessive-compulsive, or really conscious about not spreading anything to patients… doesn’t matter to me, since I am the recip
ient of all her hyper-consciousness. The frugal me wonders how many boxes of gloves they charge to my insurance company.

As she is hitting me up and hooking me up, I am watching her, having these wonderings, and simultaneously listening to Latino USA’s remembrance of Lydia Mendoza*, the meadowlark of the border, who died in San Antonio just before Christmas.

I remember hearing her sing on the radio of my youth in El Paso and always liked her voice and guitar work even though I couldn’t completely understand the words. The un-named memory of her is one of those auditory anchors that is buried in the folds of my brain from long ago, and released when there is another playing of her songs… especially Mal Hombre, which stuck in the folds of my brain, probably since listening to KELP radio softly by my bedside back in 1958-59. Even then Mal Hombre was an “oldie” on the radio. The name of Lydia I didn’t remember until today, but the guitar and voice were etched in the folded blankets of my memories to be unlocked today with the sounds of her voice. Pretty cool!

There are not a lot of people here today. I count about 12 empty chairs and wonder if folks are skipping out for a Friday night out, or if this is the norm for this 3rd shift MWF.

I have been thinking a lot since the PAC meeting about the doctor, patient, dialysis center relationship. The center has to, seemingly, be subservient to the doctor’s needs and directives and yet the center can complain to DaVita central if they think the doctors aren’t being responsive to patient’s needs.
The issue (this time) is this: a patient tries to get the doctor to agree with him related to complaints of joint pain. The doctor responds (from the view of the patient) in a way that tells the patient that he is just griping and really needs to lose weight, and therefore the doc isn’t gonna do anything or give him anything for his pains. So, the patient goes to another doctor who wants to consult with the first doc about the patient’s joints and the first doc blows off the second doc and then acts even more rudely to the patient at the next meeting. The patient confronts the doc about this, and the doc treats him even worse (according to the patient). So, the patient sees as the only solution to change dialysis centers and change doctors. That is one solution. We in the PAC suggest he change doctors in the same office (CTKA) and set up regular doctor’s visits at the office, rather than using the dialysis center’s doctor’s ‘drive bys’ as his doctor’s visits. Suzanne the Administrator says she too will bring up the situation with the doc in question.

My concerns are several. For one thing, it irks me that the ‘drive bys’ that the docs do at the center, which are in no way confidential visits between a doc and a patient, are still billed to our insurance companies as doctor’s visits. They usually last about one minute and most patients tell the doc all is fine, which is an easy thing to say when you are in the middle of a dialysis session and have neighbors less than two feet away from you. That situation doesn’t lend itself to bringing up anything really intimate. Instead it is an opportunity, usually for the dietician, nurse and doc to compare notes about meds, diet, and the recent blood work, which all patients have in common and is readily discussable in the ‘drive by’ kind of situation. The facility's answer is to offer screens if the patient wants a confidential doctor's visit, but I have a hard time imagining patients doing that, because that too makes their visit with the doc stand out to everyone else.


For another (and one I have sent a complaint letter about) is the practice of docs transferring patients back and forth without telling the patient. They claim that this is for expediency in coverage of the different dialysis centers, but from my view it is an unethical practice to switch off a patient to another doc without even notifying the patient and giving them a say in the switcharoo.

BTW: I never did get a response to my complaint letter on this, and I just solved it myself by refusing to list the doc they gave me as “MY” doctor on my insurance stuff. This isn’t really a solution, although I have cleared my brain of it for the time being. I recommend that dialysis patients not think of the in-center drive-bys as their doctor’s visits! Patients should make an appointment to meet with their nephrologist every 6 months in the doctor's office. There you have the time and privacy to bring up all you are concerned about (make a list) and want to discuss with the doc. And the session is not rushed by being in a line of chairs that they are rushing by to get to the end. Enough said.

So, I hear Latino USA, doze, ruminate over the above, watch the news, and switch over to hear Gwen Ifel’s guests talk about the state of the primaries on Washington Week**. It is a great show for taking my mind off the above, so I am thankful to Gwen again. And so it goes this week at dialysis. This week my blog has functioned as whipping post and I appreciate my readers for wading through my grumbling diatribe.

Notes:
In at 75.8 Kgs and out at 73.7 Kgs.

* Lydia Mendoza, interview on the Worship Guitars website, at http://www.worshipguitars.org/Interviews/lydiamendoza/index.html

**Washington Week, available online at http://www.pbs.org/weta/washingtonweek/thisweek.html

New Readers:
For A Welcome Post, click August 2006 on the Sidebar.

1/13/08

205) Saturday Matinee

January 12, 2008
Saturday


El Milagro:
Originally Ron the Nurse had given me a 1 o’clock time, which woulda been perfect for watching the UT game… but then Monica the Nurse called and said they’re way behind and won’t be able to seat me til after 2.
So I show up at around 2:20 and still wait for awhile before Amanda the Tech asks if she can cannulate me. Of course, I say sure. By then I have found the end of the UT / Missou game and UT is down by more than 10 points. I don’t remember the last time they lost a conference opener and am shocked to see them playing so poorly. Oh well… it’ll be a long season, starting like this.

Rosie the Tech comes b
y and shares that Jackie the Tech got sick this morning and that slowed the whole process down when she had to leave. Also, I talk to Ron about switching out of next Saturday and he says I can come in Friday, 3rd shift.

I watch the beginnings of the A&M / Colorado game but it is goi
ng to be a boring A&M win, so I shuffle through the channels until I find the movie, Memphis Belle*, just starting. So, I settle in to watching the entire movie and am a happy camper.

Notes:
In at 76.5 Kgs and out at 74.7 Kgs.

*I love WWII movies and consider 30 Seconds over Tokyo as one of my favorites
New Readers: For A Welcome Post, click August 2006 on the Sidebar.

1/12/08

204) The Spanish Lesson

January 10, 2008
Thursday

El Milagro: I’m settling into my chair and getting my supplies all in order as Rosie the Tech is bustling around… the place is hopping today. As Rosie is adjusting my machine, she calls out to one of the nurses, “Ms. ‘X’ won’t be here today” as they are wondering about a certain chair’s blankness. I wonder if it is a ‘bad’ patient who is skipping out of treatment and Rosie sees my expression and leans over and whispers, “diarrhea”. I go, “Ycch. I don’t need to hear that. She called in ‘sick’ huh?” …and she replies, “that’s exactly what she said.

Kim the Nurse comes to listen to me and Rosie and I are telling her to speak Vietnamese to her son. We have been discussing how these second generation folks are not served by melting too much into the dominant culture, and how they should keep their language and customs intact through the generations. Kim has a gringo husband so they don’t speak Vietnamese in the family, but she says her sisters are married to Vietnamese guys and their kids don’t speak it either, but at least they understand some. We talk on and Kim doesn’t feel my ankles… which is part of the nurse procedures. I obnoxiously mention that and that starts a conversation about how to say “ankles” in Spanish. Rosie doesn’t know (although I consider her to be bilingual). There are 'levels' of bilingualism, I have found… and even people who are BILINGUAL don’t know all the words. She says, “Ask Gabriel the Tech” and we chuckle 'cause he doesn’t know any Spanish even though he is Hispanic. He is one of the victims of post-generational meltational drift… having grown up in a Hispanic family where he learned no Spanish. We ask Oscar the Dialyzer Cleaner Guy. ¿Como se llama ‘ankles’ en espaƱol?” Oscar (another fluent Spanish speaker) replies, “¿Los ankles?” Finally the young Hispanic patient guy who is part of my shift family and whose name I never have gotten yet (Rodolfo), pipes up: “Tovillos” and then it takes several minutes and a written scrap of paper to find out it isn’t tobias or tobios, but 'tovillos'. En espaƱol, los ankles se llama, los tovillos. I have los tovillos flacos, as usual. And so we have had our Spanish lesson for today. (If Luis is reading this, I hope it gets a chuckle)

So, I settle into sucking some of my leftover Christmas hard candies, listening to ATC on NPR, and dozing until the news. Then I channel surf, stopping to listen briefly to Jim Lehrer’s NewsHour, part of a movie, and finally drift off to snooze until a new Gray’s Anatomy comes on. This new episode finds Dr. McDreamy breaking up with Meredith again after she hears he kissed the hot new nurse, Rose. So, it’s the same old thing for these folks who are so bent on immediate gratification that they don’t ever consider the longer term results of their behavior. This show is full of people who talk and act without thinking and they aren’t very happy with the results, from my perspective. And we in Boob-tube Land love to watch them make these thoughtless choices… I guess because they probably make our own seem so much better. By the end of the show I am holding my poke holes and ready to get out into the brisk night air and drive home to my ‘normal’ South Austin homestead.

New Readers: For A Welcome Post, click August 2006 on the Sidebar.

1/9/08

203) It's Always Something

January 8, 2008
Tuesday

El Milagro: Today is my first day back at work from vacation and as I sit here at the dialysis center I am thinking that it was weird being back at work today after two weeks off. I had just really gotten used to being at home and then I have to go back to work. But being here has a sense of stability… it never changes… I come here whether I am working or on vacation. There is no vacation from dialysis. At least at this point in my life. As I look around at the familiar scene with a sense of eerie comfort Amanda the Tech walks over smiling and I say, “Are you going to poke me?” and she replies, “Is that okay with you?I” and I say, “of course…”. She goes about the poking procedure with more confidence than last time and yet she is still very gentle and cautious. I give her positive feedback afterwards. She has stuck me so well that I find I can move my arm around quite a bit without ringing the machine’s bells.

Dr. Rowder, Jennifer the Dietician, and one of the nurses come by for their perfunctory “visit” and I report on my vacationary pistachio usage as if I were a probationer reporting drug use before it shows up on my ‘UA’. Jennifer warns that pistachios are really full of potassium and phosphorous and salt! Well, that’s why they are addictive, I guess. In addition to pistachios over the holiday I also ate some chocolate chip cookies, potato latkes, egg nog, and fancy cheeses. These holidays are killers for the kidney diet. As I was partaking of these delicacies I was telling myself “All things in moderation, my boy”, even though moderation is really too much when we are talking potassium or phosphorous. It’s now over and I am still alive, so back to the grind of the kidney-friendly diet.

Tonight on the news they are wondering about how all the candidates will do in New Hampshire… and I am getting tired of the early primaries already. I’m sure this blog will be a forum for my jeremiad at some point, so I’ll ‘back off’ now.

I listen to ATC, watch the ABC news, and then click around and finish watching a series of shows about the universe*: “Alien Planets”, and “Alien Moons”. From the mundane considerations of the regularity of dialysis to the expansive irregularity of the moons of the solar system… as Roseanne Roseannadanna would say, “It’s always something”.

Notes: In at 76.9 and out at 74.8 kgs.
*The Universe, retrieved online from http://www.history.com/minisite.do?content_type=mini_home&mini_id=54036