8/31/08

275) Saturday at the Salt Mines

August 30, 2008
Saturday

El Milagro: I'm here at 4 today because I spent the day doing yard work, trimming the oak trees, cleaning the back porch, edging and mowing, etc. Ann the Nurse checks my BP (100/65), my nursing eval and cannulates me today. She does an okay job and she forgets the thermometer in my mouth and I wait and wait and finally take it out myself. I am feeling exhausted and hope to get some sleep. I notice Rosie and Amanda the Techs, across the room, waving at me... and it takes some time to register in my little brain that I should wave back.

Once I'm hooked up, I lay back and try to go to sleep... turning the TV to some news channel that is reporting about the newest hurricane that threatens the coast. I doze... waking up sometime later, recognizing I am having some cramping in my right calf. I am able to massage and stretch this one out. Then I have one after another in the bottoms of my feet and those are easy to deal with. Then I have one begin in my left leg and I get it quickly... it's almost like chasing a pesky mosquito around my body. Finally, I get a cramp in my right thigh and I end up calling Rosie over and she switches my dialyzer off for awhile. Rosie thinks Ann set me up to take too much off to begin with so it is okay to stop for awhile. Awhile becomes about 30 minutes and it works marvelously to end the cramping. Later, I call her over and ask her to turn me back on...

I flip the channels on the TV and catch the last few minutes of "Meet Joe Black" and then watch the beginning of "Hope Floats" about Smithville, filmed around central Texas, and featuring Harry Connick Jr. wearing a KFAN t-shirt and Sandra Bullock playing herself.

Then I fall back asleep and wake up when Ann the Nurse comes over to ask me to update my meds list, which she has right except for one med. I flip the channel again, avoiding Becvar & Becvar's text laying on my chair shelf, which I brought to review for Class 2, next Thursday. "Thursday! Shoot... I can review my readings next Tuesday..." I tell myself confidently. I find a mystery on PBS (Rosemary & Thyme)
and watch until time to unhook, which, of course, happens right before the beginning of the climax of the show. So it goes in dialy-land.

Notes: In at 75.0 and out at 73.8 kgs.

8/29/08

274) Phos 7, Jack 0

August 28, 2008
Thursday

El Milagro: I am late today and yet Celeste the Nurse pokes her head out of the treatment room within about two minutes, calling me in to my chair. Today is my first class for the Fall semester and although it gets out at 4 if find it takes me about 20 to 30 minutes to drive over here from east Austin... so, I figure I'll be 20 to 30 minutes 'late' every Thursday. I report this finding to Rosie the Tech and she replies, "Just get here before 4:30 so we don't have to take you off early." Jo the Nurse is part of this conversation and she remarks that she worked at a facility that didn't close until 10 at night, specifically for those of us who work and have to come in after our jobs. Both of them seem okay with my coming in at 4:30 on Thursdays thru the fall, and that suits me just fine.

Today the person who set up my 'kit' for cannulation put size 14 needles in the kit and Rosie questioned that, asking if I knew anything about moving from size 15 to 14. I shrugged and nodded, "no". Jo didn't order the change. Usually the doc orders a change... the rationale being that I can get better clearance with larger needles. When I looked at the needle, I notice that it is so big I can see right down the hole... looks kinda like a shaved tailpipe. And, of course, sticking them into my fistula is a bit more prickly than usual, but really not too bad.

After I am hooked up and listening to NPR, Gordy the Dietician comes up with a scowl on her face and I immediatly know that my phosphorous must be up again... she says "What have you been eating? Your phosphorous is off the chart! It woulda been Sunday or Monday... do you remember what you ate? Cheese, beer, chips, beans... what was it this time?" Turns out my phosphorous is up to 7.4 (5 is the high end of normal and mine has been steadily going up: July 15 = 4.9 and August 12 = 5.9). I can't figure out what the culprit foods were last Sunday... that's ages ago... who knows what I was eating?

Dr. Rowder comes up for his last 'driveby' (he is transferring and Central Texas Kidney Assn. will again arbitrarily assign a new doc without considering the desires of the patients). At least this time Rowder is telling us that this will happen*. Rowder and I discuss my phosphorous high and I remind him I'm taking 1/2 a Fosrenol and 4 Phoslos at each meal. He suggests I try taking the Phoslos BEFORE I eat to see if that makes a difference... and, of course, make an effort to get back to my low phosphorous diet. I promise I will.

I spend the remainder of my session today copy editing the new Tex Net News for work, dozing, making notes about ideas for the class, and watching the Democratic Convention on PBS. Highlight of the convention for me tonight is hearing Al Gore talk... I wish he had had that passion when he was running against Shrub... although I think it was really in the cards that the Republicans were going to steal the election any way they could. I am afraid that they will pull all the plugs in this election season and we will have to watch them like hawks to ensure their usually illegal and nefarious activities are brought to light in time to stop them in their tracks before November 4th. "Don't get me started..." I say to myself, watching my BP raise just thinking about the possibilities of a negative campaign on both sides. I hope Obama has the integrity to stay out of the lambasting and stick to the positive reasons that the Dems can reconstruct our government. (Do you want to share your ideas here Albert?)

Notes: In at 76.6 and out at 74.3 kgs.
* See Post # 130, May 2007 about CTKA transferring patients without their permission.

8/28/08

273) Locked Door Dilemma

August 26, 2008
Tuesday

El Milagro: I arrive today a few minutes after four and wait 35 minutes before Carrie the Tech comes out and asks, "Are you ready?". This is not the thing to say to someone who has waited 35 minutes. She also reports that my chair has been ready since 1 pm! I complain to Carrie that because of the locked door, I wasn't able to come in and check, and that is the down side of locking us out of the treatment room.

So, I have been thinking about what I, as an assertive patient, can do to be part of the solution... coming up with one thing I can do. During the time I was waiting Jay the Boss, Susanne the Administrator, Marilyn the Social Worker, and Joseph the Tech all went by from the treatment room to the administrative section. The squeaky wheel gets the grease... I could easily ask each of the staff as they go by to check and see if my chair is ready yet.

Later Celeste the Nurse comes up and opens up a discussion with me, having overheard my complaints to Carrie. Celeste says they are supposed to check whenever they have a chair ready to see if the person is in the waiting room, but they get very busy with the work that is in front of them. I replied that that was exactly my point... that they are so busy that it is very easy to forget to check the waiting room... and some techs do better than others on checking and being client-centered than others. One of the options that Celeste came up with is that I should knock on the door rather than wait. I think that when I see people do that the folks who open the door seem quite put out that patients are knocking rather than waiting. So, anyway, Celeste said she would try to do better at checking for missing patients and I told her I would do better at squeaking at staff that are walking by in the waiting room.

Notes: In at 76.5 and out at 74.3 kgs.
New Readers: For an INDEX, click January 2008 on the Sidebar and page down to post # 207.

8/23/08

272) Emma Thuy's 2nd Birthday

August 22, 2008
Saturday

El Milagro: The alarm rings at 5:15 this morning and I drag myself outa bed and pull on blue jeans and a t-shirt, fuzzily thinking to myself that a 2 year old's birthday party shouldn't do this to me. Today is little Emma Thuy's birthday party at 3 pm and the only option for dialyzing, according to Rosie the Tech in a call last night, is this morning at 5:30. "NO!" I yell back at her on the phone... "how about 8?" and she reluctantly negotiates it to 6, adding, "be here BEFORE 6" and I agree. I am sluggishly stumbling around and can't decide to make or not make coffee for about 10 minutes, at which time it is time to go. It is dark. Not only in the rooms of the house and outside... but also in hallways of my brain. I drive over to the center and park with all the other early risers, thinking that there's more cars here in this parking lot than I've seen all the way over here. I walk in... the door's open... and James the Nurse is standing there, offering me a smiling "Good morning!" I manage a smile and a grumble. My chair is on the back wall and they are ready for me. This older Hispanic woman who has been around some time and yet I don't know her name comes to poke me and I nod agreement to her questions and statements and she hooks me up and I slump into my chair, hoping I can return to dreamland. I pull my hat down over my eyes, pull my blanket up around my chin, and try to settle in for a doze... no happen. "The lights are too bright" I tell myself, ducking further inside the brim of the hat... "...too much noise..." I say, sticking in my earphones and tuning in to World Cafe and then Sound Opinions and... no sleep yet. James the Nurse comes over to do my nursing eval.

Sometimes I can come in early, get hooked up, and go right back to sleep... not today evidently... so I listen thru WC and SO and then turn off my radio and just lay there with my cap down over my eyes, trying to get back to sleep. I think about all the times I have sat with Shayna when she can't go to sleep, giving her ideas about how to sleep... "see if you can slow your thoughts down to a drone" --- "how Daddy?" --- "When you are talking to yourself, slow down that each word is 30 seconds long... thirrrrrrrrrrrrrrrrrrrrrrrrrrteeeeeeeeeeeeeeeeeeeeeeeeeee

seeeeeeeeeeeeeeeeeeeconnnnnnnnnnnnnnnnnnnnnndsssssssss
loooooooooooongggggggggggggggggg..." I chuckle. She never got it... and now she can go to sleep on her own... somehow she figured out how herself. I wonder briefly about this human ability to teach ourselves things... and remember reading about Milton E. re-teaching himself to walk after polio... and so I try slowing my own self talk down. This, b-t-w, is an old NLP trick.

Maybe I sleep maybe I don't... can't tell. Every so often I crack my eyes open and it always seems to be the same time: 20 til 8! Seven forty! Twenty til Eight! 7:40! "I am looking too often" I tell myself, and then I say, "Hush! No talk! Sleep!" ....Peek. 20 til 8! "I am stuck in time!!! Must figure this out! NO! Sleep. Sleeeeeeeeeeeeeeeeeeeeeeeeeeeeep..."


"QUARTER til 8!"
So this is how this morning is going. I finally turn the radio back on and listen to Morning Edition and decide to be happy about being awake and ready to input data so early. Then I think I musta dozed for awhile.

At ten I am getting unhooked and Cheryll the Tech is much gentler than the one who hooked me up. However, she won't let me leave just yet cause my BP is down around 97/6
2. I sit for five minutes and then it is 87/46! I sit for awhile, thinking jumpy thoughts: running and leaping. 92/55. Finally it comes up to 97/70 and James okay's me leaving below the 100 cut-off point and I shoot outa there to live the rest of the day.

Later: The reason I dialyzed early today is to attend Emma Thuy's second birthday at Freddies.* She isn't old enough yet to have her own friends so it is mostly adults ooing and ahhing little Emma, and with a few kids, aged 8 months, 8, 11, and 18 acting age-appropriately.

Notes: In at 76.5 and out at 74.3 kgs

* Freddies online @ www.freddiesplaceaustin.com/


8/22/08

271) Sleeping Fingers

August 21, 2008
Thursday

Morning: We are in Fredricksburg for an overnight end-of-summer vacation and yesterday we drove out here stopping at every antique shop, crafts place, gallery, and artist's from Iceland's ranch. The highlight was meeting an 80 year old artist from Iceland: Eyfells*; and we spent some time letting him show us his work, his wife's large portraits, and his improvements on the property and plans for the future. We shopped, bought little things for the house, and ended up at the hotel pool, swimming.

We went to eat at Navajo Grill** and found the food quite good, but a little on the high side for what you get... but still worth it for the beautiful outdoor patio with acoustic western music. See Jack's Restaurant Report in Notes section.

We drove back this morning in time for me to go to a Dr's visit with Joseph Leary, my nose guy who cauterizes my telangectasias*** when they get out of control every few months. This time he found three little spots to zap and I was on my way in about 15 minutes.


El Milagro: I am late today... just can't seem to drag myself away from the home front when I am vacationing and doing little home piddling things. Imagine, not being excited about going to dialysis... So, I finally drive out of the driveway at 4 and get to the center about 4:15, wait until they call me in at about 4:30 and Big Daddy Joseph the Tech pokes me... he is getting better at this: it is weird that he just jabs those needles in, and yet he has gotten to a place where I feel the jab, but it isn't really painful. He sets me all up and I hook up my earphones and listen to ATC on NPR all the way thru the news on TV... which is turned on to the olympic wrestling and muted... but I can almost hear the grunts just by looking. I read some on my text for the fall and fall asleep somewhere in the slip of time there.

One weird thing that has happened twice now is my ring finger and little finger on my fistula hand falling asleep (see post # 263) and getting totally numb. I can play with them and massage them back through tingliness to feeling, and then within about 20 minutes they are back to numbing sleep. I wonder if this is something or just nothing. "Is it something?" I say to my self... and then I consider it and say, "Nah. It's nothing..." And then I worry some and think, "It must be something" and then scold myself and convince myself it is just sleeping fingers.

Wake up and watch most of Matchstick Men on AMC, starring Nick Cage as a person who believes, and convinces me, at least, that he has Obsessive Compulsive Disorder. Pretty good movie that I want to see the end of sometime. Not tonight though... I am done before it has reached it's cressendo and am anxious to get back to my vacation.... imagine that: I don't want to sit around here watching another half hour of a movie!

Notes: In at 76.5 and out at 74.3 kgs
* Eyfells online at www.eyfellsandeyfells.com
**
Navajo Grill online at http://www.navajogrill.com/aboutus.html

***
See more about telangectasias on Wikepedia, online at http://en.wikipedia.org/wiki/Hereditary_hemorrhagic_telangiectasia
New Readers: For an INDEX, click January 2008 on the Sidebar and page down to post # 207.

<><><><><><><><><><><>
Jack's Restaurant Report: the Navajo Grill in Fredricksburg offered (Liz) wonderful large gulf shrimp with a red chile rub (Navajo Blanket), on a bed of tortilla strips, guacamole, and other delights. Shayna and I split the Navajo Steak; a flat iron steak with asparagus (me) and brocolini (her) and it was broiled perfectly medium rare and had a smokey taste, with a light red wine worcestershire reduction. The creme brule with blueberries and strawberries was excellent.
<><><><><><><><><><><>

8/20/08

270) The Yakky Tech

August 19, 2008
Tuesday

El Milagro: The big clouds are coming in from the west. Here the sky is still clear, but over in West Austin there is a black bank of rain coming this way. It's gonna unload anytime and I think of Shayna home alone in the storm. I scoot in from the parking lot and find the door to the treatment room locked again. I sit and pull out my Bush book... read for about 20 minutes til I get tired of waiting and sneak in as someone comes out... feeling like a neighbor's sneaky cat I once knew that would zip into the house as quick as a flash when someone opened the door. Then we'd have to chase him around while he tried to hide behind the drapes or under a couch. I zip in and wander around looking for my chair.

I find my chair and Carrie the Tech checks my BP. Rick the Tech sits down beside my chair and is yaking away while preparing to swab my arm. I ask, "Have you stuck me before?" and he acknowledges that he has and then he goes on, asking about if I've been to any good restaurants in the last week... what's my book about... what is a 'neo-con'... and continues to yak on about his definition of a 'fact', etc. Meanwhile he nonchalantly goes thru the poking process and before I
can focus on what he is doing versus what he is saying, I spot that his needle stick doesn't look right.

"I do one up, one down" I blurt out. He looks up as he slides the needle into the fistula, quiping, "It's too late now!" He quickly notices the frown on my face and adds, "Its okay... it really doesn't matter..." to which I reply, "It matters to me. I always for the past two years have had one up one down." His smile disappears and he apologizes and tries to return to small talk. I'm in my head adding up all the halucinations I have about why I don't really like this new guy. He's too friendly; he doesn't focus on his tech work (with me); he is absent-mindedly teching me while yaking away about whateve crosses his mind. Maybe it is an attemp
t on his part to build rapport with patients. I think that if he would observe other techs he would see that when they are at the business of setting us up they focus on their work, not visiting... which, in fact, Carrie is doing with my machine while he is yaking. Maybe I'm just in a mood today... and want to be left to myself as I enter into another blood cleansing session.

Dr. Rowder comes up for one of his 'drive-bys' as Rick is yaking, and I turn my attention to him and his cadre of little assistants. He reports that he is changing shifts and so there will be a new doctor doing drive bys in September. He is suggesting that 'they' (the Doc's practice) will again be changing all of us to a new doctor weather we want one or not). I reply that I'll stick with Moritz. He introduces a new PA and suggests that she will be doing these walk-arounds too. The new dietician, whose name I forget, and who dresses 9 times dressier than Jennife
r (this one has high heels that look like shiny extra-pointy alligators... regular high heels that look like someone grabbed the toe with a pair of pliers and stretched it out an extra two inches to a sharp point) and shows me my lab results which are good (Rowder calls my clearance "Excellent") except for my phosphorous going back up again (from 4.9 to 5.9). She scowls cutely at me and I shrug and guess that it has to do with cheese or something... Rowder asks, "enchiladas in Laredo?" and I reply that I haven't seen an enchilada in years... "No... it is probably nachos or snacks at the conference that week". We all agree that I will do better next time.

They move on and I settle in to setting the TV muted on the weather channel to watch the storm come over, hook my earphones up to NPR, and start reading my Bush book. I am getting bored with this book, and yet I continue with it to avoid reading my texts for the semester. As usual, I switch over to the ABC News at 5:30...

I fall asleep sometime and snooze thru the rest of my session... waking up in time for Carrie to unhook me and let me go back into my life. So it goes.

Notes: In at 76.8 kgs and out at 74.5 kgs.

8/17/08

269) End of Summer Sale

August 16, 2008
Saturday

El Milagro: I am here just a little late today... had to actually go to the mall! Yes, me. You see, the Macy's had their annual end of summer sale on men's shorts... which I get every year at the end of the year at one of those big department stores: 4 pairs for $27! That slowed me down enroute to dialysis. Rosie the Tech had arranged for me to come in at 1:30 today and I was at the store at 1 to get the sale price, which I read to say was effective "after 1". So there I am standing at the checkout counter with my four shorts at about 1:10 and the sales guy tells me that the sale was BEFORE 1. I say, "No. Look at the ad." and he proudly replies, "Let me show YOU, sir". and he shows me that it says "SALE, bla bla bla for 5.99 a pair bla bla...and then written below is After 1:00 pm. on sale for $16.00." Well, I immediately claim old guy stupidity, misrepresentation on their part, and then beg for the sale sale price. He shakes his head and rings it up and voilà; it is still in the register at the sale sale price. So I am a happy camper zipping outa the parking lot and up the hill to El Milagro.

I get called in (they still have the closed door policy ~ and yes, Kim the Blogger Tech [
asthepumpturns], you are correct that in most clinics they do it the way you describe and explain. See # 267) I wait a few minutes until they call me in and Gladys the Trainer Tech cannulates me... first time in ages... she is now the trainer and has these new techs following her around like puppies. She pokes me painlessly... she's still one of the best!

I am tired of watching the olympics so I look around for some movies and find an unknown, non-star movie called "The Trophy Bride's Secret" that keeps me entertained while I doze and take off the minimal 1.2 kgs.

Notes: In at 74.8 and out at 73.6 kgs.

8/16/08

268) Another Conference Over

August 15, 2008
Friday

El Milagro: I am here on a Friday instead of Thursday because of a work obligation... had to attend our annual Gala* last nite. One of the highlights of the Gala this year was our finding Mary Gordon Spence to emcee. She was her usual home-spun self and had the audience laughing throughout the serious presentation of honorees. This year we honored Judge Sakai from San Antonio and Gloria Williams and Carmella Lucera of Austin. The Gala was held again at the Texas Disposal System Exotic Wildlife Ranch and Pavilion**. Another highlight for me was a "reunion" of old Middle Earth staff, Steve Bewsey, Jose del Valle, and me. Steve I see all the time, but Jose (another El Pasoan) I haven't seen in years... and it was great catching up with him.

Rosie poked me and we discussed my recent work schedule and her thoughts that I should be trying to back off some of the work stuff... "You are on dialysis, you know". I didn't tell her that recently I have been in a new phase of my dialysis... used to be that the dialysis was like a "maintenance" operation, meaning that I went from session to session feeling "normal" and the sessions kept me at that 'normal' state. Ever since the time I went too many days (see July 22 ~ # 260) it seems that there is now a new cycle that happens. I feel good after dialysis for a day or so, and then begin feeling more dragged out and sometimes nauseous as I approach my next dialysis session. I hope that this cycle thing that is happening is maybe related to summer and it being really hot and uncomfortable in Austin right now, like 100 each day for over a month now. My lab work doesn't seem to indicate any changes in my chemistry that may be indicative of the dialysis working less well.

After Rosie cannulated me, one of nurses I don't know did my nursing evaluation and I settled in to listening to NPR ATC and reading. First thing I read is a letter the dialysis people gave me, from the provider of my meds to my doc, saying that I am approved for continuing my prescription for Sensipar for another year... this is good, since Sensipar is one that costs $1096 a month, according to the label that reports, "your insurance saved you $1065.99".

Then I read a handout I picked up at our conference from a workshop entitled, "Navigating the Culture of Poverty"... it has a few interesting questionnaires... Could you Survive in Poverty? with some statements reflecting the certain survival knowledges one needs to have when they are poor, middle class, and wealthy.

Then I start to read on my text for the fall semester... close my eyes... and drift off into a doze... It is nice to take a long nap after working conferencing for three days straight! Just let all the stress, worries, and concerns go... and take a nap. I sleep until about seven and wake up to watch Legally Blond on ABC: a nice escapist, no brain, activity to act as a break state between the busyness of the conference and the home chores of the upcoming weekend. And so it goes...

Notes: In at 77.8 and out at 75.2
* TNOYS 4th Annual Gala retrieved online from http://www.tnoys.org/about/gala.php
**Texas Disposal Exotic Wildlife Ranch & Pavilion retrieved online from http://www.texasdisposal.com/ExoticWildLife/WildLifeRanchMain.htm

8/10/08

267) The Entitlement Syndrome

August 9, 2008
Saturday

El Milagro: Rosie the Tech called Friday night to offer me either a 5:30 am chair or an 11:30 am chair and I responded that since it's gonna be so hot, how about noon, so I can do yard work in the morning... she says "No... 11:30, not 12... 11:30". I brought up how they were late last week and she assured me the chair will be ready at 11:30! Okay.

So, I arrive at 11:30 and find from Gladys the Tech that they're not ready yet. A scan of the room indicates that Rosie isn't even there to kid with. I am waiting in the weighting room... which no longer ha
s the weigher, so I guess it is now simply a waiting room. The influence of Jay the New Boss is, I analyze, to make El Milagro look like other treatment centers I've visited around the state... with the weigh station inside the treatment room and the door closed to the waiting room. I wonder what the rationale is for those changes...

Several waiters are here: a couple and a guy waiting for their rides home and a woman waiting for her son, who is on dialysis. They TV is showing the Olympic games and they are all discussing how beautiful the opening ceremony last night was. I begin these notes. The waiters and I agree that with the closed door policy, we worry that we will be forgotten out here, even though we know that they have a chair in there with our name on it.


I notice, sittin
g here, how much I hate waiting. I am trying to decide if I want to go do something and then return. What could I do? Go down the street to the plant store... but if I bought a plant it'd sit in the truck for four hours and that wouldn't be good. I guess that not liking waiting is part of my leanings toward "the entitlement syndrome"; thinking that it's all about me, when, in fact, none of it is about 'me'. I expect things to always operate on my schedule! When I'm ready, they should be ready! (Remember Albert Ellis' "'Should'ism is shitism'")

If 'I' don't like something and I sit back and accept it without comment or any outward sign of distress, anxiety, or complaint, then I can define myself as having a taoist attitude (or Zen, if you wish). If, however, I complain and publicize my thoughts and feelings about the things I don't like an
d especially if I criticize and deride the hallucinated progenitor of my contempt, then I am acting like I am 'entitled'... they owe it to me to put me in a chair immediately! "I" am the most important king of the world and I deserve to be seated NOW!

I do notice a number of patients in El Milagro griping whenever things don't go exactly like they want it to be, and my assessment has usually been that their distress is a result of their disease. I think that many patients have an underlying and unresolved anger about their medical situation and the facility and staff unconsciously become the target of these negative emotions. Rather than accept a medical situation, it is easier for some to attack the people and programs that remind one of their terrible situation, I think. And I also think, as I said earlier, the folk
s aren't conscious of their behavior; they probably just feel some relief and maybe a little bit of guilt after they make their demands and complaints. In my estimation this is an area where the social work staff could provide much more support than is apparent on a daily basis. I can imagine a center where social workers would provide ongoing 'counseling' related to grief and anger work with the patients, which might impact their "entitlement" issues.

In fact, when I self-assess my own behavior and blush at the finding that it might be an "entitlement" situation, it helps me to step back, assess my attachment to my frustration and anger, and then reframe those 'parts' as protective devices that don't have to jump up to defend me right now. The subject of my distress, I tell myself, is simply a glitch in the system that is there to get me to step inside and remember my tai chi... the
way of the warrior is to not be where they swing. And then I can breathe in calmness and then breathe out any distress and anxiety and return to a stance of acceptance. Also I can consider how I fit into the system and how much my "questioning authority" is done for the benefit of the whole group of patients, versus for myself.

When I don't
remember to follow this strategy, or when my entitled part overwhelms my accepting part, I can become a person with the 'entitlement syndrome". Both Bill Wren and Dusty Humes, in my past, have had a lot to say about entitlement and narcissism... so, if they are reading this, I hope they offer their perspectives as well.

Both Carrie the Tech and Amanda the Tech come through the waiting room, on their way to work, with their little lunch sacks, and they inquire, "Do they know you're here?"
and I nod. Finally Amanda comes back out and reports that my chair is ready. I walk in, go to my chair and pull out my supplies for the day; radio, blanket, pillow, earphone, book... and she takes my standing BP. "How much did you weigh?" she inquires. I realize I didn't weigh in... missed it because it wasn't part of my normal pattern, since they moved the weigher inside the room. So, we unhook my BP monitor and I return to weigh in... 76.4. Amanda continues to hook me up and I listen to Tom Russell's "Hills of old Juarez"* on KUT Folkways as I tune the TV to the olympic games... women's beach volleyball. Amanda is 5'9 and we discuss how tall Shayna will be, since she has sprouted almost three inches this summer. Amanda reports that she doesn't wear heels. I settle in to watching the games.

I watch the games for the whole time, and it passes quickly. I probably dozed for awhile too cause I lost part of the time, it seems. Of note, today is the death anniversary of Jerry Garcia**, 13 years ago now...

¡Perdemos su espíritu y música Jerry!


NOTES:
In at 76.4 and out at 74.5 kgs.
* Tom Russell's thoughts: http://russelltom.blogspot.com/ (desert views ala EP)
**Jerry Garcia online at http://jerrygarcia.com/intro.html
*** Jerry in the clouds retrieved online from http://jeromeprophet.blogspot.com/2007_04_15_



8/8/08

266) Weight a Minute

August 7, 2008
Thursday

El Milagro: I am on time and in the corner. Kim the Nurse sticks me and does my nursing eval. I call Ron the Nurse over and ask him to get one of the docs to respond to a letter I got from my medications provider, saying they want to "interview" my doctor about my Sensipar prescription to see if I really need it. Now, why do you suppose the doc would prescribe a med I don't need? Another hoop to jump through.

Rosie the Tech comes by and embarrisingly shares that she forgot about the PAC meeting yesterday. Only Susanne the Administrator and I were there... and we decided to continue the newsletter monthly and let everything else slide until there is a new crop of patients that may be more interested in the PAC thing. Then Big Daddy Joseph comes by and we discuss low riders and chop jobs and metallic paint jobs on cars for longer than I'd like to admit.... and I miss ATC and the news.

Tonite I doze and flip the channels and finally end up watching a History Channel show on the Marvel of Big Trucks... and then one on the Marvel of Big Truck Stops and they do interview Willie at his place up north of Hillsborro about the biodiesel rage. This is all very interesting stuff and even though I am feeling the old twitchy feet thing, I am able to concentrate on the big rigs and all about them... reminds me of the Trout Fishing song... how many wheels on a big rig.

I am the last one out and don't really feel too hot at the end. I go out to weigh and weigh out at 75.9 and am confused, since I started at 75.7... or, wait a minute, was my beginning weight 75.7 or 77.5? What did I tell them at the beginning of treatment, cause I wrote down 77.5. Or, is the scale off, like it is frequently with John the Reader? Who knows and I am too exhausted to care, so I just walk back in and yell out, "75.9" and shrug my shoulders. Turn around and head out into a humid Austin night.


8/2/08

265) Saturday at El Milagro

August 1, 2008
Saturday

El Milagro: Last evening Rosie the Tech called to say I can come in today at 10:30 to 11 in the morning. So, this morning I get up and mow the lawn and everyone else is out cold even when I get done with the front at 10 or so. Johnny is here for the weekend (he comes back home to sleep) and his mom calls to roust him out and get him over there to help put a window AC in the studio. I make coffee and take it up to Liz and head out to dialysis... stopping to pick up a breakfast taco at our little neighborhood taco joint.

I pull into the El Milagro parking lot about 11:10 and find out from Jason the Tech that the last guy isn't out of my chair yet: they had a machine break down and are running about 30 to 45 minutes late, so I have another 30 minutes or so. I decide to head over to the ex's to eat my breakfast taco, see the guys put in the AC, and check in with Katie, who said yesterday she needs to talk to me "about Delta Zeta".

So I munch down my chorizo & egg taco and watch the boys pull the AC out of the box and get it ready to set in the window; talk briefly to the ex, and get the lowdown from Katie on the sorority. Basically, she has signed up to live in the sorority house but can't afford it.
She would like her mom and me to pay for it... and my response is to say that I will match whatever she puts in monthly from her own money. I add that it may be time to sell her jeep, buy a bike, and work in San Marcos to pay for the whole thing. She agrees to figure out what she is going to do and let me know.

When I get back to El Milagro, they are ready for me and Jason cannulates me while Connie the Nurse does my nursing evaluation and we discuss college costs these days and how inaffordable it has become since the Texas legislature lifted the caps on costs. I mention the Texas Tomorrow Fund, ways to save money for offspring's education, and the rudiments of my family's strategies, including John's college debts and Katie's working. Connie hasn't saved much cause she thinks her 10 year old doesn't like school and therefore probably won't go to college. I tell her the story of my Dad's putting money away many years ago for all his grandchildren and my not putting money away... and the result of those choices. Amanda the Tech, who is attending ACC because she can't afford the big colleges with her Texas Tomorrow Fund monies recommends Connie do something in case her child re-decides later and Connie goes off to find out if the TTF is even still open to folks.

I settle into listening to KUT's Folkways, with Tom Pittman hosting today. Tom is playing absolutely great music today and even tho part of me wants to settle back and watch some tube, I find myself reading... actually skimming today... my Bush Book and really listening to Tom's choices.

I'm now in the chapter of the book about how big a bet it is that Bush will find a way to attack Iran before he's done in January. According to Greenwald, the Manichean-brained Neo-cons are really pressuring Bush to put his fists where his mouth is. Greenwald states, "...once a president accepts and publicly declares that Nation X is not just hostile but Evil, and once he refuses even to negotiate with that country, all of the options typically available to a country in order to coexist peacefully are eliminated. But that is precisely the barron, suffocating corner in which the president's most fervent supporters want him to be in with regard to Iran, and that is where the president has chosen to be."*

Shiver! It's scary... so, lets see what Tom P. is playing this afternoon. Did I say how nice it is to listen to Folkways for FOUR whole hours while in dialysis? Right now he is playing a series of songs related to the Carters & Cash family; June Carter's Far banks of the Jordan; Carlene Carter's Ring of Fire; and Roseanne Cash's Black Cadillac, as well as a few Johnny Cash songs. He has already played stuff from Doc Watson, Ramblin Jack Elliot, KD Laing, and quite a few bluegrass numbers. Oh, and a Tom T. Hall tune you don't hear too often. I put the Bush Book down and drift off to listener land with my earphones on, my hat pulled down, and my red Mexican blanket pulled up close.

I notice Rosie the Tech walking around when I have about 20 minutes left, with the Newsletter... which I hadn't noticed. She smilingly hands it out and explains it to some folks, once pointing over at me, "If you have complaints, he's the one to talk to..." or something. As I am getting ready to leave she remarks that they have a mandatory staff meeting tomorrow and she'll talk to Susanne about scheduling a meeting for August.

Notes: In at 75.2 and out at 74.3
* Greenwald, G. (2007) A tragic legacy: How a good v.s. evil mentality destroyed the Bush presidency. New York: Three Rivers Press, p. 178
**KUT Saturday Playlist, retreived online at http://kut.org/music/playlist

8/1/08

264) There's Water on Mars!

July 31, 2008
Thursday

El Milagro: I am here on time and it takes staff about 15 minutes to get to poking me. Jo the Nurse is here today and we kid around... "You just had a birthday..." "July 2nd." "Wow. Mine is July 3rd!... but I'm a lot older than you..." "Old of spirit, young of body... wait a minute... (LOL) I mean, Old of body young of spirit..." "What do you know about my body?" Meanwhile she is setting up my BP and doing my nursing eval. Rosie the Tech comes up and joins the fracas and we are having a fine time... which keeps Rosie from hooking me up for 5 more minutes.

I wonder why the Newsletter hasn't been copied yet and Rosie reports that Susanne the Administrator has been out of office for a few days. I wish there were someone else I could give it to... since now the July Newsletter will be handed out in August.

Rosie and Jo are also discussing a new edict from Jay the Boss that they can't bring folks in early on Saturdays... and I wonder what the reason is and they guess it is a control thing... he supposedly doesn't want the staff making decisions on their own. Of course, he isn't here on Saturdays. Staff have taken it to Susanne because they argue that patients and staff both like getting out early on Saturdays. We'll see how this one turns out.

Oh, and the big news is --> there's water on Mars! According to project manager Barry Goldstein, "
Our excitement is not so much that ice is made of H2O," says Peter Smith, the Phoenix lander's principal scientist. "It's what we're going to learn about the impurities that are associated with this ice — salts, minerals and all of the things that are going to tell us about the history and the chance that this is a habitable zone on Mars."* Water on Mars. Takes me back to Whitley Strieber's 1997 fantastic accounts of being transported to Mars to attend "the secret school"**. This could be the beginning of learning about life outside of the confines of mother earth... and who knows where that research might lead.

I ponder the possibilities of water on Mars and try to read my Bush Book at the same time... basically skimming the pages until it is time for the ABC News. Then I briefly nap until Texas Monthly Talks on KLRU and end up watching all that PBS fare until I leave at 9.

Notes: In at 77.2 and out at 74 kgs.
*Palca, J., Nasa's Phoenix Lander Confirms Ice Exists on Mars. Retrieved online from NPR at http://www.npr.org/templates/story/story.php?storyId=93148447
** Streiber, W. (1997) The secret school: Preparation for contact. New York: Harper Collins Publishers