319) I'm FAT!

January 22, 2009

El Milagro: "It was the most wonderful speech ever..." Rosie cried with tears welling up in her eyes. She is over here at my chair beginning to poke me and can't wait to discuss the inauguration of two days ago. I agree that it was 'something' and direct her to this blog for my expanded dialog. When I report my entry weight (79.9) Rosie does her figures and arches her eyebrows: "You have to take off 5!" Well, there is no way I can do 5... so she sees I did 4 last time and she sets it up for 4. (You remember, Rosie usually says I can't do more than 3 without cramping.)

She hooks me up and turn to reading my Motivational Interviewing* book (for developing a workshop on MI for March) and listening to ATC on NPR. Pretty soon Jordi the Dietician (self called "shorti Jordi") and Kate the PA come by to visit. Phosphorous is up to 6 again and I share with Kate Jordi's recommendation that I take more Phoslo and no Fosrenol if Fosrenol makes me sick. I mention that I have tons of Fosrenol and don't want to just throw them away and we decide that, since they don't seem to bother me as much during the day as at dinner... I'll take a half at lunch. Then, take 6 at dinner. We also discuss food briefly and Jordi reminds me that my Rice Milk needs to NOT be fortified, or enriched.

Also Kate reports that my blood count is slipping down and we discuss my past problems with blood count. Kate just uses the low count to up my dosage of epogen. The lower my blood count, the higher the dose.... simple as that.

Later Rosie comes by and scolds me about the phosphorous. "You eat 4 little crackers, take a binder! Tortilla soup... 6 binders! Tamale... 3 binders! Whatever you eat, take a binder!" "Okay Okay" I say... and her demeanor shows she's not kidding right now.

I read til the ABC News and watch the news. Switch over to Jim Lehrer afterwards. Mute the TV and read awhile, waiting for Gray's Anatomy. But right before it comes on I find a James Bond movie and get sucked into it... forgetting Gray's until 10 til 9, when I switch over and catch the very end... and then back to Bond.

As I am watching I am having twitchy feet and jumping around in the chair... and then my right foot begins to cramp a little and then my left calf chimes in with some cramping... and adding the cramping to the twitchiness makes me jump like a penguin (<--? I don't know; "penguin" is just what popped into my mind.) I ask Rosie to pull up my chair so I can push my feet down on the floor, which always helps the cramps. She does, while shaking her head and declaring I'm becomming a gordo. I reply, "gordito" and she replies, "You're too FAT" and scolds me again. So then... within minutes I begin to feel faint and she nods, "well, look at your BP... down to 90 something over 50!". I say that's not too bad and I think she turns my machine off for awhile. I immediately feel better. I guess I was just on the edge of crashing out. I get back to watching my movie and Rosie moves off, mumbling about my needing to lose some weight.

A little later we unhook me, patch me up, and I finish watching the movie while holding my poke holes. As I am getting up to leave, Rosie tells me to exercise and I tell her I'll eat less.
So it goes on a Thursday night.

Note: In at 79.9 and out at 75
* Miller, W. & Rollnick, S. (2002) Motivational interviewing: Preparing people for change, 2nd Ed., New York: Guilford.


jr1234 said...

I just finished my first visit at El Milagro this visit 11:30 Friday and it was without any problems. The staff were very kind. Rosie was easy to ID and very helpful. All staff were again very accommodating I found that Da Vita has a few more privileges than my local veterans dialysis unit in Nashville. The Nashville unit does no allow you top bring in drinks and limits you to 3 oz cups of ice. Nashville will not allow any food. The wireless service is also a plus. I wish I had applied for he addiction position here in Austin last month know that his dialysis unit is his functional.
I just finished a workshop with Miller a few months ago on MI as it is preferred in Addictions work a the VA. Good Stuff..
I will return to EL Milagro again the next MWF.

Jack Nowicki said...

Welcome aboard John! I have found that El Milagro is a very "open" unit in general... and most of the units I've visited in Texas seem to be less open in general, but more open than the one I visited in Washington. Interesting how different a similar service can be around the nation.

On the MI thing, so far I am enjoying the book... and thinking that developing this training on MI will be in the same "strengths-based" ball park as others traings I do in SFBT, Crisis Intervention, etc.