118) Frazzle the Sodium

March 29, 2007
Thursday

El Milagro: I tell Phyllis the Nurse and Crystal the Tech my sad story about last session and Phyllis says that she is going to set the machine to "...conglomerate the sodium and fizzle the thing-a-ma-jig". I check my brain to see if it understood, and then I recognize that I have no idea what she just said. I sit there blankly. They compare notes and ideas and speak dialyseeze and I sit there in anticipation; hoping not to have a woozy time of it again. The machine gets poked and dialed, the computer gets pecked, and then I get poked. Crystal efficiently sticks me and we're off and running.

I listen to NPR, then ABC, then doze a little, then watch Survivor (I am now convinced this is the lamest, dullest Survivor series so far) The other day I ran into the one other person who still watches this show and he seemingly agreed with me, although I could tell he is still in love with it, since he only nodded and then went on to applaud one episode. After Survivor I switch channels and watch a bit of Gray’s Anatomy and Crystal shares that it is the only show she tapes to watch after her shift is over.

Around this time I ask Crystal to explain what Phyllis did to adjust the machine and why, and she matter of factly says “Oh. She just set the thing-a-ma-jig to frazzle the sodium”, and I still don’t get it, but now I also don’t care, since I have my after-session zonk going. “Oh” I reply knowingly, nodding my head up and down. I really don’t want more info right now, since the last piece was gobbledygook to my fuzzy brain. (If one of the staff who read this blog would write in to explain this sodium thing, that would be grand.) As I left, my BP was about 118 over something, so I thought that was an improvement over last time.

And so it goes……

Later: My friend, Big Kim, reports that this blog is boring... she doesn't like all the March Maddness and who's sticking me and the "save the world" links, the other "boring" stuff about my every dialysis session. She wants more of my philosophizing and stories and weirdo notions about life on the planet. Well! Let me tell you a funny story about Kimbo... she likes to talk about body functions, so... I promise to write a post in the near future about what dialysis does to urination.

What I said in response to Ms. Kim... "I am documenting the boring, the trivial, the humdrum, and the monotonous. That's the point!"

And I could've added that this is also a report of the repetitious, the tedious, the morbid, the macabre, the absurd, the painful, the bleak, the discouraging, the fetid, the noxious, the debilitated, and the dying. AND it is also a report of the perseverance, the passion for living, the healing of spirit, the acceptance of fate, the elixir vitae of life, the resolve to continue, and the tenacity of folks.

Notes: In at 75.8 and out at 72.9 Kgs.

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117) In Which Jack Gets Woozy

March 27, 2007
Tuesday

El Milagro: I am arriving at the center about 15 to 20 minutes late, having gotten wrapped up in a short project that was actually a “longer-than-anticipated-project”. As I come in, Jo the Nurse reports that the new doc has already done his rounds and he asks her to ask about if I am “okay”. Well, I am. So I’m sure I’m the last person on board, and I find my chair by my name on the dialyzer, and Matt comes over to stick me. He does a quick slick stick and we figure to take off 3.1, putting me at my “dry weight”, 72.8. My beginning BP is about 115 over 70 something. Jo the Nurse comes up and listens to my body with her stethoscope while I’m talking to Matt about something innocuous. Since I have new batteries, I go off into brain land, listening to All Things Considered. With earphones it’s like the voices, music, and the whole radio studio is between my ears, echoing around in my vacuous head. I like that experience.

At 5:30 I switch mediums and watch ABC News and some of the daily news must be lullaby-ish because I drift off into delta-land for awhile, awakening for the last human-interest story. Then I pay attention to the local news; mostly about cars awash in creeks and the amount of rain we’ve received around town (2.5 inches at my house, which gives us a raging creek out back). This is a nice sound at night with the windows open.

About 30 minutes before the end of the session I start feeling clammy and “funny”. I wait a few minutes to see if the feeling fades and it gets woozier, so I call Matt over. He checks my BP and its 72 / 34, which is low enough for really funny feelings. Matt’s first strategy is to stop moving fluid to steady the BP. After a few minutes he takes it again and it is only up slightly. Then he decides to put some fluid back in and that doesn’t really work until he has added 200 cc’s three times, plus adding some sodium which finally brings my BP up to 108 over 60. While he is doing these adjustments I lie there with my eyes closed, wishing I could just take another nap. Jo the Nurse comes around to lend her expertise and approve Matt’s work. She asks if I have gained weight lately or am I eating more. Finally the BP is stabilized at around 110 and Matt is ready to de-cannulate me. He unhooks me and by the time I’m ready to leave, my BP is 114 standing and 111 sitting. So, over all those hours I actually only took off 1 Kg, and now we have to figure out if my dry weight should be raised or if the whole thing was just an anomaly. Now I have something to ask the doc about.

Oh, and BTW: My Bracketology is Pure Poop! Only one of my teams made it to the final 4. What a rotten year for my brackets! That's March Maddnes!

Notes: In at 75.9 and out at 74.9 Kgs.
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116) March Madness Continues

March 24, 2007
Saturday

Morning: Busyness at work has kept me from posting about last Thursday, but I can tell you it was all about March Madness, watching basketball at the center and having the normal “How ya doin?” conversation with the Lt. Fuzz doctor and Ron the Nurse. Jennifer the Dietician was straggling on behind with a mischievous little smile that I hallucinated had a meaning that was known only to her. I was happy to watch A&M get beat by Memphis and it was an exciting game down to the finish. I’ve picked Memphis to play Florida for the national championship so it was good they won against A&M, although it is always good to see A&M lose at anything… those damn Aggies.

Today we challenge other Kerrville Folk Festival* Volunteer Staff to pledge $100 to KUT’s spring pledge drive and Dave Oberman** announces that challenge at 10:55 am for all to hear over the radio waves, calling us “…long time supporters of KUT and Folkways”, making me feel like a team player.

So, in case you’re wondering what a dialysis patient does on a Saturday, before going to have their blood cleansed, today we have spring raking the back yard, a soccer game, cleaning house, and doing laundry on our agenda. Lizzie is off in Marble Falls running a foster parent training so it’s up to me and Shayna to do the chores.

El Milagro: Carol cannulated me and today’s weirdness was about my blood pressure. When she first took it, with me standing, it was 84 over 50 something! I should be laid out flat with that kind of BP. I told Carol, “Nah. That machine is broken cause my BP is never that low.” She took it again and it was like 93 over something, so I sat down and she took it and it was still real low. She commented that it is okay to be low and we went on with the session. Throughout the session the machine automatically checks your BP ever 20 minutes or so. The highest mine registers today is 117 / 76 and by the end of the session, when it is usually at it’s lowest, it is 111 over 65. Usually when it is that low at the end I have some cramping and dizziness but not today. Today I feel just hunky-dory*** and can’t find any internal signs or symptoms of low BP, so it is just WEIRD.

Good thing the BP is low since my first team in the Elite Eight is losing: I picked and want Memphis to topple the Ohio State boys and although Memphis gives them a run for the money, Ohio State pulls it out and wins. Oh well. Then, on comes UCLA and Kansas (our last Big 12 hope) and it is an okay game, although Kansas played worse than I’ve seen them play all year. They aren’t making their shots and although they are tough defenders, the Bruins have Collison, who is playing like a pro today. As Matt is pulling my needles out and patching me up, I watching the score go back and forth and thinking that Kansas still can pull this one out. I rush home to catch the end of the game.

Later: So, Kansas loses and my picks for the final four are slashed by 50%. Yuck!
But, the Kick Kats won their first game of the season so that's GREAT! Shayna's soccer team was so good last season the league put them in against the next older group this season and they hadn't won a game yet (4 down) until today, when they pulled a 4 to 3 upset! La-dee-da.

Notes: In at 73.4 and out at 72.5 Kgs.
* Kerrville Folk Festival 2007 Performers retrieved online from
http://www.kerrvillefolkfestival.com/2007_performers.htm
** Dave Oberman, Folkways retrieved online from KUT http://kut.org/music/show/2
**** “Hunky dory” retreived online March, 2007 from The Phrase Finder at http://www.phrases.org.uk/bulletin_board/1/messages/2785.html
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115) Equinox

March 20, 2007
Tuesday

El Milagro: I get to the center just about on time and have to sit for 10 minutes before Carol can come stick me. I am reading two papers Barry Duncan* sent me today and reminding myself how clearly I think he writes. In one he has a picture of a dolphin hanging mid-air after a mighty jump… and right there beside it is a cow floating there as if to suggest that the cow and the dolphin are jumping in synch. He notes that “…a swimming contest between a cow and a dolphin is not really a fair comparison.”** This is such an obvious conclusion that I chuckle that he adds a picture to make the whole thing quite clear.

So I finish reading the papers, chat with Jennifer the Dietician, and watch the news. Jennifer reports on my annual lab work and the results for several of my chemical time bombs are quite good, as follows:

Albumen 4.0 (Goal is 4.0 or higher)
nPCR HD UKM 1.17 (Goal is 1.0 or higher) ---> represents protein intake
HCT CALC 42.6 (Goal is 33 or higher) ---> red blood cell count
Iron Saturation 28 (Goal is 20-50%) ---> iron
Feritin 170 (Goal is 100-800) ---> stored iron
CALC corrected 8.6 (Goal is8.4-9.4) ---> calcium
Phosphorous 5.3 (Goal is 3.5-5.5) ---> GOOD for once: this was the last time bomb that we took care of with the $900 (if I had no insurance) horse pills
CAxPhos Corrected 45.6 (Goal <> again, this is good. PTH Intact 226 (Goal 150-300) ß parathyroid hormone is good!
Potassium 6.0 (Goal 3.5-5.5) ---> Still a time bomb and Jennifer and I talk about coffee, and other things that may lower it. I’m depressed when I read on the report, “This is VERY DANGEROUS. Muscle weakness and heart failure leading to DEATH may occur.”, and that seems quite bothersome to me. My mood drops.

I guess I’ll be backing off the coffee… is that an excuse for sleeping through the morning? Throughout the rest of the session I am in a funk. Damn. I hate being reminded I am sick!

Notes: In at 76.6 and out at 73.0 Kgs.
New Readers: For A Welcome Post, click August 2006 on the Sidebar.
*See The Talking Cure online at http://www.talkingcure.com/
** From Duncan, B., & Miller, S., (2006) Treatment manuals do not improve outcome. In Norcross, J., Levant., R., & Beutler, L. (Eds) Evidence based practices in mental health. Washington, D.C.: APA Press.

114) A Leprechaun's Life-alysis

March 17, 2007
Saturday

Earlier: I called El Milagro and talked to Matt, who said I can come in at 12:15 today.

El Milagro: I get a chair that has a TV with a perfect picture today! Herman cannulates me with his usual masterly skill. You can tell by watching him do this that he’s done it thousands of times and it is like second nature for him. These El Milagro staff wear your regular medical uniforms with a dialysis flair. The females wear smocks with teddy bears or flowers and brightly colored string-tie pants and some of the younger women and most of the guys wear t-shirts that say “got binders?” on them, or some other catchy kidney saying. Herman wears one sometimes that says, “Life alysis” and today if finally comes to me that it’s a play on “Die alysis”. Funny! I wonder how many things exist in the worlds that are in our blind spots? We see the world we perceive and yet at any given time there are many things right in front of us that either have no meaning to us, or we haven't groked* them, or we don't even notice them. Some folks used to say that these things didn't exist until we noticed them, but I think it's more complicated (or simple) than that. I think they are waiting for us to notice them in order to expand our awareness. I think a magician or a genie or a leprechaun (AHA I got a St. Pat's reference in here today!) must set up the world in some mysterious way, hiding things for us to discover and have "Aha" experiences. Or, maybe finding these things we didn't know until we saw them a certain way is like peeking behind the curtain of the real universe and recognizing that the pin-prick lights we see as stars is really 'the Light' poking through the darkness of our naïveté. "Whoa Jack! Calm down puppy.... Earth calling Jack..." Okay... it could be just me catching on to things the world has understood all along.

On March Madness today I get to watch Xavier vs. Ohio State. What a great game! I find myself rooting for Xavier even though I’ve picked OSU in my brackets. I’m philosophically cogitating about why I have one strategy for picking my picks for the brackets and an opposite perspective when watching the games. For making up my brackets, I look through the games and do some research and then pick the teams I think will win, usually based on their win/loss record, history in the finals, coaches, or other non-rational tidbits conjured up in my brain. So, I end up with brackets of picked winners. Then, when I’m actually watching the games, I find myself cheering on the underdogs, dark horses, and upstarts; the teams that have to struggle, play their best, and be hyper-motivated to win. Such it was with Xavier. I wanted to see them beat Ohio State, just because it seemed like such an upset and would have been a great example of the David vs. Goliath metaphor. Of course, I am sure that my sister-in-law, an OSU grad, wouldn’t agree with this tangent. So, now I’m thinking, “I wonder how it would be to use a strategy that would have me picking underdogs for the brackology… say, pick winners for the first round and then go to the underdogs from then on?” So, Ohio State pulls it out in overtime, after Justin Cage missed his second foul shot, which woulda put Xavier in the winner’s bracket. Imagine how Cage is feeling.

Well, so then we go on to Butler vs. Maryland and A.J. Graves knocks down Goliath. What a game! And then Vandy beats Washington State in a second overtime… WOW! By this time I’m back at home again and the Saturday Life-alysis session is history. I guess that March Madness has me so hypnotized I don’t really recall the decannulation (Matt did it), weigh out (wrote it down), or drive home (very quickly, I’m sure).

Notes: In at 74.3 and out at 71.8 Kgs.
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* "Grok" see Wikepedia online at http://en.wikipedia.org/wiki/Grok

113) Of March Madness & Machine Malfunction

March 15, 2007
Thursday

El Milagro: I got in a little late today since leaving the office at 4. Of course, since it is the first day of March Madness, I get a chair with an off-color TV that makes the hardwood floors all neon orange. Debbie the Tech sticks me today and we talk briefly about her schedule and why she hasn’t been around much. I settle in to watching a show on Discovery that explains how zippers, blackboards, and some other common item of the post industrial age are made. Its all about computers now.

I watch the ABC News and then switch over to the first round games on CBS… VCU vs. Duke. Now this was a game that when I first reviewed all the data, I thought VCU might be able to upset the Dukies. But then, as always, I sleep on my pics for a few days and in the end I picked Duke, saying to myself, “Jack, you idiot; Duke never gets bombed out in the first round… pick Duke cause this is not the upset to look for this year.” So here we go and Duke looks good through the first half and VCU is tough and tenacious and keeps coming back until they wear the Blue Devils out… and Walla* ("Voila")... they win and I lose my second pick of the day. I had also picked Bobby Knight’s Red Raiders to beat BCU, and they failed me. Even though I lose a few, I don’t mind cause the whole March Madness is so great a TV event that I am happy as a clam anyway, just seeing all these b-ball games all the time.

Somewhere in the middle of the last half of the Duke game, I notice peripherally that my machine is beeping every few minutes. Gabe the Tech keeps coming by and pushing the “reset” button. And then, again, a few minutes later it beeps again. Usually when my machine beeps it means I have moved my poked arm in a way that upsets the balance of the machine, so as in the Pavlovian experiments, every time the machine beeps, I look down to see if I’ve moved my arm. But after about six of these occasions, I learn to ignore the beeps and continue focusing on the game, an example of reconditioning via a intrinsic schedule of reinforcement. The game is more reinforcing than looking at my arm, so it can overrule the direct reinforcer. If any of my old behavioral profs (Dangle, Duehn, or Polster) read this they’d probably roll their eyes and shake their heads at my confused understanding of behaviorism. But, be that as it be, the game is capturing my attention and I’m just barely aware that the beeping continues every few minutes.

Finally, Ron the Nurse comes over and says, “We’re going to have to cut your session short by half an hour tonight because the machine is crxroff gobble-de-gook robits de contrary” (<--indicating I have no idea what he actually said). I immediately thought, “What! I’m gonna miss the end of the game…” and then, “But wait, it’s on regular TV I can zoom home and get the end”, and so I said back to him, “Okay”. Then Debbie comes up and began to explain in detailed detail what was going wrong with the machine… turns out she is trained in the operation of these machines and understands them like a Volvo mechanic. According to her, the machine is just too sensitive and responds to minute changes in the clotting around the edges of the filter, causing it to sound it’s alarm, blah-de-blah. And Ron is decannulating me and my BP is fine and according to him it won't kill me to quit half and hour early (funny how if it's their idea to quit it's okay, but if it's the patient's idea to quit early, it's a no no).

So, they unhook me as I continue to watch VCU and Duke duke it out and I’m outa there with about 4 minutes left. I decide to rush home instead of watching the end at the center, and ultimately miss the final minutes, although I get to see them time and time again in the news clips.

Notes: In at 74.9 and out at 72.0 Kgs.
New Readers: For A Welcome Post, click August 2006 on the Sidebar.
*"Walla" is how we say it in West Texas. According to my international North Dallas wife, the word is actually "Voila" and its French, not Hawaiian.

112) Katie's Corner Kick

March 13, 2007
Tuesday

Earlier: I stopped by Burger Stadium to catch part of Katie’s district soccer game against LBJ. The game had been scheduled for 2 p.m. but was postponed because at 2 it was pouring buckets of rain. They finally started the game at about 2:45 and I got there around 3. The rain had temporarily stopped and I got to watch Katie make a beautiful corner kick right into the front of the goal and one of her teammates booted it in for the score. ALLRIGHT! At half time it looked like it was gonna start deluging again so I headed out to the dialysis center. Later I heard that the game was called and the win given to Crockett, 1 to zip.

El Milagro: I am early to the center, find my chair, and sit there waiting for someone to stick me. They are pretty busy and it is about 15 minutes before Carol the Tech comes over and starts the process. About that time the new doc, Nicholas Rucker, Ron the Nurse, and Jennifer the Dietician rolled up their little chart cart and the doc asked, “Anything you need?” and Matt added, “…like a new kitten” under his breath. I told the doc I was doing just fine and he replied that he would see me next time with our annual blood work results. Matt cannulated me and I settled back to watch some boob tube. (My batteries for the radio fizzled). Minimally watched an old MASH and dozed until the news. News came and went and I switched over and watched McNeil Lehrer, somehow not feeling full of news yet. Then I watched NOVA about how fast China is catching up as the most polluting country on the planet. Scary!

About ten minutes before my session is done, I begin to feel clammy and dizzy and ask Carol to check my BP, which is down around 60 over 70 again. She stops the dialysis and I sit there trying to regain some blood pressure. So, what does a person do to regain BP? I sit there trying to visualize my blood pulsing through my veins quicker and almost flex myself to squeeze the blood vessels, hallucinating that that will add “pressure”. Another part of myself is telling me, “Boy, are you nuts. This just shows how out of it you are, buddy.” A few minutes go by and I’m feeling better, so Carol unhooks me and I hold the gauze on my poke holes for awhile. Then she takes a final BP and its up around 111 over 70 something and I’m ready to go.

As Roseanne Roseannadanna* used to say, “It just goes to show you. It’s always something.”

Notes: In at 76.1 and out at 73.0 Kgs.
New Readers: For A Welcome Post, click August 2006 on the Sidebar.
*"Roseanne Roseannadanna" retrieved online March 2007 from Wikepedia at http://en.wikipedia.org/wiki/Roseanne_Roseannadanna

111) The Slow Draw & Jack Remembers "The Boz”

March 10, 2007
Saturday

Morning: Jo the Nurse called and asked Liz if I can come in in an hour. I called back at about 11 and we negotiated a 1:30 time. I didn’t want to come in earlier cause of the UT semi-final Big 12 Conference game with OSU.

El Milagro: I am here on time and seated and cannulated by Diane the Tech. Herman the Nurse stopped by and I asked him to explain exactly how 6-hour (overnight) dialysis is “better” than the 4-hour variety I am now participating in. According to Herman, the difference is “the slow draw”. When the blood is drawn through the machine slower 1) you get a higher creatinine clearance because the blood spends more time in the dialysate. Also, 2) a 6-hour dialysis doesn’t result in any cramping or low blood pressure difficulties. The difference between 4 hours and 6 hours is enough to substantially change the outcomes. We discussed the pros and cons that I had listed in Post # 105 and he reported that if they decide to run an overnight group it’ll be at the South Center. I asked it Herman would run it and he responded rather cryptically, “I’d work there if I could just be a shift nurse”. I also mentioned my thoughts about flipping and flopping during sleep, and he recalled for me his experience in hospitals. He expressed that no matter how deeply dialysis patients are asleep, they somehow are conscious of their arms being hooked up and don’t move them in ways that disturb the machine or pull out the needles. I finalized that I would continue to think about the possibility and let him know more as I figured it out.

At 3 the pre-game hoopla for the OSU / UT game started and I excitedly waited like a little kid until about 3:30 when the actual game started. The first half was excellent and I was quite sure that we’d win. But then, of course, during the first half of the second half, I was worried. The game got down to 46 seconds with Durrant having to pull us out with a 3-point shot. By that time Diane is de-cannulating me and I am watching the last 30 seconds ‘holding’ the gauze on my needle holes tightly, eyes glued to the TV hanging from the ceiling, and trying to ignore the itch on my nose. Isn’t it funny how just when you are completely tied up and can’t move, and your attention is focused on something important, you get an itch somewhere that screams to be scratched. The more you try to ignore it, the more it itches. Being able to sit through that without dropping everything to scratch is the ultimate in concentration, me thinks.

The people who say, “If you have an itch, scratch it” (mostly in my memory they were psychoanalysts) weren’t having to hold gauze tightly over two toothpick sized holes that would bleed profusely. The psychoanalyst I recall perpetuating the scratch-itch saying was Dr. Lanis L. Bosworth, my favorite psychology professor in undergraduate school (c. 1969). The “Boz”, as we called him, was the leading eccentric prof in those days. He wore argyle socks with barn-red slacks and multi-colored ties with plaid shirts. He was an older, wiser, yet virile man with a lust for life. He always walked into class (no matter which course it was), and started class with “Any questions?”, and the students would chart the flow of the class with their questions and the questions would cover the ocean of psychological possibilities. “What do dreams mean?”; “How does the superego function in adolescence?”; “How is the female orgasm different than the male’s?” I recall this one question particularly. The Boz answered it by leaning so far back in his chair that I was sure he’d fall over… and, then, slowly he put his head back, made his mouth into a large oval and began a low, guttural howl that raised in pitch and volume until many of the students were covering their ears with cupped hands. The co-ed, sorority (in my hallucination) girl who’d asked the question blushed and foolishly continued her quest, “Aren’t you exaggerating a little Dr. Bosworth?” to which he countered, “I guess you’ve never had an orgasm, have you?”. I only wish I remember the rest of the conversation, because it was an informative hoot for the whole class. What I do remember is that he always pushed people to their uncomfortable limits and then somehow drew a connection to a psychological debate. From the Boz, I learned that there are always many sides to a story, or a “rule”, or a theory. If “Question Authority” had been an aphorism back then, the Bos would’ve said it. Google doesn’t give a hint about what the Boz is up to now-a-days, but I’m sure that if he’s on the planet he is still a rascal who pushes people’s buttons as a teaching strategy.

Later: Driving home after my session, I started wondering, if 6-hour dialysis is so much better, why don’t all dialysis centers provide 6-hour dialysis as their “normal” offering, rather than 4-hour dialysis? Good question, Jack. And I hate to think that the answer, as in most things, is MONEY. My dear boy, it's always about money! They (The big "They") can make more money with less hours, period! Even so, I should ask Herman about this one, because maybe my hallucination of dollar signs is off key. We'll see.

Notes: In at 74.8 and out at 72.4 Kgs.
New Readers: For A Welcome Post, click August 2006 on the Sidebar.

110) A Regular Thursday

March 8, 2007
Thursday

El Milagro: I am on time again today and Carol cannulates me quickly. The new doctor is doing rounds today and just as I get hooked up, he and Ron the Nurse, Jennifer the Dietician, and Marilyn the Social Worker roll the chart cart up in front of my chair to check with me on “how I’m doing”. I have an audience and yet have nothing really to say. How odd. Jennifer reminds me that next Tuesday is the annual blood letting for the comprehensive labs. I ask Ron how much total blood is out of our bodies in the machine (recalling the hand pumping of last session) and he replies that it is about a pint at a time.

After they leave I listen to NPR’s All Things Considered, watch the ABC News, doze for awhile, and wake up to watch Survivor. As a long-term survivor of Survivor I am not as attracted to this new series on Fiji. One tribe hasn’t won any challenges and the other is practically living in luxury, which is really no fun to watch, as they are able to keep their energy up and the other team slowly slips into oblivion due to the weakness of having no assistance in their survival. Its much more interesting when the teams alternately win challenges. There are a few people in this series that we are cheering for, like Yau-Man. Tonight his tribe loses again and I am beginning to wonder if I’ll continue watching.

So it goes on this “regular Thursday”.

Notes: In at 75.3 and out at 72.6 Kgs.
New Readers: For A Welcome Post, click August 2006 on the Sidebar.

* Check out World Kidney Day at http://www.worldkidneyday.org/

109) Kidney of Darkness

March 6, 2007
Tuesday

El Milagro: I am a bit early today and find that they aren’t ready with my chair yet, so I am sitting in the waiting area listening to the end of Fresh Air and Terry Gross interviewing Mary Weis, formerly the lead singer of the Shangri-Las*, the late 60’s tough girl’s group... remember "Leader of the Pack"?

I finally get into my chair and get cannulated by Jason for the first time. He does an okay job, but seems a bit nervous, which makes me a bit nervous. So I’m hooked up and listening to All Things Considered when Jennifer the Dietician comes up with the newest lab report. My phosphorous is up (5.8) but not seriously “up” and Jennifer says lets wait until next week when we get the results of the annual labs that cover every possible chemical aspect of my being. Aside from the phosphorous report, the other readings are looking really good (calcium 8.3; Cal-Phos=Product 48.1; Parthyroid 163). We spend a good amount of time talking about her looking for a house to buy and whether it is good to build or buy. I refer her to my mortgage broker, Michael who knows more about such things than any of us.

At 5:30 I watch the ABC News and am happy to see that Bob Woodruff is back on the news, and tonight with Elizabeth Vargas… a flashback to when they were in the spotlight before he got blown up in Iraq. Even though he had to get blown up to make a splash, I'm thinking that the silver cloud is that now all of us are hearing and paying more attention to the horrible living results of this war. After that I doze awhile and wake up to watch PrimeTime and all of a sudden the room goes black with a “pffft” kind of sound. I’m looking up at a black tv screen in a black tv in the middle of a black ceiling in the black room… until some emergency spotlights come on, attached high on a few columns. It is an eerie sight and the staff is immediately rushing around on crisis mode. The lights only light up the ceiling area and the staff are all hunched over the machines trying to see to clamp off one line and prepare to manually get our blood back to us before it begins to clot. They say you should only go a few minutes with the machines off before you must get cranking.

“Where’s a flashlight?”, someone says. “Unhook the patients venus lines and hand pump the blood back into them”, Nurse Ron says as he comes over to my machine and starts that process. In the dark, he feels the lines, clamps one off and then starts to hand crank the blood that is in the machine, back into my arm. So, he cranks and cranks and cranks and the the sound in the dark is something like the sound of hand-cranking an ice cream maker, "tshrik….. tshrik….. tshrik…. tshrik". And he is also talking to the others as their leader in this crisis, saying things like, “Who has a cell phone… we need to call Herman” and “How many people are still on?”, and “Someone get the hand-pump BP”. The few patients left on machines are mostly laying low, but some of us are excited about this new turn of events, and are cheering the staff on. Finally Ron leaves to go talk to Herman the Supervisor on the phone, and the guy I don’t much care for comes over and is pumping my blood back. And actually now he seems more okay since he is putting my blood back into me by hand… tshrik….. tshrik….. tshrik.

Well, my blood is all put back inside me and Jason de-cannulates me and gauzes my needle holes and I "hold them" while they clot. The whole place seems to slow down and adjust to the darkness. Now there is a flashlight flashing around, and some trsansit drivers have come to pick up one of the patients and Herman finally gets there to take over. I wait for the ten to fifteen minutes I have to to ensure I’m not gonna leak, and then Jason tapes me up and I weigh out. I have stopped dialysis 30 minutes early so I know I didn’t get the full benefit of a session. Yet I feel okay and as I leave I’m wondering how my weight indicates the shortness of the session, since I still lost 2.4 Kgs. I must’ve been really immersed in that thought because I got half way home before I noticed that I left my glasses at the center. My eye itches and I scratch it and wonder why there isn't a glass barrier there. OOPs

March 7, 2007
Wednesday: I drop by El Milagro to get my glasses and Herman tells me that the cause of last night's power outage was a car crashing into a utility pole on the other side of the freeway, knocking out power to the center and the whole block around it. Well, whad-a-ya-know?

Notes: In at 76.2and out at 73.8 Kgs.
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*Penny, B.K. (2006) Shangri-Las retrieved online March 2007 from The History of Rock-n-Roll. website at www.history-of-rock.com/shangria-las.htm

108: Adding Saline

March 3, 2007
Saturday

Morning: Shayna’s basketball team seemingly decided the season is over before playing their last game this morning. By the time I left to get to dialysis on time, the score was 36 to 14 and it didn’t look like they were gonna come back. Shayna was playing okay; covering her man well and looking for rebounds, but had complained that her allergies were bothering her. I think they were all ready for the season to be over. The best part of this season for Shayna was the coach, who spent a lot of time individually with each player and really knows his stuff on the basics of playing b-ball.

El Milagro: I am on time today and the center is actually full for this earlier session. They seat me on the north wall between the front and the back areas and Melissa the Tech cannulates me. According to James the Nurse, Melissa has been around for years but working at Moncrief center. Melissa is quite easy to look at and verbally confident, saying something like, “Hi, I’m Melissa and I’m one of the best stickers in the world!” She lives up to her claim and before I know it I’m stuck, taped up, and immersed in the UT – Kansas basketball game. The first half of the game is excellent! UT plays like a championship team, shooting over 60%, hitting 11 of 14 three-pointers, and leading 54-42. But in the second half, it was all Kansas. They came back with a vengeance and ended up winning the game, which was as the bookies had predicted them to be a 10-point favorite. So, # 3 beat # 15 by a measly 4 points, 90 to 86. Now we have the Big 12 Tourney from March 8th through 11th. Oh Boy!

After the UT game I tried to get interested in UCLA get beat by the Huskies but fell asleep during the game.

My last two dialysis sessions have totally wiped me out. This time I didn’t have to get extra saline, but I did get leg cramps at the end, and was more tired than usual afterwards. I asked Ron the Nurse if he could recall how much saline they gave me last time and he replied that it was probably about 5 cc’s. So, I asked, “How would that effect my leaving weight?”, and he said, “It wouldn’t make much difference. A whole bottle of saline is about one kilogram, or 2.2. pounds and we just gave you about 5 cc’s so it wouldn’t add much at all to your outgoing weight.”

Today I got out at about 3:30 and hurried home, hoping to have some time to do some chores around the house.

Later: When I got home, Liz and Shayna were watching The Illusionist so of course, I couched out to watch too, and basically spent the rest of the afternoon in a prone position, “resting” and sleeping. When dialyisis wipes me out, that’s the home afterwards story: rest and sleep. Onward through the Fog!

Notes: In at 75.4 and out at 72.8 Kgs.
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107) Thursday Dizzies

March 1, 2007
Thursday

El Milagro: I am on time today, and being sat on the window side of the center. Usually I’ve had a chair in the back half of the center, but the last few times they’ve sat me in the front half. Today I ask Gladys what’s the deal and she responds that they are trying to only use the front half of the place now that a number of patients have left. She continues that most of them have gone back to the other center that was being re-built, but I get the idea that some have left for other mysterious reasons she’s not willing to talk about. This may just be my hallucination… I listen to NPR’s All Things Considered and am getting settled into my session when Suzanne the Administrator stops by to ask when I am available for starting the Client Advisory Committee meetings. I report to her that I sent in the forms she gave me for the DaVita committee and never heard back from them. Suzanne is surprised at that, since the national folks are always nagging the centers about getting patients involved. She says she’ll check on that. I tell her that MWF right after work generally works for me, and forget to add, “as long as I am in town”. Phyllis the Nurse also comes by at some point and invites me to come in for the second shift (11 am) on Saturday and I say “yes”, even though I might miss either Shayna’s soccer or basketball game.

At the end of my session tonight, right before they are ready to unhook me, I start having some cramps in both my calves that I am able to remedy by forcing my feet to do lateral pointe work as in ballet. Usually a few rolls of my feet into pointe will do the trick and it does this time too. So, the tech unhooks me, takes by BP and I stand for a standing BP. I find I can’t keep standing all the way through the taking, and fall back into my chair. I am dizzy and feeling faint and just want to close my eyes and rest. So, Ron the Nurse comes over and pumps some saline into me to reverse the effects of too much liquid being pulled out of my blood*. Of course the more saline they put back in, the less effective the dialysis, so we all want to just put in enough saline to bring up my BP to a minimally acceptable number. During this event, my BP is running about 80 something over 50 or so. And, because of these adjustments I don’t get outa there until about 9 pm. Finally my BP is up to 110/75 and I am able to walk around without feeling like a zombie and so I’m outa there and on my way home happily.

Notes: In at 75.4 and out at 73.5 Kgs.
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* Low blood pressure and kidney dialysis, retrieved online March, 2007 from the Kidney Patient News website at http://www.kidneypatientnews.org/kpt7.html#Low%20Blood%20Pressure%20(Hemodialysis)