145) Dallas Dialysis

July 14, 2007
Saturday

Dallas: We are in Dallas this weekend to visit Liz's mom, attend services at Temple in honor of her dad's Yahrzeit, and visit him at the cemetary. This is the custom we follow: services at Temple Emanu-El, visiting the cemetary and placing small stones on the headstone, going to lunch at Kuby's*, and then a leisurely drive back home. As a person who gets a sense of purpose and continuance through custom and "sameness", I love this experience of "family" and honoring our elders. It is always brings me feelings of connection and sanctity.

FMC Towngate: Here I am at a new dialysis center in Garland, about 8 miles from my mother-in-law's house in north Dallas. Getting a chair here was something of a bureaucratic hassle. The social workers at El Milagro first tried to get me in at the DaVita center I went to last time I was in Dallas. They refused me, saying that my insurance never paid for the visit. Seems to me that that woulda been worked out before I went. Surprised me, since I never heard there was a problem for quite awhile afterwards. So, the social worker set up a chair at another DaVita facility and I had a few emails back and forth with their social worker before they found out our insurance wouldn't pay for that one either. So, it ended up that the insurance contracts with an out-of-DaVita facility run by Fresenius Medical Care in Dallas.

FMC is in a strip mall and has a huge waiting room. All the staff I meet are very foreign sounding. A woman from India, in Indian garb brings me into a small treatment room and interviews me for about half an hour and has me sign 101 pieces of paper that show that I completely absolve them of any responsibility for anything that might happen, no matter whose fault it is. Do I want dialysis? Well, then I must sign away. Do I want to question or consider signing any of these papers? Do I want to be shown the door? I thought of hesitating to sign one of the forms, but decided I don't want to slow the process of getting on the machine. We really have no choice but to sign and then sue later if there's a problem.

When I go from one DaVita center to another DaVita center they just transfer me but when I am going to another company's facility it's as if I am a completely new patient. The process is slowed by the interviewer's almost indecipherable English. With a combination of repeats, hand signals, and guesses we complete the interview process. We two strangers from different lands discuss the color of my urine, my eyesite, and my water retention. Luckily I have a fairly transparant nature and can discuss even the color of my poop upon inquiry. Finally she takes me into the treatment room.

The Indian walks me to the in-floor scale where I weigh and then on into the sea of blood cleansing patients; three or four rows in to a chair in the middle of a section of chairs. Here I meet Aida, a beautiful Ipanema-ish woman wearing a visor like a blackjack dealer, whose English is only a little better, but whose nationality and heritage are totally unknown to me. She is all business and seemingly in a foul mood, unless this demeanor is her normal countenance for her culture. I don't know and am having some amusement hallucinating what her mood is all about. I think maybe she doesn't get along with the Indian woman and the Indian woman brought me into Aida's territory and sat me in a chair without regard to Aida's plan for the chair. I sit there for about 25 minutes while Aida and the other tech for the row take the last shift people off and ready for the next shift. Of course, the dialyzer is new and I observe and hear that they use new ones for each person all the time because they are a new type that is only used once and tossed. So, it doesn't matter what chair a patient sits in. Aida cannulates me and does a good job of it, even though she starts with too small a needle and has to take it out and put in a larger one. I forgive her the mistake and that seems to lighten her mood somewhat.

The chairs are grass green and new and have internal heater and vibrators. I fiddle around with the buttons on my chair but can't get the stuff to work. Attached to the back of each chair are five foot poles with a three-banded light at the top, green-yellow-red. When I stood up while waiting to get stuck, I looked around and saw a sea of green lights, signifying the machines doing their jobs, hooked up to probably 100 people. This place also has those swinging TVs that are attached to mantis arms like the x-ray machines at your dentist's office. Once you hook up your earphones and swing the set around in front of your face you create a little TV universe for yourself to sink into and pass the time in your own little bulb. I watch the entire Mission Impossible II and drift in and out of a dreamless slumber before it is time to unhook and re-enter the real world outside.

Aida unhooks me and patches me up and asks where I'm from and if I'll be back. She doens't seem to recognize "Austin" and says "Good bye" when I reply that this is my one time here for this visit. And so it goes in big "D" dialysis.

Notes: In at 75.4 and out at 72.8 Kgs.
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* Kuby's Sausage House retrieved online July 2007 from http://www.kubys.com/