Tuesday
El Milagro: Rosie the Tech sticks me. Jordy the Dietician comes by in her spiffy red and black scrubs and reports that all my labs look great! Except my phosphorous! We talk about my diet and my binders and I report that I've been very responsible... so why the Hell does it keep going up? We agree that I'll start taking my Foserenol again with lunch and see if that is better. Jordy says that Renagel is coming out with a powder that is now with a bicarbonate that they say should be easier on stomachs. It is out in July but she may get some samples sooner... Rosie pipes up that she wants to try it too! She says she tries binders to see what the patients are putting up with. Both Jordy and I are surprised at her statement.
Jordy gives me a card that gives a discount on Sensipar ands we talk about why Lizzie pays for my meds.
Today I picked up a rental car on the way to El Milagro so I can shoot up Hwy 281 to Stephenville tomorrow morning to do some consulting with an agency up there. This is one of my favorite road trips.
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February 19, 2009
Thursday
El Milagro: Rosie the Tech is ready to cannulate me... I am late cause I got wrapped up at work writing an abstract to present at a conference in Virginia and the thing is due tomorrow. So I apologize for getting here at just before 5, knowing that I'm gonna be the last one out and maybe even cause the techs to stay a little later than usual. Rosie says its no big deal and I share that Kathleen the Social Worker had stopped me on the weigh in to show me a handout of a workshop she attended of mine back in '98. So, somehow we get into talking about pain and I share with her about los penitentes in Northern New Mexico* and watching them march up the mountain road flagellating themselves with switches and briars. She moves off that subject to ask me a "professional" questions about a patient who is seemingly anxious, depressed, and unhappy about their dialysis... and, not getting the kind of support they need from their family. I immediately think, "family therapy" (HUH! Well I guess it's cause I resemble one myself) and I suggest Rosie find out from the new social worker if she wants to take on an actual clinical counseling client here. What an idea! That the nephrology social workers would do some counseling! At any rate, I share with Rosie that Katleen the Social Worker at least has some background with counseling and might want to do some of that here so she should ask her first. Then, if that is not kosher for El Milagro social workers, she should refer the patient to a family counselor outside of here. And, the patient should look for someone who practices problem solving or solution focused counseling so they don't have to spend a couple months explaining their whole life history and all the bad crap that has happened to them. Instead they spend their time talking about what the person can do right now to move in the direction of what they want. Rosie takes some notes and walks off to be the curendera that I imagine she really is.
Kate the NP (NOT PA!) walks up with Jordy the Dietician and she wants to discuss my labs; noting again that my blood count is UP, as is my phosphorous (7.1 from 6.6)... not good. We tell Kate about my idea of taking Fosrenol at lunch and I add that it does make me half nausious in the afternoon until dinner, but that that is not as bad as the nausiousness when I take it with dinner and it makes me want to lie down and not move a muscle in the evening. Kate wants to hear about Jordy's idea for changing to Renvela since it is supposed to be a better concoction than the Renagel was for some people. So, Kate says, "...lets give him the new Renvela NOW." and Jordy says I don't want to start it yet and Kate says to me, "So, you just want to continue feeling sick?" with a quizzical look. I immediately get it: why not change? Rather than share with her my "hating change"
philosophy, I just decide right there on the spot to "go for it" and not whine abut hating change (even tho staying the 'same' is making me sick... DUH) So, Jordy produces a couple boxes of sample Renvela and my dose will be 5 of them along with 5 Phoslo at each meal. If this works (labs next week) then I can donate all the boxes of Fosrenol I have for some poor patient who cannot afford meds. Kate also clarifies for me again that a Nurse Practitioner (NP) has a Master's in Nursing whereas PA's don't have to have a medical undergraduate degree and therefore don't really have as much medical training. I get it.
Pics: Up On Hwy 281: Old truck with cactus and curious mules.
In the news: Hillary tells some emcees of a teen show in Indonesia that since she is "older" she likes the Beatles and the Stones... "Allright Hillary!"
Report from the Lege: There are 72 bills pending related to immigration and cursing and name calling going on in the house over how we are gonna systematically pass some laws that continue to disenfranchise our Mexican brothers. One asks that all Hispanics have to show citizenship documents to register their kids in school. Now that's a good idea. Even if the kids are born in the US, their parents may keep them outa school to avoid having to register... thereby continuing Texas' claim to be one to the worst educated populations with the highest dropout rate.
And finally he Housing Issue: In Austin we haven't suffered like the rest of the country... but, housing values are down 36% this year from last year... and yet they say that Austin has the 2nd healthiest housing market in the US.
After the news, I watch Survivor and Gray's Anatomy and read some on my MI book. Towards the end of my session, Rosie comes back and as she is unhooking me, she asks, "How come you never write about how you cope with dialysis?" and then follows quickly with, "I mean, I don't read the blog... but you don't really write about coping do you?"
I answer that I have written about coping with dialysis, but most of that was back at the beginning when it was more difficult to cope with. Now it is just part of my life and I don't usually have to purge myself of my "feelings" and talk about coping. She accepted that statement and I weighed out and on the way home started pondering. She may have a point. If this blog is to be helpful to others on dialysis, maybe I should write a tome about coping... or at least part of a post dedicated to how folks can cope with being on dialysis. We'll see what develops... off the top of my head I think, "acceptance of all things as being God's will" is quite helpful... and the way I say this mantra is: "Nam-myoho-renge-kyo" ~~"nam-myoho- renge-kyo" ~~ "nam-myoho-renge-kyo" ~~ "nam-myoho-renge-kyo" ~~ "nam-myoho-renge-kyo" ~~"nam-myoho-renge-kyo"
Another thing to be said is how we can feel better and focus on positive futures by nightly self talk about what we want for our future as we go to sleep... rather than thinking of all our problems and how bad we have it. Concentration on our dreams and what we want for our health, like a new kidney, every night as we drop off to sleep is a good thing to continue doing.
So it goes on a Thursday Dialysis Night.
Notes: In at 78.4 kgs and out at 76.1 kgs.
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