Odd weather, two nights of frost, hard on the eager to get started gardeners.
My dialysis runs were mostly smooth. A couple of days I used cane. Other days I shape shifted with my walker. I am trying to make my view of my situation more positive but still realistic. My leg ulcers jumped ahead in healing following debriding by a general surgeon on Tuesday. Debriding is a somewhat neutral term for using a knife to cut and scrape away dead tissue from an ulcer. Once the two ulcers are healed, my heart surgery can proceed.
This reminds me of George Carlin‘s remark that the terms “wetland” and “rainforest” were invented by people who found it hard to raise money for swamps and jungles.
Canada geese families have been coming by to lunch on the plants on our shore. The golden goslings are tiny but that will change quickly.
I hope to get over to the Midland Model Train Show this weekend.
I have aortic valve replacement surgery coming. I was cautioned to get my dental situation checked out, since a dental infection can get to the site of the new valve. This is so certain that the surgeon will not proceed with the surgery if the dental situation has not been checked and resolved. Bad teeth are a family tradition. My Dad had bad teeth. My mother had all her teeth out when she was around thirty years old. I had a little trouble initially in getting an early appointment for oral surgery. But then a call came and I went in on Dec. 30th. The Doctor took out my remaining upper and lower teeth that day. This is referred to as “clearance.” George Carlin would have jumped all over that one. The extractions did not hurt. What smarted was the freezing needle into my upper palate. In fact, I though he was only about half done when he had complete all the work. The tough part was the mouth full of gauze.
aortic valve surgery
Next is the valve replacement, consult in late January. Surgery perhaps in February. There are risks of heart attack or stroke with this surgery, aome five per cent. I should feel more energetic after the new valve. My calcified valve is not opening or closing properly. I cannot walk very far without pausing or without sitting down for a moment. I cannot go into large stores because the distances are too much for me. We kept our late Mom’s old walker. I have been eyeing it lately. If things get any worse I may put it back into use.
Once the valve replacement is done I should return to the top of the kidney transplant list — back in October I received a call to come get a new kidney, but had to turn it down because there were a couple of big questions about my health that needed sorting out. They have been answered. The day that call came was strange. I had been led to believe I would receive a pager when I approached the very top of the transplant list. I had not heard from the transplant folk since April. So for two minutes I had a new kidney. And then I didn’t. I t has been 6 years on dialysis. In some ways I cannot imagine how my life will be with a new kidney. I think I know ,but my life with dialysis is quite engrained now. The diet, the lenghty time of treatment per week, 16 hours for me.
Weight loss success
Toothless is an aid for my weight loss campaign. At some point in 2014 I weighed 130 kg. Yesterday after dialysis I weighed 108.5 kg. For older, Imperial measure stuck folk, that is 45 pounds. My current weight is about three pounds heavier than my weight during university forty years ago. This took place over four months. I feel much better for the weight drop. I don’t feel like I am starving to death constantly. Key was smaller portions, eliminate the junk food, and as much fresh food as possible. I slipped up and had some junk food and found that after the absence the stuff tasted awful.
Lots going on and lots of curious moods and attitudes churning inside me, my heart and my mind. I spend more time talking to and patting the cats. Cat therapy is wonderful thing. Grace the dog listens to my troubling thoughts as well.
things have not been going well and much of the trouble revolves around low blood pressures on my part….
for example, today when I came in it was quite low….this makes it impossible to remove fluid without lowering my bp significantly below 100, normal and perfect is 120. I have quite few moments of low bp during dialysis and felt light headed at home and out in public after dialysis.
it seems to the nurses and I that my bp medication needs to be reduced….
when I asked them to call the on-call nepjrologist at Orillia Hospital, they said no. There is no doctor on site at the Penetang Hospital since it is principally a geriatric facility and also seems to handle physio for new amputees, altho I havent seen many amputees in a few months so that may have been moved over to the hopsital in Midland. If a patient gets into trouble, an ambulance is called and they are transported over to Midland Hospital. We see a nephrologist once month on site here at our clinic. Next clinic is pushed late in February for some reason probably winter holidays, it will take place on Feb. 13th.
I have been feeling light headed and beginning to black out, to grey out my vision, a few times over this month.
The snap by me came when they decided not to call the on call nephrologist. Instead they suggested I get a bp machine and start measuring my bp at home. It is my conviction that we have enough data over a long enough time to ask a doctor. In my sixth year of dialysis, I have lost my temper just twice. This was the second time. For some reason at the last monthly clinic the nurse preparing my chart failed to note this issue. I blew it as well by not recalling it. My talk with the doctor had to do with elevated phosphorus and with figuring out a new heavier target weight, tricky to do immediately after the holiday feasting season.
The other moment when this bp problem might get addressed is on next Wednesday when the nephrology do a clinic rounds by telephone to the “satellite” clinics (Orillia is the main unit and there are some 6 smaller satellites including Penetang Hospital).
Sitting their seething was beneficial today, it raised my blood pressure.
A little trouble to get started with dialysis treatment using my fistula today: two nurses worked it out though and I ended up with three holes not the usual two. My pump speed was excellent 420-430 and I cleaned 106 litres.
coming down the pike:
anigoplasty to fix a narrowing in the fistula
trip to Toronto, for a final check on my healed heel
end of August surgery to remove most of my parathyroid glands
seems we have lost one of our dialysis patient team to home hemodialysis, this program is ramping up in this area of Ontario – I will miss yakking with him in the waiting room
parathyroid removal is common related to hemodialysis
unfortunately, the a/c unit for the clinic failed and both our afternoon crew and the morning crew fried
my dialysis is the longest at 4.5 hours, even though I wore shorts and a T-shirt, it was scalding in the dialysis chair, after forty minutes I was wondering if I mght pass out. One of the nurses went down to the kitchen and came back with a resupply of ice. I slipped ice chips down the front of my t-shirt, and later poured melted ice-water on to the washcloth that had been trying to cool me off with a dunk in some cold tap water.
The nurses looked pretty limp after the long oven shift, they were there from just before 7 am.
I asked one of the other dialysis patients if he was well done or just medium.
He said, “You can sure stick a fork in me.”
Repairs do not look iminent, apparently several electrical surges did the nasty to the electric motor and so Thursday patients both AM and PM will have a rough time. The weather is supposed to breal cooler by Friday morning. I sure hope that cooler front does not slow down and arrives as forecast.. I thought I might pass out or vomit from the heat, but I dragged through.
There was an a/c problem last year. The hospital was trumpeting how it balanced its budget. I guess that didn’ include heavy duty preventive maintenance on that a/c unit, let alone a replacement.
One blessing, the rest of the hospital full mainly of geriatric patients, was a/c cooled all right, so those patients were comfortable.