I was waiting to see my nephrologist before posting again, and that happened this afternoon - so here I am.

My nephrologist is a very kind fellow from Bombay, India. He has a soft, calming voice, and a handsome smile. The first time I ever saw him was in October of 2003, as he was doing rounds on my hospital room mate, who was a patient of his. She was a cute LOL, and was painfully swelled up from CHF; she was having an awful time of it. She looked at him with worshiping eyes while he was there, and said: “I love you, Dr. M. You know that, don’t you?” His handsome face turned red, but he just smiled at her, and kept talking to her in a soothing way. I never forgot that. When my own nephrologist became a hospitalist early in 2007, it didn’t take me too long to look this fellow up. Today, I’m really glad I have him.

This afternoon, when he came into the room, he was somber. He told me that he’d been speaking with my primary care physician, and asked if I’d heard from him yet. I told him that I had. He asked me what I thought about what I’d been told … and for me, that’s a bad question. Although I think (sometimes,) I’m not always able to express that verbally. Gimme a keyboard, and I’ll go to town - but please don’t ask me to talk! I’m not sure what I replied, but it was some of the usual drivel I use as a stop-gap when I have a brain freeze. He recognized it for what it was, and took charge of the conversation - to my great relief.

He quietly explained that there are circumstances under which they wouldn’t be overly concerned about a creatinine of 3.8, but that for my situation, it was time to begin making decisions. We discussed both hemodialysis and peritoneal dialysis. He also asked about placing my name on a transplant list, and he looked a little surprised when I told him that I didn’t want to do that. He asked what my reasons were, and I explained as well as I could. This isn’t the right time, but I will blog about that in the near future. It’s something I’ve given a lot of thought to.

By the time the visit was over, we had decided that I would try peritoneal dialysis. When I asked, he explained that it has a higher morbidity for the first month or so, due to a higher incidence of infections, but that afterward it was better, because it wasn’t as hard on the heart. I will be able take care of it myself at home rather than go to the dialysis center, and will be able to retain my independence. He is going to set me up with a nurse who teaches PD, and with a surgeon who will place both a port in my abdomen, and also a fistula in my arm, just in case. I’ve had abdominal surgery, and there’s a question of how well the PD will work because of possible scar tissue.

And now … here is an idea of what my poor docs are up against. *blush* He gave me two orders for lab work, and asked me if I would have one of them done today - to check up on my potassium, since it had been unusually high. There’s a lab right next to his office, so I took care of it right away, on my way out of the building. I then drove to meet my dear friend Joanie at a local restaurant for an early supper. The angel drove all the way down from Bangor - a three hour ride - to see me today. I had my son, Dougie, with me, and I told him: “I’ve just had my lab work, and won’t have any for a few more weeks. This is something I’m not going to get to do much in the near future, so I’m going to cheat and have some cheese fries while I can!” The cheese fries (with bacon, no less) at that particular restaurant are absolutely to die for. I could almost taste them before I even got to the restaurant. So of course … I was a bad girl, and munched big plate of fries. They were gooooooood! >;o)

We came home afterward, and in about an hour, the phone rang. The answering machine caught the call. It was one of the nephrologists telling me that I’d had an abnormal lab result today, and to call right away. *sigh* I kind of gritted my teeth, held my breath, and called. Apparently my potassium was “dangerously high”, and she wanted me to take some Kayexalate immediately. Well, it was a new prescription, and I’d only had it once so far - but that single experience was quite enough for me to feel my gut begin to roil as I thought about the prospect of trying to down some of that nightmarish grit. She said - “How much do they have you taking?”, and I told her that I was supposed to 15 grams every Friday. She said: “No no no! That’s not enough! I want you to take 60 grams!” OY! Do you realize what 60 grams LOOKS like? Worse … do you realize what 60 grams of that stuff goes down like? *ugh!* One sip and you feel like you just landed face first in a pile of sand, 2 sips and your tongue and teeth are wearing fuzzy little sand coats and ties … 3 sips and the stuff is fighting its way back out of your tummy! I must have made a really pathetic whimper, because she went on, urgently, telling me that with my potassium that high, I was in danger of having my “heart stop.” I didn’t say anything to her, but by then I was picturing my plate full of cheese fries … you know, the one I’d eaten after the lab work was done. Ouch! And so, I took my punishment like a good girl, and will dutifully report to the lab in the morning to let the vamps squeeze more of that red stuff from me so that they can find a reason to feed me yet more yucky stuff! ;o)

And to tie things up for now, my personal plans for the next little while are as follows …

I’m going to try to blog about this as it happens. Up until now, I haven’t wanted to do that except for during extraordinary occasions, but this is different, and I want to share. Perhaps we’ll start hearing from others who are going through the same stuff.

Also, there are an awful lot of things going on in my life besides the ESRD. I’ve played my cards pretty close to my chest in the last few years, but I’d like to try to break out of that. There are other adventures that are ongoing, and others that I’m just now beginning, and I would like to share those with you, too.

So - fair warning. Those of you who can’t take the nitty gritty may want to find your reading material elsewhere for a while. There will still be silly eye benders, funny stories, garden photos and more, but there will also be a bit more patient blogging than I’ve been willing to do in the past … and more of the real stuff that’s ongoing in my little part of the world.

Lots of big changes in the wind …

Posted: Wednesday, July 16th, 2008 at 10:53 pm under: Health & Medicine, The Nitty Gritty. Comment Feed (RSS 2.0). Interact: Comment or Trackback.