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Monday, June 18, 2018

The "The Dark Side of Dialysis", edition.

Good Monday morning. The Monday after Father's Day. I treated Dad and Brian to Hot n Juicy. Their choice. It never disappoints!  

So. The dark side of dialysis. What do I mean?  It has to do with the (mis)treatment of dialysis patients. There are approximately 400,000 of us who need dialysis. Most of the patients are going to dialysis centers.  And most of the dialysis centers are run by 2 large companies..Davita and Fresenius. Now CMS, the Center for Medicare and Medicaid Services, a government agency, "oversees" these companies. If a patient has an issue with their treatment, or their dialysis clinic, or the corporations, the issue can be mediated by CMS after going up the chain. Because the care of the patient should be the highest priority. Right? Life over profits, yes?

Well.  No. Profits first. Look. $77,000 per year per patient. $77,000 x 400,000 = $30,800,000,000.  Whoa!  There's money to be made and they can't have patients rocking the boat now can they. What do I mean by rocking the boat?  There are standards of that should be maintained. First and foremost is the cleanliness of the facilities. Dialysis patients are highly susceptible to infection. Clean and sterilize facilities are (should be) mandatory. The patients have large needles put in the arms at least 3 times a week by technicians. The blood of the patients is being moved out of the body through a dialysis machine, cleaned and returned to the body. Now there are a lot things that the blood flows or the needle access that need to be sterile. Lots of places for failures. 

Now you'd think the dialysis patients have the right to question procedures when it comes to them. Infections could kill us. Once, in my center in Detroit, I asked my tech to change her gloves. She complied with no questions. But some techs get an attitude. Once I saw a tech start to use a dialysis needle on a patient that had been removed from its sterile packaging. A senior tech read the riot act to that tech. When a patient finishes treatment and is off the machine, the machine and the chair is wiped down with industrial strength wipes. The center also had a cleaning staff. But this was in Detroit. At a private dialysis center. With lots of staff. 

I moved to Las Vegas and ended up at a corporate run center. The differences were mind boggling. The ratio of staff to patient was much larger, which meant the techs were rushed and more prone to mistakes and cleaning and sterilization was not as thorough. And the staff was stressed and there was high turnover. Not good for the patients.  

So sometimes patients rightfully complain. You'd think that would fix the problem. Heh. No. The complaint can start a retaliation of the patient who has the audacity to complain. A patient may complain that a tech causes pain while inserting the needles. There are incidents, too many to count, of the tech going out of the way to make sure the stick is painful. Or ignoring the concerns of the patient. And if the patient is really lucky, management will side with the employee, disregarding the concerns of the patient. And should the patient take it up the chain to the company, the patient will be labeled a troublemaker. So now the patient lets his concerns be known to CMS, but CMS sides with the company a majority of the time. So now, the clinic gets to kick the patient out of the center. 

But wait. There's more. The dialysis center will blackball the patient and other dialysis centers will not accept the patient. You understand that this is life threatening. Basically a death sentence. They say hey, you can go to the emergency room when you need treatment. But the ER will only take you if you are about to die..potassium levels and phosphourus levels elevated, excessive fluid retention, pulmonary edema. All because the dialysis has the ability and the right to deny service. Ugh. 

I was a pretty good patient. At least in Detroit. I crossed swords with a tech once. I was about 15 minutes late. She tried to fuss at me. Bitch, I'm a grown woman. Get out of my face. I'm late because I as having digestive issues. I could have been on time and pooped in the chair for you. I chose not to. But she kept on. How they'd have to change my chair time. I told her to get out of my face and send the charge nurse over. Lol. I actually did the talk to the hand thing. The charge nurse talked to the tech and I never had to deal with the tech again. And my time didn't change. 

In Vegas, my issue was with the charge nurse and my nephrologist. They treated us with contempt. I wasn't having it. Fortunately the social worker was my advocate.  Oh. Did I mention that the majority of patients kicked out of centers were people of color?  Anyway. I'll have more on this later. A slide show passed through my timeline about an organization, Dialysis Advocates. They work with people up and down the chains to make sure people are not mistreated and right the wrongs. And yeah, I have none of these issues because I do my dialysis treatment at home.  

That's it for today. Cooler here than Detroit today. Without the humidity. But don't worry. Back to triple digits by mid week. Stay cool and enjoy your day! 

Tuesday, June 12, 2018

The "Trying This Again", edition.

Good Tuesday morning. I'm giving this blog another chance. The past several times I wrote, the software sent my post into cyber nothingness. Seeing an hours worth of work vanish is oh so not rewarding. Ugh. 

So minor updates. My phone died a horrible death. Actually the charger port died.  We know it was the port because when we took it to the Sprint store, the guy recharged it on a wireless recharger. Anyway. Sprint tried to repair the phone. They couldn't. I got a new phone. I was able to recover almost everything. Photos included. And Sprint gave me a loaner phone. I'd call it a lame LG, but a lame LG is better than nothing. Tip. Get the insurance for your cell phone. Anyway, we went ahead and got the wireless rechargers. I like it. 

My laptop was cranky. Whenever I went into MS Word, the screen would blackout. Every time I typed, I'd have to touch the keyboard to bring back the screen. That. Was. Painful. Took it to Best Buy. The guy fixed it for free..just needed some updates. And my iPad is sputtering. It's lived a long life!   Lol. Got it before I started dialysis. Holding on. 

Glen got neutered and chipped last week. He came home drugged and with the cone of shame. We got him a neck pillow. It's better than the cone, but it still looks uncomfortable. One more week for that. He also got the ID microchip. He's still a puppy, but he's mellowing out. 

Dialysis is ok. It keeps me going. Heh heh. I still do the meds and food juggling act. My blood labs will certainly tell on me. By for now, everything is ok. I'm low on my protein intake. Not sure what I can do to increase it. The dietician has threatened me with a protein drink. Ugh. Bleah. Yuck. I've been chickening and shrimping and egging. The good news is my phosphourus is ok. Just need to watch the beans, nuts and dairy. The potassium runs low, so bananas, orange juice and avocados are Ok. Yay!!!  

We got a letter from the HOA that indicated we needed to paint the garage door. They specified the color paint and where we could buy it (!). We also made a request to the management company to check in the roof. So the garage door was our responsibility. We got it done and it looks good. The roof is the responsibility of the HOA. About 2 months ago someone came out to inspect the roof. And then we heard nothing. Until last Monday when a crew showed up. They literally redid the roof. 3 days. In the hottest weather of the year to date. The noise on the roof worried Glen. He kept looking up!  Lol. 

We tried a new restaurant, Oyster Bar at Sunset Station. I got the pan roast. It's shrimp, crab and lobster in a tomato, cream and brandy sauce with rice. And you determine the spice level I got a 7.. Out of 10. Tasty!  And no, I don't do oysters. :-(  

That's about it. Dad is doing great. Brian is wonderful as always. Shawn is on the west coast and that makes me happy..even if it's Oregon. Hot again this week. Stay cool and have a wonderful day!  

Tuesday, March 27, 2018

The "Just a Day..and a Procedure", edition

Good Tuesday morning!  I slept well last night. And most of yesterday afternoon. Let's start at the beginning, Monday morning. We started the day at Heritage Park Aquatic Center. We're on the northwest side of Henderson. The pool is damn near in the mountains on the southeast end of Henderson. Literally cross town.  As a matter of fact I can see the roads dead end into the mountains or the desert near the pool!  Lake Mead is basically just over the southern mountains. I digress. 

We get to the pool, change clothes and head in to the pool area. Yeah, the lifeguards know our names now. They're mostly kids and are amused at the antics of "seniors" at deep water fitness. Brian and I are at side of the pool with the more "vocal" swimmers. Heh heh heh. Again. I digress. 

The class before us is finishing up. And the members of our class are straggling in. Oh yeah. Our instructor is a tiny little thing. With the voice of a drill Sargeant. I can hear her while I'm in the dressing room!  Once class starts we move nonstop for the next hour. Legs, arms, core, balance, stretching, resistance, range of motion, cardio are just a few things we work on. We use barbells, noodles, fins, parachutes, kick boards, and tethers. Not on the same day!!! It is work. We bitch and moan. An yet we still show up!  Lol. When we finish and get to the locker room, there is a lot of sighing and deep breathing. We just finished moving for an hour...non-stop. We complain and then show up for the next class. Lol. And's worth it. 

Our next stop was breakfast. Metro Diner. It's pretty good and there are some good breakfast choices. And they have the best hazelnut coffee!  Portions can be large...that seems to be a "thing" in Las Vegas...ridiculous portions. Time for me and Brian to share meals. I digress. 

We head home and rest from the workout because I have medical procedure at 1:00. A dialysis related procedure. I read my instructions at the diner. No food 3 hours prior to the procedures. Whew. We finished breakfast just after 10. We chill and entertain Glen until it was time to go. The Vasvular center is clear across town in Las Vegas. We try to plan the route and time because there is a massive construction project on the busiest freeways in Nevada. So then the streets get congested. Anyway. We timed it ok and arrived before 1:00. I got called in the back just before 2:00. It was busy. Oops, lots of people needed procedures. 

Let me backtrack. We are at a vascular access center.  This center services dialysis patients. Our access are our lifelines. Literally.  If the access clots, closes or blow, or any of a number things, we would be unable to do dialysis. And so then we'd die. So what usually happens is your access may clot or close up over the weekend. Or even overnight. I call my nurse who calls the access center to  schedule the appointment. On this Monday there was a steady stream of patients. For my case, it wasn't a dire emergency. My nurse gave me a work around , but the issue still needed to be addressed. 

So finally I'm called back. Brian comes with me. I chuckle at the size of my file.  I think this is my fourth time there. The nurse assures me my file is small!  Lol. We go over my meds. I remind her that I allergic to the dye...that's injected into my access to see where the blockage is. It's in my record and the solution of using benedryl is there.  So the first time I had the procedure, I had an immediate bad reaction to the dye in the middle of the procedure...the team of course, was professional and addressed it immediately and moved on. 

I'm prepped on a table. I'm hooked up to the automatic blood pressure machine. Some nodes are placed on my back and chest. I get the oxygen tube. My left arm is stretched out palm up on an extension of the table. It's get washed with blue stuff. A glove is put on the hand. A paper barrier is put up between my head and arm so I can't see what's going on. Boo. On my left side are 2 monitors. So I can see as the doc is looking for blockages and I can see when the balloon is inserted for the angioplasty. Doc gives me fentynal (?), benedryl, and inserts the dye. I actually taste the meds as they are administered and then get high. It's conscious sedation. I'm aware of what's going on and what's being said and the team is talking to me..but I feel...loopy. The procedure is fine, although I can feel when the balloon is expanded.  Lot. Of. Pressure. I squealed. Doc apologizes. Lol. Mission accomplished. 

After the procedure I go back to a recovery room. My stars are good. Doc explains what the problem was and what got fixed. I get apple juice and animal crackers. Put my shirt back on. No pressure on my left arm. Can't even use it it stand up. Done by 3:00.  We leave. Brian picks up some chicken. I slept on the way home. Because drugs. We get home, I stagger into the bedroom and fall asleep. I thought I'd watch the news but it was after 6:30 when I woke up!  At a little. Went back to sleep. Because drugs. Woke up just before 11:00. Geez. Strong drugs. And I'm sure recovery of swimming figured in there somewhere. And then.  I slept all night. Geez. 

But now, I'm just fine.  Back to running errands today. Massive hugs for Brian for bring there. At one point I woke up to find a blanket over me. I know I didn't do that. <3   

So there you have it. I needed the procedure, but it was just part of my day. I've had it several times. It's still kinda scary because it's a procedure. But you roll with the punches. It's part of dialysis. And there was a steady stream of dialysis patients at the clinic getting procedures. 2 doctors.  2 teams. 2 procedure rooms. Of course I was clowning. And during recovery, a patient in the stall next to me waiting for the procedure (his first time) starting clowning with me!  Lol. 

That's it for today!  Looking at the 80s by the end of the week. Time to pull out the sandals. And yes, I had my pedicure last week!  :-D    Have a wonderful day! 

Procedure room. 

Angioplasty. Before balloon. During balloon and after balloon. Blood can now flow freely!! 

How the fistula works. We don't want a blockage here. 

Wednesday, March 21, 2018

The "March is World Kidney Month..But You Already Knew That", edition.

Good Wednesday afternoon. It's World Kidney month and it time to remind you to get your kidneys checked. Clearly you don't want to me writing a blog about kidney failure. Nor do I want you too. Get those kidneys checked. 

Yes, it's afternoon.  I've been to deep water fitness, the credit union and my monthly care team appointment. And we stopped at Home Depot and got 2 large purple hibiscus plants in pots. They are the first of several potted plants were getting for our cute patio. I also want some impatiens.  They should do well. There is an ulterior motive for the plants on the patio. The gated community has a few grassy areas.  And the back our home has one of the largest grassy areas. And the back of our house faces the street, as does our patio. The yard is maintained by the HOA. And the yard guys are doing stuff in the community every day. The landscaping is beautiful. Anyway. There is a demarcation of our "property" and the grassy area/lawn. People walk their dogs there on the lawn. And before you freak, the dog owners have to pick up the doggy poop. That's fine. I just don't want dogs nor their people encroaching too close to our patio...hence the plant and flower barrier. Also Glen raises hell when the dogs and people get too close. So the people walking their dogs don't linger. It sounds like we have a vicious dog inside. Lolllolololol. 6 month old puppy. Lol. I'll be getting 3-4 more plants and Brian will put his herb garden planter there also. And yes, we have room for a grill and patio furniture. Coming soon. 

Oh yeah. The HOA posted a note reminding people to pick up the poop. Otherwise they'll hire a company to do it and raise the HOA fee. :-{  I'd be really pissed if I didn't have a dog and that's why my HOA fees went up. 

Speaking of Glen, how's he doing, you ask. He's a hoot. Got a haircut. He was looking a bit wild. So he looks more like a westie and less like a puppy. But make no mistake, he's still a puppy. He hurt his leg a few weeks ago in a barking frenzy. He dove off a chair to raise hell and fell with a thud. He "oomphed" and kept on going, but with a limp. Brian got him to the vet. No breaks. Whew. But a bruised something. Have him take it easy. Ok. Sure. Easy that first day as the vet gave him some drugs. But after that?  He still ran...and he ran like hell with 3 legs. It didn't phase  him at all lol. But he couldn't jump up to look out the window.  He also missed his obedience class.  By the next week, the limp turned into a skip and he eventually was back to top of the sofa barking at dogs and people passing by. And chasing toys, and knocking on bedroom doors for people to come out...puppy stuff. And he went back to class this past Saturday. So he's fine now. I think in his mind he was always fine!  

Finally on the dialysis front.  It's going ok. I had a double dose of iron injections today so my energy level should go up. My arterial buttonhole started leaking blood about a week ago. What happened was after I finished treatment, there would be blood on the gauze when we removed the bandage. And each successive time there would be more blood. Ugh  My nurse wants me to start a new buttonhole.  Boo. I'll have to stick myself with a sharp needle in the same hole for 3 weeks to establish the buttonhole, about 12-15 sticks. Boo.  My nurse started today. For the first time ever the needle stick hurt. Bleah. And I now have to visit the vascular surgeon next week. I guess I'll get a fistulagram and angioplasty. Ah well. The life of a dialysis patient. For reference. The fistulagram is where the doctor looks at my fistula using ultrasound. If there is a narrowing or blockage then the angioplasty is in order....insert a balloon in the fistula(a man made created vein where I stick in the dialysis needles) and the balloon expands the fistula. No. It doesn't hurt, but then I'm in conscious sedation anyway. I get kinda loopy. Lol. 

Also the ablation procedure I had a while back has been successful. I no longer have to take the meds to control my parathyroid and the lab numbers are stellar. My entire team is ecstatic. Whoo hoo!  

Oh yeah. It's pollen season here. Let the sneezing, sniffling and snotting begin!  The wind kicked up and we saw the pollen blowing off the trees!!!!!  :-(     I though it was dust or sand  at first, but there wasn't any sandy land near us.  And oh yeah. I got some wind chimes for my patio!!!  

Well that's it for today. Not missing the snow in Michigan. It's 75 here. Heh heh heh. 

Purple hibiscus. Pretty! 

Glen before trip to groomer.  

Glen immduately after trip to groomer.  Yeah, it's the same puppy! 

Tuesday, March 6, 2018

The "I'm Still Here", edition.

Good Wednesday morning. It's been a while. It's also National Kidney Month. I haven't been motivated to write. No idea where the motivation went. Blog topics used to crowd my brain so much that I'd have weeks worth of material. Now, not so much. I'm sure it's because of my treatment schedule. When I was in center, I had 3.5 hours 3 days a week to write.  It was consistent. Once I switched to home hemodialysis the treatment time changed. And I wasn't as bored since I was home and had Brian to talk with and...I was home!  Plus treatment was in the evening. Then I switched to nocturnal home hemodialysis. So I'm doing treatment at home, in my bed while I sleep. Can't write while I sleep!  And then we got Glen the puppy, well, time became even more scarce. Anyway. It's time for an entry. 

It's been over a month. So how's it going?  The dialysis front has been ok. My phosphourus spiked to a dangerously high level. I got it back down. So my labs are fine but I still can't get to the protein level. The magic number is 4.0. I hover between 3.8 and 3.9.  Lol. No one can eat seven servings of protein a day. My parathyroid levels have stabilized much to the delight of my nephrologist and endocrinologist. And me, too. Looks like I may not need another session of sticking a needle in my neck. {{Ugh}}. What puzzles me is the idea of doing a series of injections in ones throat makes people cringe, so they'd rather have throat surgery?  I look at this way. 1-4 injections over time if needed. Or having my throat slit, parathyroid removed and a prolonged hospital stay while my calcium levels are stabilized. Oh yeah. I've had breakfast immediately after the injections. No they don't hurt...local anesthetic. Yes, the IDEA of a needle in my throat is disconcerting, but it's in and out. The doctor using the ultrasound on my neck is worse than the injection. Ok. Enough of that. 

A few weeks ago a friend from high school visited. She was going though some challenges the same time I started dialysis. Look at us now!  It was an absolute delight to see Doris!! She stayed with friends. When I looked up the address I realized her friends live very close to where swim!  Walking distance!  She wanted to go to a Chinese restaurant since it was the start of the Chinese New Year. Well Las Vegas has a huge Chinatown. More like Asian town. Anyway. We went to Joyful House Chinese  Restaurant.  Family style. Not like Stanley's. Very very good. Table had a lazy susan and we rolled that baby around trying out food. We'll be back. Enjoyed seeing Doris!  Lots of hugs!!

Then. One morning a few weeks ago I get on Facebook and find it that a good friend from elementary school had died. I'd known him 5th grade. Cliff had a radio program in Detroit and called me to ask for an interview after the shooting here in October. He wanted a Las Vegas resident perspective.  I told him I live 7-8 mile away from the area. I did the interview anyway. I did have have some local news that hadn't made it nationally and relayed it to him. How about that? Afterwards he called to thank me and we talked about way back when. He also was a kidney transplant recipient. His younger brother Michael donated a kidney. Cliff and Mike have been very supportive of me during my kidney failure journey. Cliff will be very much missed. 

Finally Glen. My fuzz ball. He's doubled in size and weight, on his way to becoming a cinderblock. It's time to get a larger travel crate. He's mostly house trained. Not bad for 6 months. I took him for a haircut. It was pretty disastrous so I'm going to try it again this week. Glen and Brian started an obedience class. Glen was just delighted to be in a park with other dogs. He did do ok though. And then.  While barking maniacally at anyone and anything that passes in front of the house, he jumps of a char and injures his left rear leg. Brian rushes him to vet, he gets X-rays, no broken bones. Just a bad bruise. They gave him painkillers. He was out for the rest of the day.  He's getting better. Get this. I'm on the floor with him hugging and comforting him. Dad goes into the kitchen. Glen races to the kitchen at Mach One speed on 3 legs. Lol. He's just now back to jumping on the back of the sofa to look out the window. He's doing fine. 

Well. That's it for today. This is National Kidney Month. Get those beans checked. You know the drill. Have a great day! 

Thursday, January 18, 2018

The "Trying to Normalize", edition.

Good Thursday morning. (Yes, it's now Sunday...I got a little busy!) Feeling a bit contemplative this morning.  Several events in the future are coming up...out of state. Thinking of the logistics make my head hurt.  The regional conference for the sorority is in Tucson, AZ, March 8-11. Then there is the national conference in Houston in early July, 7 days.  Then there is a high school reunion in Detroit at the end of July, 2 days. I'd like to go to all. But logistics and planning. Dialysis!! :-/

Yes, my dialysis machine is "portable". All 75 pounds portable. But there is so much more than just the machine. There are the supplies that go along with it. Some supplies we take with us. Some supplies are shipped by my dialysis center. And some supplies are shipped by NxStage, the dialysis machine company. I am responsible for..and there must be enough for each day and extras for that just in case error.."portable supplies".  So for each treatment I will need...2 bio hole fistula needles (pic below), 2 syringes without needles, 1 syringe with needle, plastic tape, paper tape (to secure my needles), gauze pad, sterile pads, medications, alcohol wipes, betadine wipes, sterile gloves, face masks, Purcell, antibacterial soap, blood pressure cuff, thermometer and paper towels. I draw the line at the scale! We also need a sharps box to dispose of used needles and syringes. 

The dialysis clinic ships saline bags. Nxstage ships cartridges for the dialysis machine and the bags of dialysate. 7 bags of dialysate per treatment. Each box holds 2 bags of dialysate. Lots of boxes. And. NxStage will only ship for trips of three days or more. *Sigh. 

So. For Tucson, I can dialyze the evening of March 7, fly into Tucson on March 8, then fly back home on March 9 and for tratment when we get home. The no treatment out of town option. Or we can do the all day drive with all of the equipment. Treatment on March 7 evening. Free travel day on March 8. Treatment on March 9 and March 10. Travel on March 11 - no treatment. And resume treatment March 12 at home. I forgot to mention that I have to change how o do treatment when I travel. At home I do it during the night while I sleep, 5-6 hours,me very other night. I have a special unit that I use instead of the dialysate bags.  But when I travel, it takes too many dialysate bags, I have to do treatment 3.25 hours 5 days a week. Yeah. Trying to figure out equivalencies. And yes. It is a hassle. Will it be worth it?  I'm still thinking about it. 

For flying to Houston and Detroit, it's actually easier. We've done the week long trips before. I have a hard case suitcase just for supplies.  And yes, there are some parts of the dialysis machine we have to disassemble for it to fit into the travel the IV pole.  So we're also transporting tools. Anyway. I also opt to travel first class now because of the equipment. Even with out first class there is no additional charge for medical supplies. It just makes the travel a bit easier and less stressful. 

When we fly we have 5 pieces of luggage. The 1-dialysis machine, 2-the supply suitcase, 3-the handcart for the dialysis machine, and 4-a suitcase for Brian and 5- a suitcase for me. And of course our carry ons. And because we've contacted NxStage and my nurses, our other supplies are waiting at the hotel. And yes, I'd contacted the hotel ahead of time to let them know that packages will be delivered in my name. And no, I've never had an issue. I've detailed the experiences in previous entries. 

So. Right now Brian and I are debating what we're going to do. We both really want to go to Tucson, but the hotels are filling up quickly. Perhaps another time. We'll see. 

That's it for today. This week we'll have some Las Vegas winter. Got up to 70 yesterday. Today it stays in the 50s with the high 30s in the evenings. No regrets. None. Some one asked me where I was from. I said Detroit. I was corrected. I am now from Las Vegas. Detroit is my hometown. I concur. Have a great day!  

My home hemodialysis set up.  Those things that say15G are the needles I insert into me. The vial of medication is heparin. It prevents clotting. Clotting during treatment sucks. 

The hard case for flying. It weighs 24 pounds. So with the NxStage weighing 75 pounds it's just light enough for free. Heh. 

For the road trips. The hard sided case is mandatory for going thru checked in luggage. We've seen that 99 pound package on a carousel. Who does that? Lol. 

Friday, January 12, 2018

The "I Have More Than a Doctor, I Have an Entire Team", edition.

* I started writing Friday morning. Finished today, Sunday morning. Don't judge! 

Good Friday morning. Heh. I'm trying to figure out where did the week go. Somehow I'm stuck on Thursday, even though I've been to my Friday deep water fitness class. And by the way, the instructor took great glee in kicking the collective asses of the class!  I've digressed....but...the instructor is part of my health care team. Huh. I'm having trouble typing and keep getting crew, instead of team.  I like the term crew. My health care crew it is!!

Let's start. When I first started dialysis in November 2012. Yes, it's been that long. I had dialysis techs, a social worker (team), a dietician, a team of nurses and a nephrologist. I learned to understand the role of each and it worked out well. I've kept in touch with one of the social workers since I've left the state. And she is  sorority sister.  I'm also in touch with one of the nurses, since I've left the state. She is the sorority sister of one my buddies from high school. Small world, eh?  These 2 women set the standard of what I would expect when I moved to Las Vegas. 

A quick statement on the team when I moved to Las Vegas. Culture shock. Social worker was instrumental in helping me with health insurance and getting me signed up for home hemodialysis. Dietician helped with some meds, but she left within a month of me starting. Huge turnover in staff and the number of staff paled in comparison to the staff in Detroit.  Nurses were cool. My assigned nephrologist was a prick. The charge nurse was a bitch. And I stood my ground. Lol mi was the person who had troublemaker tendencies. Eh. I stand up for myself. I started home hemodialysis training just before things went bad. Lol. I wasn't taking any shit. My Detroit staff made sure I had high expectations. There was a tendency to treat dialysis patients poorly.  No respect. None. So anyway I was out of there. 

Which leads me to my current crew. I have 2(!) nurses, a social worker, a dietician, a nephrologist, and a case worker from my insurance company(!). I meet with them monthly. I also have the primary care physician, a vascular surgeon, a cardiologist and an endocrinologist. That's a lot of people!  And I've included my trainer in the mix. It's important that they all keep in sync regarding my health. Of course there are hiccups. And the primary care physician is the most worrisome...he attempts to second guess the specialists (eye roll). 

My crew is incredibly supportive. I listen to them. And this is the important part...they listen to me!! I've been reading about dialysis patients that have an assortment of issues with the technicians, the nephrologists, their primary care physician, nurses, etc. I can't begin to understand why. But here is my takeaway. When it comes to your health, be informed, stay informed and be an active participant in your health care. It truly could be a matter of life or death. Feel free to question any member of your health care team. You know you and your body better than anyone. My crew works with me, each and every one. And I appreciate them so much. And it makes living with End Stage Renal Disease a bit more palatable. I do have some control over my treatment...and my life.  

That's it for today. Checking out the weather in Michigan, I'm not missing winter. Glen is doing well. More on him later. Have a great day!!