The "There's More to Las Vegas Than the Strip", edition.

Good morning!  There really is more to Las Vegas than the strip. There's downtown!  No just kidding.  Lol. Las Vegas is really a city. A large city. Well let me check that. The city of Las Vegas is really small. The metropolitan area seems to be made up of a lot of little places, not unlike Hamtramck or Highland Park. We were rudely awakened to this fact during an election for mayor. Therefore I couldn't vote.   Even though my mailing address clearly says Las Vegas, I don't live in Las Vegas. My phone says I live in Paradise. The sign on Maryland Avenue just past Desert Inn says , "Welcome to Winchester". Then of course there's North Las Vegas, Summerlin, Henderson and Anthem. I'm still confused. But I am part of Clark county.  There are just over 2 million of us in Clark county and 600,000 in Las Vegas. Now you know. Heh. Now I know!  

In the last blog I said I'd go over the end of treatment. While I'm on the machine, there is a 2 step process to ending treatment. After a while, an alarm will sound to indicate that all of the requested fluid has been removed. A few moments later, up to 30 minutes, a final alarm will sound indicating that all of the toxins have been removed.  I need to clarify that ALL of the toxins are not removed but as much of the toxins as possible. Now you can imagine that when that first alarm goes off, I'm getting antsy. The end is near!  But not near enough!  Lol. I always ask Brian how much time is left. The answer is always too many minutes...well usually 20-30 minutes. ....too many minutes!  

The last alarm finally goes off. But wait!  There's more!  I have to take a final blood pressure. Argh.  Then we need to do a rinseback. What's a rinseback?  Brian disconnects my arterial line (blood out) and attaches back to the dialysis machine. Then pushes a button. The process returns the remaining blood back to me. Because, you know, once treatment is stopped, there is still blood circulating through the machine.  I want the rest of my blood back!  It's mine!!!  It's flushed back with saline. When the venous (blood in) line runs clear, the rinseback process is complete. But wait!  There's more!  Brian attaches a syringe filled with saline to each access line, venous and arterial. It's a final flush of the lines. This kinda makes sure all of my blood is returned. 

Now. We can finally remove the needles. First out was last in. The venous needle. But it's not a matter of ripping out the needle. First Brian has to remove the tape. Yes. He tapes the needles and he tapes them according to standard procedure. There are 8 pieces of tape on my arm during dialysis. Each needle has 3. The first secures the butterfly part of the needle. The second piece is a half width piece of tape that sort of V's around the needle, called a chevron. And finally a piece of tape with gauze over the whole shebang.  This is the process for both accesses. Finally a piece of tape over the accessss to make sure it stays. A piece of tape over the tubes on my shoulder to keep the needle tubes steady, and finally a piece of tape over the tubes on my left shoulder to keep the tubes out of the way and so I don't pull them out. I need to find a photo of that. 

Anyway. Brian removes the tape from the venous. He then hands me a piece of gauze. He counts to 3 and as he removes the needle I apply pressure to the hole. And hold it. For freakin ever. Or so it seems. I need to hold it until the blood stops flowing. Oh yeah. Prior to all of these, we have to slather our hands with Purel and then put on the rubber gloves. The process is repeated for the arterial needle. I end up applying pressure to the needle holes for about 10 minutes to stop the bleeding in both holes. But wait!  There's more!  Once the bleeding stops. And it's fun watching Brian peek under the gauze to make sure it's stopped. Because there have been times when he's been surprised by the gushing of blood.  Although he hasn't experienced the marvelous spurts. Mt Vesuvius!  Anyway. After the bleeding has stopped, he puts antibacterial cream on the gauze and then tapes it over the holes. Gotta protect against infection!!  Finally he tapes up the whole thing. Which will always elicit comments when I go out. What happened to your arm?  Or, you just visited the doctor!  I do admit it's a pretty impressive bandage looking thing!   Lol. 

Finally it's almost over. I have to take my final stats..temperature, sitting and standing blood pressure and ending weight. Whew. It's over. About 20 minutes after that final alarm goes off, I'm finally finished. And I'm still good with this because I'm at home. Yay!!!

Well.  That was long. You try to explain one of your processes and see how it goes!  The heat has arrived in Las Vegas, along with a boxing match..which seems to have consumed the city. Rolling into the mid 90s for the rest of the week. 

Well that's it for today. Enjoy the sights and smells of spring. I don't have seasons here..and I'm not complaining.  But enjoy your spring. Just stop and really take look at the trees sprouting, the grass trying to get green and the first flowers peeking through!  Have a great day.  :-)

The "I Think I'll Keep Brian", edition.

Good morning!  I like to sleep with the blinds open. I like to see the lights at night going up the mountains when I wake up during the night. Well now the downside is the sun wakes us up in the morning. The window faces directly east and whe that sun rises over the mountain, it's big and bright!!  And to add insult, the bathroom mirror also faces east so when the sun comes up, it hits the mirror. Wow. Reflection-palooza!  Nothing like searing your eyes first thing in the morning!!  Lol. We're scrambling to close the blinds!  I'm not complaining, though. It was cold and cloudy and windy and rainy this past weekend.  I love seeing the sun. I missed it!  And yes it was cold and windy. But then that's relative, isn't it. I actually had to wear long sleeves this weekend!!!!  But no sweater or jacket. I'll stop whining now. 

Yeah. I'm keeping Brian. He was right there with me every step of the way on Thursday evening. Now I have no idea of what he did after I passed out, but I do know that it was his voice that brought me out of oblivion. Nothing like the blood rushing out of your head and you passing out. Coming to is always interesting. Each time I come out of a faint, I'm having a dream. Surprisingly enough I'm not confused when I "wake" up. But I do know I passed out. So yeah, I hear my name and I look up and I see Brian. I'm laying on the floor and realize what happened. I'm fully cognizant, but a little loopy. He still needed to get the needles out..even though they were partially out, but it did it. And he handles the blood spurts when the needles became dislodged. All while I was on the flor and trying to move. Or something. I was still light headed and then nauseous. But Brian was the cooler head that prevailed. 

When EMS came, he got my meds and was all ready to ride in the truck with me. I asked how would we get home. He said your dad can get us. And Dad was all, "yeah, I can pick you up". In the end, Brian followed the truck. Which was better anyway. :)  He was with me each step of the way in the hospital and never left my side. 

He is so diligent setting up the machine for dialysis. He is so careful while administering the drugs prior to treatment. He records the numbers on the machine and blood pressure and status every time the timer goes off, every half hour. After treatment he's breaks down and cleans up everything so it's ready for the next day. Now conside this. There is no vacation from this. Ever. At best we get 2 days off a week. I'm keeping him. And as a side note, he makes sure we have all of our supplies for our painting class!  Can't run out of alizarin red!  Lol. 

Finally, I wanted to tell you that the best and worst part of treatment is at the end, when the needles are pulled. I have to sit there for 5-10 minutes applying pressure the the accesses until they stop bleeding. But I'll save that for another day. HahahHhHahah. 

The photos are of the pool where do deep water fitness. I just wanted to show just how large this pool  is. This pool and the others we've seen make anything place we swam in Michigan look sad. It's just interesting to see how funds are spent here versus back home.  Well the temps are going to soar to the 90s this week. So I'll quit whining about cold and switch to whining about hot!  Have a great day. :-)

The "Uh Oh. 911 Was Called Last Night", edition.

Good morning. I'm a little late this morning. We didn't go to bed until around 4:00 this morning. And I'm sure both of us will be taking naps during the day. So. Why were we up so late?  Of course that's what you're asking, based on my teaser of a title. 

Yesterday, Thursday,  was a pretty good day. Wednesday night treatment was ok. My blood pressure dropped near the end of treatment and I needed to take my time standing up. Admit it..most of us just jump on up from sitting, but when we do that, beware, your (yes yours) blood pressure drops when you stand up.  So my BP was already low, around 94/78 and I'd stand up and get woozy.  Anyway. I went to bed..when I woke up on Thursday morning, I was a little better and I really need to take my BP several times a day now. As much I'd like to think I'm invincible, I'm not. I did go out later in the day. 

After dinner, we prepare for and start treatment. As usual, it's a non-event. About 3/4 of the way through, my BP starts dropping to stupid numbers. During the run it was actually pretty good, averaging 116/78 to 86/66. Yes those are reasonable numbers for me. I told you since starting home hemo, my hypertension is pretty much nonexistent. Well. The BP started dropping. I'm not happy when it hits under 75. And it went there. I started getting the telltale symptoms. Lightheaded, anxious, hot, cold clammy and finally straight out panic and basic irrationality. By the time this happened treatment was about 1 minute from being complete. Completion is 2 steps. Step 1 is flushing of toxins is complete and step 2 is all fluid is removed. 

I told Brian my pressure was dropping. He gave me 100 ml of saline, which is what he's supposed to do. It wasn't enough and I wanted to lay prone.  I was crazy, irrational and panicked. I attempted to clamp my blood lines and lay down in the bed. I remember clamping.  Then I remember Brian calling my name. I had passed out on the floor. Not only has I passed out, I was in some odd position. My feet were tucked under my body.  And the needles were pulling out which caused a bit of a bloody mess. Let's just say, once I came to, I was still light headed and now I was also nauseous. And I could not get up. Eventually Brian called 911. I couldn't seem to recover. 

Response was less than 5 minutes. I counted 6(!) responders. I think the fire guys were here first.  They took my vitals, got me up and put me on a gurney. A second group, the EMTs took over. A third group were there, I guess, because they responded also?  In the ambulance I was given an IV and oxygen. I was feeling  little better. 

I was taken to the closest hospital, which is little more than a mile from where we live. By the time I got there, I was feeling better.  Tired, but better. I was sort of surprised, but not much, that my nurse had never heard of home hemodialysis. "You stick yourself?!!"  But the ER doctor was aware of it.  So apparently a dialysis patient showing up after passing out was not a rare occurrence. Lol. After some tests they let me go home. After I paid my co-pay. Glad I got that insurance thing taken care of. The verification letter came on Thursday. How fortuitous. 

We came home, I took a shower because I was covered COVERED In blood. Brian cleaned up the blood on the floor and we went to sleep. Dad was up when we got home. The very last thing I want to do is upset Dad. Or Brian. I was an idiot. What lesson was learned?  Allow Brian to give more saline if/when needed. And quit panicking. Now I'm not sure how to control that, but I do know the nurses would  get real stern with me when I got low BP idiocy.  I suggested Brian do the same. I won't hold it against him. I promise. And finally, keep my ass in the chair no matter what. But I gotta tell you. I hate that feeling when my BP drops. I feel like the life is draining out of me. Like I'm dying. I probably am. 60/40.  And dropping ugh. Oh yeah. I'm sure you're asking why my pressure dropped. It means we're taking to much fluid off. Apparently removing 1.5 kilograms is too much now. Imagine that. I couldn't tolerate more than the removal of 3 kilograms when I was in enter. Now it's less than 1.5. 

Well. Not doing deep water fitness today. Going to rest. Going to take my lumps from my home hemo nurses. And I was feeling aces yesterday. Plans were coming together and issues had been resolved. It's always something, isn't it. Anyway. Have great weekend. May the snow just stop in the Midwest. It's late April for goodness sake. Have a great weekend. 

The "When The Visit to the Doctors Office is Fun", edition.

Good morning.  Yesterday I went to my monthly doctor visit. Actually, we can call it the monthly care team meeting. A most exciting 45 minutes.  I'll start out with my insurance issues. They never seem to end, do they?  Last week I received a letter from Humana indicating that my Humana SNP (Special Needs Plan) had been canceled because they never received the confirmation form...the form signed by my doctor that I was special needs...ESRD (End Stage Renal Diseass). Wait!  What?! The social worker told me she sent the signed form back to Humana in February.   Not only that I'd received the form in the  mail from Humana in March.  I gave it to the social worker and she called the Humana rep and she was assured that the original signed form was on record. So imagine my panic when I received the termination letter last week?  I called Humana that same day and they said yep, terminated at the end of April, but if I get the signed verification form in before the end of April, service will continue. I contacted the social worker who contacted Humana and was told, there has been no interruption in my coverage. 

Ok. What's going on?  I called back a few days later and now I'm told, my coverage was fine. WTH?  I asked for documentation to be mailed to me to indicate that I was covered. Soooo. On Monday I receive ... A verification form. Lol lol. That's fine. I had my care team appointment on Tuesday.  Since I'm meeting my doctor, I'll have him sign it and mail it back myself. 

As we arrive, I was met by the social worker. I told her about the form. She said she'd been told that there had been a glitch at Humana. All of the SNP enrollees got the termination letter. The social worker took the letter and she said she'd get the signatures and would send it in a third time. Before I left the appointment, she had been in contact with Humana regarding my form and it looks like that issues is over. The plan is a Medicare Advantage plan and it covers most of my dialysis costs, some  dental and vision coverage and non dialysis medical visits. It's not as good as my Blue Cross of Mochigan Medicare Advanatge, but it's OK. I get a $50.00 for over the counter stuff. So my Tylenol and and toothpaste, etc are free.  Lol?  And some of my ridiculously priced meds are costing a lot less.  Let me tell you. Having decent health care is a great thing. ...So I won't go on a rant about politicians wanting to get rid of the Acfordable Care Act. Or cutting funds to Medicare.  Freaking idiots. 

So the rest of my care team appointment was ok. We got our supplies replenished. The nurses gave me the dreaded injection of iron. When I get the injection, I can "taste" it. Yuck. And it's a slow injection. I also signed for the meds I have to self administer during treatment. We review the past month of dialysis. My numbers are good. They're satisfied with my blood pressure. Been off BP meds since January!!!!  I met with the doctor who wants me to ease up on the physical activity until I see the cardiologist. 

And finally I meet with the dietician. Actually I met with her first and that set the tone for the rest of the appointment. I received a copy of my lab report. I'd already seen it online. I knew my numbers were good. Great!  So the 2 of the numbers I need to keep down are phosphorous and potassium.  Well, both are on the low range. The low phosphorus allows me to have bit of nuts, chocolate or ice cream. The dietician tells me I need to increase my potassium!!!!  ????   :-D  Whoo hoo!  What's does that mean?  Well back track. She wants me to eat high potassium foods everyday.  Ok I need to stop hyperventilating.  It means I haven't had a banana in 3 years and now I can have one. I can eat some guacamole. Or have avocado on a sandwich. I can have a glass of orange juice. Or a baked potato with skin.  Or as Shawn told me, I can have Bananas Foster!!!!  Best desert ever!!!!   I'm just so giddy!  Anyway, that being said, I was having potatoes (fries, hash browns) and/tomatoes up to 3 times a week anyway...  But by dialyzing every day, the potassium is being flushed out daily, so I need to replenish it!!!  Happy dance. A serving of a high potassium food every.single.day. 

Finally, we received the documentation and equipment we need to travel. I have a letter signed by the doctor letting the airline know that we are transporting life saving equipment. And the case for the machine. Geeez. It's huge. And it's going to be heavier with the dialysis machine.  Good thing I've rented an SUV in Illinois!  And we're going to need a portable, collapsible cart/dolly to take with us. My dialysis care team is pretty excited about us traveling. They like having their dialysis patients doing more than just having treatment. I warned them that Brian and I like to travel. They were all, "Go for it!"  

So that was my day. I'm not having bananas fosters today or even upping the potassium today. We need to shop. Lol and I don't have time today!  We have deep water fitness, we need to return to the dialysis center. They forgot..we forgot. We don't have out sharps container for used needles. Also since I received the iron treatment yesterday in my arterial access, I didn't want to stick a needle in the access again later on that evening, so we'll be doing the treatment today that we skipped tonight. And. We have our drawing class tonight. So yeah. We have a full day. But tomorrow. Tomorrow!!!  A banana. Or avocado. Or something!!!  Lol. 

Have a wonderful day.  ....maybe banana pudding.............

Banana Foster

The cooking, carmelization of Bananas Foster.  

Happy Face!!!!

The "It's Hot Tub Time Again!", edition.

Good morning. The weather has been pretty nice out here. Not too hot yet, but I know it's coming. Last week Dad said its time to get back to the hot tub. I think he and Brian last went in early  November. Was too chilly for me, but that was it for the winter. And yes, the hot tub was open all year. Lol. So this morning it was about 70 degrees at 7:00AM. The three of us headed for the hot tub. It was sunny and no clouds on the sky. And the water was just fine. 15 minutes of pure relaxation.  Monday mornings are hot tub days now.  

Yesterday, Dad hung out with Carl so Brian and I did brunch alone. Brian wanted to go to a movie. We went to brunch at Texas Station because they also have a movie theater. Brunch was pretty nice. Texas Station has a made to order Tacos Pastor station in addition to the omelet station. Brian selected the movie. We saw Furious 7. I've never seen any of the movies in the franchise. Well. This movie was non stop action. Lol. My heart couldn't take it. My only complaint was not enough of "The Rock". But he came through when needed. :)  I enjoyed. A great movie to just get lost in. Just go with it. Lol. And the best part was since we went after eating, no snacks, no drinks. :)  The stunts and special effects were worth the suspension of belief!  

Dialysis is still just something we do. I go to the center tomorrow for my monthly checkup and replenish my supplies.  Talk about down to the wire!  I had just enough needles to make it through tonight. Emphasis on had. I opened a needle packet on Friday and the needle was missing a part. Ah well. I have to go to the center today to pick up a few needles and then go back tomorrow for the appointment and the rest of the supplies. Bah. We also got low on tape and gauze. The thing is, we get 4 weeks worth of supplies, but the time between appointments this time was almost 5 weeks. In addition, I ordered some meds. The pharmacy tells me after the fact that there is a problem getting the meds. Ugh. At least it's not one of my must, must haves. Just a must have. It's a week late.  

Nice short entry for today. Have deep water fitness today. We've signed up for a trip to go to Zion National Park in Utah next week. Never been to Utah. I'm looking forward to it.  We'll see how the walking goes. I've called the hotel in Champaign to let them know my dialysis equipment will be delivered and they have no problem with that.  I talked to the airlines and transporting the dialysis machine will not be an issue, even at its weight because it's medical equipment. So the trip is coming together. I am so looking forward to seeing my baby!!  I'm such a mom!  Lol

Have a great day!  

The "Living in Las Vegas", edition.

Good morning!  The winds have died down. The high winds started Tuesday afternoon and continued through yesterday, Thursday. Granted, the winds weren't  as severe yesterday, but those plastic bags were still soaring past the 2nd story window. Years ago I was with my mother in law and some of her friends and one of her friends refered to the flying plastic bags as ghetto kites. I thought that was hilarious. Not so much anymore.  I digress. 

We finally got back on track on the dialysis schedule last night. But the adjustment wasn't an issue. I loved the flexibility of how we adjusted the dialysis schedule. Tuesday morning instead of Monday evening. Then on again on Wednesday morning..Wednesday is my scheduled off day, but I needed to make up a day. Here's how Wednesday went. We have deep water fitness at 11:30 AM. We came home afterwards and started treatment a little after 2:00PM.  We finished the entire process, including stopping the bleeding and recording the stats a little after 5:00PM. Our drawing class starts at 6:00 PM. We made it with time to spare. It helps that we live near UNLV. :)   Yesterday we fell back to evening dialysis and we complete the week tonight. I am really pleased I switched to home hemodialysis. Oh yeah, the drawing class.  It's a lot fun and I can't draw worth squat. Lol. But I am learning theory and technique. I can only get better.  Lol lol. 

I've been in contact with representatives with the National Kidney Foundation here in Las Vegas. I'll start volunteering for them in May. Most of the events are on Saturday. And right now, we have a watercolor class on Saturday. There will also be a kidney walk in October. I'm looking forward to that! 

I have more photos from our tourist day. One is a customized bicycle. The bus stopped at the Golden Nugget,  which I guess was hosting a customized bike convention?  After posting on Facebook, I found that I posted  a photo of the president of a bike club from Detroit !  The gold chain handlebars and gold "rims" caught my eye. 

The weekend is starting today. I've told you how we go to brunch every Sunday. Well, ever since we took Dad to Texas de Brazil, he's been trying to get back to a Brazilian steak house. There is one near us, Fogo De Chao.  He's treating us this afternoon since it's not open for lunch/brunch on Sunday. And he's looking forward to it!  Lol. This leaves his Sunday free, so he and Carl will spend Sunday watching basketball. Brian's an I need to figure out what to do with ourselves on Sunday!  Lol. 

Finally, im just leaving you with a bunch of random photos. This first one is my latest acrylic painting. It's from a real class, not a one day painting experience.  We've done those, also. The painting took about 6 weeks. Have a great weekend!  

I did this!  

A customized bike

Container Park. A shopping area made up the containers that are hauled by semi trucks. Check out the metal insect in front. 

A view of the Fremont Street Experience. I'll get a better photo another day. I like Brian's head in this. Lol. 

The "The Chair is MINE!!", edition.

Good morning. Did you know Las Vegas has a windy season?  I didn't. But I know now!  Yesterday, Dad and I were talking and a plastic bag raced by about 3 stories up.  Lol. Later on, Brian and I went out. The car is parked in a garage. The condo is built over the garage. It's not inderground and as a matter of fact, the condo sometimes designates the garage as the first floor. Anyway. We got to the garage and it was windy but not overly so. As we drove to the store we noticed the trees bending. But the best was yet to come.  

We got to the grocery store and we took our time shopping. There are no windows in the grocery stores, maybe taking their cues from the casinos. Heh. Oh yeah, there are mini casinos in the grocery stores.  Anyway, we paid for the groceries and headed outside. Oh my. While we were in the store, a sand/dust storm had started!  Usually we can see the mountains from any direction in Las Vegas. But not yesterday. Heck, we couldn't even see The Stratosphere....the major landmark in and highest structure in the city. Lol. We live fairly close to the strip. Couldn't see that. The haze and dust was just that impressive. As soon as I stepped into the dust storm, I swore dust swirled into my eyes. I felt like my breathing was starting to be difficult , but it may have just been the idea of walking into the swirling dust.  Ugh. The temperature also dropped.  But then I still didn't understand people walking in full on winter gear.  Lol. The temp started in the mid 80s. I digress. 

The wind continued the rest of the evening. Apparently the wind affected the planes landing at the airport. The news showed a plane doing a kinda sideway landing. My friend who had been in town last week left yesterday morning. That was a good thing.  If she'd tried to last later in the day her flight may have been postponed or even canceled. Oh yeah. All,of the city's attraction closed because of the wind storm. Today is better, but it's chilly this morning. Photo of the storm. 

So. The chair is mine. What am I talking about?  About the dialysis chair!!!  Someone in the dialysis group posted about claiming his dialysis chair and an entire discussion started.  I've mentioned my chair before while I was incenter. Now the claiming of a chair is not a common occurrence.  When I first started incenter dialysis, my chair time was 2:15 PM. I pretty much got whichever chair was available on my module. More than likely it was the same chair, but it was dependent on the person before me. Once I went to first shift, my chair was static. Same chair everytime. I was on first shift in Detroit and Las Vegas. And I had my chair.  MY chair. Lol. 

In Detroit, during a blizzard, the entire process was changed to deal with the shortage of staff and patient transport issues. A first come first serve process was in effect.  I, alone, was the only first shift person during that emergency who actually ended up in their own chair.  Score!!   Lol. I know. It was the luck of the draw and I'm sure I'd been fine in any chair as long as I had treatment, but I got my chair. MINE!!!  In Las Vegas, I had a chair on first shift, them I got changed to even an earlier time on first shift. That changed my chair, but I was good with that. My chair. Imagine my dismay, when I arrived one day and the machine didn't work and I had to change to another chair.  Disaster!!!! .  Lol. Anyway. It's just shows how we become used to and dependent on our routines. And maybe for dialysis patients that's not a bad thing. Kidney failure and dialysis are stressful enough without all of the other variables that go along with treatment. Also, when I left the discussion, the group started talking about having the same techs and getting antsy when the center plays pick a random tech. I've even written about that.  You know. Me not letting some people near me. 

Now I'm doing home hemo. My chair is my chair. Although Brian sits in it in when I'm not doing treatment. Like now. Even Dad sneaks a sit in it. I can share. *cough, cough*.  It is a comfy recliner. And Brian is my tech. And I'm also my tech. I am quite happy with the arrangement. Do I miss incenter?  Sort of. I was there several hours a week. I was with people who knew exactly what I was going through.  We could help each other. I was there with techs, nurses, social workers and doctors who could answer questions and work with me. It was a social atmosphere, even if we looked like we all lost a fight by the tiem we left.  But that being said, I like...I love the flexibility of being home. My friend visited on Monday evening. I missed treatment, but we just made if up Tuesday morning. Hah!  In a perfect world, my kidneys would be fine, but it's not perfect and my kidneys don't work. This will do. I'm ok with it. I have no choice. It's all good. I'm still smiling. :) 

More photos of playing tourist in Las Vegas. 

A leaning hotel. I forgot the name. 

The Cleveland clinic. It's insettling to look at, isn't it?  Lol. 

The "We Played Tourist on Sunday!", edition.

Good morning!  How was your weekend?  The weather here was perfect.   In other words, we're enjoying the weather before the temperature gets outrageous. Saturday, the condo had a yard sale. I chuckled about the redistribution of items of the residents. In other words, why would I want someone else's discards, especially in a 55 and over community.  That being said, we've been purging stuff since we arrived here, so we had nothing to sell. Brian and I intended to go and see, but I was feeling a little punky and the entire thing was over by 1 PM. 

We started our watercolor class. When you walk into class and you see a copy of the painting that we'll be doing, it's always daunting. It was no different on Saturday. A France  street scene, including the Eiffel Tower.  Yikes!  And yet. It started coming together. With each painting we learn new technique. The same thing happens in the acrylic class. One day I'll show you the last painting we did. I'm kinda impressed. 

Sunday, we went to Main Steeet Station for brunch. Dad's favorite place. Afterwards Brian and I attended a craft fair. I came away with 2 pairs of earrings and a necklace.  I had to get out before I wanted something else. Not wanting to go home, Brian suggested we take The Big Red Bus tour. What is that?  A double decker bus that tours the strip area and downtown. We sat on the upper level and had a ball. The weather was perfect. All that was missing were our hats!  Lol. 

I took a lot of pictures. Some were challenging because of the sun. But you know what?  That camera on the Galaxy 6 smart phone adjusted. I had so much glare that I wasn't sure I even got a good photo. The camera took care of that. I pointed and clicked and the camera did the work. I have no particular dialysis update. We started treatment last last night because of the tour, but then that's  the beauty of home hemodialysis, isn't it. The flexibility. Heh.  That's it. 

A few of the photos. 

This fight is big out here. I'm not sure how much press this is getting in the rest of the country, but it sure is dominating the news here. Especially the ticket prices. $10k!  Outrageous!  

Doesn't this look like fun?  I've never been there, but a trip to M&M World is in my future. 

This gives you an idea of the sun. We are facing west in this photo. I couldn't see the image in my screen and hoped for the best. Check out that Ray of sun!  Lol. 

That's it. I'll have more photos next time. We enjoyed the tour. And I'll more info on that also. Have a great day!  

The "It's Been a Good Week", edition.

Good morning. How was your week?  Mine was pretty good. We started out with the Easter Dinner for Dad and his friends. We'll finish it up with a visit from friends from Detroit. And what did we do in between?  Well after dinner we cleaned up and still did treatment!  The guests apparently had such a good time that they stayed later than we expected. And that was just fine. They didn't leave until after 7 PM. They were with us for almost 4 hours. We usually start the process to start treatment between 6 and 7. On Sunday, we started after 8PM. No complaints. Both Brian and I slept during treatment..waking up when the alarms went off to take blood pressure and readings. Fortunately treatment was uneventful.  

Monday it was time to go back to water aerobics. Tuesday our last class with our acrylic teacher.  Wednesday was water aerobics again and starting the drawing class at UNLV. We figured if we were going to paint, it might help if we knew how to draw a little. The drawing teacher is pretty cool. He explained how we use the left and right sides of our brain and how if you allow the left side to dominate, your drawing is pretty bad. Of course I'm paraphrasing. So he had us do exercises to start training the right side of our brains. Lol. I'm not ready to show you those drawings, but we understood what happened. 

Thursday was Dad's birthday. We gave him his cards and a gift. I posted his birthday on Facebook.  I showed him his birthday wishes. He really liked seeing the birthday wishes. He called it the birthday card that keeps on giving. He also had birthday wishes on his own Facebook page. I'll show him everything today. He also liked looking at the photos that I'd posted. He also got a lot of phone calls, including calls from my brother and from Shawn. He always likes that. 

Brian and I had some errands to run early in the day. When we returned home, we took Dad shopping. See, he needed a new mattress. His current mattress is pretty low and when he tries to get up from the bed, he has to bounce to get the momentum to get up. Sound familiar?  Lol. When Brian and I purchased our new mattress when we moved in, he laughed at the fact that our mattress was fairly high off the bed, but it was the natural height of the mattress and box spring.  He joked we would need a step ladder to get in. Well. Fast forward.  We took,him to a mattress store.  He tried out several mattresses and selected one he liked. Looks like he'll need a step ladder. Ha!  Seriously, he got a nice mattress and it sits high enough that he doesn't have to bounce on the bed 20 times to get enough momentum to lift himself off the bed. The bed will be delivered Monday. 

I got my labs back. Well what happens is Brian takes my blood and we send the samples to the lab. Part of the supplies and process is we have a centrifuge, tube holders and packages to to send the blood. I guess Davita has a huge account with Fedex. Brian calls Fedex to let the know to pick up the blood. There is no cost to us. Well I'm sure there is, but you know what I'm saying. So if we know we're going to draw blood on Monday, then on Monday, Brian calls Fedex with the account number and requests a pick up.  Sooooo.  Pickup was Tuesday. We were supposed to draw on Sunday, but we were too tired for dinner.  I get an email from Davita that the lab results are ready and I log on to the account to see the results.  Since I've been doing home hemodialysis, my labs are just fantastic. I can also see all my lab results since I started using Davita. My phosphourus and potassium numbers are almost too low!  One day, I'm going to splurge on a spicy Bloody Mary.  Yum!  And maybe some avocado.  Still scared of bananas. Lol. But health wise, home hemodialysis has exceeded my expectations.  I've very quickly become a rabid advocate of home hemo.  And I do understand that it's not for everyone. And. I've got some exciting news about my home hemo. I'll go into detail later. 

Well.. That's it for today. I had one other something I wanted to write, but it's slipped my mind. Ah well. Lol. Have a great weekend. Apparently Las Vegas is going through it's windy season. Lol lol. Who knew?  Oh yeah I remembered as I was proofreading. I got a response from The National Kidney Foundation. There is a contact in Las Vegas, but Vegas is part of the Souther California retail area. NKF had the Vegas office contact me. I've found my precious kidney walk. It'll be in October. In the meantime I'll be involved with health fairs in the area!  Yay!  I'm also going to talk with my social worker about resuming the mentoring.   Ok. Now I'm signing off!!!  

Photo of Mom and Dad at their 50th anniversay celebration and photo of a sample lab report.  

The "Do You and Your Kids Know How to Swim?", edition.

Good morning!  We've been dealing with Easter leftovers, but they should be all gone by tommorrow. On Monday, we had a full on duplicate of Sunday's dinner. Yesterday, Brian made a creamed ham and cabbage soup.  And yes, it was delicious. And easy!   Remember, we had a lot of raw cabbage left over because I apparently can't determine how much of anything I need!  And even though we got a Honey Baked ham for 6-8 people, we still had quite a bit left over...so voila!  Soup. The guests have checked in and they've finished their leftovers and are working on the jelly beans!  Lol. Also, Dad's birthday is Thursday and he requested Easter leftovers for his birthday dinner. Yeah. He did. We have some ham, macaroni and cheese and corn...no cabbage, but he's good with that. 

One more thing. Gruyere macaroni and cheese. Pure heaven. I'm never going back to using cheddar.  Ever. I make a white sauce and then add the cheese to melt in the white sauce, but here's the kicker. Remember, I'm still on a renal diet. And there's a lot of dairy in Mac and cheese. So I do how deal with that?  I use non dairy creamer instead of milk!!!  It works. And it works well. And it tastes soooo good.  We've found the that the non dairy creamer works in several recipes that call for milk and/or cream.  

Ok swimming. Do you know how to swim?  Do your children, nieces, nephews, grandchildren know how to swim?  If you or you children don't know how to swim, I'm judging you. Already, 2 young children have drowned out here in home pools. If you go to pools, beaches or water parks, you need to know how to swim. Brian and I swim. Back in the day, we both were certified Red Cross life guards. We both have taught swimming. We like to swim. But we have the utmost respect for water. Did you know I was certified in adaptive aquatics?  I was trained and Red Cross certified to teach swimming lessons to people with disabilities.  All disabilities. Physical, mental and emotional. Children and adults. 

   

We started Shawn with swimming lessons just after her first birthday. Brian and I attended a pool party and took Shawn with us. While we were swimming, Shawn decided we looked like we were having fun, so she jumped on in the pool!!  Yikes!!!  Lol. I got here her and she's laughing. I put her on the side of the pool to get out and she cannon balled right back in!!!!  Lol. I got the hint big time. That Monday, we went to the Birmingam Y for baby swimming classes.  She continued with swimming lessons until she was around 8-9 years old. In addition, she attended Howard University. One the conditions of graduation is taking a semester of swimming.  And one of the conditions to pass the class is the students have to tread water while singing the Howard University song. (We called it the funeral dirge, but that's a story for another day!-lol). Swimming has become a lifelong skill for her. While at Disney World, she and her friends were able to go snorkeling with sharks. They all went to Howard and they all know how to swim.  

The last thing I want hear is, ".... But my hair". Look. You can go natural  for the duration of a beginners class.  Frankly, you need to go all the way through to an advanced class...jumping into deep water, learning how to tread water. Learning  basic self-life saving skills. Again, if you ever go to a pool, beach or water park...or go on a boat, then you need to know how to swim.  Brian and I are in water aerobics and for now it's in shallow water. We're transferring to deep water aerobics. The number of adults who are afraid to go to deep water is really sad. And it's not that you need to know how to swim, because we wear a floatation belt, but if you're afraid of the water, it seems you won't trust the floatation belt. People are afraid of the water. 

Well that's my rant. Swimming is a necessary life skill. If you don't know how to swim,it's not to late to learn. And if you aren't willing to learn, at least make sure the children in your life know how to swim.  

Singing off.  On my way to water aerobics.  Ugh. Watching a Rand Paul interview. He's a dick. I've digressed. And I've lost my train of thought.  Have a wonderful day.  And learn to swim!!!!!!   And yeah. I'm in the deep water here!!!  

The "The Weekend Was Pretty Nice", edition.

Our weekend was pretty nice. I attended sorority meeting Saturday morning. It seems I joined just in time to for the 50th anniversary of the chapter. I also forgot that I need to bring a checkbook to meetings. Lol. Its all good. No, I'm not attending the anniversary activities. The gala weekend is in 2 weeks and we aren't prepared, but I'll participate in future activities. 

After I left the meeting, I drove down Las Vegas Blvd. I turn into the street just south of downtown. I like driving down the blvd on Saturday because it's a great place to people watch. I pass by the pawn shop featured on Pawn Stars. There's always a line of people waiting to get in. In fact, there's an entire business outside the shop.  Parking lot, souvenirs,  refreshments!  Security guards. And always a substantial line.  I also pass several wedding chapels. I saw Elvis outside of one of the chapels this past Saturday. I was also behind a guy in his low rider and I got treated to him bouncing his car.  Lol. 

Sunday we had dinner for Dad and his friends. This dinner didn't take a lot of time and effort. We cooked and froze the corn earlier in the week   Dad shucked the corn, Brian cut the kernels of the cob, I cooked it and Brian froze it. Since we send food home with Carl, Dad wanted me to cook a little more food. I planned on 12 ears of corn for 6 people. I ended up buying 20. Wait. Let me explain. At the store, the produce bags held 4 years of corn. So I got 4, then 8, then 12, then 16. I got 18 and figured why not fill out the final bag?  Which I did. I got 20 ears. Yeah. I know now that that is a lot of corn. A lot. 

I also fixed cabbage. I fixed it the previous week to test it out. It was good, but it looked as if one head of cabbage wouldn't be enough for 6 people. So we bought 2 heads of cabbage. After Brian finished cutting the cabbage I went to the kitchen to cook it. I had a giant bowl overflowing with raw cabbage. I think I ended up using one head of cabbage. Lol. I now have a bowl with raw cabbage in the refrigerator.   And yes.  I overshot with the Mac and cheese also. lol. Not as much, though. I have a half of casserole dish of the Mac and cheese left. Everyone went home with leftovers. I called it the Fields-Perry carry out. 

So let's backtrack. I made Easter baskets for everyone. I got small cardboard baskets, multicolor paper squiggles and plastics eggs from the dollar store. Brian and I dyed some eggs on Saturday. We had small Lindt chocolate bunnies, Easter eggs full of Starburst jelly beans and a dyed egg on each basket. Oh my goodness.  My senior citizen guests enjoyed their baskets. lol. I placed a basket at each seat and they were just tickled. Oh. Who were my guests?  Well Carl age 93, of course.  And Pauline, age 95 who lives in the building and is also a longtime friend of my mom. And Pauline's friend, Herbert   He's a young 85.  Lol. And the there's Dad, who'll be 89 next week!!  

As usual, Dad went to pick up Carl. I had a cheese and cracker snack plate waiting for them. And they sat on the couch drinking champaign, eating cheese and crackers while watching Lebron  James. This occurs about 2 hours before dinner is served. Anyway. They all ate heartily. The corn and cabbage was a big hit.  Lol. All plates were emptied. After dinner was coffee, cake and ice cream. They stayed 3 hours just talking and having a good time. Everyone went home with containers of food...corn, macaroni and chees, cabbage, slices of Honey Baked Ham, rolls and cake. And Carl also got the rest of the 1/2 gallon of ice cream.  Lol. And they made sure they had their Easter baskets.  :-)

Brian and I also enjoyed being with them. They told lots of interesting stories and we got some history lessons about their experiences. It was also fun listening to them reminesce. Movies costing five cents! Lol. Herbert grew up in Hawaii on a sugar plantation and we got stories about that also. We really had a great time. That being said, I got a really late start on dialysis, but that's the beauty of home hemodialysis, isn't it. Lots of flexibility. 

Well we're back to our schedule this week. Our classes all had spring break last week!  And I don't have to plan for another meal.  Well. Sort of. I'll be having a dinner once a mo the for our "family". The next dinner will be Memorial Day. Barbeque, baby!!!  

Signing off. Got lots of leftovers. Gonna try a ham and cabbage soup this week. Have a wonderful day!  

Photos of table before dinner and during dinner. 

The "A Little Terminology and Explanation, Part 3", edition.

The end of this little series details the end of the run. I know it's not exciting, but I hope you learned a little about what happens during dialysis. Specifically home hemodialysis. The treatment lasts just under 3 hours. There is a 2 step removal process. We're notified when the toxins are removed and then notified when the fluid removal target is reached. When the fluid removal target is reached, the treatment is over. The time between the end of toxin removal and the end of fluid removal seems to be between 15 - 30 minutes. I think if I need more fluid removal, the time between the two is less. For instance. If I need to remove 1.5 kilograms of fluid, once the toxin removal is complete, it takes an additional 15 minutes to remove the rest of the fluid. If I need to remove .7 kilograms of fluid, it takes an additional 30 minutes to remove the rest of the fluid once the toxins are removed. 

So we're at the alarms. I like hearing the first alarm, toxin removal complete. This means the end of the treatment is near. When the final alarm goes off its time to go into action. The first thing I do is track my final blood pressure. Brian gets a saline filled syringe and attaches it to my artieral (blood out) access. He then attaches the venous tubing to a saline bag. Then he starts the "rinseback" process. What is that?  It's the process of returning my blood back to my body. Though the venous access...blood in. The blood remaining in the dialysis machine is returned to me flowed by the saline. When the venous access line runs clear, the rinseback process is complete. Brian then disconnects me from the machine and attaches a saline filled syringe to the venous access tubing. 

So now I have the the needles with the tubing still in me and the end of the venous and arterial tubing have syringes attached. Brian now checks the tubing for air bubbles, and then injects the remaining saline into my venous line. After that he removes the spiderweb of tape.  He gives me some gauze. As he removes the needle, I apply the gauze, with pressure, to the needle hole. After a few minutes we repeat with the arterial line. During the break between the two needle removals, he breaks down the dialysis machine. 

I apply pressure to the needle holes for about 5-7 minutes. Brian then applies an antibacterial ointment to gauze and tapes the gauze over each button hole, and then tapes the whole shebang. It takes about 5-6 pieces of tape. Heh. Sometimes when I'm out people ask about my uber bandage. I just say. I came from the doctors office. :). I leave the bandage on for no less than four hours. Just a precaution if the buttonholes decide to bleed and it allows scabs to form, leaving me less suseptible to infection. We don't want an infection in the bloodstream now do we?  

The final steps are taking standing and sitting blood pressure, a final thermometer reading and finally my weight after treatment. Oh yeah. The nurse wants me to take my weight au naturel. :-)   Anyway.  Sometimes during treatment my blood pressure drops. Well...always during treatment. It's averaging 90/70 with a 82 heart rate. I'm feeling fine with the low pressure, but to be on the safe side, Brian plies me with pickles. Clausen pickles. Yumm!  Oh yeah. The pickles for the salt content to help raise the pressure some. It works about 99% of the time. If I'm feeling like all hell is going break lose, I ask him to return some saline to me. And that works everytime. So, so far so good. 

Now you know the process and you learned a few dialysis terms. Flashback, rinseback, arterial, venous. 

Today we're finishing up getting what we need for dinner Sunday. We picked up the Honeybaked ham. And I got a praline cake from Nothing Bundt Cakes. Today I'll pick up some flowers and the remaining groceries. And we're dying eggs on Saturday. Have a wonderful Easter. :-)

The "A Little Terminology and Explanation, Part 2", edition.

Explaining what happens for me to get on the machine takes longer to explain thans the actual actions.   I left off with the priming process. That's where both needles have been inserted in my arm and Brian advances the blood in the tubing by opening the caps at the end of the tubes. See. Once I insert the needle,mother blood doesn't immediately fill up the tubing. Priming is the action that does that. So here I am with the 2 needles with tubes in my arm. One in my arterial access, one on my venous access. 

At this point Brian has to administer medication via the tubing or get blood samples via the tubing. The medication happens every time. I get Heparin every treatment. Heparin insures that my blood doesn't clot. I also got Heparin when I was in ICU. The injected it in my stomach. I digress. 3 times a week I also get a dose of Epogen.  Epogen is a prescription medicine used to treat a lower than normal number of red blood cells (anemia) caused by chronic kidney disease in patients on dialysis to reduce or avoid the need for red blood cell transfusions.  The need for this drug is based on my monthly labs. I also needed doses of iron. But it's under control for the moment. These are medications I need I. Addition to the ones I take orally on  a daily basis. Again.  I digress. 

I have vials of drugs. I use syringes to get the correct dosages. The Epogen and heparin have separate size syringes. I insert the needle into the bottle to get the correct dosages. In order to administer the medications, Brian takes the needles off do the syringes and attaches the syringe to the tubing and pushes the syringe to administer the meds. He also has a nifty tool to withdraw via the tubing. 

Once the drugs have been administered and the  look has been drawn, I'm hooked up to the machine. He attaches longer tubes to my arterial acces tube and my venous access tube.  Arterial flows out, venous flows back into me. We check for air bubbles. Because air bubbles in my bloodstream can be bad. We don't care if there are air bubbles I the arterial access, because it's flowing out and the machine will trap them. We do care...a lot..if there are air bubbles in the venous access. We can get them out. Once the bubbles are out, it's time to get the party started!  Buttons are pushed. Brian enters how much fluid to remove and the he enters the rate of removal. We record the time he starts and we're off. 

About 2 hours later the machine signals that the toxins have been removed and about 10-30 minutes later, the fluid removal,is complete and it's time to get off the machine.  Before I go into the end process I want to mention that I take my sitting and standing blood pressure before I'm hooked up to the machine. Every 30 minutes the machines notifies us to record my blood pressure and other stats on the machine. Prior to the run we record the blood pressures, my weight, my temperature, and any changes since the last run. We record it on a flow sheet. 

So yeah. One more day to go over the end of the run. This may be boring, but I'm trying to let you know what we do. As time goes on we're getting better...making it a routine and we can explain the reasoning behind everything we do. 

I made the reservations for our trip to Illinois.  This requires more planning than going without the "portable" dialysis machine.  I need to contact the hotel and let them know my supplies will be delivered. My nurse has the information and will contact NxStage so they know where to deliver the supplies. *Sigh*. My nurses will know where I am at all times.  The good news is NxStage has a 24 hour service desk and there is a Davita Dialysis center in Champaign...yeah I've been there..and they do home hemo training so we're pretty well covered if we have issues. 

Well,signing off. I have a lot of ears of corn. I'm serving sauteed corn for Easter.  Today, Dad is going to,shuck the corn, Brian is going to get the kernels off the ears and I'm cooking and freezing it.  That takes care of not doing everything on Sunday. :-)   And I got enough corn so Carl and Pauline can take some home.  Lol. Call us the Fields-Perry take out.  Have a great day. :)

Photo of the dialysis machine carriage to get an idea of all of the tubing and a bonus photo of Brian at the race track gift shop!