The Mumbles

Bob Here.

Dialysis patients have different means of communication than other members of society.

During my long tenure as an in-center hemodialysis patient (I now do treatments at home), I was witness to some rather unique methods of getting messages across that I’m pretty sure aren’t used by any other segment of the population.

Several years ago, a gentleman was a few minutes into his treatment when he discovered that his needles had infiltrated.  For those of you blessed members of the “non-dialysis patient club,” infiltration occurs when one or both of your needles decide to really mess things up by going through your access vessel and into your surrounding tissue.

This unseemly act causes blood, dialysate, saline, and everything short of the kitchen sink to go into your arm instead of merrily finding its way through your vessel where it belongs.

The result can cause your appendage to grow to previously unseen proportions, to the point where you could stamp “Goodyear” on its side and float it up above a local sporting event.

Anyway, when this guy saw his arm starting to resemble an entry in the Macy’s Thanksgiving Day Parade, he held it up for all to see and made a noise that sounded something like, “WHOA HOWA HOOA HOO HAH.”

Surprisingly, the staff seemed to understand the communiqué perfectly, and rushed to the man’s assistance.

Personally, I find that my method of communication during treatment tends toward the unappreciated art form known as “mumbling.”

You see, dialysis patients spend long periods of time in a stationary position undergoing a treatment that’s about as much fun as falling out of trees.

Some lucky soles are able to sleep, which I’ve never been able to do.  In fact I get jealous of people who conk right out, to the point of plotting revenge.

For a long while, I sat next to a guy who would go out almost as soon as he sat down.  Even the attendant putting his needles in barely caused a stir.  His head would be back with his maw gaping open the entire treatment.

I often found myself with an almost unbearable urge to toss something over there to see if I could get it in the hole.

Finally, during one treatment, dialysis boredom got the best of me.  I crumpled up a piece of paper and found myself doing the old schoolyard fantasy of a last second basketball shot to win the game.

“The kid dekes…three seconds left…he speeds by the defenders…two seconds…head fakes half the team and several members of his own squad…one second…he’ll have to give a desperation heave…up it goes…”

And, almost unconsciously, I let the paper fly.

Missed badly though.  Must have caught an updraft.

Later an attendant eyed me suspiciously as he picked up the crumpled mass.  I just pretended not to notice.

So, for those of us who have to stay awake, our minds tend to drift, and we find ourselves picking up bits and pieces of other people’s conversations, which, I acknowledge, are truly none of our business.

This is where mumbling can emerge as an effective tool.

I generally think of my mumbles as falling in one of two categories.

(Hey, I told you we have a lot of time on our hands.)

The first is the “intentional mumble,” where I kind of want the recipient to hear, but not really.

One time a female attendant was talking up a blue streak at the nurse’s station.  I was trying my best not to pay attention to what she was saying, but, well, you know…

Anyway, my machine alarm started going off.  Ms. Gabbypants stood up, but apparently felt that she needed to get a few extra points in to her listeners before coming over.

I looked at the people she was talking to, other attendants and a nurse, and they were all keeping themselves busy while being beset by this barrage of verbiage.  To say they were, at best, inactive listeners would really be an understatement.

I just sat waiting for her to reach a breaking point, or a need to come up for a breath, and make her way over to reset my alarm.

She finally headed in my direction, still yakking away as she made her way over.

I lost track of the subject matter, but as she reached my chair, she said something like, “Is that a ridiculous notion, or what?”

I mumbled, “Not as ridiculous as expecting the machine to reset itself.”

She turned to me.  “I’m sorry.  What?” she asked.

“Oh nothing,” I replied.

“Oh, okay,” she said with a smile.  Then she turned in the direction of the desk and continued her diatribe.

Next, I heard, [yada yada yada yada] “…I mean, nobody is giving me any awards for doing my job…”

I mumbled, “Not winning many points for brevity either.”

She looked at me.  “I’m sorry.  What?”

“I was just saying that your workloads are really heavy too.”

She gave me a doubtful look as she made her way back to the station.

I once had a young man attendant who, shall we say, took liberties with the notion of fashion sense?

He always seemed to be making an effort to outdo himself with outrageous outfits and looks.

One day he was wearing his smock over pink paisley pants, his hair was a Halloween shade of green, and he had big round Elton John glasses.

I had just sat down with the third-shift crowd when he came walking by.  The other new patients were staring with disbelief.  As he got close to my chair another guy yelled out, “Nice pants.”

He smiled.  “Yeah, don’t you think they make a statement?” he asked.

I mumbled, “Not unless the statement is ‘I don’t own a mirror.'”

He stopped short.  “What was that Bob?”

“Oh, I just said, ‘Couldn’t be any clearer.'”

He laughed a little and went about his business.

The other mumble category is when someone asks a question and you really don’t want them to hear your answer, for whatever reason.

I saw another patient do this once, when the doctor was drilling him about his phosphorous level, which was apparently approximating his area code.

“What’d you have for dinner last night?” the doctor asked in a not-so-nice tone.

[mumbledy mumbledy mumble] was the guy’s answer.

“What was that?” shouted the doctor.


“AHA,” said the doctor, and the conversation went on from there.

Another time, a bunch of attendants were standing around kibitzing about concerts they had been to recently.

While they were doing that, my mind wandered to adding up their estimated ages to see if I was older than all of them combined.


I realized one of the attendants had asked me a question.

“Yes, I’m sorry, what?”

“I asked you what was the last concert you went to?”

At this point, the whole lot of them was staring at me waiting for my answer.

[mumbeldy mumble], I said.

“I’m sorry, what was that?” the attendant asked.

[A little louder mumble mumble.]

They all moved closer as a team.  One of the girls said, “Still can’t hear you Bob…”

“ART GARFUNKLE,” I yelled.

It took a moment, but after getting over their initial shock, the team started laughing.

And, before very long, they were all busting a gut.

I went back to reading my book, ignoring their looks, which were similar to museumgoers checking out a new species of dinosaur bones.

I should point out that my mumbling technique is not just useful in the dialysis center.

One time, the wife, who is painfully aware of my aversion to anything that involves interacting with others, came prancing into the kitchen, where I was minding my own business reading the paper.

“What do you think about going to a party with my tennis friends this Saturday night?” she asked.

I mumbled, “I’d rather have my wisdom teeth pulled out through my ear.”

“What was that?”

“Oh, uh nothing honey.  Sure, sounds like a great idea.”

She looked at me suspiciously, but the went on.

“Yeah, it’ll be fun.  There’ll be music, hor d’oeuvres.  Maybe we can all go in the pool!”

I put on my best phony smile.  “Well, there are certainly worst ways to spend a Saturday night.”

She seemed satisfied with that.

Then I mumbled, “I can’t think of any offhand but…”

“What was that?”

“Oh nothing honey.  I think it will be a real hoot.”

Hey, you know what they say:  Happy Wife, Happy Life.

Thanks for reading.  Take care.

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Random Ramblings II

Bob Here

Happy New Year to all as I empty my attic of thoughts, some dialysis-related, some just random ramblings which may show signs of PESD.

(Post-Election Stress Disorder, that is.)

Being on dialysis, I’m all too familiar with very long, very painful processes. But this election season turned out to be the ultimate test of endurance.

For you lucky non-dialysis folks, it was probably akin to having your gums scraped for six months in the dentist’s chair.

I honestly think they should scrap all the antiquated forms of torture being used in the field. Waterboarding? Hah, I say. Just strap our adversaries to a chair and force them to watch an ongoing stream of political ads. They’ll give up all their secrets, their children, their mother, whatever we want. And in a relatively short amount of time. I promise.

Ok, let’s get this out of the way while we’re on the subject of TV. I have never seen a single episode of “Game of Thrones,” “The Walking Dead,” “Downton Abbey,” “Homeland,” or “House of Cards.” These were all nominated for Emmy awards this past season. Also nominated were “Better Call Saul,” “Mr. Robot,” and “The Americans.” Not only have I never watched any of the latter three, but I had never heard of them at the time the nominations were announced.

Needless to say, I skipped the awards show this year.

Binge watching? Sure, I’ll partake. Serve me up some “Star Trek,” “Bonanza,” “The Odd Couple,” or “I Love Lucy.” And, I guess it’d be okay if we sprinkled in some “Cheers,” “Taxi,” and yes, even a few “I Dream of Jeannie” episodes.

It never ceases to amaze me how dialysis mishaps tend to come in bunches. You can go along your merry way for weeks, even months on end without anything being amiss with your machines.

Then, we were making a new batch of dialysate in our Pureflow, and we got a CSC Test failure and a Sak Compromised error all in the same day. Not only that, but it turns out that the control unit crapped out at the same time and had to be replaced. I asked if the first two errors were related to the loss of the control unit. “No. Those are totally separate,” said the guy from Nextstage.

Somewhere, the dialysis gods were having themselves a snicker at my expense that day.

A wise man once said, “Regular naps can prevent old age. Especially if you take them while driving.”

There’s definitely a wide disparity in workout clothes investment going on. I walked through a Lululemon store recently. Turns out the cost of one pair of these yoga pants used by a lot of the women in my gym cost more than the entire assortment of old shorts and ragged t-shirts that I use.

And, for that matter, you could toss in the clothes I wear for dialysis treatments as well.

So this hunter calls 911 after his friend has a heart attack. The hunter tells the dispatcher, “I think my friend is dead.” The dispatcher says, “I can help. But first, let’s make sure he’s really dead.” The line goes silent, a shot is heard, and then the hunter gets back on and says, “Okay, now what?”

That one always cracks me up.

So, I hear Google is calling their self-driving cars project “Waymo.” Is that as in, “Waymo likely to die?”

I don’t know about you, but I’ll be ready to hop into one of those self-driving cars right after I fly to the moon on my magic carpet.

I was having a conversation with one of my dialysis attendants a long while ago. She somehow got on the subject of lawyers just as we were setting up. “In my opinion,” she said, “they’re just a bunch of bloodsuckers.” As she spouted this bit of venom, she was turning my machine on and it started circulating my blood. The irony hit both of us at about the same time. We were still laughing an hour later.

Football game broadcasts feel like 30 minutes of football and three and a half hours of commercials. Now I hear the commissioner is complaining that the games are too long? Helllooooo….

Sunday Night Football? Tony Dungy and Rodney Harrison are so good, they make watching a show with Dan Patrick bearable.

Ok, just one more blurb about football. Really want to lose weight? Drop your current team and adopt the New York Giants. Current fans know what I’m talking about. The stress from watching the Giants will peel off those extra pounds in no time.

I still maintain that hockey is the best sport to watch live. Those of you who disagree with me have probably never been to a live game.

By the way, when did being rich become a requirement to attending a live sporting event??

I really thought Mrs. Northam’s youngest boy had seen everything until I witnessed the Pokemon Go phenomenon this past summer. My best oft-repeated responses to nearly getting plowed over by a person or group partaking were, “Really?” and “Seriously?” Of course if the perpetrators were adults, my answer changed to, “Are you <bleeping> kidding me??”

We’ve figured out the perfect lifestyle situation for the beach. We want summer weather and winter crowds. Is that so much to ask?

I know you’re all anxiously awaiting my picks, so here they are. The best movie I saw this past year was “Sully.” The best book was “Killing the Rising Sun” by Bill O’Reilly. Best TV show? Uh…well…let me see now…

Tell you what, I’ll get back to that.

If there’s a dumber idea out there than parkour, I’d sure like to know what it is.

E-cigarettes, you say? Legalizing marijuana? Well, ok maybe. But, seems to me that if you want to fall off a building, you don’t really need someone to train you for it.

HGTV is a sure cure for insomnia.

Best movies with dialysis? I know I’ll get a lot of “Steel Magnolias.” And even a few mentions of “Star Trek IV,” referencing where McCoy comes up to a patient who says she’s on dialysis. “Dialysis,” spits McCoy. “What is this, the Dark Ages?” But my vote goes to “Who’s Life Is It, Anyway?”

I particularly like the part where the attendants sneak their quadriplegic patient off the basement to hear their band play an impromptu session. When questioned by staff members about where they’re taking him, the attendants say, “Dialysis.” The band scatters when a security guard finds them. “Hey, what are you doing here?” the guard barks at the patient, who’s been left behind. “Isn’t this dialysis?” he says. Good stuff.

I moseyed into a Target store recently, looking for “Hatchimals” for my grandkids. I had no idea these infernal things were so hard to get. I asked a young lady if they had any. She looked at me pitiably. “Uh, nooooo,” she said. “When they do come in, we give out tickets at the door, starting at 6 a.m.” “Aha,” I said, before slinking off. I thought about playing the, “But I’m on dialysis and can’t get here that early” card, but then I figured one pathetic look per visit was quite enough.

The wife was feeling brave around the holidays and wanted me to go to Christmas Eve service with her. Then she was reminded why that’s such a bad idea.

We came to a part of the service where the printed program said we were going to hear a solo song by someone named “Maggie” something. When it came to Maggie’s turn, some guy got up and started singing. For some reason, I found that intensely funny and was busting a gut trying to keep from laughing out loud. “Damn,” I said to the wife. “That’s the ugliest Maggie I’ve ever seen.” Then I was convulsing again. For her part she was ignoring me/pretending she didn’t know who I was.

The growth and success of Starbucks is really something to see. Then again, it helps when you sell an addictive product.

On the other hand, the airline industry is about the least “customer-centric” business imaginable. If retailers ran their operations like the airlines, the only people getting rich would be the bankruptcy lawyers.

As I’ve discussed previously, my personal ineptitude with machinery, or anything with mechanically moving parts, sometime extends to my aura, or mere being. In other words, I can screw up a machine just by walking in a room. Recently, our centrifuge, which had never shown any signs of trouble, was in its spin cycle on top of a mini-fridge we keep in the dialysis area. It suddenly shook violently, fell off the fridge and rolled down the hallway. Now, I was on treatment at the time, but the wife still eyed me suspiciously. I said, “Hey you can’t blame that one on me.” She just snorted and chased after the unit, not looking at all convinced of my innocence.

So, I hear the latest craze is to hide and spend the night in an IKEA store. Heck, if I was going to risk arrest, I’d find a better place than IKEA. Maybe a toy store? Or, even better, a liquor store. C’mon people, jazz up the old imagination some, willya?

Oh yeah. My favorite TV show, right? Well, I really like the “C’mon Man” segment of the Monday Night Football pregame show. Does that count?

Thanks for reading. Once again, Happy New Year. Take care.

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Company Loves Misery

Bob Here

Home dialysis is a very lonely activity, and you know what?

Most home patients wouldn’t have it any other way.

If I may be so bold as to project my personal feelings on all my brothers and sisters doing home treatments (don’t worry, nothing dirty), I daresay most folks would just as soon not subject our loved ones, or anybody else for that matter, to the monotonous, tedious, humdrum, and frequently nauseating routines in which we partake in order to avoid an early membership in that big kidney-failure group in the sky.

And, more times than not, our isolationist desire works out just fine.

And then (drumroll, please), company arrives.

Now, don’t get me wrong, I normally welcome visitors with open arms, bandages and all. Heck, we live at the beach. If we didn’t want company, we would have moved to some God-forsaken adobe hut on the plains of Texas.

I hope I’m not insulting any of my nomad-leaning friends, but at one point in our lives, we were regularly making the six-hour drive between Dallas and Lubbock when our son was attending Texas Tech.

And, I’m here to tell you, you ain’t seen isolated ’til you’ve driven between those two metropolitan areas, where your idea of company is a tumbleweed blowing down the dirt road, and your options for fine dining start and stop at the local Dairy Queen.

Yep, I’m pretty sure we wouldn’t have to fend off too many unwanted drop-ins living out in those boonies.

But nope, we live at the shore and there’s nothing to keep friends and family from visiting other than my well-known predilection for being permanently parked on the anti-social side of the desire for companionship.

It’s still not unusual for me to plot devious ways to get out of pending social functions or invitations. Whenever I come up with a new or slightly used excuse, all of which are at various levels on the “lame scale,” the wife will almost always give me her infamous, “what-could-I-have-been-thinking” look before walking away in disgust.

However, the lure of the ocean is strong enough for people in the know to put up with my idiosyncrasies and occasionally off-putting personality and set up temporary residence in our humble abode.

Which brings up an interesting juxtaposition between guests and The Big D, home edition.

Long-time dialysis patients can become somewhat taciturn about our regimen, even when something goes wrong.

“Uh Bob?”


“You’ve got blood running down your arm onto the floor.”

“Yeah yeah. I’ll clean it up later.”

“Well…do you want me to…”

“Hey! Do you mind? I’m at a really important part of my book.”

However, to anyone who hasn’t gone through a few thousand treatments, the sights and sounds of dialysis can be a bit disquieting.

Not long ago, we took the plunge (That’s a pun. You’ll get it later.) and decided to partake of the domestic form of torture known as getting one’s bathroom remodeled. (Get it? Bathroom…plunge?)

And let me tell you, waterboarding has nothing on this exercise.

I wrote about the experience previously, about getting to a point where I had to lug my machine to our basement because our normal setup is right outside said bathroom. I somehow managed to avoid hernia surgery and moved the operation back upstairs when our contractor was adding some finishing touches.

He was an affable young man and his curiosity was peaked by our home process, and he decided he’d like to watch as we finished up one of our sessions.

I tried to talk some sense into the boy, but he wouldn’t hear it.

Everything was humming along smoothly and I even took an unusually active role in describing what we were doing every step along the way.

The wife was giving me a strange look.

“What?” I asked her.

“Since when did you become such a tour guide?” she asked. “Normally, if I get you to string more than two sentences together at once, it’s like a new record.”

The contractor snorted, but I ignored the barb and went on.

“Now it’s time to take the needles out,” I said.

I noticed the guy took a couple of steps back.

“You really don’t have to stay if you don’t want to,” I said.

“Uh, no. No. Go ahead. It’s no problem,” he said.

I nodded, but, being a guy and all, I knew what was happening.

Boys are taught at a young age that if you retreat from something scary, you acquire a permanent membership in the “candyass club.” If you’re going to chicken out for whatever reason, you just hope and pray that there’s nobody around to see it happen. Especially, let’s be honest, a female of the species.

I tried again to break through the “macho barrier.”

“Look, seriously, this isn’t for everybody. We won’t think any less of you if you don’t want to watch.”

“No no. Go ahead,” he said, his face a bit ashen.

Now, I won’t get too graphic, but it’s just about impossible to take two one-inch, fifteen gauge needles out of a person’s arm without there being a little, shall we call it, spillage?

Of course pressure is applied instantly to keep the “spillage” from becoming a deluge.

So, I was still a bit doubtful, but without any alternative, out came the needles.

“Jumping Jehoshaphat!” yelled the contractor.

“You okay?” I asked.

“Uh, oh…yeah sure. Well, I’ve got another appointment…so anyway…thanks for the demo…uh…see ya…”

At that, he headed down the stairs and out the door like the house was on fire.

The wife and I just looked at each other.

“Well, I tried to warn him,” I said.

She just shook her head. Fortunately, she spared me her description of how the male gentalia outweighed their brains by a double-digit multiple.

But I knew that’s what she was thinking.

Anyway, this past summer, after my favorite baseball team won an important game, the wife, all flowers and roses, came prancing in and informed me that she had invited an old friend from work and her spouse to come spend the weekend at the beach.

See, she does this strategically after something positive happens in sports, knowing how that tends to put me in a positive frame of mind, and keeping her from having to remove all the sharp objects from the house.

I just looked at her, my good mood draining out of me fast.

“Oh? And where, pray tell, will they be staying?” I asked, although I already knew the answer.

“Here, of course.”

“Ah. Of course. Well, you know I just might…”

“No. You’re not going to a hotel.”

So, that was the end of that.

Now, I knew these folks too, and the visit started out pretty well. They came in on a Friday after we had already treated, and I normally take Saturdays off.

But on Sunday, our friends dropped the bombshell that they would like to watch an entire dialysis treatment, soup-to-nuts.

“Why would you want to do that?” I asked. “Don’t you have enough giving you nightmares these days? Think about Donald Trump or Hillary Clinton being president.”

No, once again, they insisted. They wanted to see what this whole dialysis mishegoss was all about.

Again, outside of shoving them out the door and changing the locks, we didn’t have much of a choice.

So, it finally came time to start setting up. Our guests came upstairs.

Donna’s friend said, “Now I want you guys to just act normal, like we’re not even here.”

I said, “Right. Now put this mask on.”

“What? A surgical mask? Why? Oh never mind. Of course.”

I handed one to her spouse, who looked like he’d rather be having a prostate exam than be partaking in this insanity.

“You too,” I said.

“When’s the last time you washed your hands?” I asked the woman.

“Uh, I…I don’t really remember…”

“Go do it now please. Use the anti-bacterial soap and dry off with a paper towel.”

She went hesitantly into our newly remodeled bathroom.

“You’re next,” I said to the guy. He seemed like he was giving serious consideration to bailing.

“Bob?” the woman called out from the loo. “You do know that when we said we wanted to watch, it didn’t mean we wanted to participate. Right?”

The wife stepped in. “He’s just being his usual curmudgeon self,” she said. “Technically, yes, visitors are supposed to wash their hands and wear masks, but we’re not like saying you guys aren’t clean or anything.”

She gave me a withering look. So I figured I’d: 1. Stop giving her friends a hard time, and 2. Watch closely to be sure she didn’t slip a little bleach into my lines “by accident.”

But, we got through the treatment without any fatalities.

When I put my needles in, the couple stepped away from the stairway in case one or both felt a fainting spell come on.

So, no matter how much I try to warn our visitors that dialysis is clearly not a spectator sport, it seems unavoidable that at times, company truly does love misery.

Thanks for reading. Take care.

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Party Flavors

Bob Here.

There’s really no graceful way to decline something offered to you at a party because said item is not one of the scarce allowable foods on the dialysis diet.

I can say for sure, though, that men and women employ entirely different strategies when confronted with such dietary dilemmas.

Now, the fact that I’m worrying about this tells you that it’s an issue with some bite. (Get it? Bite?)

As one traverses this vast world, one comes to realize that there are people who worry about social graces and there are those who don’t find it objectionable to wipe their mouths on one’s sleeve. Or, for that matter, someone else’s sleeve.

My betrothed would gladly testify to my belonging in the latter group.

Okay, it’s been a while since I wiped my mouth on someone else’s sleeve. But that may be because the wife immediately ensures there is an ample supply of napkins whenever she musters enough courage to be seen with me in public.

Anyway, being offered food that can bring a visit by the renal diet police is usually not a big deal. Nine times out of ten, a simple, “Oh, no thank you” will do the trick.

It’s only when someone insists that you try their latest addition to the culinary universe that trouble begins to brew.

The issue is compounded by my intense dislike of discussing my dialysis reality with complete strangers.

Truth be told. I don’t like having that discussion with friends either. Or enemies.

I just don’t like talking about it, okay?

Thanks. I feel better now.

I had a conversation on this subject with a patient of the female persuasion when I was suffering through a dreadfully long in-center treatment a while back.

She said, “I never know what to say when I’m at a party and someone wants me to try something that I’m not supposed to eat. I don’t want to be rude, or hurt a person’s feelings, but I’m pretty strict about staying on my diet.”

I just nodded quietly, not really wanting to delve into this territory where my responses might run afoul of generally accepted common decency.

Just then an attendant walked by and I flagged her down.

I blurted out, “Hey, how much time I got left?”

“An hour and twenty minutes.”

“Oh crap.”

I started pretending to read even though my heart wasn’t in it. Much to my dismay, my neighbor wasn’t about to let the subject lie.

She continued, “The last party I went to, the hostess brought around these little mini pizzas. She was really proud of them. When she got to me, I said, ‘Oh, no thanks. You see, pizza checks off just about every serious diet no-no for a dialysis patient. There’s phosphorous and calcium in the cheese. There’s potassium in the sauce. And don’t even get me started on the sodium.’ She looked a little hurt. But what was I supposed to do?”

More sympathetic nodding and a grunted out, “Yeah, sucks huh?” from me apparently didn’t satisfy her need for feedback.

“Well, how would you handle a situation like that Bob?” she asked.

I felt kind of trapped. I considered asking to move to a different chair, but didn’t think that was realistic.

So I said, “Gee, I don’t know. I don’t really go to a lot of parties. The wife tries to get me to go, but unless I owe her money or she threatens to leave me for our paperboy, I generally opt for the ‘stay-home’ route.”

She laughed a little. But then she persisted. “But can you think of any alternative way of explaining why we just shouldn’t partake of certain food groups?”

I understood why she couldn’t let the subject go. These long treatments sometimes bring on bouts of the ‘I’m talking and I can’t shut up’ syndrome.

I said, “Well, you could tell her that the thought of eating her little pieces of slop make you want to hurl all over her shoes.”

She gave me a look. “C’mon Bob. I couldn’t say anything like that.”

I said, “Okay, well, how about ‘Oh, no, really, I’m heading right to a colonoscopy after this.’ Or maybe, ‘Oh, sure yeah, just make sure there’s nobody between me and the crapper.’ Would either of those work?”

She rolled her eyes, shook her head and turned her TV on, figuring the conversation was going nowhere.

Toward the end of the treatment, I apologized for my rude and crude behavior, but, funny thing. She never asked for my opinion on any matter related to social graces again.

Imagine that.

At any rate, dialysis patients shouldn’t feel the need to review their medical history every time we’re in such an awkward situation.

Let’s face it. We’re different. Our lives are restrictive in many ways. We might be able to go all foot-loose-and-fancy-free for a short time every now and again, but if we do it too often, our next appointment will be with that big kidney-failure club in the sky.

So don’t fret it if your hostess is doling out little goodies that will give you nightmares about how your next lab sheet will look. Generally a polite refusal will suffice.

Either that, or the next time you get a party invitation with an RSVP, send back a note saying, “Moved. Left no forwarding address.”

Thanks for reading. Take care.

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Miss Me Yet?

Bob Here.

I remember the day I told the charge nurse in my dialysis center that I had decided to start training to treat at home.

This, of course, meant that, when my training began, I would no longer be a charter member of the regimented M,W,F first shift brigade, and that the in-center staff would no longer be subjected to my childish tomfoolery and misbehavior, which was manifested in direct proportion to the degree of dialysis-level boredom I was feeling on a particular day.

Just a week or so prior to my big decision, that same nurse was over fiddling with my lines during an excruciatingly long treatment.

“Did you ever think about free will?” I asked her.


“You know. Free will. Determinism. Whether our actions are controlled by a causal chain of events, some external influence, or whether we actually make up our own minds?”

She just rolled her eyes. “Uh, no Bob. I haven’t thought about that lately.”

“Seriously though. Scientists all say that atoms and particles behave in probabilistic ways. Well, our minds are made up of atoms. So how can we truly say we have free will?”

She was looking at me like I should be locked away somewhere. “You know, most patients ask me how their venous pressure is running. Or how much time they have left in their treatment.”

“Well, I was just wondering if we’re all here because of some predetermined set of interactions among the atoms and particles in our minds.”

“No,” she said. “We’re all here because the second and third shifts are all full.” Then she started walking away.

I called after her. “But if we don’t have free will, what’s the point in participating in the passage of time?”

I heard her say, “My passage of time is slow and painful right now. Mostly thanks to you.”

So, when I told her that I was going to try home dialysis, I half expected her to start break dancing in the middle of the treatment floor. But she just thought for a few seconds and finally said, “You know, I never thought I’d hear myself say this, but I’m actually going to miss you around here.”

Of course, I still had a couple of weeks before training began, so the next day, I was all hooked up with nowhere to go and I challenged my neighbor patient sitting next to me to a free throw shooting contest using the waste basket sitting about five feet away.

At first, the guy looked at me like I was nuts.

Then, apparently, the dialysis-level boredom took over his thought process.

“What will we use for a ball?” he asked.

I had a magazine that I brought with me, so I tore one of the pages out, crumpled it up with my free hand, and sent it sailing to a perfect, nothing-but-net, three-pointer right into the basket.

Of course, I hammed it up with an imagined crowd noise and high-fiving my invisible teammates.

The guy looked amused, but he still hesitated to participate.

I ripped another page out, crumpled it up and tossed it over to him. “Your turn,” I said.

He took his time perfecting his aim, tossed the page and it hit the side of the waste basket and rolled away.

“Pfft,” I said. “Amateur.”

“Wait,” he said. “I didn’t account for the wind.”

I crumpled up my nose. “Wind? In a dialysis center?”

“Yeah. There are people in here talking…and breathing. It affected my shot. Gimme another one.”

So I did. He took a really long time setting his aim. Not wanting to miss two in a row.

I said, “If you don’t shoot pretty soon we may all get called for a transplant.”

“Don’t rush me. Don’t rush me.”

He finally took his shot and made it.

“One to one,” he said.

“What? We’re keeping score?”

“Of course. How do you have a free throw shooting contest without keeping score?”

Then my competitive nature kicked in and we made a big scene of shooting crumpled up pages, cheering our successes, and making lame excuses for our misses.

“I felt a cramp coming on…”

“The light was in my eyes…”

“Mary across the way moved while I was aiming…”

And so on.

Even other people sitting nearby were watching. And of course, everyone was laughing it up and being loud.


I heard what sounded like our nurse trying to get our attention. I looked up and much to my horror, she was standing there with the regional dialysis center auditor, a woman who had no discernable sense of humor and the mien of a prison guard in Alcatraz.

My neighbor and I just kind of froze in our seats. We were waiting for the two to go about their business, but they just stood staring for what seemed like an eternity. I had picked up the magazine to rip out another page, but instead, I turned the page and pretended to be reading it.

Somehow, I don’t think they were fooled.

The auditor came over, picked up my chart and, as if nothing unusual had happened, said, “So,” she looked down at my name, “Mr. Northam is it?”

Now, I have several evasive shticks that I use when I don’t feel like talking, where I fake narcolepsy and seem to fall asleep mid-sentence, or pretend that I’ve forgotten how to speak English. But I didn’t have the nerve to put any of those in place at this point. I figured I was in enough trouble with Nurse Ratched here.

“Uh yes,” I said. “I mean, yes Ma’am. In the flesh, ha ha…”

Not even a hint of a smile. “How is your treatment going Mr. Northam?”

“Well, I thought I hit a bit of a cross wind with my last shot…”

I looked over at our nurse and she had bloody murder in her eyes.

“Uh…I mean…fine…fine Ma’am. Everything is just fine.”

“I see,” said Ms. Personality. She put my chart down with a thud and the two of them continued making their rounds.

Later my nurse came over to enter some readings on the terminal next to my chair. She looked down at me and just shook her head.

I just looked up at her smiled, and asked, “So, miss me yet?”

We all know the old saying that absence makes the heart grow fonder, but it might actually turn out that the absence is really the best part after all.

The first day the wife and I reported for our home dialysis training, our training nurse sat us down and reviewed some basics. We were to train for four weeks and do all our five-per-week sessions right there in the training room.

“We’ll get to know each other very well by the end of your training,” said the nurse.

The wife muttered, “Oh boy” under her breath while she eyed me out of the corner of her eye.

Now, it’s been well documented that my being around machinery could sometimes be recorded into a disaster film documentary of sorts, and it seemed that the two training dialysis machines were no exception.

The first day we walked into the training room, the machines started beeping with errors.

“That’s strange,” said the nurse as she walked over to reset them. “I’ve never seen them just do that on their own before.”

“Yeah, this is a new one for you Bob,” said the wife. “Usually you actually have to start working on a machine before you mess it up.”

Now, although we successfully completed the training and have been treating at home for a few years now, to say the training had its glitches is a bit of an understatement.

The first time I tried to set up the machine on my own, the flood was so bad we almost had to call FEMA to the scene.

My first attempt at putting my own needles in went so badly that afterward, I heard the nurse wonder aloud to herself what other kinds of work she could have gone into.

And one time when I was gathering supplies to bring over to the chair, I tripped over my own feet and sent the gauze, tape, syringes, test tubes, needles, gloves, and placemats flying, some of which plopped down on the poor training nurse who had been sitting nearby, minding her own business.

“Holy crap,” she exclaimed. “I should get combat pay for taking you on.”

So, after we started at home on our own, I had the occasion to go back to the training center to pick up some supplies.

I saw our training nurse sitting in her office and I barged in and said,

“So, miss me yet?”

Thanks for reading. Take care.

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What, Me Worry?

Bob Here.

How often in our lives do we have one of those moments when we say to ourselves, “Gee, if only I had known that earlier?”

You know, like the time you drove around for an hour with your ‘Check Engine’ light on and ended up with your prized vehicle burning down to a cinder on the side of the road? You end up thinking, gee, if only I had known that’s what would happen I would have either taken it to a service station or seen if I could get a good buy on a fire extinguisher.

Not that I know anyone that has happened to. <Ahem>

One of those epiphanies struck me recently when it occurred to me that we worry too much about things that we either a) cannot change, or b) don’t really matter anyway.

You have to admit that most of the things that give us pause in this world are not truly worth worrying about.

Even for a home hemodialysis patient, whose appropriate responses to problems that arise during setup and treatment can range from spitting out the occasional curse word to making sure their will is up to date.

Now, I’ll have to admit that when I first started at home, the process was a little nerve wracking. I was so uptight while setting up the machine, that if you snuck up behind me and tapped me on the shoulder, you would have had to peel me off the ceiling shortly thereafter.

I remember our training nurse trying to reassure us that doing treatments at home was not equivalent to buying a one-way ticket to that big dialysis center in the sky.

“Don’t worry too much,” she had said. “There are enough safeguards in the machine to keep you from doing any real damage.”

I didn’t know whether to laugh or start shopping for burial plots.

Of course, as one moves along in life (read: gets old), you experience many instances of worrisome circumstances. And with the wisdom of age, we start to realize that there really aren’t that many that could be classified as “meltdown worthy.”

I noticed a change during last year’s brutal winter in New Hampshire where we have chosen to go to pasture after working in industry for 35 years.

We had made our primary residence in Texas before moving up north. And even though we’re both from the Northeast, we adopted the very Southern practice of completely freaking out when the slightest bit of freezing precipitation was in the weather forecast.

Now, my friends in the Dallas area can correct me if I’m wrong, but I found that as little as an inch of frozen precip can paralyze the entire metroplex.

Now, in fairness, Texas doesn’t have the snow removal equipment that exists in the North, so a little snow or sleet tends to wreck a lot more havoc.

All it took was for one of the weather prognosticators to say something as innocent as “Oh, and we may get a stray snow flurry tomorrow,” and people would be scurrying like rats to their nearest grocery store to stock up on bread, water, and as many canned foods they could carry without herniating themselves carrying them out to their cars.

All of which would be kind of funny, except, of course, for the fact that I was one of the rats.

But oh how things have changed. This is our third winter in New Hampshire and we had a doozy last year. We accumulated 120 inches of snow in about five weeks time.

So now, the meteorologist can predict getting a decent amount of snow, say 8-10 inches, and I’ll be like, “Huh. Might take me five minutes longer to get to the gym.” And the wife will say, “Huh. Good day to go get my hair and nails done.”

What a difference.

There are many aspects of dialysis which have caused agita over the years that have triggered similar changes in perspective as we gain more experience and as our nerves in general have calmed with the accumulation of years.

(Isn’t it great the way I avoid saying that, “We’re getting old?”)

Just the other day, we were setting up for treatment, minding our own business, and the micron chip leading to the dialysate dispenser started leaking all over the place. The word, “leaking” doesn’t really do the situation justice.

Unless, of course, you consider Niagra Falls to be “just a little leak coming over the hill.”

Now, I’m certainly no stranger to leaks on dialysis, many of which came at my own hand.

When we were in training for treating at home, I accidently opened the wrong clamp during a trial setup.

“Oh crap,” I said before proceeding to panic and close two of the clamps that weren’t leaking and opening another wrong one which made the original spill even worse.

To make a long (and wet) story short, after cleaning up the flood, I looked sheepishly at our training nurse.

“Does this mean we’re disqualified from the home program?” I asked.

She just rolled her eyes. “No, but I think I will up our flood insurance coverage for the rest of your training period.”

To show you how far we’ve progressed, when the tidal-wave sized leak started pouring out of the chip this past week, we were both very calm. The wife just turned the Pureflow off. We both realized that we couldn’t use the batch and we said to each other at the same time, “Bags it is.”

(The pre-mixed dialysate bags are the alternative to using the Pureflow.)

So now, my attitude toward accidently causing a deluge is simply:

“What, me worry?”

(With all due respect to Alfred E. Neuman.)

Probably the most worrisome step in executing a home treatment (or any treatment, for that matter) is cannulation.

For you lucky non-dialysis patients, cannulation involves the placing of your needles, or, in the vernacular, “Getting stuck.”

All hemodialysis patients know that one of the keys to having a good treatment is the proper insertion of the needles into your blood vessel, a fistula in my case. All you non-patients need to know is that having to do so is one of the many reasons you don’t ever want to go on dialysis if you can possibly avoid it.

When I first started in-center treatments, I admit, I worried aplenty about which attendant or nurse was going to put my needles in. Truth be told, there is a wide range in quality of “sticking ability.”

Early on, when my fistula hadn’t yet matured properly, I got to go through the less-than-joyful occurrence of “infiltration” where an inexperienced attendant put one of my needles right through the vessel and out the other side.

Now, I won’t lie, the pain was substantial. But I didn’t know any better, so we proceeded with the treatment.

The net effect of infiltration is that blood, fluid, water, dialysate and everything short of the kitchen sink flows into your tissue instead of traveling along its merry way into your vessel where it belongs.

I was looking down at my arm with concern. The attendant must have noticed because he called over, “Is everything okay?”

I said, “Well, if my arm gets any bigger, we’ll be able to enter it as a float in the Thanksgiving Day Parade.”

He rushed over, saw the swelling in my arm, avoided fainting, and said, “Holy Crap!” and shut the machine down.

Obviously that incident did nothing to ease my concern about “getting stuck” properly going forward.

But now as a home patient, lucky me, I get to self-cannulate, or put my own needles in.

Now, if anybody had suggested such a thing when I first started, I would have done about anything to get out of it. Maybe act crazy, so they wouldn’t think I was capable.

I could have said something like, “Sorry, the voices in my head say I can’t do that.”

But treating at home has its advantages, so I agreed to give it a shot.

I use “buttonholes” which mean I put the needles in the same place for every treatment. It’s generally an easier process, except for the fact that buttonholes can stop working.

So, back to the agita.

When I first started at home and I had trouble getting a needle in, the freaking out process would begin anew.

My initial tendency was to apply a principle that I had used frequently in my mostly-unfortunate endeavors into DIY home repair:

“When in doubt, use force.”

I would end up pushing as hard as I could and, although occasionally successful, in general the only breakthrough I achieved was setting a new high for systolic blood pressure.

But now, being the sage, experienced dialysis guy that I am, I know that, in general, if you calmly back the needle out, re-excavate the entry point, and try again, you can have a high rate of success without having to notify an emergency medical team.

So, my attitude towards self-cannulation is now similar to when I hear that we’re going to have a blizzard or when something I do causes a waterfall from my dialysis machine.

“What, me worry?”

Thanks for reading. Take care.

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This, That, and Another Thing

Bob Here.

Happy New Year to all.

Passing along a few random thoughts while wondering whatever happened to Gabe Kaplan.

We can put a man on the moon, but we can’t figure a way to dialyze somebody that doesn’t involve needles the size of Godzilla’s toothpicks?

Travelling while on dialysis never ceases to be an adventure.

It kills me when the airlines say they have a “very full flight.” I always thought of “full” as being an absolute. The flight is either full or it isn’t. Unless they’re seating extra people in the overheads, how can a flight be “very full?”

E-cigarettes? To me, inhaling any foreign substance into your lungs sounds a little crazy. Then again, shoving two one-inch, 15-gauge needles into your own arm five times a week doesn’t exactly seem real normal either.

I am going to forget this football season ever took place. So if you start a conversation with something like, “Hey, how about that game last night, huh?” you will now understand my corresponding blank stare.

Spoiling your grandchildren, then leaving their parents to deal with the carnage may not seem very nice. But, trust me, it’s a lot of fun.

When you do home hemo and go in-center as a visitor, just expect people (staff and other patients alike) to gawk when you place your own needles. They will then proceed to look at you like you’re a space alien for the balance of your treatment.

Forcing us innocent TV viewers to watch political ads should be banned as cruel and unusual punishment.

Do you know what the abbreviation IoT means? Answer and explanation later. How’s that for building suspense?

Try to sell me on the internet being the greatest modern technological breakthrough if you want, but my vote still goes to the Keurig coffee maker.

On the same note, others might get embarrassed if someone caught them on the floor bowing to their Keurig, but not this guy.

The most brilliant members of our society? I know, I know. Rocket Scientists, Brain Surgeons, yada yada yada. Yes, they’re a smart lot, but from my perspective, anyone who understands the current health care rules and laws has them beat. Hands down.

In honor of the new Star Wars movie, some theaters were showing all seven films consecutively. To the same audience. Personally, I’d rather have my toenails pulled out with pliers.

Being on dialysis is to exercise what having acrophobia is to being a tightrope walker.

Possible, just not easy.

Is there a more incomprehensible concept than Kim Kardashian making $53 million last year? If there is, I am listening…

While I was in-center recently, a young attendant came over and asked me what my favorite meme was from the past year. I told her I’d give it some thought, at least temporarily hiding the fact that I didn’t know what a meme was.

I avoided a long line in the airport by checking in using one of those kiosks. I was really proud of myself and amazed at the technology. That is, until I got to the end of the process and the *#@%* thing told me it couldn’t print my baggage check strip because it was out of ink. You gotta love modern technology.

Whoever runs the big dialysis companies (you know who they are) must have failed Business 101. They must have stayed home when they taught the part about the customer always being right.

Another time in another center, a young lady patient sitting next to me was filling out one of those magazine surveys. She asked me what the last thing was that made me cry. I gave it a minute, but when I told her it was “When I pulled out a nose hair wrong,” I think she was less than impressed.

I have one word to describe the movie “Spotlight.” Wow. That’s it. Just Wow.

I know many shameless service providers take advantage of the elderly, but anyone doing so to my mother would have to face the fact that she could probably still lick ’em in a fair fight.

I quit drinking when I started dialysis and I know many of my fellow patients did the same. But nobody deserves to tie one on occasionally more than a dialysis patient. Another example of life being unfair.

If I could keep from falling down so much, I’d be a much better tennis player.

Likewise dancer.

The producers of current TV comedies should lock themselves in a room and watch a constant stream of replays of I Love Lucy, The Dick Van Dyke Show, Mary Tyler Moore, Cheers, The Odd Couple, and Bob Newhart. Then they might have a revelation. Shows do NOT have to be vulgar to be funny.

After treatment once, I couldn’t decide whether to hold my sites, scratch my itching, or stretch out my cramp. So I just…fell down.

Let’s get this straight: There’s living at the beach. And there’s living everywhere else. Got it?

I’ve never been able to sleep on a plane. Or on dialysis, for that matter.

If you’ve never seen a hockey game live, then you’ve never seen a hockey game.

Wouldn’t the world be a better place if we all vowed to treat each other with civility? Doesn’t sound that hard, does it?

If I could sleep while I was on dialysis, I’m pretty sure I’d only dream about vampires.

Oh yeah. This IoT thingy. It stands for Internet of Things. As I understand it, it refers to everything in our lives being interconnected. Soon, you’ll be able to turn on the lights, start the oven, lower the volume on your stereo, and start your car all without moving. Does that sound like a couch potato’s fantasy or what?

A hoverboard? Thanks, but I really don’t need any help falling down.

Sometimes, dialysis makes you feel like a pinata after a kid’s party.

I adamantly refuse to get on any ride that’s going to turn me upside down.

Psst, all dialysis patients. Wanna be the life of your next party? Let everyone feel the buzz on your fistula. I promise. It’ll be a real hoot.

Donald Trump vs. Hillary Clinton? Seriously?

I’d describe the fashion that I wear to the dialysis center as “nouveau hobo chic.”

The racial divides in our society make me sad. We should all be better by now.

While we’re doing a dialysis treatment at home, our cat looks at us like we’re total whacks. Think he’s onto something.

You know you’ve been living in New Hampshire for a while when 3-6 inches sounds like a dusting.

I know you’re all on the edge of your seats wondering, so here are my picks: The best book I read in 2015 was Outlaw Platoon by Sean Parnell. The best movie was Spotlight. The best TV show was…uh…let me see now…oh yeah. I watched an amazing infomercial for the wearable towel. Does that count?

Winters like last year are the reason the Good Lord gave us snow blowers.

A reality show about Babies Behaving Badly? Think I’ll pass.

What ever happened to good mystery writers?

For some reason, I can’t watch an ad for the Apple Watch without thinking about Maxwell Smart.

The dialysis diet could basically be summed up as “bread and water.” But only white bread and…you know…not too much water.

Best knock knock joke from the past year:
Knock knock
Who’s there?
A little old lady.
A little old lady who?
Damn, I didn’t know you could yodel.
Cracks me up.

Oh, and did you hear about the guy who said, “My wife says I deny everything, but I really don’t think it’s a problem.”

If there’s anything more relaxing than looking at the ocean on your morning walk, I’d sure like to know what it is.

In the “one and done” category: When I was in college, I sold vacuum cleaners door-to-door.

Isn’t it amazing when you’re wearing headphones at the gym and someone still tries to talk to you? Just once I want to yell out, “Helloooo? If I wanted to talk, I wouldn’t be wearing headphones!!”

During a very long treatment one time, a visiting doctor came over and asked how things were going. My response was something like, “Well, you could make the treatments a little longer. Make the needle insertions a little more painful. Keep me from eating some more of the things that I love. And, hey. How about dreaming up a few more miserable side effects?” He just stood there staring at me. I don’t think he got my sense of humor.

What was I thinking? This is the age of the internet. I just looked up Gabe Kaplan. He’s alive and well and active in the World Series of Poker. Guess we could call his new show “Welcome Back to Reality.”

I’m Bob Northam and I approved this message. (See? The political ads have gone to my brain.)

Thanks for reading. Take care.


email me at

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She Said, He Didn’t

Bob Here.

When one is doing in-center hemodialysis, every once in a great while one finds him/herself with some idle time where one can observe the psycho/social dynamics taking place in the room.

Translation: Sometimes you’re bored stiff and you stick your nose into other patient’s business.

And, let’s be honest, it happens a lot more than ‘every once in a while.’

Every single three-per-week treatment? That might be a bit of an exaggeration.

Maybe two out of every three weekly sessions?

Now we’re getting warm.

Anyway, over the seven years or so when I was in-center, and having a proclivity for studying interpersonal subtleties (Read: I’m nosy), I noted that there may be communication approaches driven by forces which are chromosomal in nature.

That’s my subtle attempt at being PC in pointing out that men dialysis patients communicate differently than women.

Okay, so that may not rank up there with Einstein’s Theory of Relativity, but its implications might be more far-reaching.

Heck, that physics stuff just has to do with time, gravity, and funky things happening around black holes.

The communications issue hits us right where we live.

I started making observations to support my ground-breaking theory shortly after starting the Big D. I noted at the time that perhaps no scientific discovery had so come about because of intense, stultifying, mind-numbing boredom.

I was in the midst of a session that seemed like it was taking decades to complete. My attendant had told me that the woman who normally sat next to me had mono and they were going to dialyze her in the isolation room.

“I never touched her,” I said.


“Isn’t mono called the kissing disease?”

“Yeah, I guess so. So what?”

“It wasn’t me, I swear.”

She rolled her eyes. “Oh geez,” she said, walking away.

I called after her, “It wouldn’t be that hard to believe, would it?”

She didn’t respond to that piece of Zen.

A short time later, my neighbor came in and headed for iso.

The room was a short distance away from me and had glass walls, so I could continue being nosy…er…that is…continue to make by scientific observations.

A short time after Ms. Mono started treatment, the head nurse put on a mask and went in to check on how she was feeling. I couldn’t hear what they were saying, but it became clear that the two of them were having a good old time catching up.

There was lots of laughter, funny gestures. The nurse decided to stay a while and pulled up the chair. More genial conversation, lots more laughs.

At one point, I thought the patient pointed out at me. She covered her mouth with her hand and said something to the nurse on the sly, then they both broke up. I told myself I was just being paranoid, but honestly, I’m not so sure.

A while later, the nurse got up. I thought she was going to break it up, but she just went to get the social worker so she could join in.

The social worker put on a mask and before long the three of them were having a tea party. Of course, there was no actual tea – fluid restrictions and all, you know? – but by all other standards the meeting was more like a social shindig than anything medical in nature.

I timed the duration of the get-together. (I told you I was bored!) In total, it lasted 27 minutes.

Pretty impressive.

So, after the party, the nurse and social worker came out and went over to the guy who was sitting in my neighbor’s spot.

The nurse said, “So Jeremy (not his real name), how are you doing?”


The two just stood there waiting for more, but…nothing.

The social worker gave it a shot. “Everything okay with your insurance? Anything you need from me?”

“Uh, nope.”

More waiting. More silence.

“Ok then,” said the nurse and the two of them went back to their stations.

Total time of the interaction?

About 38 seconds.

So, see? The difference in the sexes can actually be quantified.

Female response to stimulus takes about 43 times longer than that of a male.

How’s that for science?

But, I suppose this difference really shouldn’t come as any big surprise to anyone.

Even in the non-dialysis world, the differences are stark.

When doing my hardly-exhaustive research on these chromosomal differences, I didn’t have to look any further than my own home for another prime example.

I hardly ever get any personal phone calls now that I’m retired. I use my phone in so many other ways that I occasionally have to remind myself that my device is actually a telephone.

My wife, on the other hand, has practically worn her ringer out.

Family members, mutual friends, casual associates. They call her. Never me.

I took the usually risky step of asking the wife why she thought that was.

“Oh I don’t know,” she said. “Maybe people are tired of interpreting your one-word answers,”

“My one-word answers?”

“Yeah. As a matter of fact, sometimes you don’t even take the trouble to form words. There are just these noises…”

Then she held an imaginary phone up to her ear. She said, “This is Bob talking on the phone. Mmm…ahh…ugh…aaaarrooohaha…got it?”

She continued, “Then whoever was on the other end calls me for a translation.”

So, for those of you who are scientific by nature and need a quantification of this dynamic, I could field 100 phone calls in a single day, my wife could take just one, and she’d still utter 100 times more words than I would.

Okay, I used nice round numbers, but you get the point.

Anyway, back to the dialysis center. I also noticed a vast difference over the years in the way men and women respond to what was, for me at least, one of the prime ways that the DC staff manages to torture their clients.

I’m referring, of course, to the dreaded: annual social worker assessment.

It’s an excruciating process whereby the well-intentioned social worker does her best to ensure that being on dialysis isn’t making you want to do a nose dive off the nearest suspension bridge.

When I first started, I grit my teeth and got through my first assessment by figuring that it was a one time thing, and that the only times I’d have to say anything to the SW going forward would be around the holidays.

Something like, “Oh, tomorrow’s Easter? Ok, well you have a good one now, y’hear?”

You can just imagine my dismay when I found out that it was an annual exercise.

When the time was rolling around to repeat the process, I could feel the dread building in my system. I hadn’t heard anyone else around me going through it, so I hoped upon hope that they’d either skip a year, or just forget about the whole thing.

But I had a regular female neighbor who snagged the SW on her way by one day.

“Hey,” she said. “Isn’t it about time to do our assessment again?”

I made another of my noises that sounded something like, “Heyunnngmmmmhiml.”

It was my not-so-subtle way of saying, “What are you, nuts?”

“Oh Bob,” said my neighbor. “I just love the assessment. It’s the only chance I get to talk to (the SW) in depth.”

I just hung my head in defeat.

Sure enough, this woman’s assessment was another little tea party, lots of sharing, lots of laughs, other staff members joining in, etc., etc. All the while, I was stewing in my chair, wishing I had been born in another part of the universe.

Fortunately for me, however, I had developed a pretty good rapport with Ms. SW, and it was pretty easy for her to sense that I didn’t exactly cherish the thought of going through the same questions yet again.

So, when she rolled up in her stool, she looked a little leery, saying, “Okay Bob. You ready for your assessment?”

I just looked at her. Then I said, “By any chance, do you still have last year’s answers?”




“Yeah. You know. Likewise.”

One of the reasons I got along with her so well was she had a sarcastic wit.

She said, “Okay, so this year’s assessment is a grand total of one word. Oh did you want that to be ‘Ditto’ or ‘Likewise?'”

I don’t think she was real happy with me, but she rolled on over to her next patient.

I ended up having a running agreement with her that she would concoct a new assessment from my previous answers each year.

So, for a couple of years, I was sitting pretty, thinking I at least had this part of the dialysis ordeal licked.

But, of course, nothing lasts forever.

I hadn’t seen my regular SW in a while, and one day, before I knew what was happening, some strange woman rolled over on a stool, introduced herself as the new social worker and said, “Are you ready for this year’s assessment?”

As I’m sure you can imagine, included among my answers were a fair share of indecipherable noises…

Thanks for reading. Take care.


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Maybe Next Halloween…

Bob Here.

It’s scary to think about how someone would look if they dressed up as a dialysis patient for Halloween. Isn’t it?

I think it’s safe to say that kidney failure and dialysis do weird things to a person’s body and mind.

I was somewhat prepared for the shape-shifting aspects of this disease after I had a kidney transplant.

At the time, one of the drugs they were using to suppress your immune system (to keep your body from giving the transplanted organ the boot) was prednisone.

Prednisone, for those of you who don’t know, is a corticosteroid. It is used to treat a number of ills in addition to preventing rejection. It’s an anti-inflammatory, which is really ironic considering some of the side effects.

We’ll get to the physical changes that prednisone causes in a minute.

The byproduct that particularly impact the people around you are the personality changes.

I know. Someone is out there saying, “You mean it changed your personality and someone complained??”

Valid point, but steroids are well known to cause serious mood swings and an increase in aggression. When I first started taking it, I did everything short of growing hair and fangs and howling at the moon. The people around me, both in my private life and at work, about wanted to have me caged.

Now, the effect was minimized once my body grew accustomed to the drug. Then people only wanted to have me caged around the full moon.

And the mood swings were about as wide as the Grand Canyon. I could be talking civilly to a person one minute and look like I wanted to bite them in the throat the next.

I remember meeting with some doctor as I was being put on the Prednisone regimen.

“You might experience a little fullness of the face,” he said.

“How’s that again?” I asked.

“Yes. Because of the prednisone. It might cause your face to look a little fuller.” He held his hands out about six inches from his face to emphasize the point.

“You’re kidding me right?”

“No. It doesn’t happen to everyone and the effect is usually temporary.”

“Usually? Any other side effects I should know about?”

“Well, there’s the possibility of mood swings and irritability.”

“I haven’t had a pill yet and I’m feeling that.”

The doctor ignored that and went on. “Possible irregular heartbeat, numbness and tingling in your arms and legs, unwanted hair growth, an increase in hunger…”

“Wait a minute,” I interrupted. “The nutritionist just left after listing an encyclopedia of foods that I should restrict, which basically consisted of everything on my regular diet. And now you’re going to give me a pill that’s going to increase my hunger??”

“Well…not every side effect takes place in every patient. Everybody’s different…”

“Never mind. Let’s go back to the face thing…”

Now, I’ve never been vain about my looks, but I also didn’t want to go back to work resembling a blow-up action figure either.

But, there weren’t very many alternatives, so I started taking it, and sure enough, within a week, I looked like I swallowed a pizza tin whole.

I looked like a cross between a koala bear and Miss Piggy’s little brother. My face looked like a bag of melted caramels.

The effect did turn out to be temporary. As soon as I was able to step up my physical activity, the swelling went down.

The hunger thing was very real though. Here I was trying to be careful what I consumed and the prednisone about made me want to eat up the tablecloth.

The other immunosuppressant I was on was cyclosporine, and that same doctor had warned me that another risk of taking these drugs was that they made you more susceptible to certain kinds of cancer.

In my case, skin cancers turned out to be an issue. If my dermatologist had a frequent shopper program, I would have been rich. Seemed like about every other week some new surprise would pop up, and off I’d go to have it removed.

So, once I started on the Big D, I was pretty well prepared for any new “wrinkles” that were in store.

But, don’t even get me going on the chest catheter that got implanted in the hospital. Forget about the fact that you have to enclose yourself in Saran Wrap every time you take a shower.

The tubes are something out of a Doctor Octopus comic book. And, the thing bulges out and shows through dress shirts, which I was wearing steadily at the time.

I had been on dialysis for about six months when the cath decided on its own to take leave of my body. I was in the office at the time and my shirt was drenched in no time at all.

I calmly walked out looking like a prop for a Friday the 13th movie.

Another aspect of dialysis that came as a surprise in the hospital was the possibility of developing pica. I remember the conversation with yet another doctor as I was starting up treatments.

“Oh, and by the way,” he started, very casually. “You may develop an appetite for substances that are non-nutritive.”

I just sat looking at him. Then I said, “Non-nutritive? What the [bleep] are we talking about here?”

He was still very calm. “Things like paper, metal, chalk, soil, glass. Perhaps even dog food.”

“Somebody put you up to this, right?”

“No, I’m serious. Dialysis patients tend to have iron deficiencies, which can lead to these symptoms.”

“Dog food? I may start wanting to eat dog food?”

He said, “It’s just a possibility that we have to point out.”

“Look, I could put up with my face growing to three times its normal size and developing multiple personalities with prednisone when I got my transplant. Even having a ‘Growth of the Week’ contest with my skin. But now you’re telling me that I won’t be able to pee and I have to replace the chili-dogs in my diet with Alpo??”

Now, I’ve been fortunate not to have been inflicted with this ailment in my years on dialysis, but I did have a neighbor in one of my centers who might have been exhibiting symptoms.

He was a guy who sat next to me fairly regularly and he generally kept to himself.

In other words, he was my kind of dialysis neighbor.

One day, he grumbled something to himself and since he was normally quiet, it got my attention.

“Excuse me? Did you say something?” I asked.

He said, “No, I was just thinking that cement looks good.”

“Cement? What?”

He pointed out the window and some guys were paving the sidewalk out front.

I was just looking at him. Then I said, “You mean they’re doing a good job paving?”

He looked flustered and said, “Uh, yeah. Yeah that’s what I meant.”

But I was worried that the guy might not have had the ‘pica talk’, so I went through it.

“Hmmm,” he said. “I have noticed my dog’s Milk Bones looking pretty tasty lately.”

After that, we agreed that he would get his iron checked and he would keep from getting into a chow war with his German Shepherd.

Anyway, this guy with pica goes into a bar, right? And he orders a drink on the rocks…

I know, pretty bad.

Dialysis patients with fistulas also have some unusual physical changes to deal with.

It’s always interesting to see how people react to the buzz, or the “thrill'” in dialysis lingo. It’s a killer at a party.

Some people will touch your arm and recoil in horror, while others will just emit a “Wow” and look at you like you’re some kind of space alien.

But over time, some of us develop what our wonderful doctors describe as “aneurysmal enlargements” in our vessels. They are these unsightly bulges that look like a small rodent set up camp under your skin.

I’m sporting a pretty good sized one of these myself, and one time I met a tennis friend of my wife’s and we shook hands.

“Holy crap, what did you do to your arm?” he asked, his eyes the size of golf balls.

“Oh, that’s nothing to worry about,” I said laughing it off.

“Nothing to worry about? No seriously, do you want me to call an emergency medical team?”

I reassured him that he didn’t need to summon the EMT’s or the Marines, and ran through a brief explanation, but even then the guy didn’t look totally convinced that I shouldn’t be packed on ice under quarantine.

So back to the Halloween costume idea. For a kidney failure/dialysis patient, the outfit could consist of a big, bloated-face mask, maybe with some wolf-like hair all over the mug, some zombie-like skin deformity makeup, a phony arm with a blown-up balloon for a blood vessel. And maybe carrying our own little dog food bowl.

Pretty scary, huh?

Thanks for reading. Take care.


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I Got This

Bob Here.

“I Got This,” said the guy in the TV commercial, and, out of the corner of my eye, I saw the wife cringe.

Truth be told, she all but curled up into a fetal position. “Make it stop,” she muttered.

This scenario may seem weird to some, but I completely understood what was going on and I couldn’t help but give a little laugh.

You see, despite years, ok, decades of ineptitude at involvement with anything technical and pretending that everything was ok despite impending doom, I’ve been known to confidently avow that “I Got This” when faced with a new challenge.

My use of the phrase came to light recently with, what I must admit were fairly predictable results

I was driving home from the gym, minding my own business, happy as a clam. I’ve always said that the best part of working out is when you’ve finished.

All of a sudden, a warning light flashed on my dashboard. I immediately thought of Sheldon on The Big Bang Theory telling Penny that her “check engine light was on.”

This one was a squiggly little line on top of a flat surface. I also wondered who configures these things? It looked like some car company executive had his five-year-old draw the shape with crayons.

But I knew from experience that it meant that I had low air pressure in at least one of my tires.

In fact, now that I think about it, the wife was with me the first time the light came on. Neither of us knew what it meant, but, being me, I just told her not to worry. “I Got This,” I said.

Anyway, I pulled over and looked to be sure I didn’t have an actual flat. The tires all looked ok. Hardly even warranted a pressure alarm, I thought. So I just kept on going. I pulled up at home and decided that, rather than pull a Penny and just ignore the light, I’d better check the pressure in my tires.

So I did. First one: Fine. Second: Fine. Third: Also fine.

At that point, the wife looks out from the front door. “What’re you doing out there?”

I just looked up as if this happened every day.

“Got a low air pressure warning on one of my tires,” I said. Then it was if she was just waiting. Sure enough, I followed up, saying, “Don’t worry. I Got This.”

She then backed out of view, probably running for her rosary beads or something.

So, I came to the driver’s side front tire and, of course, I couldn’t get the valve cap off. After a few more tries and more than a few choice words, I went in to get a pair of pliers.

Gripped the cap as hard as I could with the pliers. Still wouldn’t budge.

I decided, time for the heavy artillery. Went back in for my ratchet set. The wife was nowhere to be found.

Found the right size socket and went to town. I’ll show that cap who’s boss, I thought.

Sure enough the cap came off. Unfortunately, so did the inside of the valve and all the air came whistling out of my tire.

I just stood there for a long time, holding my trusty ratchet and staring down at my tire, now flat as a pancake.

My first thought was, now that warrants a pressure alarm!

I walked back in the house, my head hanging low. The wife was at her computer.

“Calling for a tow truck?” she asked, not even looking up.

I just grumbled something in response.

So, I’m sure you’re all wondering how being such a catastrophe-in-waiting translates to doing home dialysis, where you yourself are responsible for a lot of the technical aspects of your treatment handled by trained professionals in a dialysis center.

Well…it’s going okay now, but let’s just say there was a bit of an adjustment period.

After we finished our training, it finally came time to do a soup-to-nuts treatment all by our little lonesome selves at home. No nurses, no attendants, no emergency medical teams.

We decided to divvy up the responsibilities for the setup.

“I’d better set up the machine,” said the wife.

I tried my best to look offended. “Why don’t you pull the supplies and fill out the treatment sheet,” I said. “I’ll do the machine setup.”

She looked at me like I had finally gone over the edge. “You? You want to be around working machinery? The handyman in our last house has a home in the Bahamas because of you. Don’t you remember when you went downstairs to change out a fuse and almost burned the house down?”

“Hey, I got through the setup in training, didn’t I?”

“Yeah, and the center will never be the same. The flood was so bad the building almost floated down the street. The people there don’t call you ‘Hurricane Bob’ for nothing you know.”

“All right, so there were some learning pains. But I know what I’m doing now. Practically an old pro, heh heh…”

She looked at me doubtfully, but finally relented.

The weird thing is that despite my dealings with all things mechanical all but reaching disaster-movie status, I see every new opportunity as a challenge. Even when it goes against my better instincts.

So, I started the setup. The wife was eyeing my every move.

I expertly loaded the cartridge and untangled the lines, my confidence growing with every step. It was time to spike the saline bag.

I looked over at her. “Hah. And you were nervous,” I said. I told you there wouldn’t be a problem.”

And then it came. “I Got This,” I said.

But I must have been over-confident and taken my eye off the target. I completely missed the hole and the spike went right into the side of the saline bag.

I want to tell you, those bags may not look like much, but just wait until they’re pouring out all over your machine, your Pureflow, and, of course, your floor. It was like Niagra bleeping Falls.

“Oh crap,” I said. I tried putting my hand over the hole, but that just succeeded in expanding the flood zone.

The wife just calmly took the bag off the holder, turned it upside-down and went over and put it in the sink.

Neither of us said too much as we started cleaning up the mess, but after a while, I looked over and she was laughing so hard tears were running down her cheeks.

Now, I also tend to be a bit stubborn admitting that I might need help because of injury or illness, another trait that doesn’t bode well for a dialysis patient.

When I first started as an in-center patient, the staff, the docs and I were doing a “trial and error” routine to try to get to my correct dry weight. Turns out, mostly error.

For non-patients, your dry weight is essentially where you should be after you’ve been treated.

And the fact is that taking off too much fluid, or not enough for that matter, can cause complications.

While the good folks are calibrating your weight, it’s very important to give accurate feedback on how you’re feeling.

Hence the problem with being block-headed about such communication.

In one of my early treatments, I did start to feel a bit light-headed.

(The first one to say, “How could you tell the difference?” is in big trouble.)

I honestly didn’t know enough to determine that this might be a problem. Thought it was just a normal part of the treatment.

Anyway, my blood pressure started getting low, so the staff gave me some saline.

I remember the nurse coming over.

“How do you feel?” she asked.

“No big issues,” I said. “I Got This.”

She just rolled her eyes.

When it came time to take me off, the nurse was hanging close. Looking worried.

So, the needles were out. They took all my vitals. And it was time for a standing blood pressure.

They need that to make sure you’re okay to do something really complex, like walk to the scale.

“Do you feel up to taking a standing pressure?” asked the nurse.


She came to my side. “Need a little help getting up?”

I just waved my hand. “No worries. I Got This.”

I stood up out of my chair and immediately went down like a sack of potatoes.

The staff managed to get me back in my chair, all the while, apparently, despite my insistence that I didn’t need any help.

They called the wife to tell her what happened. I heard the nurse say, “He kept telling us, ‘I Got This.'” Then she laughed.

“What’d she say?” I asked.

“She just groaned and asked if we needed to take you to the emergency room.”

So, I just want you all to know that when it comes to getting anything fixed up or telling you honestly how I’m doing…

Don’t worry about a thing. I Got This.

Thanks for reading. Take care.


Posted in brovado, dialysis, Humor, medical | Tagged , , | 2 Comments