pd

Let's celebrate "Everybody draw Mohammad day!"

2010-05-20T07:19:00.001-07:00

Yeah, I know - I swore not to write anything more on this blog, but this is far too important for words!

Today is "Everybody Draw Mohammad Day," an attempt to combat self-censorship in the name of tolerance, which is not so much tolerance as it is simply a cowardly cave-in to childish, but terrible terroristic tantrums of one set of fanatic followers of one religion. I believe there should be no such self-censorship OR government-imposed censorship to legitimate free speech, in the US or anywhere around the world - if an idea, yes, even a religious idea, is to be accorded respect in the world, it has to fight for attention in the same marketplace of ideas as a non-religious one. Terrorising people in the name of religion only begets terror - not respect. Respect is earned, and cannot demanded.

Heh, check out the alliteration - "terrible terroristic tantrums" :-)

Since I'm the world's most inept at drawing anything, I can't contribute a cartoon of my own to the archive, but I can certainly paste a link to THE definitive archive of Mohammad images through the centuries - including full-face depictions in Islamic art, no less:

http://zombietime.com/mohammed_image_archive/

An image of Mohammad (Medieval Art) from the above web site:

Mohammed receiving his first revelation from the angel Gabriel. Miniature illustration on vellum from the book Jami' al-Tawarikh (literally "Compendium of Chronicles" but often referred to as The Universal History or History of the World), by Rashid al-Din, published in Tabriz, Persia, 1307 A.D. Now in the collection of the Edinburgh University Library, Scotland.

How I came to home hemo-dialysis training

2010-03-18T21:27:00.000-07:00

The original blog post is here: How I came to home hemo-dialysis training on NxStage

You would have read my posts more than two years ago, for peritoneal dialysis and my training on the Baxter HomeChoice cycler (look at the very first few of my blog posts). Welcome to my hemodialysis training blog series!

I would much rather have posted a COPY of my own blog post, but the almighty google sayeth: "Thou shalt not use copy-and-paste, even from thine own blog post"

BLAST EM!!!

And therefore dear readers, please go forth to my new blog location because I will be damned if I use almighty google's blogspot ever again.

Cross-posting from my blog at NxStageUsers.com

2010-03-18T21:20:00.000-07:00

Hi everybody (all 3 of you!) :-)

After this loooooong absence, I bring to you the blog entries that I wrote for the NxStageUsers forum - all further blogging for a while is going to be in that location, so please consider reading them at their source. I will tryand re-post them here, with explanations of terms when I can, as I head towards the end of my training for home hemo-dialysis, and get to bring my NxStage System One cycler home.

Without more ado, here is the series.

Bringing a slimebag to justice, after 30 years

2009-10-20T15:19:00.000-07:00

Roman Polanski. That slimebag. Please please please extradite him, and bring him to the US, so he can pay for what he did to that child. And he can pay for the resulting crimes as well - running away, and being allowed to stay free in France (how disgusting is it that the French govt won't extradite this sorry excuse for a human being - one of the lowest slimebags I have had the misfortune to actually hear of).

And shame on you, Whoopi Goldberg and the rest of Hollywood! You who think the "poor widdle thing has already been punished by having to stay away from his dear country all these years" - DO YOU GET IT? This piece of slime DRUGGED AND RAPED a child, barely 13 years old. DO YOU GET IT? This pedophile DRUGGED AND RAPED A 13 YEAR OLD CHILD. So what if he makes good movies? I'd happily, joyously live without good movies than see this piece of slime go free.

Given my druthers, I'd much rather see this child-rapist behind bars, where I know he will be treated as he deserves. Evil, I know, given the state of prisons in the US, but oh so apt for Polanski.

You would be within your rights to ask why I haven't done anything about this until today. Because I didn't know he had drugged her first, before raping her. Because I had only heard his side of the story. No excuse, I know. I did know that his victim was young, but I didn't know she was literally a child. I didn't know what I could do about it.

Here's something I can do about this - I can at least try to publicize this petition to extradite Polanski and bring him to the US to face his crimes.

Blue Dogs - bite the hand that feeds you at your own peril

2009-08-24T18:22:00.001-07:00

H/T Tula Connell of FireDogLake:

Blue Dogs Bite, Unions Bite Back!:
Sheet Metal Workers (SMWIA) General President Mike Sullivan:

The Sheet Metal Workers International Association (SMWIA), has decided to suspend all financial and intangible campaign activity in support of every political candidate until real health care reform is passed.

Not just "suspend all financial and intangible campaign activity" - but they are using the money well-saved to air a series of radio ads in in Montana, Iowa, North Dakota, and Arkansas. I LOVE LOVE LOVE THIS! The ads focus on Senators Chuck Grassley (IA), Max Baucus (MT), Kent Conrad (ND), and Blanche Lincoln (AR) - the last three supposedly allied to the Democratic Party.

And what cools my heart even more is to hear, AFL-CIO Secretary-Treasurer Richard Trumka has also warned the likes of Max Baucus and Kent Conrad (the Senate version of the Blue Dogs), and Rep. Mike Ross (D-Ark.), Rick Boucher (D-VA) (both of them Blue Dogs) among others, that they are not going to get re-elected to Congress if they keep up their douche-baggery.

From Sam Stein at the Huffington Post:

Trumka's warning shots come at a time that the AFL-CIO is charting out a more aggressive campaign to target lawmakers who, as one official put it, "take labor's help but don't vote for labor's interests." Part of that process is to hold out the prospect of electoral consequences.

I am so happy to see progressives all over this country at last showing up the turds in Congress who are so happy to take our money at election time, but think we will forever put up with being sidelined when push comes to shove. And now that push has come to shove, if you do not vote for the progressive agenda, you will face your toughest ever re-election campaign, and that's a promise from this long-time (LEGAL) resident and soon-to-be citizen of these United States.

Fantasy Dinner Party

2009-08-19T18:28:00.000-07:00

Here's a tag my sis invited me to steal: Fantasy Dinner Party and so I am stealing (her dinner service idea, among other things - read on to find out what else I am stealing). All the following is assuming I will be allowed to be present in the room --> I don't need to eat with all these people, I just want to be free to interact with them, and listen and follow all the cross talk and everything.

The rules are:- you can invite anyone, living or dead- you have a table that seats eight, but as you are one, you can invite seven people- you have to explain why you'd invite them. And for bonus points:- what would you serve them for dinner?

The Guests:
Guest #1: Hypatia of Alexandria: A Greek scholar from Alexandria in Egypt, considered the first notable woman in mathematics, who also taught philosophy and astronomy. A woman who cultivated her mind, the first famous feminist (at least, as far as I am concerned), a mathematical genius. Murdered by a Christian mob, while defending the famous Library of Alexandria.

Guest #2: Dr. Richard Dawkins: A contemporary scholar, quietly but VERY firmly atheist (*heh*), he is a British Ethologist, evolutionary biologist, popular science author, and was was formerly Professor for Public Understanding of Science at Oxford. Dawkins is an atheist, secular humanist, sceptic, scientific rationalist, (all like me) and supporter of the Brights movement (UNlike me). Although mischaracterized as "Darwin's Rottweiler," he is actually a very gentle and polite person - I love the way he can give someone such a hard time, and do it all poitely, without raising his voice. My hero for the current decade :)

Guest #3: Subrahmanya Chandrasekhar: One of my favorite Indian scientists and Nobel Laureates - Subrahmanyan Chandrasekhar. He was a Nobel laureate in physics along with William Alfred Fowler for their work in the theoretical structure and evolution of stars. I LOVES me some astronomy, at the dinner table or otherwise!

Guest #4: Sir Terence David John Pratchett: My very very very very favoritest (if there is such a word) author, is an English novelist, known for his frequently comical work in the fantasy genre. He is best known for his popular and long-running Discworld series of comic fantasy novels. I love him even more for mixing in real science with his usual witty comments about Discworld's magic, in the "Science of Discworld" series. I have Part 1, and am looking for the rest of the series (hint, hint - brother and sister! *wink*).

Guest #5: Sri K. V. Guruswami: My mother's oldest brother, an absolutely fascinating man. I managed to get him to write a bit about his childhood, growing up with so many younger siblings - he obliged, but then got busy planning my brother's marriage ceremony, and has not updated his blog at all. Mama, I may not have bugged you about that, but I am plenty bugged, I tell you. This is a very public plea from me to PLEASE re-start your entertaining and well-written vignettes. I think I would be absolutely fascinated to follow his conversations with my other guests, and his musical discussions, in particular, with my next guest.

Guest #6: Smt M. S. Subbulakshmi: The golden voice. She needs no more introduction. The goddess of Carnatic music. She might be used to people being overawed in her presence, but I am sure my mama would get over the awe toot-sweet - there's no way he would pass up a chance to talk music with the woman who simply blew through the glass ceiling for Carnatic concert performances (amazingly enough, when she was young, only men could perform in public...can you believe it!).

Guest #7: My father (another guest I have stolen from sis), Sri S. Ramanathan. For the same reasons as sis states.

Guest #8: My father's brother, Sri S Tarakesan. For the same reasons that my cuz states :-)

And what the hell, as long as we are cheating, why not make this a table that seats 10?!

Guest #9: My mother, Mrs. Kalpagam Ramanathan. A very thoughtfully different person under all that humility and shrinking-violet-ishness. It would be lovely watching her hold her own against all my other illustrious guests, although MS might just make her tongue-tied with awe :-) I watch her make instant friends here with, literally, strangers off the street, that she meets while on her daily up to an hour-long walks, and wonder where in the world this person was hiding all these years. Maybe her siblings might know.

And finally, to round it all off,

Guest #10: My mother's sister, Gomathi Natarajan. I have heard so much about her from my mother, about how feisty, no-nonsense she was, intelligent and not hiding it, keenly interested in the arts, wanting, but unable to follow her academic interests, but finding other ways of learning than traditional schooling... Wish I could have known her better before she died. But this is my fantasy, so everything I want, goes!

The Menu:
Each person's top two favorite dishes from their favorite cuisines - and a third dish to be a choice presented to the table at large, per person. Most certainly not cooked by me - and because Amma cooks everyday, she will get a chance to relax this time.

2009-08-04T22:39:00.000-07:00

More about this later... but I found this most thoughtful!

Teesu, "hint, hint!" *heheheh*

Via Inevitable Conflict

Chiropractic is DANGEROUS nonsense -- edited to add lines apparently sanitized by his lawyers

2009-07-29T16:32:00.000-07:00

(Note: this is the infamous article on chiropractic that got Simon Singh sued. It is being reposted all over the web today by multiple blogs and online magazines.)

Why should I be left out of the fun? :-)
h/t: Pharyngula

Edited to add the sentences from the original article (removed in the lawyer-sanitized version that I had originally posted. Corrections/Additions are in this font. Where you see odd stretches of no text, you will see the original text if you select it.

h/t: En Tequila Es Verdad

---------------------------------------------------------------------------------------------------
Some practitioners claim it is a cure-all, but the research suggests chiropractic therapy has mixed results - and can even be lethal, says Simon Singh.

This is Chiropractic Awareness Week. So let's be aware. How about some awareness that may prevent harm and help you make truly informed choices? First, you might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that "99% of all diseases are caused by displaced vertebrae". In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.

In fact, Palmer's first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.

You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything. And even the more moderate chiropractors have ideas above their station. The British Chiropractic Association claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying, even though there is not a jot of evidence. This organisation is the respectable face of the chiropractic profession and yet it happily promotes bogus treatments.The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying - even though there is not a jot of evidence.

I can confidently label these assertions as bogus utter nonsense because I have co-authored a book about alternative medicine with the world's first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.

But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic.

In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.

More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.

Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.

Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: "Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck."

This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.

Bearing all of this in mind, I will leave you with one message for Chiropractic Awareness Week - if spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.

---------------------------------------------------------------------------------------------------
Simon Singh is a science writer in London and the co-author, with Edzard Ernst, of Trick or Treatment? Alternative Medicine on Trial. This is an edited version of an article published in The Guardian for which Singh is being personally sued for libel by the British Chiropractic Association.

Free Iran!

2009-06-15T16:18:00.000-07:00

An update - found this video on Pharyngula:

Image lifted from this post on Hullabaloo

A well written article on MidEast Analysis.com

And from Hullabaloo itself

And from Bitch, PhD .

And this is not terrorism.... just how?

2009-05-31T18:32:00.000-07:00

Update 2: Another post by Sara at Orcinus: Jesus Jihadis

Update (from one of the comments on this post at Feministe):

GallingGalla says: May
31st, 2009 at 9:22 pm - Edit several
forced-birthers (o excuse me, so-called “pro-lifers”) have posted comments
purporting to be expressing grief, shock, etc.
your words ring hollow. you had better think about the responsibility that you and your fellow
forced-birthers have in creating the environment that encouraged and abetted an act of terrorism. when you demonise and dehumanize doctors and abortion providers; when you spread lies about the women who are getting these abortions and hide the fact that the vast majority are getting abortions because the fetuses are so deformed that they CANNOT SURVIVE; when you slut-shame women and imply that they got pregnant because they did not “keep their pants on”, you are setting the ground work for these acts of terrorism.
“pro-life feminist”? give me a break, angry lifer. being a forced-birther is incompatible with
feminism. you advocate state control and male control over women’s bodies and women’s choices. you demonise and dehumanize women and seek to punish women who do not meet your definitions of what a “proper, chaste” woman is supposed to be. you demonise and dehumanize their health care providers. you harass and terrorize women trying to use those health care services, including those who are just trying to get a Pap smear or attend prenatal health classes.
there is no middle ground here. you are all hypocrites. you should be ashamed of yourselves.

I agree with this comment with all my heart, and wish I could express my rage and sorrow as clearly as she has.
----------------------------------------------------------------------------------------------------------

From the Seattle-PI: Kansas abortion doctor gunned down in church

The only doctor in Kansas who provided the FULL range of women's health services (including perfectly legal abortions, early or late) has been gunned down in the foyer of his church. The cowardly murderous slime that did it then "bravely" ran away. Leave behind the obvious fact that abortions were only a very small part of his offered services, and the fact that the major part of his practice involved providing basic gynecological care for girls and women of all ages - all those anti-abortion terrorists could think about was the fact that he helped girls and women end pregnancies that they were not ready for.

For the most part, in Kansas and other bible-belt states, a girl or woman who cannot afford his services outright has to go through so many kinds of hell to get to him in time that by the time he sees them, they are well into their second semester. And so the doc would have to do a late-term abortion, because of all the obstacles and harassment put in the way of women who are in no position to raise a child - either because they are too young to have jobs, or because they already have other children and cannot afford this one, or for WHATEVER reason the girl or woman may have, because I know that this is never an easy decision. EVER. For ANY woman.

Anyway, here are a few snippets from the story that really got my blood boiling:

Police did not release a motive for the shooting. But the doctor's violent death was the latest in a string of shootings and bombings over two decades directed against abortion clinics, doctors and staff.
Long a focus of national anti-abortion groups, including a summer-long protest in 1991, Tiller was shot in the foyer of Reformation Lutheran Church. Tiller's attorney, Dan Monnat, said Tiller's wife, Jeanne, was in the choir at the time.

And this:

The family said its loss "is also a loss for the city of Wichita and women across America. George dedicated his life to providing women with high-quality health care despite frequent threats and
violence." Stolz said all indications were that the gunman acted alone, although authorities were investigating whether he had any connection to anti-abortion groups.
Tiller's Women's Health Care Services clinic is one of just three in the nation where abortions are performed after the 21st week of pregnancy. The clinic was heavily fortified and Tiller often traveled with a bodyguard, but Stolz said there was no indication of security at the church Sunday.

And then this precious bit of smoke and mirrors - of course they are "shocked", why would they not be? After all, these are the people who constantly portray women health service providers as murderous scum that should be taken down any way possible. Of course I believe you, Operation Forced-Pregnancy, of course... NOT!!

"We are shocked at this morning's disturbing news that Mr. Tiller was gunned down," Troy Newman, Operation Rescue's president, said in a statement. "Operation Rescue has worked for years through peaceful, legal means, and through the proper channels to see him brought to justice. We denounce
vigilantism and the cowardly act that took place this morning."

Bah, these people make me sick. And then this:

The movement's leaders fear the killing could create a backlash just as they are scrutinizing U.S. Supreme Court nominee Sonia Sotomayor, whose views on abortion rights are not publicly known.

A backlash against what? Them? Who in the world would ever care what a few fundie god-bothering forced-pregnancy fools think, except that they provide havens for terrorists like the cowardly murderous slime that killed Dr. Tiller? And why in the world would Judge Sotomayer's opinions about ANYTHING need to be public? She has already made it clear by her history on the appellate courts that she follows the LAW. End of story.

And anyway, why in the world would the confirmation of a judge even be a matter in any way remotely related to this conscientious and compassionate doctor's murder?

Hilarious (but occasionally NSFW) cartoon site

2009-05-31T00:21:00.000-07:00

Urf -- by Phil Selby

(click to embiggen either pic)
or this:

(h/t) Bay of Fundie

I'm FLOORED!!!

2009-05-03T14:43:00.000-07:00

I'm perhaps about the last person in the world who hadn't heard Susan Boyle sing, either live or on this YouTube recording. But better late than never!

This is the first chance I've had, since I heard about Susan Boyle, to find the link and hear the voice that has captivated the world -- and now that I've heard her, I'm almost too ashamed to leave my own puny offerings up on my blog. THAT is pure VOICE! Oh to have that voice...... Ms. Boyle, I wish you all the very best, and am waiting for your first album to come out. Any recording company that has heard you sing, and NOT signed you up immediately is the dumbest ever!

I can't find the embed code I need to display the video on my blog... So here is the URL - for those who haven't heard her, I urge you to click on the link and listen to that sublime voice...

Without more ado, here's Susan Boyle

Genius on a bicycle (no more comment needed, see it for yourself)

2009-05-02T22:59:00.000-07:00

(h/t Neuron Culture via Decrepit Old Fool)

A very useful site - especially for frequent travelers

2009-05-01T18:38:00.000-07:00

I ran across this site today - One Bag - The art and science of traveling light - and have been reading it - you never know what you'll come across while idly browsing the internets, in an effort to find something to do while waiting for traffic to ease (thus keeping your sanity out and temper in during the daily commute drudgery).

The author has almost made a science of packing the minimum necessary for travel. I think this is a wonderful site - if you like doing things systematically, and tend to build up by-rote habits that allow you to get things done with your hands while your head is busy working out other problems. I can't travel much, so this is just fascination for me, but others, who do travel often for business or pleasure, will find this has at least a few good tips, if nothing else.

Thinking of my brother, whose new job involves criss-crossing the country from his base in Boston...

An oddly addictive blog

2009-05-01T18:12:00.000-07:00

This one reviews pens, and their writability and balance and a whole bunch of other characteristics... The author has a run-of-the-mill interesting style of writing - and I mean the way he puts words together to describe things, not how his handwritten words LOOK. He also maintains a blog about notebooks and notepads.

These are both odd things to be an addict of, for sure, but I think I know at least one someone (hi Shyamali :-)) who'll find this brilliant. I am enjoying reading reviews of pens, notebooks and notepads (all of the non-electronic variety), but haven't written anything on paper for the most part of 15 years, other than hurriedly scribbled notes at meetings, etc. Otherwise, all my "writing" is done with a keyboard, so much so that I seem to have lost my neat handwriting altogether.

Anyway, thought this was a cute site, so here it is :)

(edited title to be grammatically correct)

New writer I have come across - B C Woods

2009-04-29T17:33:00.000-07:00

BC Woods is a Pacific Northwest local resident, which for some reason it took me this long to "get", considering where I live :P

Anyway, I have his blog bookmarked just for his writing style - humor, passion, cynicism, reality, sadness, anger, everything, all mixed up in blog posts that somehow really resonate with me. A lot of his autobiographical posts are more than a bit shocking, in their language and dark, gallows humor, especially to someone like me, who's had a sheltered childhood, and a sheltered adult life (this by choice)...

But I do think BC has a real talent for writing, and I'm happy I found his blog (don't even remember how I got to it the first time), all I know is I read the top post of his blog at the time, was simultaneously horrified and hooked, read everything else on his web site, and bookmarked it as one of my favorites. He isn't quite as prolific as I would like him to be (not least because he has a day life as a student), but it is always thrilling to see his posts that don't have to do with live-blogging Battlestar Galactica :)

Here're a few links from BC's blog - cutely called "Dunce upon a time." Read them and then read all his posts... This is someone I would love to have as a friend. If I weren't too distracted from everything by the constant pain in the feet and the neverending work. And too lazy to set up and maintain correspondence even as a first step.

Without more ado - here's B C Woods:

The Value of Maintaining Homeostasis: A Rant Against Over-Sensitivity Autobiographical, and definitely not child-safe. But still funny as hell. He's one of the few people who can keep me in side-splitting laughter while still being totally horrified by what I'm reading, and further horrified by the fact that I am laughing helplessly.

The writing on the wall is one of his science fiction shorts. Not a very representative sample of his writing, but no matter what, most of his stories really resonate with me.

Smiling sick is a sickly kind of fantasy story. Didn't totally "get" it, but still.

Autobiographical - funny how the man can make you laugh hysterically while he describes his less than 20-20 vision :D

This one is also autobiographical. And funny, as always.

Read and enjoy.

Absolutely GORGEOUS - geography in action

2009-03-19T15:38:00.000-07:00

What does the island nation of Tonga bring to mind? To me, it evokes gorgeous little green jewels of islands dotted in an azure ocean under blue sunny skies...

But see what's been happening around there - an undersea volcanic eruption that this throwing out a plume of steam, ash and debris a 100 feet into the air!

http://www.boston.com/bigpicture/2009/03/undersea_eruptions_near_tonga.html

Ignorexia Verbosa

2009-03-05T16:49:00.000-08:00

The perfect term to describe the affliction of your typical TV talk show host and/or news reader (doesn't matter daily, weekly, daytime, nighttime, political, doesn't matter which TV/radio channel, etc).

I LOVE this term! :D

Picked it up from Ed Brayton's "Dispatches from the Culture Wars"

CEOs of Indian companies - maybe they actually HAVE self-respect and integrity (contrast any fat cat on Wall Street or in Detroit)

2009-01-08T12:42:00.000-08:00

The scandal broke in India last week - the CEO of Satyam Computer Services Ltd, India, had announced that the company had been reporting vastly inflated monetary profits and reserves for the past several years, which had been artificially keeping their stock prices up. Satyam Computer Services is the largest software services company in India and a major global player.

Then on Monday, this letter from the CEO (B. Ramalinga Raju) was widely reported in newspapers all around India (addressed to the Board of Directors, copies to the various stock exchanges and the SEBI (I think that's the Bombay Stock Exchange?):

The highlight of this letter is that last line:

“I am now prepared to subject myself to the laws of the land and face the consequences thereof”

– B. Ramalinga Raju (ex-CEO of Satyam Computer Services, LTD)

Anyone care to bet on the odds of this happening in the US or Europe?

Compare and contrast that ex-CEO of Washington Mutual. Walking away with his $20 million without the slightest hint of shame or anxiety about prosecution. Ditto the Wall Street fat cats and the Big 3.

Satyam CEO - Letter to Board of Directors

Publish at Scribd or explore others: Stocks Business

Sinkin' Soon

2008-11-27T12:59:00.000-08:00

Sinkin' Soon - by Norah Jones

We're the oyster cracker on the stew, the honey in the tea
We're the sugar cubes, one lump or two, in the black coffee
The golden crust on the apple pie, shining in the sun at noon
We're the wheel of cheese high in the sky
But we're gonna be sinkin' soon

In a boat that's built of sticks and hay, we drifted from the shore
With a captain who's too proud to say that he dropped the oar
A tiny hole has sprung a leak in this cheap pontoon
Now the hull has started growing weak
And we're gonna be sinkin' soon

We're gonna be sinkin' soon, we're gonna be sinkin' soon
Everybody hold your breath and down and down we go

We're the oyster cracker on the stew, the honey in the tea
We're the sugar cubes, one lump or two, no thank you, none for me
We're the golden crust on the apple pie, shining in the sun at noon
We're the wheel of cheese high in the sky
But we're gonna be sinkin' soon

Ten Cents A Dance

2008-11-27T12:51:00.000-08:00

"Ten Cents A Dance" - Rodgers & Hart

Lyrics:

I work at the Palace Ballroom, but gee that palace is cheap
When I get back to my chilly hallroom, I'm much too tied to sleep
I'm one of those lady teachers, a beautiful hostess you know
One that the Palace features at exactly a dime a throw

Ten cents a dance, that's what they pay me, gosh how they weigh me down
Ten cents a dance, pansies and rough guys, tough guys who tear my gown
Seven to midnight I hear drums; loudly the saxophone blows
Trumpets are tearing my ear drums; customers crush my toes

Sometimes I think I've found my hero, but it's a queer romance
All that you need is a ticket, come on big boy, ten cents a dance

Fighters and sailors and bow-legged tailors
Can pay for their tickets and rent me
Butchers and barbers and rats from the harbors
Are sweethearts my good luck has sent me
Though I've a chorus of elderly beaux
Stockings are porous with holes at the toes
I'm here till closing time, dance and be merry
It's only a dime

Sometimes I think I've found my hero, but it's a queer romance
All that you need is a ticket, come on big boy, ten cents a dance

A Minor Bird

2008-11-27T12:38:00.000-08:00

"A Minor Bird" - by Robert Frost

I have wished a bird would fly away
And not sing round my house all day
I have clapped my hands at him, from the door
When it seemed as if I could bear no more

The fault must partly have been in me
The bird was not to blame, for his key
And besides there must be something wrong
In wanting to silence any song.

Periya Mama has a new blog!

2008-10-27T11:22:00.000-07:00

Hey everybody!

After much, much begging and nagging from yours truly, Periya Mama has started a blog of his very own :-)

I have asked him for a bare minimum of one story per decade of his life, but obviously I'm hoping that he's going to get bittten by the writing bug and write WAY more than that (an online memoir of sorts). So go pay him a visit at his blog, and leave encouraging comments, y'all!

For those of you having trouble clicking the link in the title, here is the actual link:
Mama's Memories and Thoughts

Kalakkanavu

2008-09-04T18:33:00.013-07:00

So, I've been drifting towards perhaps changing the focus of my blog from just peritoneal dialysis to everything under the sun. As a first offering (well, technically second, since the "Last Lecture is the first - you really should take the time to watch this video in its entirety, because the man is such a wonderful teacher!), here's:

STAGING DREAMS OF CHANGE - Strands of history that remain incomplete
Githa Hariharan

The writing of history need not be a solitary exercise conducted among dusty books in a library. Nor need it be an exclusive business monopolized by scholars. History — or some of its strands — can be portrayed onstage and debated in full public view. These were among the cheering thoughts that came to mind when I recently witnessed the performance of a “feminist docudrama” that maps afresh a little chunk of history.

The docudrama, called Kalakkanavu or “A Dream of Time”, is unusual not only for its content and form, but also for its overall objective. As far as content is concerned, it retells almost a hundred years of history from a feminist perspective. The form is equally ambitious: the drama pieces together select extracts from Tamil women’s writings, speeches, songs and stage performances from the mid 19th to the mid 20th century. The central objective is a debate on women and change; but this is not just a scripted debate to be presented onstage. It’s open to the questions and comments of the “actors” and the “audience”. To this extent, the script, written by V. Geetha, is in a state of becoming, open to further dialogue. In fact, the idea of dialogue seems central to the enterprise — a dialogue with the past to explore some historical moments that precipitated the beginnings of social change; and a dialogue between those historical moments and present-day debates to enrich our understanding of what we are living through.

The dialogue hangs on the framework of five historical moments that made change less of a dream. During each of these landmark moments, women were enabled, in some way or the other, to imagine their lives travelling beyond the domestic sphere of marriage, motherhood or household work. Each of these individual journeys also left a legacy for other women — by giving them models through which they could rethink the nature of personal and social relationships. The models are not always “successful” — some of these women paid a terrible price for venturing off the safe and familiar path. But the models said it could be done. Change was possible; at any rate, re-thinking the familiar sanctioned world could pave the way to change.

The first of these historical moments is a period of nationalism when the “new Indian woman” was a recurring motif in what nationalists and reformers had to say. In Tamil Nadu too, the great nationalist poet, Subramania Bharati, is credited with having imagined the new woman into existence through verse and song. Bharati’s new woman was fearless in her commitment to the national cause; she was an equal partner in the grand adventure of nationalism. (There was, however, “the muse and mascot element” — part of this new woman’s role was to inspire men to be courageous and self-sacrificing.)

Thus the play begins with an examination of the truism that Bharati’s new woman is an important ancestor of today’s feminist. Several female contemporaries of Bharati respond onstage through words from newspapers and magazines, diaries and letters. Together they suggest that we need to look beyond Bharati and ask a couple of new questions. What did the age of science mean to women, for instance? And did the emerging rationalist and anti-caste ideologies influence women?

Having considered the “new woman”, the play moves back in time to focus on the relationship between conversion to Christianity and status. What did the new religion mean to women? Which class or caste of women was drawn to it and why? Several stories emerge as these questions are tackled. There’s the story of Grace Samuel who spoke of marriage in terms of companionship. She felt her faith gave her the means to redefine her marriage as a relationship between equals and friends. There’s the story of Clarinda, a Marathi Brahmin widow, who dared to “live in sin” with an East India Company soldier. She was one of the first upper caste converts to Christianity. There’s the story of the Nadar women, who struggled, with missionary support, to gain the right to wear the breast cloth denied to them by the upper castes. There are also the stories of the numerous lower-caste women converts who worked with Amy Carmichael, an Englishwoman involved in rescuing girls dedicated to temples against their wishes.

Having arrived at the devadasi issue, the play allows us to hear two different female voices in tandem. Ramamrithammal and Muthulakshmi were two remarkable women from the devadasi community. Ramamrithammal was a community activist and a vocal member of the self-respect movement led by E.V. Ramasami (“Periyar”). She publicly denounced the priests, landlords and institutions responsible for the maintenance of the devadasi system. Muthulakshmi drew upon a discourse of rights and morality to argue against the devadasi system. But in their protest against the injustice of this system, both women had to adopt a “moral public voice” — either by castigating the immorality of the caste order and denouncing dasis who would not abandon their vocation as Ramamrithammal did; or by working to legislate the system out of existence as Muthulakshmi did.

But what was “moral” and why?

The play examines this vexed question through the life of a stage actress and singer, K.B. Sundarambal. Her troubled marriage and love life as well as her stage career attracted gossip despite a measure of legitimacy that came with her involvement with the Gandhian movement. The point is that women in public life were essentially vulnerable; and the tool that reduced them to this vulnerability was the construct called “morality”.

Who set the rules and standards of this morality? The play examines this dilemma through the public and political choices made by the women who became followers of Gandhi, the women active in the Tamil language purity movement, the women who participated in communist struggles. There’s a range of forgotten voices that are narrated back into memory through song and verse — from that of the intrepid Manalur Maniamma, who organized Dalit agricultural workers in east Tamil Nadu and who died in suspicious circumstances, to that of the Sufi thinker and novelist, Sidi Juaniada Begum.

The play ends with numerous women who were active and articulate in Periyar’s self-respect movement. Jeyasekari, Neelavathi, Kunjitham, Janaki — these are only a few of the women we discover as we hear their views on socialism, female labour, abortion, contraception, motherhood — in short, issues and debates we live through today. Critical voices are not muffled. With Periyar’s emphasis on self-criticism providing the context, we hear some sharp and acerbic comments on male activists in the self-respect movement who were unfailing radical — till they entered their own homes.

Finally, attempts like Kalakkanavu examine the concept and practice of feminism in a public setting. Could feminism be more than an idea, or a feeling? Is it a political choice that influences the personal and the political in equal measure? Answers are not always possible; and when they do come, they are rarely simple or unmixed with new questions. But what this debate of a play manages to do is acknowledge certain strands of history that remain incomplete. Then it asks questions, the first step in any significant project to understand ourselves.

An explanation of some terms for my non-Tamil readers:

Deva-dasi - literally, "God's maid"
In reality, a temple prostitute. The temple would pay their meager living expenses out of its revenues, and in return, the devadasis provided entertainment to the masses on special occasions, via song and dance, but more importantly, provided sexual services to the priests (and other men rich enough to pay for such service via the temple). Generally looked down upon by most of society - because they were prostitutes, and regardless of their supposed "status" as "maid of the Gods". Girls from poor and/or lower caste families were often sold into such sexual slavery, perhaps because the parents believed that it was a good thing for the girl ("at least she will always have a roof over her head"), or because they lived in such desperate poverty that the money brought in by selling the girl into this kind of slavery could help them educate the more-important boy child(ren), or because they were flat out greedy for the money.

Of course, considering that girls are still looked upon as a "burden" to their parents until they are married (when they become the husband's and in-laws' "responsibility"), even in this day and age when a majority of urban women are working second jobs outside the home, in addition to their first job of general household slave... I mention urban women in particular, lower-middle to middle-class, because that is what I am familiar with, and have observed. The poor, I have only observed in terms of the servant who used to work for my grandmother, cleaning the house, washing dishes, etc. I would see her go from house to house, doing a LOT of drudge work, to be paid a miserable wage in return. By the time I grew up enough to become a self-aware feminist, I had moved to the US, so all I can do from here is support the few legitimate charities that focus on helping them. As far as I am aware, the majority of rural women already do an enormous amount of work every day, inside and outside the house (mainly, working all day beside their men in the fields, then coming home and doing all the household chores as well, rearing children while being severely nutritionally challenged, among ever so many more disadvantages). I know I wouldn't last so much as one DAY!

Heh, somehow my explanation drifted into a rant... Usually happens on the occasions that I try to contemplate the role and position of women, past or present, in the patriarchial societies that predominate around the world. Notwithstanding the current circus playing around the Republican VP nominee being a woman - all that she possesses in common with any woman with an ounce of common sense and self-preservation is two breasts and a vagina. In every other respect, she is so anti-woman, it has to be seen to be believed. It terrifies me that she and ol' zombie-McCain might yet win this election (and if they do, I might just take up dear b-i-l's offer of a job in his company and move to England - that's how bad it can and will become here in the US of A if the voices of reason are trampled in favor of religion- and fascism-based insanity for another 4 or 8 years). I would much rather the US also had a multi-party system - the field looks ever so much better when you have actual choices - versus the kind of "this one is not as bad as that one, so I'll hold my nose and vote for him/her" dichotomy and stranglehold that the Republicans and Democrats have. Then the politicians will be actually forced to work in a multi-partisan environment and learn to live with compromises, instead of ramming through one party's objectives while mouthing pious rot about "co-operation in a bi-partisan environment." Hmmm... maybe I should move to England. Although New Zealand or Iceland would be way more tempting :-)

Argh! Feminist rant turned into political rant! Sorry folks, looks like this is ranting season at chez Radi - I am going to fall into silence again until my rant-y mood lifts.

A last lecture

2008-07-27T00:46:00.005-07:00

Randy Pausch, 23 October 1960-25 July 2008

Singing

2008-07-26T21:57:00.000-07:00

July 26, 2008

Note to any readers I might still have: I started this post several months ago, so please don't hold the "today" against me :P
=======================================================================

Today I had my first singing lesson since I had the catheter implant surgery, waaaaay back in October last year. Turns out my vocal range is still mostly there - a full step down in the top range, as my teacher says, but my low range is intact. What's completely missing is any sign of stamina. And of course, the fluid didn't help.

Fluid? Yeah, fluid. Last night, I was so focussed on getting my dialysis started by 10pm, because my supplies for the next month would be coming in early this morning, that I totally forgot I would have to use slightly different programming, and a regular bag of dextrose solution for my last fill of the morning (and do a split midday exchange). Didn't realize my mistake until this morning. N very kindly offered to reschedule, but I refused. I had been waiting for this day for simply months! No way was I going to put it off, even if I did have my full complement of fluid for the day.

Speaking of fluid - I've in fact been consciously been speaking in shorter sentences, because I find that I lose my breath completely by the time I get to the end of long sentences. It is very disconcerting, because I've never had to think about breathing while speaking. I mean, we outgrow that by the time we learn to speak, ferchrissakes. I hate that - that and the completely unexpected hitch in my breath (almost sounds like a sob) as my diaphragm goes into spasms every now and then. VERY annoying.

But back to my lesson - I had a very enjoyable session with N. I have missed this so much all these long music-less months! I didn't notice the time pass at all, and WAY before I was ready, I had to leave. But I am set for the next 5 weeks at least, after which N and her husband are going on a cruise to the Galapagos Islands. Wish I could go to the Galapagos too! Anyway, I'll be there at her house like a burr, once she gets back.
================================================================================================

Moving on to the present...

I haven't voluntarily cancelled a lesson since I started up again. In fact, since I wasn't able to attend the spring recital, and the summer one was cancelled due to lack of interest (there were exactly two singers willing to go on, and not enough songs prepared for even a half hour recital between the two of us - yeah well, what did you expect?! Of course I was one of the two), I now have a new repertory of 7 songs that no one has heard, except for N, of course, and her two kids, who are usually home when I have my lessons.

N says I have enough to have a small concert al my own, which we have yet to schedule. My aim was for after Amma gets back from CT. Now I have several people planning to visit (or flying in to live here) who are all going to be there the second week of September, so it is tempting to do it then. But I will have to really get ALL the songs in perfect shape for that, and with just 5 weeks to go, that's a little daunting. Not to mention all the work work work that is hanging over any plans, like that alien ship over the city in Independence Day... :-(

So if and when that solo concert happens, I will be sure to update you, all my two blog readers. Until then, adios!

CCPD Part III - Setting up the machine

2008-02-10T17:45:00.000-08:00

Read the CCPD posts in order, so they make more sense :)
CCPD, at last!
CCPD Part II - Training

Setting up the CCPD machine at home took longer than I expected it to - after all, it was just a matter of plugging in the machine, right? Yeah, right!

I started moving the boxes I'd left on the stairs up to my bedroom - it was past midnight at this point, so I had to do everything without creating too much noise. And realized that the top solution bag would have to be heated, so first thing I did was sweep the top of the nightstand clear of all the clutter, put the machine on there and plugged it in. Set the bag on top and let the machine warm it up (it would take at least a half hour to fully warm up the solution to a comfortable temperature).

Then I still had to clear out the drawers of the nightstand, so I could use the top one for the 2nd 6-liter bag and put some tubing supplies in the bottom drawer (while still having to have space for the flashlight, lightstick, antacid, and other stuff that usually littered the top of the nightstand). I took all the stuff out of the drawers and moved them to the bottom drawer of the other nightstand, and put some more supplies into the top drawer there.

I moved the nightstand closer to the bed, so I would have room to stack boxes between it and the wall. Took the box of red-cap dextrose solution (2 bags remaining), added the remaining 2 green-cap solution bags, and used that as the base to hold the box of pink-cap Icodextrin solution bags. My plan was to put the Ico bag on top of its box - but the level was too low, it had to be more or less at the level of the top of the nightstand. So I took one of the many empty boxes, turned it upside down and stacked that on top of the pink-cap box. So far so good.

The big 6 liter bag fit comfortably inside the top drawer, but now I had no room for my little tray of end-caps and hand-sanitizer. There was just enough room on the nightstand for the machine and my alarm clock. If I set the tray up there, I would just knock it over in my sleep when the alarm went off the next morning. I brought one of my handy little stools and set it by the bed. Now I couldn't open the nightstand - but that wasn't as big an issue because I could simply move the light-weight stool when I needed to open the drawers.

By this time it was past 1am and I was still trying to do everything ultra-quietly. But the outer bags of the solution bags are SO VERY NOISY! I opened all three bags and got out the instruction sheet (3 pages!). Then I had to figure out which was the drain line extension, of all the bags that I'd brought back with me. Once I got the drain line, I set it up to drain into the toilet and brought the other end into the room. It was a 12-foot extension, which gave me PLENTY of slack in the line. Next I opened up the cassette & tubing bag, opened the front of the cycler and inserted the cassette. Figuring out the spaghetti of tubing was another matter, although there was also a "tubing organizer inclulded with the cassette package. Going from right to left, the 6 tubes are:

Drain tube
Top (first) bag - red clamp tube
2nd and 3rd bags - white clamp tubes
Final bag - blue clamp tube
Patient line - the one that eventually attaches to my catheter

The nurse had explained that I should go methodically from right to left while connecting the tubing, so I wouldn't make mistakes. So I started with the drain line, attached it to the extension and made sure that the drain clamp and extension clamp were open. Yes, open. Next, I had to use the thingamajig (the CXD device) to punch the red-clamp line through to the solution bag on top of the machine, that was by now a warm-and-toasty body temperature. The next line went to the bag in the top drawer, ignore the line after that, use the blue clamp line to the final solution bag (the pink-cap Icodextrin solution). Then it was time to hit GO and sit back while the cycler primed the tubing with fluid, to remove all air bubbles in the tubing.

Priming... said the machine. And kept saying it for a good 15 minutes. Then I heard a sputtering sound from the bathroom, strode in and almost had my feet slide right out from under me. I'd forgotten to take off the plug at the end of the drain extension tubing that went into the toilet. And apparently, the machine was pushing hard enough to spray fluid all around the toilet. The door was wet almost half way up. I pulled out the plug at the end of the tube, and the machine happily finished priming. Meanwhile, I was looking for some way to secure the drain tubing to the floor and door jamb, so I wouldn't trip on it if I needed to get up in the dark. And then the solution came to me - I would tape it down, securely. After all, I had lots of tape to play with :)

And after that, all I had to do was connect myself, so I did, and gratefully fell into bed. It was 3am. Only to have the machine beep a warning "Patient line blocked," about 30 minutes in. Argh! I had accidentally kinked my catheter, and blocked the flow. Unkinked it, and made sure it wouldn't kink again even when I turned around in my sleep. And went back to blissful sleep :)

Do you KNOW just how absolutely blissful it is not to have to interrupt my sleep to do an exchange? Absolutely, utterly blissful. That's how blissful. You notice I said "blissful?"

CCPD Part II - Training

2008-02-10T17:12:00.000-08:00

In the last post (CCPD, at last!), I left you all with the good news about my being able to sing again. I will elaborate on the process to accomplish that in another post. Let's go on with the story of the CCPD training, right now.

We started opening packages, the nurse and I - the fluid bags, and the CCPD "cassette" that has all the tubing required to accomplish the dialysis. There seemed to be miles of tubing, lots more than with manual exchanges. There was also this handy-dandy little mechanical thingamajig that we were to use to connect the tubes to the bags, and which was much safer than using our hands. I was flabbergasted when she told me we were going to use all three bags. She gave me a set of instructions on how to program the machine, which I dutifully followed, and then the machine was ready. She showed me how to work the lever on the front to insert the CCPD cassette, and then we started sorting out the various tubes attached to it. This was the drain line, that one with the red clamp was the line that went to the first bag, the next two went to any intermediate bags, and then the last tube with the blue clamp would go to the bag that would be used for the final fill.

Conveniently enough, there was a drain just at our feet, in that room that was used for CCPD training. In real life, at home, I would need to use a 12-foot drain tubing extension to drain directly into the toilet. Then we started using that little thingamajig to punch the tubes through to the bags, in order. Then it was time to "prime" the tubing - the machine would pump fluid through all tubes in use and make sure that it was all clear for fluid to flow in whichever direction it needed to. The priming takes about 5 minutes, so I started chattering (brainlessly, because I was nervous and excited). Once the machine beeped its OK, we checked to see that there was fluid to the top of the line that I would attach to my catheter - the patient line, as it is called. Then it was time to connect - and once that was done, all I had to do was hit GO. The machine drained the fluid out, pumped a new amount in, waited about 20 minutes, drained again and filled once again. Each drain-fill-dwell set is called a cycle, and for my training we would only be setting up the machine for 2 cycles, then final fill. This would take about 2 hours, during which I tried to nap, but only succeeded in dozing now and then because I would start awake each time the machine made any kind of noise.

I was wondering how the fluid in the other bags would be heated up to comfortable temperature, because only one bag was actually on the heating stand. Then as I watched the machine go through its priming phase, I got it - the first bag, being heated, would be used for the first drain/fill cycle, then while the dwell phase was going on (in this case for 20 minutes or so), the machine would mix around the fluid in the other bag(s) into the bag on top so by the time the next drain/fill cycle came around in 20 minutes, there would be fresh heated fluid in the bag on top! Neat idea, I must say. In real life, at home, my dwell time is about an hour and 45 minutes, plenty of time to heat all bags...

We finished up by 11:30am on Thursday, and I was home and online to work by 12:45pm. I didn't get to take the machine home that day because the one ordered for me hadn't arrived yet, because of weather delays in the mid-west. So I still had to come home and do my other 3 exchanges for the day. But that night was my last manual exchange - I haven't had to do a manual exchange since, and it is GRRRRRRR....EAT!

The next day, I left the house only at 7am, sure that Friday traffic wouldn't be bad at all, and I was right. I got there by 7:30am, but was left cooling my heels until 8am. This time, it was my own machine (it had arrived the previous evening), and the nurse merely watched while I went through the steps of programming the machine, and setting it up for that morning's 2 hour, 2-cycle session. She pointed out a thing or two that I missed along the way, and then started discussing emergency procedures - what to do if the power goes out, what to do if you need to disconnect right away, what if the machine shows an error, etc. And then she left me to the tender mercies of the machine, which clicked and whirred away cheerfully, draining and filling and mixing and dwelling. This time, the last bag was an Icodextrin bag, so I wouldn't have to do any more manual exchanges that day.

Once again, I was all packed up and ready to go by noon - training was over, and I could take my machine home with me. The machine itself, I put on the front passenger seat, and the whole trunk of my car was taken up with the supplies for the machine that would last me through Tuesday, which is when my month's supplies will arrive. The nurse had already called in all the changes to my prescription that would be necessary, so I wouldn't need to do anything more, just be home to receive the pallett-full of bags and tubes and cassettes and all.

I came home and promptly unloaded the car - supplies and all. 5 boxes of green-cap 6 liter bags (2 per box), 1 box of yellow-cap 6 liter bags, 1 box of pink-cap 2 liter bags (the Icodextrin, which is rated at 7.5% concentration), a few plastic bags of the tubing and other supplies necessary for the cycler. Took the machine out of the car first and lovingly laid it on the bed, while I figured out where to put it. There was really only one spot to put it in - on my left-hand nightstand. Which meant I would have to clear it out before setting everything up. I went back downstairs, and started unloading the boxes and figuring out which were the minimum supplies I would need upstairs for the night. Plopped the boxes on the stairs, ready to be taken upstairs, then sat back, absolutely pooped. Then my friend called and asked me to come over, because her 18-month-old twins were up. So of course I hurried over there, and spent a happy several hours. When I came back home, I was still pooped, and actually fell asleep on the sofa until 11pm.

After that, I still had to have dinner, so I did. Made a quick little chickpea chundal (I luuuurve those canned chickpeas, man!), had it with yogurt. High protein AND high fiber. Good, or what? :P

The next post (CCPD Part III - Setting up the machine)will have details of how I set up the machine at home.

CCPD, at last!

2008-02-09T20:45:00.000-08:00

This started out as one post, but it got so long that I decided to split it into two or more posts! So on with it...

Coincidentally enough, the first song I heard so very early on Thursday morning was Etta James' "At Last" - lovely lovely song, and what a voice! To make sure that I would be at the PD clinic by 8:00am sharp, I left home at the ungodly hour of 6:30am (well, aimed for 6:30 am, actually left at 6:45am, then realized I had to stop for gas. Argh!), and by the time I was really on my way, it was already 7am. I was dreading the traffic jams on the way in, which from experience I knew would be bumper-to-bumper most of the way. Didn't help that there was a traffic jam even before I reached the freeway, too early for some idiot to be out driving...

But let me start at the beginning. The week before, on Monday, I'd called the PD unit and complained that they hadn't yet called me in for CCPD training, and when were they going to? Well, Tuesday, the nurse called back and asked if I'd be available Thursday and Friday of the following week. IF I would be available? Hell, I rearranged my work life to BE available those two days! So I started counting down the days until I could have the cycler training. I didn't mind that I had to work really hard, harder than usual, in the days leading up to. I was going to have my cycler training! And I had absolutely no idea of what to expect. No idea how large the cycler was, although I knew it had to be small enough to be hand-luggage on a flight - but have you seen the size of some suitcases that people bring on flights as carryon bagagge?!!

I woke up at 5:30am that day, because I needed time to take a shower (I'd been working with my India team until almost midnight the previous night). I need roughly one hour to finish up my morning routine with shower, and I really wanted to be able to leave the house by 6:30am. I hurried through the shower, getting my dressing changed, picking out the outfit to wear that day, and was downstairs and almost ready to go by 6:!5am. I knew I needed a cup of coffee to stay awake through the drive... And by the time I finished the cuppa and responding to a couple emails, it was 6:35am. Got my socks on in record time, and was out the door. Got in the car, started it, then realized I'd forgotten my book. Run in again, get the book. Back in the car, I realized that I'd forgotten my dialysis log, so off I ran upstairs to get it. Finally, I managed to actually leave the house. Then one look at the gas gauge, and I groaned. I would have to stop to get gas, because I certainly didn't want to risk sitting in traffic all the way into Seattle with less than a quarter tank of gas.

What happened was - there was hardly any traffic on I5 heading into Seattle. I got there by 7:40am! Crazy weird, it was, because most other weekdays, traffic would be horrible. Mom, K and S would all readily testify to horrible traffic, I think. This time, in the clinic, I got the room with the bed, and there, finally, was the mysterious machine that I had been hoping would solve my singing issues. It was about 24x12x8in - about the size of 4 17" laptops stacked one on top of the other. There was a lever on the front of it, and a basic control panel, but nothing else. I couldn't see where any tubes would be connected. There was a BIG bag of solution on the machine, being warmed up - I saw that it was a 7 liter bag (picture bugging out eyes at this point). There was another big solution bag in the shelf below, as well as a regular-sized one.

Because I hadn't done my morning exchange yet (having left home at such an ungodly hour), I was getting anxious by the time the nurse came in at 8:00am. First thing I blurted out was, "I haven't done my morning exchange yet." And she said, "Good, because we are going to use the cycler to do a short cycle of 2 hours." She told me that she had a choice for me - I could entirely eliminate the daytime exchange if I used a relatively new sort of fluid, that used a different molecule (Icodextrin) instead of the regular dextrose. And the thing about this new fluid is that it NEEDS to be in the body for at least 8-14 hours to do its best work. Which nicely eliminated the daytime exchange, but it didn't solve the problem of the 2 litres of fluid that I would still have to have in me all day. I got a little upset at that point, because it meant that I still wouldn't be able to sing - I wouldn't need to do daytime manual exchanges, but I still wouldn't be able to sing.

And then my brain lit up with an idea - was there any way I could do a split exchange, that is, do a drain, go have my lesson, then come back and do the fill? The nurse said that of course I could, provided I didn't go more than 3-4 hours between drain and fill. That part was easy, because I could be at my lesson and back within an hour and a half. The not-so-easy part would be to remember to use not an Icodextrin bag the previous night, but just a simple dextrose solution bag (like my usual) for the final fill. *whack* That's the sound of palm meeting forehead - turns out I could have used this very split-exchange technique even while doing manual exchanges, so I need not have given up on singing at all! All these months lost... Oh well. But I was also literally dancing around the little room because I would be able to sing again!

And I will leave you with this happy thought, until the next installment of the CCPD training series (CCPD Part II - Training) :)

In other news...

2008-02-01T19:05:00.000-08:00

I am finally going to get trained on the cycler - on Thursday and Friday next week. I wonder what my prescription's gonna be... As always, please remind me to post pictures once I get the machine home. Hah, who am I kidding? I doubt I'm going to post any pics of anything - promised photos of my dialysis corner (now rapidly expanding to take over my entire bedroom) notwithstanding - because I am too frigging lazy to take my camera upstairs, take some pics and upload them, then add them as links or embedded images here.

Oh I hope I hope I hope I won't have to have anything but a "keep the catheter afloat" amount of fluid during the day, so I can finally get back to doing what I have missed all these long months - SING!!

And THIS is why I didn't want to consider paying for a kidney in India...

2008-02-01T18:26:00.000-08:00

I find the sale of human organs abhorrent - there's no way in hell I'll ever take part in it, or do anything that might possibly encourage it. There's no guarantee that the donation is voluntary, that the donor remains healthy after the kidney is removed, that there's any kind of medical followup for the donor, etc. No doubt because there's a market for these illegally acquired organs, there's a full supply chain, at the top of which are the usual suspects, and that chews up and spits out its victims, most of whom are barely literate, and who most likely don't have a clue about possible health repercussions, and are unlikely to look farther than the next meal, because of the daily scramble to make a living.

From the article:

NEW DELHI - Police said they were raiding hospitals and guest houses Monday as part of their investigation into an illegal transplant racket that removed kidneys from up to 500 poor laborers and sold their organs to wealthy clients.

Police suspect that dozens of doctors were involved in the kidney racket, which had a waiting list of some 40 people hailing from at least five countries.
...
...
...
... the Hindustan Times newspaper reported that those who were paid for their organs earned 50,000-100,000 rupees (between $1,250 and $2,500).

The kidney ring had a waiting list of dozens of people from India, the United States and Greece, according to the Hindustan Times. Several patients waiting for a transplant were at the facilities when police raided them Friday, but they were allowed to return to their countries without being held for questioning.

And why were the waiting recipients allowed to leave? They should bloody well be held accountable for their part in this. But oh wait - they are the ones with the money, so they get to go scot free. This makes me SO VERY ANGRY!!!

The doctors who would take part in such a thing - they are beneath contempt. I hope they are caught and punished, with a huge dollop of humiliation on top. Greedy buggers all up and down the chain... What the article I have linked to did not mention (but I heard in a radio news report of this) was that the people at the top of the chain got to sell each kidney (or other organ) at up to a 5000% markup over what the actual donor was paid.

I'd much rather remain on dialysis than take even an unwitting part in anything like this. If I can't find a donor among my family and/or friends, then so be it. I will wait. I will wait until some unfortunate accidentally dies, and their family donates the organs. And when I die, I want each and every part of my body that can possibly be used to help somebody else, to be so used, including skin.* The rest can go to a body farm or other biological research facility. I have a will and have stated as such in it.

*HAH - you didn't think of skin as an organ, did you? But it is - the body's largest! And cadaver skin can be used to save burn victims, for skin grafts, especially if the victim is burned over a large part of their body and needs large skin grafts.

An amusing anecdote

2008-01-10T22:56:00.000-08:00

So my brother had flown down from Connecticut to be with me on Dec 26th (the day I had my PD equivalency test). It was a Wednesday, garbage collection was very early the next day, so I put the very full and smelly garbage can out on the sidewalk. What I didn't realize that day was that garbage collection would be one day later that week because of the Christmas holiday.

As K was getting ready to leave the next evening, I asked him to go bring in the garbage can, which he did. Faithfully. All the way almost to the door between the house and the garage. It is one of his enduring, sometimes endearing, habits - he gets so absent minded, it is mostly amusing (after I'm done ranting, usually). He was in his usual I-may-be-here-physically-but-mentally-I'm-playing-my-perfect-game-of-tennis mode, so he forgot to even register that the garbage can was still heavy (in other words, not empty). So naturally he forgot to tell me that he brought in a bin that was still full of garbage into the garage. All the way up to the door into the house. I'm lucky he brought in my bin, and not one of my neighbors'. :P

Next day, I came into the garage to get some solution bags, and got a BIG whiff of "eau de garbage". I thought, "Huh. Note to self: Rinse out the garbage bin." It wasn't until I had to move the bin to get to the solution bags that I realized it was still full. Very carefully rolled the bin into the farthest corner of the garage, as far away from the house as possible. But I still had to live with a smelly garbage bin - by the time garbage collection time came around the next week, my bin was full to overflowing... and a very potent smell of garbage was beginning to permeate the house.

I gladly rolled the VERY full bin out to the sidewalk that week, I'll tell you that! Next morning, garbage had not been collected. I just thought they were late that day (it being Jan 2nd, after all). Came back from work that evening to see that the bin was still full, so I left it out one more night. The garbage-men came by on the Friday, instead of Thursday. Again.

In a huff, I went to look up the phone number for the waste-management company, to complain, and to ask if garbage collection was now changed to Friday mornings. And on the calendar they had sent me the previous year, I saw a * for the weeks of Christmas and New Years. *Garbage collection will be one day later when there's a holiday in the week*

Hmph! Deflated again. Palm, meet forehead *THUNK*

A link that everyone on or starting PD needs to have available

2008-01-01T17:20:00.001-08:00

OK, so it is almost 3 years out of date, and it is only a page, not a blog, but it does have some useful information...

http://www.bryanjrollins.com/MPGN1/peritonealDialysis.html

Radi's first adventure

2008-01-01T16:06:00.001-08:00

Adventure, you ask? Yes, indeedy-doody, I reply.

As has become customary, I went to BFF CMR's house for New Year's Eve (I started the custom last year *heheh*). And we had good food, good wine and we played a fun board game, the name of which I don't remember now. But the real adventure lay in what came next: I was going to stay overnight!

What's the big adventure in staying overnight at a friend's, you might ask? Go ahead, I KNOW you're going to ask anyway. The big deal is that this is the first time I have stayed away from home sweet home for any duration longer than 8 hours, the max I can go between exchanges...

I went well prepared - well, except I didn't remember if I had taken the little baggie of extra supplies like masks, clamps and catheter caps. But I didn't have the time to turn back because I was already running late to meet J at the theater for a good bloodbath ("Sweeney Todd", in case you're interested). As it was, I made it with barely 5 minutes to spare to showtime! Was a good movie too, I must add. I had fun trying to keep up with the body count - and this bloodbath was more fun than the last bloodbath I went to see ("No country for old men"), because at least this had people bursting into good song. Some of the lyrics were so wickedly funny!

After the movie, J suggested we take a look at the view from the 28th floor of the same building (which is actually a Microsoft office location). So off we headed upstairs - the cafeteria has some really beautiful views through its picture windows AND from the balcony that runs along one side of it. For being the last day of December, it was a really mild day - we'd had bright sunshine all day, and by the time we got up to there, it was verging towards a beautiful pink sunset. And there I was on the 28th floor balcony, without needing a jacket! Of course, as soon as the sun went down, so did the temps - down to a few degrees below freezing, I think. Dunno, was in CMR's place, which like most houses other than mine, is a few degrees too warm for me.

So I didn't really know if I was going to be able to stay overnight at their house (I might have previously mentioned - J is CMR's husband :)), and I wouldn't until I checked the status of my daily solution-bag-heater bag. If I didn't have my extra supplies baggie, and if the little baggie of supplies in there was ehough to last the night and the morning, I would stay. Otherwise I would have to go back home in time for the next exchange after the last possible one with my travelling supplies. And miss the wine, conversation and just plain fun of the games (which I usually end up losing, by the way).

I took enough supplies with me to last until the midday exchange of New Year's Day. And when I got to CMR's, I found that I had been an incredibly (if unconsciously) good packer-of-supplies, because lo and behold! That little extra supplies baggie was there, tucked into the front zip. I have ABSOLUTELY no recollection of doing that before leaving home - my last memory of that baggie is that I set it out on the bed, all ready to be packed. Sometimes I feel that urge to pat my own back so much I almost pop my arm out of its socket :P

After the movie, J and I went our separate ways - me to go straight to CMR's house, him to get a cuppa joe before heading home. By the time I got to there, I was miserable - I'd finally had my flu shot for the year that morning, when I went to the doc's to get my weekly EPO shot. That, combined with the fact that I had drunk a full half-liter of water while eating most of a "medium" bag of popcorn (medium - HAH! it was ENORMOUS!), that I was mildly feverish, very sleepy and EXTREMELY bloated. I actually had to fight to keep from zoning out while driving there... a very odd feeling, that. Was never so happy to park in their driveway. Then I stood outside in the rapidly freezing weather, still sans jacket, banging on the door, loaded down with my full solution-bag-heater bag, ringing the doorbell, banging on the window. All to no avail. I could see CMR sitting on the couch with her daughter, but nothing I did could get her attention. I finally dug out my cell phone and called her - which thankfully she heard. Turns out her mother had been vacuuming, so she couldn't hear the doorbell, not over the noise of the TV and music as well.

I finally got into the house and THEN got my jacket on, because I still had one more trip out to the car to get the rest of my overnight supplies - the VERY HEAVY backpack with three solution bags in it and my overnight stuff. I lugged it into her spare bedroom, and announced that I would be staying overnight. Then I almost passed out, I was feeling that bad, so I flopped into bed for a nap. Somehow, every time I go to CMR's house, I seem to spend at least 50%-60% of my time there flat on my back, snoring my head off... I really need to break that habit. I mean, I got there at 4:45pm, was in bed for my nap at 5, woke up at 7pm, did my evening exchange, then managed to stay awake another 7 hours before succumbing to sweet slumber again (after the nighttime exchange, of course). Then I stayed in bed for the next 10 hours, only getting up for the morning exchange, before finally wandering out for my New Year's Day spinach omelette and a glorious cup of coffee :P

I hung around for a few more hours, until it was almost time for the next exchange - technically, I could have done that at their house as well, because I had all my supplies, but I really had to give myself the incentive to get home, because I had so much to do at home that I'd been neglecting during the holidays. Top of that list was cooking for the week, one of my most hated chores. So what did I do as soon as I got home? Called big sis on the way home, yakked with her for a while, meanwhile doing my exchange, made myself a VERY late lunch around 4:30pm.

Then I headed over to the Gold's Gym around the corner, feeling ever so virtuous because I was about to start a membership at the gym and an exercise program, on the first day of the new year. And what happened to that? The gym was closed, because it was New Year's Day. So much for THAT! So I headed over to a friend's house, and played with her two kids (aged 18 months and 5 months respectively). Then I came home, saw that the original movie version of "Sweeney Todd" was on cable, watched that as I did my evening exchange, then vegged out with one more movie before I ended the night. So much for cooking... HAH! Made myself a few dosas for dinner and went to bed, including the night-time exchange routine, of course.

Effects of dialysis on my body

2007-12-27T12:09:00.000-08:00

Good:
=====

1. My hair is growing like crazy, has stopped falling so much, and is back to what used to be my normal "untamed forest" (no doubt due to the far better diet I'm eating now, rich in protein)

2. I have far more energy during the day (in other words, I don't nod off every time I sit down for more than 5 minutes, like your typical nonagenarian)

3. My ankles don't disappear at the end of the day (all right, I might have a little golf ball there some days, but not always)

Bad:
====

1. I feel like a bloated snake all day.

2. I have yet to feel hungry, since the day I started dialysis - I have to force and/or remind myself to eat (and make sure I eat nutritious food).

3. I frequently feel out-of-breath because the fluid pushes on my diaphragm, not allowing me to take a deep breath.

Things that haven't changed:
======================

1. My feet hurt just as much as before - for a while, after I started dialysis, it felt like the nerve pain was getting better, but no, that was just an illusion.

2. I am still just as lazy and averse to exercise

3. I am still not losing as much weight as my doctor would like to see - still struggling to get down to my dry weight (and no, I'm NOT publishing that number for all the world to know!)

I'll add more bullet points in each section, as they occur to me :)

Well, the big day has come and gone

2007-12-27T11:14:00.000-08:00

No, not Christmas, silly! December 26th. NO, not Boxing Day either. Nor the anniversary of that horrible day two years ago when the earthquake struck Indonesia, and the tsunami struck the rest of Asia. This was the day I would have my big PD tests to figure out how well the dialysis was working for me. And exactly like the aforementioned Christmas build-up, the let-down is just as bad. So what did happen, you ask?

They had me collect my bags from each exchange of the previous day, and do a 24-hour urine collection as well (and pitifully little it was too, another reminder of what my kidneys ain't doing any more). Also to make sure that the last exchange of the night should be a green bag. Dear brother, who came here specifically to accompany me to the PD clinic on this big day, toted the heavy box of used dialysate bags into the clinic. Elevators weren't working, so we took the stairs.

The nurse had me start my first exchange of the morning - but only the draining portion. They wanted me to drain as much of the fluid as possible - so this time it took me almost 30 minutes just to do that thorough drain, leaning from side to side, standing up, etc. About all I didn't do was do a hand-stand. Once the drain was done, a nurse disconnected it from my catheter and took it away for testing. Then we waited a little bit, another nurse came in with a green bag, attached it to my catheter and had me do the fill. She timed both the drain and fill - and during the fill, she had me turn on each side a few times, so the fluid would reach every nook and cranny of my peritoneal membrane. Then she immediately drained a bit of it, and took a sample, then returned the rest back to me via the catheter. At 20 minutes, she drained some more, took another sample, etc. Then at 2 hours, and at 4 hours, she took a blood sample as well, then had me do my next exchange.

This time with a red bag, because my doctor had said so the previous week, and I'd not done because I didn't want to chance having my BP drop really low (which there was a good chance it would, because the red bag pulls out the most fluid from the body) while I was alone. I wanted to do it either at the clinic or at home with K around. So red bag it was. The nurse sat by me, again recording exactly how long it took to drain the remnants of that morning's exchange, and how long it took me to fill.

Then they said - thank you very much. You can go home now. We'll send you the results next week.

HUH?! I don't get to train on the cycler this minute? I have to do the manual exchanges for the next god knows however many months? I have to go around being a bloated snake for longer? I don't get to even attempt to sing for however many more months?

I asked the nurses when was the earliest I could start training on the cycler - the answer was: earliest by early February, latest could also be end of March. ARGH! Until then, I have to do my 4 exchanges a day, no matter how my test results come out. And until next week, I won't even know if and how much I will have to carry around during the day once I do start on the cycler. I want to know RIGHT NOW! And I want to start RIGHT NOW! And that has about fuck-all impact on when I get to start the cycler training, because the nurses at the clinic are swamped - they're going to train 11 new PD patients next month, which is why the cycler training has been pushed back. Us patients already on manual PD can live another month or two doing more of the same, but the same can't be said of those new PD patients, now can it?

Tips and tricks

2007-12-20T12:14:00.000-08:00

Here are a few tips and tricks I use to help me remember to:
a. Do my exchanges in time
b. Log my bags used, weight, temperature and blood pressure

#1: I've set up reminders on electronic calendars for the midday and evening exchanges
- on my office account
- on my phone

#2: I've set up reminders on electronic calendars for lunch time (30 minutes before exchange time)
- on my office account
- on my phone

#3: After my last exchange of the night, I set out a paper towel AND the thermometer on the tray
- this helps remind me to log my temperature, blood pressure and weight every morning, because I leave the thermometer on the tray while I'm doing my morning exchange...

#4: I always keep backup supplies of catheter caps, paper towels, hand sanitizer, etc within easy reach of my chair, and replenish my supplies tray as soon as it begins to get low on anything.

#5: I know how long I've been washing my hands (well, gloves, at home :P) by the consistency of the soap foam - as it gets thicker and thicker, and the bubbles get smaller, the foam starts to almost get ropy. That's when I know it's time to rinse the soap off - and most times, just as I finish drying my hands (gloves) I hear the microwave ding so I know the bag is heated and ready to go.

#6: I always have a book with me (or a book AND my laptop) so I don't get bored as I wait to either drain or fill. Or for that matter, so I don't get maudlin - too much time to think and brood otherwise, and then all I want to do is rant.

I also always have a supply of the following in the house to keep the horrible potassium/calcium imbalance cramps from killing me (or even worse, disturbing my sleep :P):

1. Orange juice
2. Bananas or oranges
3. Raisins and other dried fruits

As it so happened, I needed the orange juice last night - I woke up in the middle of the night with that "going to have cramps" feeling, so I quickly chugged down some OJ and ate several handfuls of raisins. Which successfully warded off the cramps so I slept so well I completely overslept and didn't wake up until 9:30am. So I decided to work from home - voila!

The X-prize of organ replacement

2007-12-20T12:07:00.001-08:00

How about this - here's a company that's developing an artificial wearable kidney. That's good, in fact that's great! It is a big step forwad, especially if more studies prove its efficacy and the problems aree fixed (there's only been one so far, funded by the company itself - some positive results, but also problems with the device, AFAIK).

Now how about developing an artificial implantable kidney? Especially one that doesn't need replacement more than once a decade or so, or even better, at all. I would be all over that project, really :) That's the real X-prize of organ replacement, IMO.

More observations about life on dialysis

2007-12-06T17:25:00.001-08:00

So that rant in my last post, where so many of you tried to cheer me up? I've discovered the cause - I was hungry as hell that night. I didn't feel that hunger as one normally feels it (a pain in the general stomach region), because I don't, not since I've started PD. I only remember to eat before every exchange because I remember the faintness and dizziness that came over me once when I hadn't been eating right.

That was the day I filled the whole 2.5 litres, because I wasn't paying attention. So the usual feeble signals that I get from my stomach were also completely absent (that little gnawing sensation was simply not there that day). I completely forgot to have dinner. And so I had myself a huge bout of self-pity, compounded by the fact that it'd only been a few days since Amma left, so I was missing her like crazy, I hadn't yet settled into an Amma-less routine. That's where the rant came from. I've not stopped missing Amma, but I'm sloooowly settling into that Amma-less routine I mentioned.

Yesterday, I was feeling really whiny and close to tears, for no apparent reason - snapping at poor CMR even though she is likely under even more pressure than me at work, being on two projects at once. I was a BEAR all through our team conference call last night. And then it hit me - I hadn't had my dinner. Then I also realized that that vague nausea I'd had all evening was my poor stomach signaling that it had much too much acid and not enough food in it. Palm, meet forehead! I almost knocked myself out with that thwack :P

Some of the dumb things I do, I tell ya!

Now when I feel all whiny and run-down, I remember this lesson and go eat something nutritious. I have finally learned to pay attention to what my body tells me. Typical conversation:

Me: "What now?!"
Body: "Go take some Tums, dummy - I'm being eaten up with acid!"
Me: "Oh, yes, now that you mention it... I am feeling that little twinge of acidity."

And now I really have to go take some Tums.

============================================

PS: It is really amazing how much my body's internal voice sounds like big sister's :P

Filling and draining... filling and draining... on and on and on

2007-12-04T21:03:00.000-08:00

*sigh* Why is it that I already feel as if I have been doing this for ever? I can't wait for the PET (Peritoneal Equivalency Test?) that will let the PD clinic know if I qualify for the night-time cycler. And more important, IF I qualify for the cycler, how much fluid, if any, I will have to fill during the daytime... If I'm VERY VERY lucky, it will only be just enough to float the catheter (barely felt); if I'm not lucky, I might still end up doing daytime exchanges... I CAN'T WAIT FOR Dec 26th!

And do you know what all this washing of hands ALL THE BLOODY TIME has done to my poor hands? My skin is cracked and peeling, and no amount of cream or lotion stops the flaking and itching. Yes, you read that right - my farking HANDS are flaking and itching (looks like I have dandruff of the hands). My solution for that is to use disposable latex gloves - I remember the PD nurse telling me that even if I use gloves, I have to treat them like my hands; in other words, even if I do wear disposable latex gloves, I still have to wash them for 2-3 minutes with antibacterial soap, use the Purell where required, etc. Fine, so what if I feel silly washing gloves - at least this will allow my skin to heal and get back to being merely dry.

In fact, by day 2 of my PD training, my hands went from being soft and only requiring lotion once daily after my shower, to looking like the nurses' - dry and wrinkled and old and needing moisturizing cream after every single exchange. It doesn't matter if the nurses' hands look old - they are in their late 50s. My poor hands have got so dry that even not-very-fine cloth catches on them (like I have miniature velcro hooks in my palm *grr*). Now I have to remember to wear gloves while:

a. Rinsing out my catheter belt
b. Doing the dishes
c. Doing anything else (except showering) that involves water

The list of things I have to do is becoming endless - as it is, it takes me 2 hours from the time I get up to the time I come downstairs for breakfast, ready to go out for the day. Roughly one hour to finish my morning ablutions, showering and replacing the exit-site dressing, and then at least another half hour to 45 minutes doing my morning exchange. I really really really REALLY resent the 1 hour and 30 minutes of lost sleep. With the cycler, I will be able to do my usual (and required) 9-10 hours uninterrupted sleep time; having to get up before 8 in the morning, EVERY SINGLE DAY, is really getting me down.

Sorry to end this post on such a downer, but I am thisclose to losing it, today! I miss Amma! And I have to wait 6 long months before she can come back. :(

The 5 Commandments of Peritoneal Dialysis

2007-12-04T20:05:00.000-08:00

The Five Commandments of PD
====================

1. DO NOT drain your belly too well, for you shall suffer the agonizing cramps of gas that expands to fill the void.

2. DO NOT drain your belly too well, for you shall suffer the agonizing tickling and almost-pain of the catheter not floating any more.

3. DO NOT drain your belly too well, for you will have gas and fluid fighting for the limited space in your abdomen during the subsequent fill, something that can get really painful really fast.

4. DO pay attention to the fill volume, for if you fill more than required by your prescription, you will feel like a VERY bloated snake (where you would normally feel like a mildly bloated snake).

5. DO pay attention to fill volume, for if you fill more than required by your prescription, you will have no desire nor indeed room for food or drink, if you had any before.

Well, there are other things too - minor things lilke "follow infection control procedures", "always wash hands for 2-3 minutes with antibacterial soap before every exchange", "don't touch the exposed end of your catheter with anything except a Betadine swab or catheter cap with Betadine sponge", "don't get constipated", etc. Thing is, in PD training, they go over all that - din it into your head, in fact. The things I have posted above? Only experience will ever tell you that. Learn from my mistakes, do!

2 Week Checkup

2007-11-28T19:29:00.000-08:00

Went for my two-week checkup after starting dialysis. This time I dragged dear brother with me too, because I wanted him to meet the nurses, and ask questions and satisfy himself about leaving me alone. Poor guy had to work - he works on East Coast time when he's here, so he'd been up since 4:00am local time (he's one of those strange ones - a morning person). I was eating up the better chunk of his best productive hours, but because he can be overprotective at times, I wanted him to be really at ease about my starting dialysis, and living alone.

So he asked his questions, mainly to do with that one thing I hate above all - exercise. I'm not supposed to use the rowing machine now (not that I ever did use it on a regular basis... HAH!). So now he's going to ship the rowing machine off to his home, and get me an exercycle. Or even worse, a membership at the Gold's Gym across the street. HORRORS! :D

Amma and K dropped me off at work that day, then came back around 4pm to pick me up. I'm afraid I gave them (and CMR) a small shock because they showed up at the front door, but I wasn't there to meet them. They tried calling me, but my cell phone doesn't always pick up calls because of the abysmal reception in the guts of the building, where my little corner is. Tried again, still no me. After the third try, they called CMR, who in turn tried to call me as well. She also tried to find me online. Amma says she came in and asked the recep if she could in and check on me, but the recep could not allow that. What was I doing in the meantime, you ask?

I'd packed up my stuff - shutdown the computer, stuffed it in the bag, etc. I was chatting with another person in the same cube-farm. She was planning a trip to India, for a month, and I was busy telling her about Kaziranga National Forest, and the Gir Forest and all the stuff I could remember. I had my phone in hand all this time, mind you. I was wondering why Amma didn't call me again - they were pretty close to the office when I'd talked to her last. Finally, around 4:45pm, my phone buzzed with a text message, "Where are you?" It was from K, finally! I sent a text message back saying I'd be right there, then realized I had to head to the loo first. Did so, and my what a reception I got when I got into the car! First thing I did was call CMR to let her know I was OK, then calmed down Amma and K and told them what to do if they wanted to find me and I wasn't responding on email or phone (they're supposed to call Security and ask them to either take a look see or escort them to my desk, and back out if I'm not there).

So that's the little story for today...

Going real-life speed now

2007-11-28T19:22:00.000-08:00

Ladies and gentlemen, boys and girls!

That was the last of my stored-up posts. Posts are now going to be in real-time, and may not be as frequent or nearly as long, given my schedule and my known propensities for sheer laziness. Be warned! :-)

Dialysis at work

2007-11-25T13:23:00.001-08:00

Sunday evening found me busy setting things up so I could do my lunch-time exchange at work. I put together all the supplies I'd need for the day (two clamps, fresh catheter end-caps, paper towels, Purell) and stuffed the lot into a backpack. The heating pad I wrapped around the solution bag, and put that as well into the bag. Then, even though the collapsible IV pole came with its own bag, I stuck the whole thing in and totally unbalanced the backpack. But that's the way it had to be, because there are only so many things I can hang on one shoulder - the right one bears the brunt of any load. So what do I hang on there? Handbag, laptop bag, lunch bag and now the dialysis bag.

At work that day, I thought I would be distracted, but I actually got a lot of work done. I love working with CMR because of the energy she brings to any room, but she is able to work in short bursts, get interrupted and immediately get back to the thread of whatever she was working on before the interruption. I can't do that, not to save my life. I can only look on in awe of anyone who does that. I don't like being interrupted at work because it takes me a long time to fall back into that concentrated phase where I get the most work done. However, to get back to business - CMR wasn't there to sidetrack me that day, because she was on vacation for the week. I got my loooong list of things to do that day whittled down to a surprisingly short one, mainly because she wasn't there tacking stuff on to the end as I finished up things :P

Because of my exhaustion the week before, I'd actually messed up at work - I was supposed to put a particular report on our production system so the person who'd asked for it could run it first thing in the morning (and his mornings are pretty damn early, too!) Monday. I managed to finish it up on Sunday and proudly put it on our pre-production server. I'm so used to doing that, because I HATE to put anything on our production server that hasn't been vetted by the tester. Anyway, I totally, completely forgot that I had to put that report on production, not pre-prod. Monday morning, CMR called and asked me about that report. Which is when I realized my boo-boo... I managed to smooth it over with the guy by saying I wanted our tester in India to take a look, etc. He took my explanation at face value and said he'd check the report the next morning.

Anyway, apart from that, I had no problems on Monday. As soon as I got to work, I set up the heating pad and wrapped it around the solution bag. A very noisy process, because the outer bag that holds the actual solution bag is the thickest, crinkliest plastic they could find. Luckily, people are used to odd noises from CMR's and my little corner of the cube farm (CMR has a lap band, a form of bariatric surgery, so se burps frequently, and me, with my little teeny "ow"s or big startled "OW"s because of my feet), so no one peeked over to see what the noise was. An hour or so after I set up the heating pad, I checked how hot it was - it had certainly heated up the filing cabinet that I'd set it on, but the bag itself - hmmm... not so much. That was when I figured out that this particular heating pad didn't heat equally on both sides. Maybe that's what all heating pads do - I wooden know, as the joke goes. Anyway, I changed sides on the heating pad and checked again after another hour, and what do you know - the bag was finally heating up enough so I could use it!

When it was time, I just put the whole shebang back in the backpack, picked up my laptop in the other hand, and off I went to the restroom which has that mother's room. Nary a a second glance from anyone, which is one thing I like a whole lot - people who are not nosy. Anyway, all the furniture that's in that mother's room is: 2 very low sofas and one low-ish teeny tiny side table (about a foot long by six inches wide, and standing a bit higher than my knee). Oh, and a huge baby-changing station, of course :P Unpacked my stuff there, set up the IV pole, hung the bag. Then closed the door almost to, washed my hands for the prescribed few minutes, and carefully trying not to touch any other surface without a paper towel between it and my hands, I came back into the mother's room and sat down, connected all tubing, etc. Then when it was time to drain, I sat there and watched, but there was nothing coming down that tube. Those bloody sofas were too low for me to be able to drain!

So for 10 minutes, I stood, while the fluid drained from my body (meanwhile doing fun stuff on the laptop that kept my neck and upper back muscles entertained, trying to minimize pain in the afore-mentioned areas). Luckily, standing really drains me FAST. About 5 minutes into the process, I realized I had forgotten to lock the door. Somebody actually poked their head in to see why the door was closed - WTF?! Lady, read the sign on the door - MOTHER'S ROOM! If the door is closed, it stands to reason that someone in there requires P R I V A C Y! I didn't really yell at her - I didn't have to, my expression was enough to send her right back out. And then I inched over and tried to lock the door, but I was already tethered to the one heavy bag on the floor and another heavy bag on a not-too-stable IV pole. So I carefully moved the IV pole enough so I could just reach the door lock with my fingers. Needless to say, I haven't forgotten to lock the door after that.

So - once I got to the fill process, I could sit back down (this time the low sofa helped), and I could change the angle of my laptop screen back to normal. Once my fill was done, I cleaned up my papertowels, the old screw cap and the wrapper for the new one, the crinkly crackly outer bag, wadded it all up and walked out of the room, and casually dropped it into the trash. Went back into the room and packed up the rest of my stuff. There wasn't anybody in the restroom at the time, but while I was emptying the bag/s into the toilet, I did hear someone come in. I had to babysit the entire process of emptying the bags, because the stall doors aren't close enough to the commode for me to employ my usual method (at home, I have a hanger over a door, hang my bags there, wedge the tube under the toilet seat, making sure that it won't spray anywhere outside the bowl, remove the rubber seal, and walk away). ARGH. But at least it didn't take too long - this gravity business is a good deal, I say!

After the bags were empty, I resealed up the tube with the rubber stopper, folded up the bags as small as I could, wrapped the tubing tightly around them, and dropped it into the trash, washed my hands. Walked back into the room and retrieved my stuff and walked out. Time elapsed: 45 minutes, including set up and packing. I was actually surprised to see everything still the same around me, when I left the restroom :D

The next day, I decided to try the other "mother's room" in the building - all I knew was that there was one. So I asked the receptionist, who emailed right back "Yes, there is. Room #blah, right by the kitchenette." What do you know - that was too easy. Close to my desk and all. BUT the door was locked, with an electronic number lock. Back went the email to the recep: "Number lock on door - does that mean this facility is for employees only?" And just as promptly came the reply: "No, here's the combination." So I went there, tried out the numeric key, and looked the room over. Not very big, just an office converted to two teeny nursing cubes (with phone at each desk, and a lamp), with a refrigerator in the corner. No sink. But I stowed my gear in the room, washed my hands as well as I could in the kitchenette sink, and decided to rely on Purell's claim to kill 99.9% of germs on contact. Nothing I could do about the .01% *shrug*

Did my exchange, and then realized I would have to carry back the full drain bag to the bathroom, as a separate step. Another shrug. I'd chosen to go with this room for today, after all. Packed up my gear into the backpack, with the full drain bag (and only a small, abused rubber stopper to keep the liquid in the bag until I was ready to let it out). Took the bag to the bathroom, pissed at one remove, and threw the bags away.

All right - the decision was made. I'd keep using the mother's room in the bathroom. But one of these weekends, I will have to take a chair in there (and leave a note for housekeeping not to remove it) that's at a reasonable remove from the ground. And whose height is also adjustable - high for easy drain, then low for easy fill. If I can also ask them to bring a bigger table in there... but then they're likely to point me to the "other mother's room" and ask me to use that. Besides which, I can't ask for anything, officially, I am not a blue badge (for those of you not around Microsoft people, that's a permanent employee of the Big Satan). I am but a vendor (contractor), a lowly orange-badge. I have also seen purple badges around - gotta ask what kind of employees those are. Royalty, perhaps?

Setting up for dialysis supplies

2007-11-25T12:32:00.001-08:00

If you've paid attention to my previous posts, you'll remember that my garage was getting cluttered with stuff that we had to put together - shelves, and my laptop table. I like to keep at least the garage uncluttered, so it really grated on me, having that stuff around, not put away. Besides, we HAD to set up the shelves that weekend, because after that we wouldn't have any time before Tuesday, when I'd get 28 boxes of dialysis solution! So I dithered and dithered, and finally called CMR (my acknowledged putting-things-together expert) past 10:30pm on Friday - "Hey, I need help putting together shelves in the garage. Will you be able to come by Saturday (tomorrow)?"

What I'd forgotten was that CMR and her husband J had gone out for a formal dinner, related to J's membership in some organization or other (forget which, between them they belong to so many). So as soon as she got out, she checked her cell phone and found my message. Since I don't usually call her that late at night, she immediately called back, just this side of midnight. I assured her that I was still alive and well (and able to continue working *heheh*) - just that Amma and I needed some help. She said she would come - sometime over the weekend, probably Sunday - but she WOULD make it. So I relaxed - CMR the constructive whirlwind would take care of everything. I'm getting so spoiled! Time was I would set up the shelf without calling anyone for help, but since ever since I met CMR, I have been getting lazy and let her do stuff for me that I should be doing myself. Remind me to tell you the story of the portable AC units, sometime.

Next morning, I got a call from J - CMR had a major migraine (we'd initially bonded over migraines, I think) and wouldn't be able to do anything except lie in bed in a cool dark room - so he had been dispatched to help me with the shelves. He'd drop off their daughter E at ballet - or gymnastics, or something (like parents like daughter, E has been enrolled in so many things, I simply can't keep up) at her school in Woodinville, then come by and put the shelves up before heading back to pick her up. Even before his call, Amma had already been busy moving stuff around, clearing out the garage - this included my car as well. Since Amma won't even drive it enough to move it out of the garage, I had to do so, putting my baby out in the pouring rain. We cleared a 3x4ft corner of the garage closest to the house, and then Amma decided, as long as the garage was this empty and clear, she was going to sweep and mop the floor where the supplies SHELF was going to be.

And so we mopped the floor, with an antibacterial soap *sigh* that we'd found in my shelf of cleaning products, and watched it not dry because I believe the relative humidity that day was 100% - there was nowhere for the extra water to go! Remember I said it was POURING outside? So I got another mop, and pushed the soapy water around energetically enough that it finally started drying. I was about to head upstairs and get my hair dryer, but I guess it heard my threat :P

Just about the time that the floor was finally dry, J arrived, cup of coffee in hand, as always. Amma had set up the various components of the shelf so they were ready to be put together, so as soon as J walked in, we were ready to rock. He took a look at the instructions and deftly put together the first part - unfortunately, he'd got a few bits in upside down, so we took them all apart and J put them back together the right way, while Amma and I stood by, generally being ornamental.

In what seemed like no time at all, J had the shelves put together. Poor man didn't get in any farther than the garage that day, because as soon as the shelves were up, he noticed that it was time to go pick up his daughter. So off he went, back in the rain, not even able to refill his coffee... I tell ya, with friends like these, I could learn to be VERY VERY lazy indeed! I am already far enough down that road that my back trail is empty to the horizon. Can you believe I actually toyed with the idea of asking J to also put together the laptop table? Good thing he had to run that day :P

So now my 2-car garage is officially a VERY roomy one-car garage. Or rather, one-car-and-stuff garage.

PD Training - Day 4

2007-11-23T12:40:00.000-08:00

Last day of training. Waited to do my morning exchange until we were in the PD unit, noted weight, temperature and blood pressure as usual. The nurse announced that today I was going to learn how to give myself EPO shots. These are weekly shots that I have been taking at the doctor's office for the past 4 years or so. I kept trying to stab myself with the needle, and I could NOT do it. The needle would get to within about 1cm of my skin before it stopped cold, as though I had an invisible shield against my skin. It isn't that the shot is painful - I know from long experience that it is NOT.

I. just. CAN'T. stick. myself. with. a. needle.

Finally, the nurse got tired of watching me try and fail to inject myself, and at the next closest approach of the needle, she tapped me smartly on the hand. Needle went in, and I was able to push the plunger, no problem. I had managed to inject myself! But the nurse agreed that I would probably not be able to inject myself with the EPO at home, so she told me to take my supplies over to the doctor's office, and have them give me the shot, as usual. Reason I now need to take my EPO supplies to the doc's office is something to do with insurance and starting dialysis. At the first mention of "insurance", I gave in to that black magic and didn't ask further questions.

When we were ready to leave, the nurses loaded up my car with supplies that would last until Tuesday, when my first dialysis shipment would come in. That's when I realized that the new supplies that had been ordered were for the 2.5 litre bags - because they had been ordered before we found out that even though I was at the weight that they usually used 2.5, I could barely funtion with 2.0 litres in me. This means that once I start using those supplies, if I want to avoid feeling like a stuffed sausage, I am going to have to pay attention to the fill process, not just take off the clamp and happily continue reading until I realize the fill bag is empty (which is a major culprit in extending my exchange times). I am going to have to keep an eagle eye on the bag and not fill more than 2 litres...

I also borrowed a collapsible IV pole from the PD unit - the one I'd ordered wouldn't even be shipped until Monday. Even now, I'm sitting here patting myself on the back because I thought about this in advance, and actually remembered to ask the nurse if I could borrow one. Best thing I could have done. Stickman Industries, the main (and as far as I know, the only) maker of Peritoneal Dialysis peripherals, must be making money hand over fist - remember I said I'd ordered $500 worth of stuff? That was one collapsible IV pole ($125), one solution-bag-heater bag ($300), and 4 tuck-away belts for my catheter ($20 each).

And loaded down with all these things, Amma and I got home, I finished up work for the day at 7pm, completed my evening exchange, and then we went hunting for a foot stool/cushion for my rocking chair. Also a lightweight rolling laptop table, for those occasions when I know I'm going to have to work upstairs. So we started at the farthest store (BigLots, if you want to know), where I'd previously got the foot cushion that I use at work to keep my feet elevated.

The intention was to go on to whichever store sold computer furniture, and get that lightweight laptop table. We didn't find the foot cushion at BigLots, but we did find THE cutest little footstool, which we got for a mere $8 - it was listed for $16, but Amma pointed out that the cushion looked a little frayed. So the guy at the checkout stand promptly said - how about if I give you a further 50% discount on that? And so I just as promptly said "Yes!" :-) And the laptop table too was a bargain - it was a $35, where it would have been at $60 at most other stores.

And since we'd found both items we needed, we didn't need to go to any other store. YAY! Have I mentioned I HATE HATE HATE shopping? Oh also, remind me to post pics, one of these days, of my little dialysis corner that is sending questing tendrils into the rest of my bedroom. *sigh* Gone are the days when my bedroom was all mine and just for sleeping. *heavy sigh*

PD Training - Day 3

2007-11-23T12:36:00.000-08:00

At home training. Blissful, getting up at 8am instead of 5:30. I did my morning exchange, had a bit of breakfast, and headed right back up to bed. I slept like a log, trying to catch up on all my sleep debt I'd accumulated that week and the previous week, until it was time to do my next exchange, and have lunch. Felt lower than a snail's belly because I hadn't told CMR that I was actually going to be home all day. I needed the rest, but that didn't make me feel any less slimy.

So anyway, I started work at 3:00pm. Before I knew it, it was time for the evening exchange. Brought down the time for an exchange from 1 hour and 15 minutes to just about 50 minutes. Some progress. This day, I was supposed to use only yellow bags (thanks to the almost-fainting episode the previous day).

Today was also the day that I went online and ordered PD-specific stuff to the tune of almost $500. There was a collapsible IV pole (that I absolutely need at work),a solution-warmer-in-a-bag that I can take to work and leave it plugged in, and 4belts for me to use during the day to tuck my catheter into. I have two home-made belts, made of the softest muslin, and they do the job, but they can only be backup for these belts that are MADE for the express purpose of tucking the catheter into. Unfortunately, they didn't have overnight shipping, so I would have to use my homemade belts, and use a backpack with the heating pad, to carry my PD stuff to work.

Remember I said my friend V had picked up the shelving unit for me from Costco? When he got here, I was upstairs in the middle of my evening exchange. I heard the door bell ring, then suddenly Amma's voice was GONE! I didn't know WHAT to think. Then I heard what I thought was the hot water tap in the downstairs bathroom, and thanks to all the CSI and other crime dramas that I like to watch when I do watch TV, my imagination started running wild. I yelled my loudest, and finished up the exchange in record time, then ran downstairs to see what was going on.

V had arrived, Amma had opened the garage door (what I thought was the hot water tap) and they were both outside and couldn't hear me in the slightest anyway - debating how to get the shelf box out of V's car into the garage. It was too heavy for him to lift alone, so they opened the box, and unloaded it in pieces. It just occurs to me now (as I write this), that I could have just reached over and opened the curtains to take a peek outside. I would have seen V's car, and my BP would have been OK...

PD Training - Day 2

2007-11-23T12:26:00.000-08:00

This time, I got to the PD unit at 8am sharp. First thing I did was an exchange, all by myself (with Amma looking on worriedly, following along with the instructions, as always). Then the nurse came in, and we went through a few chapters of the training manual - this was mostly to deal with what to do if I so much as SUSPECTED an exit site, tunnel or peritoneal infection.

For the latter two, I'm supposed to take bags for 2-3 exchanges, the drain bag from the suspicious exchange and page 47 of my PD guide, and head straight to the closest Emergency Room. Page 47 gives the ER staff instructions on what to do until the PD unit or one of my doctors can be contacted. The drain bag is so they have something to culture so they can tailor the treatment to the particular infection agent. Until the agent is identified, I will be on broad-spectrum antibiotics.

Which reminds me, I need to make a copy of that sheet and keep it with me always...

For an exit site infection, I'm supposed to NOT clean the site, but just put the same dressing back on and head to the PD unit as soon as possible. This is so they have something to culture, to find the infection agent and tailor treatment to that.

After the rather intense drilling I got on this, Amma and I were ready to break for an early lunch. This time, I was smarter. I ate only two idlis, and didn't try to eat any more. In fact, it got to the point that I was actually afraid to eat, because I didn't like feeling so full all the bloody time.

Before I knew it, it was time to do the next exchange and then leave. In the middle of it, the nurse said, oh-so-casually, "By the way, you are going to be doing the next stage of your training yourself, at home tomorrow." I was simultaneously elated that I wouldn't have to get up in the middle of the night, practically (which 6am is, to me), and terrified that I would make some mistake in the procedure and end up with a peritoneal infection even before finishing up my training.

We left at 2pm as usual. As on Day 1, we got home about 3:00pm, then I started work. As soon as I was done with that, we went shopping - I wanted a microwave to install upstairs, to be used ONLY for heating the solution bags, and I wanted a footstool for the rocking chair. And I wanted a couple tables and other stuff as well. What I finally got that day was just the microwave oven. I'm still not allowed to lift anything heavy, so Amma managed to get the microwave out of the car, and take it upstairs, all by herself (she wouldn't even let me help). I got to hover around her and watch her possibly strain her back. VERY frustrating.

We went to Costco and identified exactly what shelving unit I wanted for the garage. However, we couldn't lift the box, so I asked my friend V for a favor, which being the generous man that he is, he did immediately. I called Costco and got him the item number of the shelf, a general description and even the aisle number in the Woodinville Costco, so on his way home Thursday, he stopped there, got the shelf, unloaded it in my garage.

We got my little Dialysis Corner set up a bit better now, with the microwave sitting on a nightstand from Amma's room (which was the closest to "sturdy stool" that we could find at the time). There was no notable drama with the next exchange I did - the only thing was I forgot the mask, again.

Story of the first home exchange

2007-11-23T12:13:00.000-08:00

I ran into the bathroom to start washing my hands (had to wash them for 2-3 minutes with antibacterial soap). Washed for about a minute before I realized - oops, forgot my face mask. Get the face mask on. Back to the bathroom and wash again... Oops, forgot to get catheter out of my clothing, so get it out, and wash again. Meanwhile, the bag was cooking in the microwave downstairs - technically I wasn't supposed to use a microwave oven that was also used for food, but it was all I had to warm the solution bag (the nurse had forgotten to give me the warming pad). Amma was in charge of that part. She brought the warmed bag upstairs and then started part 2 of the dance.

The instructions said have a paper towel in your lap to protect your clothes. Bloody paper towel wouldn't STAY in my lap - any time I moved my hands or my legs or any part of my body below the neck, the towel would slide off my lap. Keeping the rest of my body very very still, I pulled up my mask, connected my catheter to the tube from the solution bag, grabbed for the paper towel, then looked at the list of instructions to see what to do next. OK - clamped the fill bag, grabbed for the paper towel, broke green cone, grabbed for the paper towel, opened clamp and watched fluid flow down the pipes (oops - tubes) into the drain bag. You got that part about grabbing for the paper towel? OK, then just insert it at every step from now on.

Then re-clamped the fill bag, broke the blue cone, unclamped the catheter. Watched the fluid drain out from my body into the drain bag. Slowly felt the hunger again that had been suppressed. After drain was done, clamped the drain bag, unclamped the fill bag and watch the fluid go into my body. Slowly felt the hunger fade as my belly filled. After the fill bag was empty, clamped everything, disconnected catheter from tubing and put the screw-cap on the catheter. And voila! It was done.

Cleanup was easy - wrap the discarded screw-cap in the paper towel and throw it in the trash. Empty the drain bag into the toilet and throw that in the trash as well. And you know what? Now I can actually ask someone else to finish peeing for me *heheh*

A typical exchange is supposed to take about 30 minutes - this took more than an hour, mainly because of my keystone kops style of doing it. I have to say that I have brought the whole process down to about 40 minutes, start to finish, now that I have a little more experience with the process.

PD Training - Day 1

2007-11-23T12:01:00.000-08:00

My PD training began the next Tuesday - I was to show up at the PD unit at 8am sharp. Amma and I got there at 8:15am *Indian Standard Time, heheh* Anyway, the nurse doing my training was very nice about it and didn't mind that we were late.

We started off with the usual round of signing documents - luckily I'd signed most of them back when I had my first flush, so that made up for my tardiness that started the day. There were basically three strengths of dialysis fluid - 1.5%, 2.5% and 4.25% dextrose (or the yellow, green and red stoppers at the end of the tubes). Yellow pulled the least fluid from the body, and red the most - like the goldilocks story, there was one that was just right. We used the green bags that day.

The fluid has to be at close to body temperature when it goes in, otherwise the results are extremely uncomfortable cramps, and inefficient dialysing (too hot OR too cold). In the PD unit, they had these multiple-bag warmers, but out in the real world, I would need a microwave at home and use a warming pad to heat the dialysate at work. I would also need to fill out a daily log of the bags I used, my weight, temperature and blood pressure after the first exchange of the day, which had to be turned in at the end of the month.

Then it was time to do my first full exchange. The nurse showed me the exact process, then I had to do it again - 5 more times that day! After the first one, she always had me do them by myself, because after all, I had to get used to doing them by myself. At the end of exchange #1, I felt b-l-o-a-t-e-d. Only to be expected, after all, because I had 2 litres of fluid sloshing around in my belly.

Now I truly learned what it was like to be a (smallish) snake that had just swallowed a (largish) goat whole. But I didn't get the full effect of it because I was sitting. I was really really uncomfortable for the 30 minutes between the first and second exchange. At the second exchange, I got increasingly comfortable while the fluid drained, but by the time the fill bag was empty (i.e., the next lot of fluid was in me), I felt the same as before.

Then the nurse declared that it was time to break for lunch. Amma was pretty much famished by that time, but I hadn't felt the least twinge of hunger (and I told the nurse so). She said that was the fluid pushing on my stomach, which dulled the pangs thoroughly,so the next time and until my body adjusted to the extra fluid, I would have to fill only1.5 litres, because I needed to be able to eat. Glory be!

In the exhuberance of the thought of only 1.5 litres of fluid to be filled, I ate 4 whole idlis (a bit less than my usual of 4 regular + a few little ones). Big BIG mistake. Right there I came face to face with the undeniable fact - I simply couldn't eat as much as I had always eaten, at any one sitting! I would have to do 6 small meals a day instead of 2-3 big ones (as I had been wont to do).

Exchange #3: When I had finished draining, I was finally able to breathe freely again. Unfortunately, I had to do the fill part of the exchange, and even though it was "only"1.5 litres, because I'd had a full breakfast I was back to bloated snake again. The irony of it - now I could eat all my fave foods, but I didn't WANT to eat anything. GAH!

Exchanges #4 went pretty tamely... Except that at the end of #4, I was feeling VERY lightheaded and woozy. My blood pressure had dropped quite dramatically, because of all the extra fluid that had drained out with the dialysate. So it was feet up and head down - amazing what that doctor's office chair can do - it can recline just enough to put your feet up, or it can recline flat and beyond until you're practically upside down. Amazing. So the nurse matter-of-factly said that I should use the yellow bag at home that night, instead of the green.

"At home? Tonight? *gulp*." I was supposed to do one final exchange at bedtime, all by my lonesome. Without the nurse along to hold my hand.

I would have to change my feeding habits of the past 7 years too - for such a long time I'd been watching my protein and potassium (making sure not to have too much); now those instructions were overturned. Instead of a paltry 38gms of protein a day, I now had to eat up to 100gms, at least, each and every day. And the potassium restriction was also gone - I could eat potatoes again! YAY! And then the other shoe dropped - because the dialysate essentially worked by exchanging dextrose molecules for whatever was in my blood - I had to eat a low-carb diet. Potatoes = major carb, therefore that had to be fairly limited, still. :(

After I'd had a little nap, we were ready to leave. I stood up, and learnt a whole new meaning of discomfort - my whole abdominal area ached like I'd been doing continuous pull-ups and crunches for the past 5 hours. The nurse said it was probably because my abdominal muscles were also trying to compensate for the weight and volume of the fluid.

We left the PD unit at about 2:30pm, finally - got home at 3:00pm. On the dot at 2pm, CMR had called to find out what I was doing. So soon's we got going, I called her from the car, and let her know that I would be online at about 3:15pm. That was what she had been waiting for, because she had to leave early that day, and she wanted to debrief me on the happenings and emergencies of the day. Which she did, in detail. So soon's I got home I had to log in to work even though ALL I wanted to do was take a looong nap. Then it was 4 hours of intense work. By 7pm I was POOPED!

The PD unit had loaded us down with solution bags, face masks and clamps so I would have everything I needed for the home exchange. I already had the antibacterial soap and waterless hand cleanser at home. As soon as I was done with work, Amma and I had to set up my little Dialysis Corner, upstairs in my bedroom. We took the rocking chair upstairs and set it up as the core around which to add all the other stuff. Moved all the little lightweight stools upstairs, at least until we knew how many I would need. We found that I needed a total of 3, so the others have come back down.

Peritoneal Dialysis Training Unit

2007-11-22T22:20:00.000-08:00

As always with a new place, I had to get lost once or twice, and I went right past the entrance, but I still managed to get there by 7am sharp. I went in, and as soon as I gave the receptionist my name, out came all the nurses in the unit - "Oh, so YOU are the poor dear - we all felt so bad that we just couldn't help you at all when you called that first time". As luck would have it, the brusque nurse who caught my first call was the one doing the flush. She kept saying "you would have been fine with a flush next week!" So anyway, she added another length of tubing to my catheter, and gave me a big fat book (basically, the course-ware for the "dialysis training" session). We were done with the flush by 9am and out the door shortly after.

A flush is basically a mini-dialysis session, but the difference is that they only leave the fluid in for about 5 minutes (the procedure is to drain any fluid from the belly, let in about a quarter of the dialysis bag, let it out, rinse and repeat until the fill bag is empty, and the drain bag is full.) With each drain, I kept feeling tireder and sleepier, which I initially thought was because of my lack of sleep; but by the time she finally drained the fluid, I got extremely woozy (which got my mom extremely worried), to the point that I could not even stand without support - but that passed in a matter of minutes. The nurse didn't seem to be worried about that at all, so I decided not to be worried either.

I made an appointment for the next flush a week from then, and walked out a happy camper - at least I knew that the catheter was OK, and I had my bag of supplies in hand to change my dressing every day. Oh did I forget to say - the PD nurse removed the original dressing, applied another while showing me how to every step of the way, and handed me that box of supplies, along with instructions to call my nephrologist and get a prescription antibiotic cream. As soon as we got back to the car, my mom and I fell on our packed breakfasts (yummm... idli and molagapodi)and polished them off before we tried to leave.

I came home, sat back down to work for a few hours - at home, I work in the living room, sitting comfortably in my recliner, with light-weight stools around to hold the laptop, my phone, a bottle of water, maybe a little something for me to snack on,etc. I also have my handbag and laptop bag within easy reach, sitting down. So anyway, I looked up from work, set the laptop aside because Amma had been calling me quite a few times to come sit down for dinner. Soon's I stood up, I felt a cold chill in the general vicinity of the surgical incisions - sure enough, my dress felt a little damp in the general abdominal region. I put it down to sweating from the heat of the laptop.

Come the weekend, I was still feeling damp every time I sat down for a longish bit,so finally Sunday evening, I called the PD unit - the nurse on call was very nice and gentle. I told her about the leaking, and also mentioned that I wasn't in any pain or seeing any signs of infection. She told me to call the PD unit again the next morning (Monday, in case any one's lost track) and talk to the nurses again. I promptly offered to be AT the PD unit at 7am Monday, when they opened. She sounded a bit dubious about that, but agreed that it might be a good thing for me to do so. So when I got there that morning, I totally didn't expect the slightly amused look on every nurse's face. The first available nurse sat me down, took a look at my dressing and said, "oh yeah, that flush last week was definitely too soon - your catheter incision hasn't healed as much as it should. There's no way we are going to be able to start your training next week!" At which I totally panicked (yes,AGAIN), because I was going to be in NY! With my family! My sister and b-i-l are flying in! So they said, OK - we'll start the week after. That should give the incision time to heal better.

I was scheduled to see the surgeon for my follow-up that week, as well. When I mentioned the leaking to her (of course, it had stopped by Monday morning when I got to the PD unit), she was a bit concerned, and insisted that I come see her as soon as I got back from vacation. Then I was free to go - this had been a very short, flying visit - I was in and out in less than half an hour. Needless to say,my appointment at the PD unit to flush the catheter that week was cancelled. I was told to get an appointment at the PD unit for the week after my vacation. And I duly did.
Thursday of that week (I was scheduled to fly out to NY on Saturday), I got a call from the PD unit that my training had been scheduled for the week after - I was to show up at the unit from Tuesday to Friday, for 5-6 hours a day. Panic mode, again,"Omigod - 4-5 days, 5-6 hours a day?!! In succession?!! I can't possibly disappear from work for YET another week, right after my vacation - I need to keep my job!"

So the scheduling nurse said "OK, someone from the unit will contact you again later".Later was Friday afternoon - the first nurse (the not so bad one from earlier) called,sounding faintly irritated by my rescheduling request. We rescheduled for the week after, and everything was hunky dory. Well, I still had to tell my project manager, CMR, that I was going to have to disappear for that week of training.

Needless to say, CMR was NOT pleased. We worked out that the best way to work around this was for me to go to the training in the morning, but since I would be out of training by about 2pm, I should work from home, covering the project, from 3pm until at least 7pm. This was not going to be easy. In CMR's defense, I have to say that she had been very understanding about my doctor visits and strange schedules for a whole year before that. This was truly a case of immovable object meets irresistible force (project schedule vs. keep-me-alive schedule). Did I also mention that CMR is my BFF - best friend forever - to borrow a term from the revolting Paris Hilton? We just "clicked" from day one that she joined the project, so much so that another guy who joined the same as she did actually complained that I liked her better than him!I didn't know anyone bothered about that kind of stuff after middle-school. Needless to say, we ignored him :)

But this is the PD story.

One week later, after a good trip to NY, I showed up at the surgeon's office for my appointment. And waited. And waited. This WOULD be the day I forgot to bring a book to read. After about 45 minutes of this, I gave in and called my PM - told her I'd be even later than expected (and felt the ice crackling in my ear - I hadn't even been to work yet after vacation, even though I'd looked at email from home that morning).Finally, the surgeon whizzed in, took a look at the various incisions, whizzed right back out - all in less than 5 minutes, and told me that everything looked good, but she'd leave the stitches in for a just a bit longer (the nurses at the PD unit would take them out). So off I toddled to work - this time the doctor's office visit had taken almost 90 minutes.

Two days later, Wednesday at 8am, I was at the PD unit for another flush - this time there were no issues, and they finished off the flush in a very short time. Fortunately there were no issues with the catheter. I innocently mentioned to the nurses that the doctor said the PD nurse would remove the stitches. And before I could say anything more, they snipped off the stitch! I'd wanted to add - the surgeon said I'd better keep it in until I start the PD training. Oh well, what the hell. *shrug*

Dropped Amma off at home, and headed to work -I was at work by 10:30am, which isn't bad, considering the long distances involved.

Chronicals of the PD warrior

2007-11-22T22:09:00.000-08:00

So this is my third attempt at starting a blog (didn't have enough of a focused topic on the other two, which have been abandoned). This blog is going to be my personal experience of the whole dialysis thing, of which I have been much afraid for a very long time. Just that whole concept of being hooked up to a machine for my very survival. *brr. yuck*

So the whole saga started more than 7 years ago when I received the bombshell news that my kidneys were failing, and that I would be on dialysis within 5 years or so (as some you who know me may have noticed, that "or so" has been stretched to two whole years :)).

My choices were:

Peritoneal Dialysis (4 times a day) - best option
Home haemodialysis (8-10 hours every night) - next best option
Haemodialysis at the dialysis clinic (2-3 times a week)
Er... let's leave that be for the next 30-odd years at least, shall we?

I was assured that PD was the best, because we would be tricking the peritoneal membrane into acting like the kidneys. More or less. Less, really. But it provides just that bit of filtering of the blood required to keep:

Me alive
With major organs fairly undamaged

I finally had the surgery to install a peritoneal catheter about a month ago. And as drearily usual, I had more pain from the aftereffects of the anesthesia than I had from the actual incisions. Oh did I mention? This was laproscopic surgery, with a theoretical back-to-work time of 3 days. In less than 24 hours, I was off the pain meds for the incisions (but still on the pain meds for my feet - another long dreary story there).

*TMI Alert! People who are squeamish about bodily functions and fluids had better skip to two paragraphs down!*
36 hours post surgery - no bowel movement. 48 hours - still nothing. I was about to give in and call the doc, even though it was a weekend. Then, I felt that urge... but while the spirit was urging, the flesh was totally on strike, refusing to pass that huge rock of shite. After a bit of unadvised pushing, out came a big lump, along with a generous amount of blood from the straining. Did I mention said lump felt like a prickly pear, coming out? All the pain I was feeling from that point on was due to my poor abused shithole.

So, for 10 days after, going to the bathroom was a process fraught with pain (and the memory and anticipation thereof) - until my backside healed. I had my "bathroom book" at hand each time, and a worried mother who never failed to ask after my shithole. And I finally understood why people kept books in the bathroom - reading helps mitigate the pain of constipation. The day the bathroom book went away, we had a celebration! :D For those with chronic constipation - my heart goes out to you!
TMI Alert over!

Getting back to the topic at hand - the implanted catheter is just a simple soft plastic tube coming out of my belly. For one week after the surgery, the whole shebang remained untouched - my surgeon had made bloody sure that the whole catheter was properly strapped down - so much so, that when the time came to remove the original surgical dressing, the nurse almost had to resort to scissors (and this from a PD nurse who is all too aware that ALL sharp objects are a BIG no-no anywhere near the catheter). Which brings me to the Peritoneal Dialysis Unit. Of which there is only one in the entire Puget Sound region (or something like that) - it does mean that I have to drive into bloody downtown Seattle from my nice comfy digs WAY far away from the hustle and bustle of the city. That drive takes me an hour, door to door - when I can take advantage of the carpool lane into Seattle. I shudder to think of how long I'm going to be stuck in Seattle traffic once Amma leaves, and I can no longer use the carpool lane. :{

My nephrologist told me - oh, just call the PD unit a day or two after your surgery, they'll know what to do to take care of the catheter. This, after she had dinned into me that the catheter absolutely HAD to be flushed at least once a week, otherwise it would clog up, necessitating another surgery to clear it (and this may make PD out of the question because of scar tissue formation, etc). So I dutifully called the PD unit the day after the surgery. Only to be told "oh, we don't have your paperwork so we will likely only be able to get you in sometime the week after next" - and that was it. The nurse who talked to me that day sounded very brusque and totally unfeeling (I found out later that she isn't anywhere near as bad as she sounds). So I called my nephie's office IMMEDIATELY - she calmed me down, and said she'd send the paperwork immediately. This was on Friday.

Monday - I dutifully waited for the call from the PD unit. No call that day. So bright and early Tuesday, I call them again - have you got my paperwork? Can I come in this week? And they say, "No, you don't exist in our system, and can't until we get your paperwork from the doc's office, along with a blood workup. If you're going in to the doctor's office this week, have them draw that and send it off to the lab, then give us a call - we should be able to fit you in sometime next week." Again, I totally panicked, called my nephie's office - she said "Oh, I'm watching that paperwork go through the fax machine right now. Do you want to come in for your blood work at the same time as your EPO shot?" Man, you could have cooked an egg on my head,that's how FURIOUS I was; absolutely fuming! I almost screamed at her: "But YOU were the one who told me I HAD to get the catheter flushed at least once a week, and because of the lack of paperwork the nurse at the PD unit said she couldn't help me at all until probably the week after! What happens to the catheter?" I was thisclose to crying by then. "OK - does the medical assistant have time to draw my blood today? Tell me when, and I will be in."

So I went in that day, had my blood draw, and asked the doc why they hadn't sent the paperwork until the last minute. She wouldn't answer, just said "they have it now, so try giving them a call again in a couple days." I was still mad as hell, but I've made a habit of being nice to doctor's office folks, so I was still polite. Yoicks, but I think my mother learnt a few swear words that she was unfamiliar with, on the drive back home. So Thursday, bright and early, there's a call from the PD unit - "Can you come in at 7am tomorrow?" And my answer was - "Of course! Whatever time you tell me to be there, I'll be there!"

Anyone who knows me knows that I am NOT a morning person - I am an inveterate night owl who loves her sleep. So agreeing to be there at 7am was a sacrifice for me :P