Update on busy Wednesday 

My Wednesday started at 5am and concluded at about 5pm, which is a load for a cancer patient. 

I have bad news and good news (yes, I hate that phrase too). My oncologist did not have any news for me about the kidney biopsy from last week. He simply has not heard any news as yet, which was a real bummer. 

The good news, came as big surprise to Melinda and I, was Doctor Anderson canceled the Chemo treatment for the day and sent us home. That was a first for me, and since as last weeks bwas a scheduled Chemo as time off means that for the first time I could enjoy back to back weeks without Chemo. I’ll take it! Doctor Anderson said that my overall numbers continue to show inprovment, but that I looked tired. Amen to that. He also mentioned that based on my numbers it’s ok to take some time off because, “we’ve got Melanoma on the run”. That felt good to hear. 

He also scheduled a blood transfusion for today, which I have been wanting to some time because my hemoglobin level is very low and is leading to Amemia and dizziness when I stand which is a leading reason for a couple of recent falls I’ve had. The last transfusion I had was a couple of months ago and was a big help. 

A very busy day on my schedule 

Wednesday is almost certainly the most hectic day of the week on my schedule, with today as no exception. 

I’m already in the dialysis chair which should end around 10am or just a bit shorter. I will take a break for a lunch or breakfast meal and then it will be on to Dallas for Chemo. Melinda is taking the day off so that she can driive me. Most of my Chemo sessions take place at the Moncrief Cancer Institute in Fort Worth, which I really like because its an easy drive from my house and it is usually not crowded and I can get in and out pretty quickly. 

The reason I will be making the longer trip Dallas today is because I will not only Chemo but I have an important meeting with my oncologist, Dr. Larry Anderson, who is based at based there at UT Southwestern, wich owns the aforementioned center in Fort Worth. I except that Dr. Anderson will go over the results of the kidney biopsy I had last week. Of course I hope that he has good news and that I can transition away from Chemo and towards Stem Cell Transplant surgery, which I will explain as I get closer to it. 

What’s the deal the Dialysis?  

Dialysis is a medical procedure that is cloaked in more mysterie than Bigfoot and Amelia Earhart. It’s a process that has been around extended lives for many years, but yet not much is known about what really happens behind the doors of a dialysis ficilty.

I am not an expert but I will do my best explain what I see from my viewpoint.

My technician getting my machine for my dialysis session.

Every Monday, Wednesday, and Friday at 5:45am, I will sitting in my “chair” at my dialysis center in Arlington, just a few minutes from my house. It’s as true and easy too predict as the mail. The only day it’s the center closed is Christmas.  Rain, sleet or snow it does not matter because most all centers have backup power to make sure treatments get done. The treatments have to get done because life and death are depending on it. 

Simply put, when kidneys can not longer function the chances are high you will need Dialysis to do the job for you. My kidney failure is being cause my cancer, Multiple Myeloma. Without dialysis I would die. There is no other way around it.

When your kidneys fail, dialysis keeps your body in balance:

  • removing waste, salt and extra water to prevent them from building up in the body
  • keeping a safe level of certain chemicals in your blood, such as potassium, sodium and bicarbonate
  • helping to control blood pressure

There are many dialysis centers to chose from. Most major hospitals will also house a center treatment, if fact the unit at UT Southwestern in Dallas saved my life because I needed immediate treatment due to toxins in my body that I could not get rid on my own and it was dialysis to the rescue!

There are many dialysis centers to consider, and in my search location was very important because a dialysis treatment is described as going as an equivalent as a 10k race an so you don’t want a long drive after a secession. After trying a few locations I cloose a center operated by American Renal Associates and it’s been a wise choice. 

I have found the people who work the centers to be, as a whole, good people and professional at what that they do.  They really care about you a patient and a person. I have never run across an employee I felt shouldn’t we working there and that makes for a good atmosphere for everyone. 

The center I has a about 25 beds, give or take, and they are all pretty much in use at most times. There are about 7 or 8 technicians who are very quick to respond when you need them, of if one of the mechines sounds an altert that it needs attention for some reason. There are also 1 to 2 full full time Registered Nurse’s on duty at all times and they serves as “the boss”.  The center also a has still a social worker and dietitian on staff and I have found them very useful. 

A least once a week you can expect a visit from your doctor, who works for the center. A doctor who specializes in kidneys is called a Nephrologist wich comes term  comes from the Greek word “nephros”, which means kidney or renal and “ologist” refers to someone who studies.

So let’s try and explain, in simple terms for me and you too, the Dialysis flow. I arrive at roughly 5:45am and, and after having no my weight and temperature taken I head to my chair, which is assigned and always the same.  I’m greeted by a technician who takes and records my temperature and weighted. The weight is critical because it determines how fluid the machine will “take off” this session. 

I walk to my chair where I will be greeted by my technician to for this treatment, which will likely change from one session to another. Once settled in the chair the procedure of hooking me up to the machine will begin, starting by a blood pressure reading, both sitting and standing. The technician then begins hooking me up to the machine, based on which way access to my blood is used. It’s either going to be a chest catheter or what called a fistula, wich is what I have as the point of dialysis access. 

The fistula is an ugly looking divice which I had surgically installed back in March.  I hate the look of it but I love how easy it makes the Dialysis process run smoothly. Above is an image of a fistula like in this one my arm,  with the entry and exit needles inserted and ready to begin the Dialysis process. 

My arm ready to go for dialysis.

The only part of the entire dialysis process that involves pain is when those needles are inserted, and the technicians know that and are very careful to make it as painless as possible. I’ve never found to be worse than a routine needle insertion. 

The technician will next go through the process of  actually connecting you to the machine, which I don’t know much about about but apparently is nothing more than flipping a few switches. At that point the the clock is running.  

At that point is comes down to how well you can manage the clock, which is clearly visible from any sport in the room and serves at constant how much time you have remaining in your session. Most all people are hooked up to the machine for four hours and the is no way to cheat on the time. It is what it us and I’ve found the best thing to do I’d simply occupy your self and ignore the ticking clock. 

All the chairs come with a TV with enough channels to entertain you, though there not a lot of real popular choices at 6am, I still manage to find something to watch if I choose to. Sleeping? There are times that I sleep I do find it’s difficult to truly sleep with a room full of people.  The chairers also equipped heateted, a very important feature because dialysis treatment tends to make you cold, and seats recline three what to help with comfort. I read, I write, and I talk to the technicians to help pass time too. 

Me looking as relaxed as possible during a recent dialysis treatment.

Finally the machine alarms signaling your time is up! Your technician will begin removing from the machine which will take about ten minutes. They will remove the two needless from your arm and will and will badge it.  A final bood pressure reading is taken from a sitting and standing positions.  The technician will escort you the the weight where a final weight and temperature are taken. If all checks out, you are sent along your way, until the next time. 

Completed Kidney Biopsy 

I hope another step on the road Stem Cell Surgery was accomplished today with the completion of a kidney biopsy procedure.  

Waiting to go in to surgery

The hour long out patient survey took place at UT Southwestern Hospital in Dallas, as was needed to see if my Multiple Myeloma cancer has spread to my heart, a condition known as amyloidoses

The thinking is that it’s safer on Multiple Myeloma patients to do a kidney biopsy rather than a heart biopsy. 

The rusults, which should be available in four to five days, hopefully will show a decrease of amyloidoses, 

Rolling into Kidney Biopsy surgery

enough that I can transition past Chemo and look ahead to stem cell transplant surgery. 

Gift from Sara Yates

My friends are so kind, generous and thoughtful to me that I do get moved literally to tears. Ask Melinda. 

The mailman and parcel services are getting a good workout too. Today I opened a box and inside is a beautiful, thoughtful card and a cool looking Texas Rangers mug from good friend Sara Yates. I can really use the mug to help measure and control my daily fluid intake for Dialysis as purpose. Thanks Sara. 

And thank all of you for your gifts but I very much appreciate the prayers and words of encouragement. It fills my soul with much needed energy. 

Ugh…Another fall. 

This is getting bothersome! I fell down again this morning but I am still extremely lucky because there is no damage. No broken bones anything. 

As mentioned in an earlier post, multiple myeloma patients are at a very high risk for broken bones. 

The main reason for falls both today and last Friday is because I am getting very dizzy of late when I stand up too quick from sitting and start walking. 
My hemoglobin count is the culprit. As of my last blood work by my Oncologist, my hemoglobin count was at 7.8. That’s low. According to the Mayo Clinic, “low hemoglobin count is generally defined as less than 13.5 grams”.

The lower the count is lower the amount of red blood cells my body is getting for oxygen and I feel faint when I get up until my body stabilizes things. 

A blood transfusion is a quick way to boost the red blood count and I did have one a couple of months ago and felt great afterwards. My Oncologist has not ordered one this time. Yet. 

Today I was headed to the restroom and started feeling dizzy and faint about halfway there. I made it to the door handle and hit the floor, landing on all fours. I stayed that way for a minute until Melinda helped me up. I made a quick inventory of my body and declared myself fine.