Thursday, April 22, 2010

It’s a Boy!.... And Another Boy!... and a Large.. um.. Small Girl!

You will note that I have added a new subtitle to this blog; i.e. “And the Renal Road to Happiness”. Inasmuch as my ferritin level is now at 48.8 and inasmuch as I will go three months before I have it checked again, the blog contents will be even more bland and vacuous than they generally are. I won’t be tripping down to the Infusion Center (where they all hate me because I dragged a Surveyor from the parent company through one of my linguistic grist mills). I will not see “Doc Holliday” for another year (I am not the cash cow I used to be). The Lab Tick will not be drawing my blood as frequently as in the past (and we were getting on so well!). So what to do? Jabber and nonsense about kidney disease.

I decided to go with “Doc Wurlitzer”, a nephrologist who works down at the Central Utah Clinic, a place that looks something like a Swiss ski chalet. It is just west of the Infusion Services office. The Lady in Red and Chester were watching from the roof of their building as I pulled into the other parking lot. There was a lot of shouting and stamping of feet as I walked into the chalet; I believe that they miss me already.

The receptionist was pleasant and was anxious to hook me up to a siphon. “We need a quart or two to find out why you are here…. Oh! You have such lovely veins!”

“That’s what all the girls tell me. I know why I am here. I have too much creatinine, and other stuff that I can’t pronounce properly, floating around in my blood. Here is the paperwork from “Doc Holliday’s” office. The analysis is no more than a week old.”

She looked at me blankly for a moment and then said, “Oh, so it is. What a disappointment! You have such lovely veins…my, my, my…”

I asked her when I could see the doctor. She said, “Oh, not for about six weeks. He is a busy fellow with all of the degenerative kidney disease going about. But I wouldn’t worry about any of this for a while. According to this creatinine report, we could schedule you for April 17, 2040 and you would still get in under the wire.”

“So you will let me know what I am to do next.”

“Yes,” she said, with eyes fixed on the inside of my left elbow, “I will let you know what you are to do next…. You have such lovely…..” I slipped out of the side door and ran for my life.

About a week later, I received a phone call from the Imaging Department of the Clinic. “Hello, Dr. Beeblebrox? Dr. Wurlitzer’s office called us to have you come in for an ultrasound on your kidneys and your bladder. Could you drop by tomorrow sometime?”

I said that I could.

“In anticipation for the ultrasound, could you please drink 64 ounces of water a half an hour before you come in? It is easier to see your kidneys if you are bloated.”

I sloshed into the Imaging Center about 10:30 the next morning. Scylla and Charybdis were waiting for me. I have no idea why I came up with those two names (neither one of them looked like a whirlpool and they only had one head each). Scylla was an intern (or an extern; the medical students can’t seem to keep their “-terns” straight). Inasmuch as she was new to the game, she was the one who was tapped to slather the gel on my left side. “Oooooo! You have such lovely……”

“Now cut that out!” I shouted.

They fiddled around for about an hour; sounding me out here, then sounding me out there. Finally, Charybdis said, “Well, it’s official. You have twin boys. What are you going to call them?”

“Tom and Bob,” I replied.

“Oh! Thomas and Robert. How lovely!”

“No, Tom and Bob. Our relationship has been and will continue to be rather intimate and informal. How are they doing, by the way?”

“Well looky here! Do you see these blue dots? That is blood coming toward us. Do you see the red dots? That is blood going away from us. We use the latest in Doppler technology here.”

I was impressed. “What is that little white smudge right there?”

“Oh! That’s Andromeda.”

Then they pounced upon my bladder. Remember the 64 ounces of water they had me drink before the procedure? The whole gallon was inside. After a while Charybdis said, “Would you like to relieve yourself?”

Silly girl!

Then they commenced again to check out how my bladder was doing. “It’s smaller!” the two shouted. “Wow! Yippy! Wonder of Wonders! Miracle of Miracles!”

Finally, once the exuberance settled down, I said, “I have come up with a name for my bladder. I am going to call her ‘Ginger’.”

The most that Scylla and Charybdis could tell me was that my kidneys looked fine. When degeneration is in full bloom, Tom and Bob would have looked like shelled walnuts. The boys look like fluffy little tribbles. Ginger was big in the beginning and then became small after I returned from the bathroom. What could be better than that?

Sunday, April 11, 2010

Beam Me Up, Scotty!

In 1936, the Queen Mary was commissioned into service as an Atlantic Ocean passenger ship. In 1967 she was decommissioned and took up residence in Long Beach, California, where my sister Judie lives. As part of the renovation as a public attraction, the three smoke stacks were removed. They were, and are 36 feet long and 23 feet wide, 62 to 70 feet high, made of one inch thick steel. During her many years of service, the smokestacks were painted at least 30 times. When the stacks were removed and placed on the dock, they crumbled into paint chips, the one inch of steel having long since rusted away. Needless to say, those responsible for replacing the stacks were somewhat dismayed.

Let’s talk about dismay. When I started this blog two or so years ago, my ferritin level (somewhat analogous to the steel lining of the Queen Mary’s smoke stacks) was at 837. With pedestrian steadiness, “Doc Holliday” and myself have cautiously reduced that level. Four or five months ago, I stood at 127; a month or so later, it went back up to 137. I then took matters into my own hands again and had a phlebotomy every month for the first three months of this year. On Friday I went into to see the good doctor and found that my ferritin was now at 48.8! How about that! Everybody who is anybody ought to be happy with that. Friday was also my annual examination and when “Doc Holliday” took off my smoke stacks to see how things were going, he discovered something else amiss. Alas! Alack! Woe is me!

Two years ago, when I had my first serious examination in many years, I noted that the laboratory had exclaimed with some enthusiasm that my Calcium, Creatinine, and Blood Urea Nitrogen were somewhat elevated, indicative of degenerating kidney function. When Trillium and I asked “Doc Holliday” about it, he said, “Well, I not particularly concerned about that now. What I am concerned about is that you are becoming a fat little bunny. You need to walk about; you need to knock off the sweets; you need to eat a bushel of broccoli a day.”

“What about Guacamole Bacon Cheese Burgers, with Emperor-sized fries and drinks (a bushel of potatoes and a 30-gallon drum of root beer)?”

The response was about what you would expect.

One of “Doc Holliday’s” charms is that he generally telegraph’s his concerns and advice by how he dresses and how he combs his hair. If He wishes to chastise me a little, he always comes into my cubicle dressed in a dark suit, white shirt and tie, and a name tag that says “President Holliday”. If he thinks I am going to react negatively, he dresses like a home base umpire. Friday he was wearing a grass skirt, a shark tooth necklace, and had his hair woven into long shiny dreadlocks, waving a large rattle in each hand. Apparently in the confines of his bamboo hut, the good doctor had reviewed my blood work for the last three years and had observed that for each of the last three analyses, my creatinine levels had gone up steadily, one tenth of a point every year.

“At this rate, it won’t be long before you are on a dialysis machine! But I can’t figure it out. You have no indication of diabetes; all of the other blood indicators are just fine. For your creatinine to creep up like this is unnerving; and doubly so because there doesn’t seem to be an explanation for it”. He then shook his rattles a couple of times and turned back to the computer screen. “I think that I am going to send you to a nephrologist, a specialist who knows everything there is to know about the renal system. He will take a lot of blood samples and urine samples… so much so that you probably will not need a phlebotomy until next March”.

Oh! Joy!

I now have a list of local members of the nephrology clan here in Utah Valley and will have to make a decision soon about what I am going to do. I asked “Doc Holliday” when I would be ripe for my first dialysis. He said when my creatinine is at 5.0. I asked him what it was in 2008, 2009, and 2010. He said, “In 2008, it was 1.7; the following year it was at 1.8; and now it is at 1.9. This is a bad trend!” I was really dismayed, until I started doing the math. If my creatinine increases at the same rate, I will be ready for the first blood filter on my 98th birthday! In the meantime everyone is telling me that I have to stop eating chocolate, stop eating potato chips, no more French fries, no soda, no ibuprophin…. In other words, I may just have to ask Jack Kervorkian to drop by tomorrow for a little house call. The terminally ill get to have morphine; why can’t I have a potato deep fried in vegetable oil? It’s cheaper and I will feel better about it.

Monday I will do the doctor hunt. I have five on my list, three of them with names I can’t begin to pronounce. The other two have possibilities: Doctors Terry Wurlitzer and Lenny McCoy. Wurlitzer’s motto is, “There isn’t an organ I can’t fix”; McCoy has emblazoned next to his name, “Take two of these and see me in the next Millennium”.

I may just go to Dr. McCoy. I want to ask him about my liver; you know, because of all of the problems with iron-overloading. I can hear it all now, “Dagnabbit, Zaphod, I’m a physician, not a blacksmith!”