POS Labor Union

The definition of ‘insanity’ is doing the same thing over and over again and expecting different results.
NOT Albert Einstein

There is another election next month, and in California, we have another dialysis related proposition sponsored by SEIU-UHW. This is the third time the labor union has used the proposition process to try and force themselves into the dialysis industry. I was so upset about it last time that I posted on the topic twice. Here is the list of propositions so far:

Proposition 8 was focused on limiting profits for dialysis centers to 15%. The vote was 59.9% against the proposition. Two years later, SEIU tried again but changed the requirement to staffing each dialysis center with a physician. This also failed with a vote of 63.4% against. For 2022, SEIU is resubmitting the same proposition as 23, but will allow a physician assistant to fulfill the staffing requirement.

This is political blackmail. SEIU is claiming that dialysis clinics are not allowing them to organize. I realize my experience is anecdotal, but all the nurses and technicians were against the prior two propositions. My clinic was part of St. Joseph hospital, but many of the providers previously worked for one of the major for-profit dialysis companies.

I predict proposition 29 will fail by about the same 60/40 margin. SEIU knows this, but their goal is not to pass the propositions, but to use the proposition process to blackmail the dialysis companies into letting them organize. This is totally fucked up. As I posted before, adding a full-time physician to each dialysis clinic would hugely increase cost with minimal benefit. SEIU is morally bankrupt and should be fined for intimidation and abuse of the proposition process. It is also telling that there is no political support for proposition 29. The Democratic party usually carries the union’s water, but there is no endorsement this time, as there was for proposition 8 and 23.

Proposition 8 (2018) support (plus two huge list of organizations and unions):

Proposition 29 (2022) support:

We still have another month until the election. Perhaps the usual ~~suspects~~ union supporters will speak up before the vote. If nothing else, the union has cost the dialysis companies a lot of money.

Expenditures	For	Against
Proposition 29 (2022)*	$7.9M	$76.5M
Proposition 23 (2020)	$8.8M	$104.7M
Proposition 8 (2018)	$19.3M	$111.4M

*so far

Old Fistula

My fistula surgery was in early 2020 so I have had it for about two and a half years. There are a few photos in earlier posts when it was in use, but I have not used it since the transplant surgery twenty months ago. This is what it looks like now:

The bumps disappeared quickly, and all that is visible is some discoloration at the three needle insertion points. The fistula is still working fine as you can still hear and feel the high-pressure blood rushing through the vein.

There have been some changes recently, however. I often feel a slight burning sensation in my forearm near the fistula. At the same time, I also feel an increased numbness in my right hand. I often feel cold or numb in my right hand while using the fistula since it diverts a portion of the arterial blood flow into the surface vein, bypassing the hand. This is the first time it has been noticeable post-transplant.

*https://www.saintlukeskc.org/health-library/arteriovenous-av-fistula-dialysis*

Factorio

I have been binge playing Factorio for the past several weeks. I remember purchasing this on Steam a long time ago. Google says the game was published in February 2016; I likely got it when it first came out. Typically, Apple Macintosh computers are not known as gaming PCs. Since the new M1 Pro MacBook Pros are supposed to be pretty fast, I installed Steam and Factorio was the first Mac compatible game I tried. I cannot remember if I finished the game (launch a rocket), but I did get pretty far before. The game starts simple but gets complicated fast with all the research requirements.

This is my base with using five out of seven research chemicals:

The research tree is ridiculously complex, and each new research chemical is much harder than the previous one to produce. I stared with the red flask, then added green, black, and blue. In the beginning, you need to use conveyor belts to move raw material and WIP around. But soon, you can build floating robots that will move material for you, albeit slowly. The crucial technology to make this logistics network function requires five hundred yellow flasks. I could not construct a connected network, so my build was very disjointed, and needed me to run around as a courier. The enter research cycle for this technology took almost an entire day to complete, but now I can push/pull material from anywhere to anywhere. Unfortunately, I think i need to tear down most of the build and reconstruct it to take advantage of the floating logistics network.

I am not sure why I did not play this game all that much during dialysis. It is the perfect time suck but does require logic and concentration to build ever more complex systems. Looking back, I probably suffered from a bit of brain fog while on dialysis since it only cleans your blood enough to keep you alive. There are still lots of toxins in my blood and electrolyte imbalance is a thing. Anyway, I am taking a break to think about how to reorganize and reconstruct the base to move to the next level of complexity.

Not sure who reads this blog, but if you like building games and never heard of Factorio, get it. The game is $30 on Steam, and there are frequent sales.

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Closer view of current base. This is the first research chemical build. It is fairly orderly, with conveyor belts going to research labs. It gets a bit more complex as I tried to double up production and squeeze more and more into the same space. There are several clever (self-assessed) conveyor rerouting to have everything run automatically.

This is the right, or newer side, of the base. The black flask production was still pretty automated, but after getting the oil refineries and chemical plants, the build for yellow flasks was totally chaotic. Notice the abundance of boxes instead of conveyor belts supplying all the factories. Ugly.

However, this was just to get through the advanced logistics research, which awards you with more flexible boxes to move material through the air.

Blog Tagline Update

I just noticed that my blog tagline still read “Life with Dialysis (and CABG).” Initially, it was only about peritoneal dialysis since I needed somewhere to vent my struggles with the process. Along the way, I needed a quadruple heart-bypass surgery, then switched back to in-clinic hemodialysis. Having this semi-anonymous blog helped me cope with all the health issues I was dealing with.

Anyway, I did not want to delete the dialysis part since it was a huge part of my life for ~4 years. I found a website that would generate strike-through Unicode text and I replaced “with Dialysis” with “post-transplant” and left the CABG bit. I did the same for the subtitle(?) as well.

Life is definitely easier with a kidney transplant than having to rely on dialysis to stay alive, but there are still struggles. Additionally, problems like diabetes or peripheral neuropathy do not go away just because I now have a working kidney.

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I still have not decided what to do with this blog and my old blog on Blogger. There is ~15 years of posts on the other blog, but lots on this WordPress blog too. I think the easiest is to make posts linking both blogs and continuing here.

ESRD Post-Transplant?

I guess not.

I always wondered about this. It makes sense since a kidney transplant restores almost all the functions of the original kidneys. Likely why Medicare cancels ESRD coverage three years after transplant.

I saw this paper recently: Electronic health record analysis identifies kidney disease as the leading risk factor for hospitalization in confirmed COVID-19 patients

Even though kidney transplant recipients are no longer classified as ESRD patients, this study shows that they are still as susceptible to hospitalization as those with Stage 5 ESRD. Table 4 in the paper shows:

Additional analyses using eGFR and USRDS data confirmed our findings that patients with stage 4–5 CKD, ESRD on dialysis or with kidney transplant are at extremely high risk for severe complications due to COVID-19 (Table 4).

It appears that patients with eGFR < 15 are 13x more likely to be hospitalized with COVID-19 as compared to those without ESRD. The paper suggests that “physiological stress caused by excessive inflammatory response to SARS-COV-2 infection could destabilize organs already weakened by chronic disease” or “direct organ-specific injury from SARS-CoV-2 infection could act as a second-hit to these organs.” The article also mentions “consistent with this hypothesis, kidney and heart are among the tissues with the highest expression of ACE2, a SARS-CoV-2 receptor.”

So why is the results so high for kidney transplant patients? The n value is low at only seven cases, but the risk is about the same as Stage 5 ESRD or dialysis patients. The article does not discuss this finding, but my guess is the immunosuppressive medications weaking the patient’s immune system. That and a muted antibody response to COVID vaccines. This means even though I have a kidney transplant, the risks of COVID have not changed for me versus one-year ago while I was still on dialysis.

ProPublica Kidney Transplant Article

Initially, I ended the previous post with a paragraph regarding an article on ProPublica written by the same journalist that contacted me nine months ago. However, as I read the first few paragraphs of the story, I felt it needed its own post for discussion.

ProPublica is a nonprofit newsroom that investigates abuses of power.

ProPublica begins all their stories with the above line. It pretty much tells the reader their biases and how they will tell the story. After reading the first few paragraphs, I was not wrong.

First, there are plenty of things that are wrong with the dialysis industry. I came up with the following just from memory (no Google):

Two for-profit companies control 70% of the market
Medicare coverage provides distorted incentive to maintain the status quo and milk the system for profit
Very little public awareness on the impact of dialysis on ESRD patients
Even less awareness on the need for organ donation

Just from the recent ballot proposition fights in California between the for-profit dialysis companies and SEIU (employee union) demonstrates even the industry cares only about profits and not patients.

Having said that, ProPublica is obviously biased against dialysis and transplant providers. First, if I assume my interview request in September 2020 is related to this story, the timing is a bit off. The actual article was published on December 15, 2020, but the subject of the article passed away earlier in August. So, by the time I was contacted, they already had most of the information needed for the article. What did they need my story for? A supplemental article about how getting a transplant suck for everyone?

If you read about the life of JaMarcus Crews, it is definitely a more compelling story than if they had written about me. JaMarcus was was black, living in Alabama, and likely experienced a lot of discrimination/racism in life and the whole dialysis/transplant process. Me, being a middle class Asian in California and getting relatively good care, will be a boring subject for the story ProPublica wanted to tell.

I found a few questionable items at the very beginning of the article.

When it was over, and all anyone wanted was sleep, JaMarcus drove to the wide parking lot at Target to wait for his cashier’s shift. He missed working at the bank, but a nine-to-five was no longer possible.

It is true that in-center hemodialysis takes up a lot of time, but many people work full-time. ProPublica just says this without any sources or statistics. I worked full-time for the first two years of hemodialysis and during peritoneal dialysis. If JaMarcus was a teller, then he must be at the bank in person, which makes it difficult, but not impossible. He could be assigned different tasks during dialysis days. It heavily depends on how willing employers are to accommodate the employee’s dialysis schedule. I was lucky but also essential to my company, so they were very accommodating.

JaMarcus didn’t tell his wife or son that he was making calculations in his head: most people didn’t survive five years on dialysis. He was nearing seven. His mother had died in year eight.

This one is totally false and can be researched with a quick Google search. I posted on this topic a lot, and most sources say that mortality is 20% after the first year of dialysis, and 50% after five years. That is definitely not “most people didn’t survive five years on dialysis.” The statistics are also skewed by older dialysis patients with multiple medical issues. JaMarcus was 36. That does not mean there is no risk, since JaMarcus did pass away, but the statement is absolutely false.

Having gone through all of this, ESRD and dialysis is definitely a huge problem that needs more attention and research. JaMarcus’s story is sad, and not even unique. I know my comments may be premature based on the first few paragraphs, but one-sided stories like these just entrench people and hinder progress. I am still amazed that I am not dead after years of ESRD and dialysis. If you browse through r/transplant on Reddit, there are lots of anniversary stories from transplant recipients. Of course, the process could be better, but I am hugely grateful and satisfied with my experience. Everyone I have engaged with, from my nephrologist, dialysis nurses and techs, transplant coordinators, surgeons, post-care doctors, to phlebotomists, have been compassionate and caring. The main issue is the scarcity of transplant organs that causes all these issues downstream. ProPublica should focus on that part of our society, but that does not fit their mission of investigating the abuse of power.

Maybe I will change my mind after reading the entire article.

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Just saw these lines at the very top of the story:

For years, JaMarcus Crews tried to get a new kidney, but corporate healthcare stood in the way.

He needed dialysis to stay alive. He couldn’t miss a session, not even during a pandemic.

That is lame. Whatever you think about “corporate healthcare” in general, JaMarcus weighed 400 pounds and had heart problems. There is no way he was going to get on any transplant list when healthy people must wait 8-10 years. I can see him getting a transplant if there were lots of organs available, but with only 10% of people on the waitlist transplanted each year, he needs to improve his health situation. No way this is the fault of “corporate healthcare.” Also, WTF is “corporate healthcare?” Of course, it is large hospitals (corporations) doing transplants. You do not want the procedure done in someone’s garage, for fuck sakes.

I also do not understand the second sentence. I had to go to my clinic during COVID pandemic. That is the only place I went outside of my house. Even without a pandemic, dialysis patients cannot miss sessions since that will mess up your health even worse. Is this the fault of “corporate healthcare” too? How is this racism? I thought ProPublica was like NPR: a good news source that leans a bit left. But so far, this seems like a total hit piece.

In hindsight, I am glad the journalist did not follow-up. I would be really pissed off if I were part of this story the way it was told.

Dialysis Interview

I gave an interview yesterday regarding my dialysis experience. It was not with a new organization, but rather a student in the medical field. One of their instructors assigned a project to interview a current or prior dialysis patient. The student said they did not know anyone on dialysis so they posted a post on Reddit r/dialysis for volunteers. I actually see quite a few of these requests, from interview with medical school and bio-mechanical engineering students, to surveys regarding mental health and dialysis patient comfort. Hopefully this interest will lead to better care and improved treatment, including a functional artificial kidney.

Anyway, the interview was over Zoom (no cameras), and took about 40 minutes. Mainly it was about my experience with ESRD and dialysis, and what my pros/cons were with each type of dialysis. Even though I was not on dialysis that long compared to some other patients, I went through a lot of changes and medical procedures in the process, and can compare life before, during, and after (transplant) dialysis. Maybe I can give a decent TED talk.

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So about nine months ago, I receive a request from a ProPublica journalist for an interview about kidney transplant wait times. Like above, the request came through Reddit, probably because of my comments about my waiting experience. At the time, I agreed to an interview but wanted to be anonymous since I did not want to risk any negative out-of-context comments affecting my transplant chances. The journalist agreed but never got back to me, and I do not know what happened to her project.

Time Management

Now that I am four months post-transplant surgery, I have almost forgotten how much time dialysis take up.

My first hemodialysis (HD) experience started with 3.5 hours twice a week. It eventually changed to three time a week. My scheduled time was from 12:30 pm to 4:30 pm Tuesday/Thursday/Saturday. This was before COVID so I drove to work Monday/Wednesday/Friday, and worked from home Tuesday/Thursday mornings. I would bring my laptop and cell phone, and managed to do some work with the help of my analyst in the office. For weeks where I was too tired to work in the mornings, I took a PTO day to cover.

When I switched to peritoneal dialysis (PD), I started going into the office daily, but that meant zero free time during the week. I could watch TV or use my computer after connecting to the cycler, but would have a 20 foot tube attached to me. I found out later that during dwell times between cycles, I could disconnect the tube, and reconnect before the next cycle. This however, increased the risk of infection each time I disconnected, but I could move around the house for an hour or so.

After the bypass surgery and returning to HD, my schedule was now T/T/S from 5:30 am to 10:00 am. This was fine while I was out on medical leave, but not so good once I returned to work. I ended up doing the same thing as before: going into work 3 days and working from home for 2 days, except in the afternoon. After COVID hit in March 2020, I started working at home full-time. I still took a vacation day here and there to cover for missing hours, but that got tedious too. Finally, I switched to a part-time schedule (30 hours/week) that allowed me to keep my health insurance, but with a 25% pay cut.

Post-transplant, I took about 9 weeks of medical leave, and returned to work full-time starting April 2021. Since I am taking anti-rejection medications, I am working from home every day. I have got used to not seeing people from work, but it is difficult. I think I work better if I can talk to people in person, but realized that society has changed, perhaps permanently, due to COVID. Most of my staff were working from home this past year (all computer related), and will likely work a few days from home each week after things return to “normal.:” For me, after 3.5 years of dialysis, it is still hard to think about the next treatment session. Some days, I lose track of what day of the week it is, and try to join conference calls that are scheduled for another day. In addition, as California is opening up in a few weeks, I do not know what my work expects from office workers that do not need to be there physically. Since I do not know if my Moderna vaccine shots are effective, I will likely stay home for a few months more.

Creatinine Levels

One of the most important indicator of kidney function is the level of creatinine in your blood.

A creatinine test is a measure of how well your kidneys are performing their job of filtering waste from your blood.
Creatinine is a chemical compound left over from energy-producing processes in your muscles. Healthy kidneys filter creatinine out of the blood. Creatinine exits your body as a waste product in urine.
A measurement of creatinine in your blood or urine provides clues to help your doctor determine how well the kidneys are working.
Mayo Clinic

Since the transplants, I have had minor issues with lab results, primarily potassium (too high), calcium (also too high), phosphorus (too low), and blood sugar (way too high). However, the creatinine levels were pretty solid, though on the high end of normal. Here is a chart pre-transplant:

The huge spike was right before my bypass surgery when the nephrologist determined that peritoneal dialysis (PD) was not working for me anymore. Since this chart is from St. Joseph, the six month I was on PD with Satellite Health is missing. Typical readings were between 9 and 10 while I was on dialysis.

Here are results from UCLA starting the day after transplant:

My creatinine levels dropped pretty quickly right after surgery, and after less than two weeks, stabilized at around 1.3. The transplant has seemed pretty happy about my creatinine numbers so I am happy too.

Blood Sugar Update

Three and a half months post-transplant, most of my test results are looking normal. Even my blood pressure, which has fluctuated a lot both before and after transplant, has settled down somewhat to ~140 systolic standing and ~120 standing. The only remaining problem is blood sugar. I have type 2 diabetes for many years. While on dialysis, whatever insulin I naturally produce stays in my body since it is not filtered out during dialysis. However, post-transplant, the combination of anti-rejection medication side effects and new kidney flushing out insulin means high blood sugar and need for insulin shots. I finally figure out how to export and graph blood sugar readings from my meter. Here is data since last November when I switched to the new meter:

The text is a bit hard to read, but it is pretty obvious when the surgery occurred. Post-surgery, I have been on three different insulin injection schedules. Again, it is hard to see, but the first 1/3 period after transplant was just Humalog on a sliding schedule. The second 1/3 period was two insulin pens but at a low dosage. Finally, the last 1/3 period has the same two insulin pens but will a higher dosage. There is a slight downward trend at the end of the graph. It is likely a combination of lower tacrolimus dosage and me actively avoiding food with added sugar. Hopefully the trend continues.

The data also says that there are 438 readings on the chart. The time scale is just shy of six months so that averages out to 2.5 lancet pricks per day. If you look at the fingertips of my left hand, you can definitely see hundreds of tiny dots showing where blood was taken for each blood sugar reading. My iPhone 12 camera cannot focus close enough to get a decent photo; I may have to get out my SLR and a macro lens to see if I can get a clear pic.

High Blood Sugar

A kidney transplant is supposed to fix a whole host of sins. Most of my lab results are much better, but there are still a few problem areas: potassium, blood pressure, and blood sugar/glucose.

Here is a chart from Apple Health of my blood sugar readings downloaded from my Accu-Chek meter. It covers about a month of data. You can easily see when the transplant surgery occurred and I started taking the anti-rejection medications. Prior to surgery, I was measuring blood sugar once a day before breakfast so it’s probably the lowest reading of the day. Even taking that into account, the number are definitely higher post-surgery.

The issue is even with an insulin shot before each meal, the numbers are still pretty high. My endocrinologist doesn’t like the numbers being over 200, which appears to be all the time except in the mornings. She want me to do another injection that has all-day insulin. The HumaLOG I’m taking now is very quick acting but doesn’t last that long. Two insulin injection pens… great.

This either means my blood sugar was high while on dialysis but was getting dialyzed out, plus my old kidneys were not filtering out any natural insulin, hence the low numbers. Or my blood sugar was normal but now the anti-rejection mediations are spiking the sugar levels plus new kidney is getting rid of natural insulin, so I need more. Hopefully it’s the second and the eventual lower anti-rejection medication dosages will fix the problem.

Blood pressure is hight too but I haven’t been able to figure out any patterns yet.

Weird Dreams

Since the transplant surgery and recovery in Westwood, I’ve been having more dreams at night. Not sure if it’s because I’m sleeping (a bit) better or there are less toxins in my bloodstream? Anyway, dreams are always kind of weird when you wake up and think back. The latest one is that a coworker is suddenly on dialysis. This new occurrence happened while I was in the hospital for my surgery. In my dream, we talk about it like it’s normal. It felt so real that when I was awake, I though I should call into work and find out what happened. However, other than my faulty memory, I can’t find any evidence of the coworker being on dialysis. So I didn’t call. Probably the right decision; otherwise I’ll sound really stupid when no one know what I’m talking about.

Creatinine Levels

Oh so close!

Lab results from today was 1.4 for creatinine. This is a leading indicator of how well your kidneys are working. Normal range for men is 0.7 to 1.3. While on dialysis, my results were from 7 to 9; when peritoneal dialysis failed, creatinine levels shot up to close to 20.

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Post-transplant creatinine trend:

Date	Creatinine
1/11/2021	10.49
1/28/2021	6.74
1/28/2021	5.99
1/28/2021	5.35
1/29/2021	3.64
1/29/2021	3.47
1/30/2021	2.81
2/1/2021	2.2
2/4/2021	1.4

I think the next set of labs will likely have creatinine inside the normal range.

No More Dialysis

So I am done with dialysis, hopefully. Today was the last session before the transplant surgery tomorrow. It was pretty uneventful. One of the techs that know how to cannulate me was in so she stuck the needles in without any problems. There was a bit of pain here and there but not too noticeable. The session did seem to take forever though. Each time I check the clock, it seemed like it was standing still. Most of the nurses and techs came by to say goodbye so that was nice. I hope I never see them again in a clinical setting.

Right now it about 1:45 pm and I’m packing for both the hospital stay and the two weeks in Westwood. I’m trying to take as little as possible, especially to the hospital but four days is a long time without all my tech toys.

Penultimate Dialysis Session

Ugh. It was a terrible session today. The tech must have hit a nerve inserting the arterial needle. It hurt really bad, probably the worst cannulation pain ever. She tried flipping the needle and it hurt even worse. They ended up using the top-most insertion point and removing the initial needle. I had to hold a piece of gauze to prevent bleeding and that hurt too. I’m not sure why but the pain didn’t completely go away and kept hurting for about three hours. They even gave me some ice in a latex glove but it didn’t really help. On the way out, I bled a bit so it took until 10:20 am for me to get out. Typically I’m out by 10:05 am.

Another weird thing was my blood pressure. I took a reading as soon as I woke up and it was really high, like 177/105 or something. I know I took my medication last night so I didn’t take anything else. Well, I went and took a shower, and when I got out, I felt a bit dizzy. I took my BP reading again and this time it was 110/70 sitting. That means it’s even lower when I’m standing or walking. Even skipping my normal morning medication, my blood pressure got down to the 90’s during dialysis. I don’t know if it’s fluid balance or something else. Hopefully it will stabilize post-transplant.

I only have one more dialysis session (hopefully)…

Dialysis 911

When I arrived at the dialysis center this morning, I saw a few nurses and a tech run out of the building toward a parked minivan. I wasn’t sure what was happening, but they ran back into the building asking someone to call 911. Definitely not good. I didn’t hear anything else about the incident so no idea what happened. I guess a patient didn’t want to go to the ER and came to dialysis instead.

My blood pressure was pretty low this morning. I couldn’t remember if I took my blood pressure medication last night, so I took a reading and it said 195/110. Thinking that I forgot to take it, I took another one and within 30 minutes, I felt dizzy as my blood pressure dropped to about 100/60 lying down. I rested for about 15 minutes and drove to dialysis. I was fine sitting down but when I stood up, things got a bit dizzy again. I ended up having low blood pressure throughout the session. The tech even gave me oxygen but I don’t know how much it helped. I ended up sitting after the session for about 10 minutes until my blood pressure came up a bit.

Two more times… going to be so glad that dialysis will be over.

Four Sessions Remaining

There was a new tech today at the dialysis center. I’m not sure how the scheduling works but he was assigned to me, even though the other tech in my pod/area has stuck me successfully many times. Both needles hurt a lot going into my arm, and it seems like both needles hit the same nerve. My lower arm and wrist was both hurting and numb for several hours. The blood flow was good however, and there were no alarms for the entire four hours.

I don’t know if it’s because I think the end to dialysis is near, but time moved really slowly today. I tried sleeping on the dialysis chair without success, and ended up watching YouTube. This is what I watched for an hour:

I listen to three or four genre of music, and one of them is K-pop by female artists/groups. The girl being interviewed is Nicole Jung, a member of KARA, which was a huge second generation girl group. Anyway, the entire show is in English and pretty interesting. Here is a performance from 2009. She is the one with short hair.

Sadly, the thin girl with long hair is Goo Hara. She committed suicide in November 2019.

Asian Females

There is a new chart available on https://occovid.com/vaccinated that show vaccination data in Orange County.

If you look by ethnicity, Asians seem to be overrepresented. There is also a chart by gender and it’s skewed towards females at ~8:5 ratio. The simple explanation is Filipino nurses. If you look at just my dialysis center staff, I would guess more than half are Filipino females.

Just had to post that before going to dialysis. Seven more sessions to go…

Eight More…

I just realized that if everything goes according to schedule, I only have eight more dialysis sessions left. It’s kind of weird to think about something that is an integral part of your life just ending. It was hard to avoid letting dialysis become who you are, just like the tendency to say your work title when asked the question, “Who are you?”

First Hand COVID Statistics

Today was the “dialysis” day of 2021 and there was a personnel change. In the past, the dialysis techs would rotate to a different pod/unit every three months. They are still rotating but the schedule seems more random now. Anyway, my “new” tech is a younger guy that I’ve spoken to a lot before, but this is the first time he’s stuck me with dialysis needles. The first attempt was unsuccessful and very painful; he ended up calling over another tech and she was able to place the needles more accurately. It was fine but my arm did hurt for about 30 minutes at the beginning of the session. It’s about 1:30 pm now and it’s hurting again at home.

I also spoke to my nephrologist. She was there last Tuesday but had to run off before talking to me. I convinced her to raise my dry weight to 79.0 kg since my blood pressure is crashing (low) each session now. Today, I sat up near the end and it dropped to 85/58. I felt really sick and thought I was going to pass out. They stopped the fluid removal and pumped back about 250 mL of saline to try and stabilize my blood pressure. Hopefully the higher weight limit will mitigate the constant hypotension.

My nephrologist also said that it’s probably better to wait a bit on the transplant, if I get approved. She also does rounds in the main St. Joseph Hospital and she said the place is a zoo. People are waiting hours and days to get into the ER since there are no open beds in the ER nor the main hospital. She mentioned she saw OB doctors doing ER triage, which is not really ideal. Personally, she said five of her patients died from COVID this weekend; she has patients at various hospitals and facilities. The youngest was a otherwise healthy 27 year old. The dialysis nutrition also stopped by to chat and said they’re losing about a patient a day at the hospital due to COVID. I don’t know who still thinks this is all some kind of fake news but their attitude is killing people.