Monday, Aug 25
We were at Northwestern at 8 AM for the third fistulogram since May 14 and received a very friendly welcome by the same prep nurse we had last time. Unlike then we were ushered in almost immediately, before we had a chance to complete the necessary forms. Equally fast was the arrival of Dr. Padia in the prep room who explained the procedure and the possibility of having to perform a balloon angioplasty or placing a stent, depending on his findings. This would widen the fistula to increase the blood flow. Scott was whisked away into the operating room before I had even time to give him his good luck kiss.
Instead of the predicted 45 minutes for a fistulogram I waited 2 hours, having been warned that it might take longer if a balloon angioplasty was necessary. And indeed it was. Luckily Scott only received a local anesthetic which made recovery much faster. Nurse Jackie who attended to Scott for the third time was happy to see us again (under the circumstances). The procedure had gone well and Jackie had already made the follow up appointment for the fistula check up Dr. Padia requested, which will be on Oct 8 at 7 AM. These early appointments ensure minimal waiting time, unless the IR Department has emergencies to attend to.
Before rushing home to a much needed meal we stopped by at Dr. Garnett's office and had his assistant Erica look at an infection Scott had developed in one of his incisions from the last surgery. She cleaned, disinfected it and made an appointment to see Dr. Garnett's partner Lin on Wednesday to have a look.
We just started a busy week with an outpatient procedure and a doctor's visit in addition to the 3 dialysis sessions, which will get us to Northwestern 5 times in one week. Scott is hoping for a more quiet time and only 3 dialysis visits.
Sunday, Aug 24
We closed the week by spending a beautiful afternoon with our dear friends Ken and Susi, one of our longest social outings so far since February. During the past years we have spent many enjoyable afternoons and evenings at their home. While we admired Ken's 2008 album on his collection of the most unusual and fascinating photographs we have ever seen on Vienna (he has a great eye for photography and sees details from a different perspective than anybody we know) Susi prepared another one of her five star meals. Sitting on their porch in the light summer breeze we dined for hours enjoying every morsel and every minute. Being in very frequent contact there was no catching up to do on current health issues and we concentrated on other topics and also future travel plans.
Saturday, Aug 23
No walk today and we got to dialysis a little earlier than usual, just in case we needed to add more time on the machine. Ginny was Scott's technician and Norma, Dr. Schlueter's assistant and in charge of scheduling and matching patients with technicians (finally) decided to assign Ginny permanently to Scott. She is the one who knows his fistula the best and proved it again tonight.
The session went much better than we had expected and hoped for. Scott was prepared for an early collapse (of the fistula), which fortunately turned out to be utterly pessimistic. A green light all the way through the 4 hours, no extension needed, the blood pressure acted up just a little bit at the end, but recovered quickly. Both the Kt/V clearance and processed blood volume were up in acceptable ranges again, not optimal but much better than after the last 2 sessions. This is particularly important before the long weekend.
We floated happily out of the center and home to a late dinner. Not even the discovery of the AC leak and soaked carpeting in front of the window in our bedroom managed to dampen our mood. We will deal with that tomorrow. Who cares about a damp carpet if we got the toxins from the body removed and enough blood cleaned.
Friday, Aug 22
We have 2 favorite art shows we have been attending religiously year after year, the American Craft Expo in Evanston and SOFA Chicago at Navy Pier. Today being the first day of The American Craft Expo we ventured out. The new oxygen equipment would not only allow us to stay out for several hours if we elected to do so but also move around a lot more inconspicuously. As usual the show was a collection of the countries best artisans. Interrupted by several rest stops we visited our favorite artists Valerie Hector, Galen and Ann Carpenter, Todd Reed, Randall Darwall & Brian Murphy, Martha Fieber, Patrick Dragon, Cliff Lee and admired some of the newcomers to the Show. Our visit was much briefer than it had been in recent years, our departure hastened by the sparse use of air conditioning in the hall.
Once again we left with impressions and memories of great work and conversations as well as sore backs, a stiff neck and a beautiful little vase by glass artist Paul Runde whom we had discovered last year. I also got my traditional ACE Show power snack, the best oatmeal raisin cookie from Foodstuffs, the concession stand in the exhibit hall.
Back home and comfortably cooled off, Scott hit the couch for a much deserved rest after our 3 hour show outing. The outside and indoor heat combined with the slow walking had worn him out, but he had a great time and would not have missed it. Scott got a new attribute from the master fiber artist Randy Darwall, who called him bionic.
I called the dialysis center to find out about the pending appointment for the fistulogram, but learned nothing. A few minutes later the hospital called and gave us date and time. Monday morning, August 25 at 08:30 am, luckily we got a morning appointment. This will be the third fistulogram since June 5, I don't know if we are heading for a record here, but it sure feels like it.
Thursday, Aug 21
Scott was predicting a problematic session and unfortunately he was correct. After the first half hour the problems started, the flow rate needed to be reduced, one of the 2 blue needles exchanged for a green and the arterial pressure acted up numerous times.
His treatment time could only be extended minimally as Thursdays is dialysis machine cleaning time and the last patient needs to be unhooked by 9:30 pm.
We dreaded to look at the Kt/V screen until the last minute to see the lowest numbers in a long time. Scott could feel the fistula collapse and we were even able to watch the vein on his wrist quiver and sink. Sounds probably weird.
The next fistulogram is unavoidable. Dyn will give the order to the IR Interventional Radiology Department of Northwestern and hopefully we will get an appointment for Monday. We should know by Friday afternoon.
In order to get as much of the toxins removed as possible before the long dialysis weekend (with 3 treatments a week, our 2 consecutive days off are Sunday and Monday) we asked Norma, Dr. Schlueter's assistant and scheduler for an earlier time on Saturday. This would leave us more room to have the session extended as needed to reach an acceptable toxin removal level. Scott had previously reached a level of 1.99 and is now down to 1.18; the target should be at least 1.2.
Yet another challenge. Just got the problems with oxygen system sorted out and we are already working on the next pebble in the road. Scott, the cork will pop up again. We are patient and we shall persevere. John Quincy Adams "Perseverance and patience have the effect to make difficulties vanish and obstacles disappear".
Wednesday, Aug 20
While I had a very enjoyable lunch with our friend Judith at LaFonda's, Scott was also having a happy experience. The new system was delivered and the dinosaur tanks removed. It comes with a carrying case on a shoulder strap and a portable belt pack. It can be worn on a belt!!!! Imagine that, on a belt!!! You can lift it on one finger!!
Scott is still smiling. His recent and unusual use of four letter words will be drastically reduced again.
We will take a walk later in the park attracting for sure less attention than on our previous walks.
Tuesday, Aug 19
We had good news and not so good news.
The good news are we received a call from Walgreens with the promise to schedule an equipment exchange by tomorrow morning. Finally we will be able to get rid of the big oxygen tanks and get the much more user-friendly HELiOS System.
Now to the not so good news. Scott was able to catch Dr. Schlueter prior to the start of his treatment session and discussed the recent problem of the low Kt/V clearance vs. the blood volume and show him the data he had collected on the plotted chart. Dr. Schlueter suspects a recirculation problem, which impacts the blood flow. He wants to wait until Thursday to see how well that sessions works with 2 blue needles and if that is not satisfactory, another fistulogram will be necessary.
Ginny who was Scott's technician for the day noticed a difference in the flow when she set the needles, it has definitely slowed down.
The session itself did not go that well, the yellow light went on after the first hour, indicating clearance problems. It turned back to green later, however the blood pressure dropped and Scott needed 200 ml saline solution to get stabilized. His usual 4 hour treatment was extended by 15 minutes to get an acceptable clearance from the toxins.
Instead of having to go through a fistulogram again, there are access recirculation assessments tests on the Fresenius 4008 dialysis machines available, which are taken during the treatment sessions. The Fresenius 4008 machines are in use worldwide except in the United States. The Fresenius 2008 versions being used in the US have much fewer functions. Would it not make more sense to use the Fresenius 4008 also in the US and avoid some of the expensive outpatient hospital tests that could easily be avoided or at least minimized? A fistulogram amounts to several thousand dollars. Why are dialysis patients in the US centers being treated on less capable machines than patients in the rest of the world? We also get fewer blood tests, (once a month instead of once a week in other countries). And the icing on the cake - in Europe the cost for dialysis is lower, with more tests for the patient on better machines.
Monday, Aug 18
Even though it was warmer and 2 days after dialysis, Scott felt better and we dragged Dino again to the park, hoping the respiratory person from Walgreens would show up in the afternoon as scheduled and relieve us of our historic relic.
We were not disappointed. The respiratory specialist showed up as scheduled and started to demonstrate the system Scott would be getting once he was evaluated. While he was being tested for pulse rate and blood oxygen level before and after carrying the equipment (a piece of cake compared to Dino) around the living room a few times, the Walgreens rep admitted having never met such a knowledgeable patient before. "We hear that a lot" I told him. Anyway Scott qualified for the HELiOS system which hopefully will be delivered soon.
Attacking our next "problem" Scott completed the spreadsheet he had started on plotting the Kt/V clearance vs. the blood volume of his dialysis treatments. It clearly shows the trend line and the deviation of the last two sessions. Scott does not believe it to be a problem with his fistula but rather a defective series of dialyzers. Hopefully Dr. Schlueter will make his rounds tomorrow and we can address the next step to take.
Sunday, Aug 17
After breakfast Don and his son Greg stopped by on their way to the Air and Water Show to park their car. It was a beautiful day again and I insisted on a walk. Scott was more tired than yesterday and somewhat reluctant to leave. However, Dino was taken for a late morning walk in the park. I felt guilty about dragging Scott out, he was obviously uncomfortable, but did not complain. Upon our return home and a long hot shower, he hit the couch (as did I).
Don and Greg came by again in the late afternoon to show us their vacation pictures from Yellowstone as well as the most recent sunburn from the Air and Water Show. We ate dinner together, Scott and I had pasta with our own homemade basil pesto, Don and Greg attacked a pizza washed down with cokes. Scott shot envious glances at the pizza and I know he would have loved to dig in as well. However, he controlled himself very well and did not even drool into his pasta.
Saturday, Aug 16
A day of more new milestones!!!
We are more than ready for new milestones, having taken baby steps only with our tragicomedy experience with the oxygen tanks.
Scott was quite perky all day and did not take his usual midday nap. He decided to drive to the center and we parked Dino (that's what we named our dinosaur oxygen tank) on the back seat and took off. Scott has been driving every now and then but never to dialysis and back. So, this was our first milestone of the day.
Arriving at the center Scott was assigned to Naja one of the young and caring, but lesser skilled technicians. Lauren, her cousin was called over from her station to set Scott up with his blue and green "rainbow" needles and the session went off with a good start. Into the second half of the treatment, blood pressure and toxic clearance started to drop and it seemed like an identical replay of Thursday. I had noticed earlier in the afternoon that Scott's breath had a slight uremic smell, indicating toxic build-up in his body. Not good. Another insufficient session was not what we needed here particularly on a Saturday with a two day hiatus coming up. We talked to Dyn, the head nurse of the day and asked him to extend the treatment by another half hour to get better toxic clearance. He had to page Dr. Schlueter to get his permission to reset the machine to 4 1/2 hours. Within a few minutes Dr. Schlueter called back - we were very pleased and impressed - by that time it was already 8:30 PM on a Saturday evening and gave his green light for the extended treatment. Another milestone. Dyn reset the machine and also suggested to Scott to watch the Bears game to get the blood pressure up.
We achieved our goal and got the better clearance, however it is puzzling why the clearance is dropping all of a sudden. Dyn had no explanation and we will address this new problem with Dr. Schlueter next week.
Friday, Aug 15
Our first restaurant outing since surgery at the end of February! A new milestone.
We had been in contact for a long time with Myra and Wendy, two wonderful Bead Society friends, to find a good time for a get together. Myra, a former dialysis and kidney transplant patient, knows exactly what Scott is going through and experiences about dialysis and related topics were exchanged. Wendy's uncle is also a patient at our dialysis center, although following a different time schedule. On one of my recent shopping trips I had run into Beatrice, the owner of LaFonda, a neighborhood Central American restaurant and one of our favorite's. She knew about the surgery and inquired about Scott's health offering to prepare anything that would agree with his current diet requirements. And that is where we met for lunch, just a few blocks from our building. Beatrice was happy to accommodate Scott and he had one of our favorite dishes, salmon salad prepared according to his new diet.
Time flew by, after a while we ended up being the only patrons in the place. Talking about health issues (the older we get the more prominent of a conversation topic it becomes), news in our lives since our last meeting, family (Wendy had just recently become a grandmother), travels, jewelry (Myra, an incredibly talented artist showed us some of her recent work and collections). We parted with the intention of getting together in more frequent intervals.
Thursday, Aug 14
A quick trip to the Thursday farmers market on Daley Plaza to get more fresh basil for another batch of pesto. No time for a nap, which would have been impossible anyway with the roar of the planes over the lake practicing for the Air and Water show starting tomorrow.
The dialysis session was almost identical to the one on Tuesday. The blood pressure held nicely during the last hour and actually went up (could watching the Olympic beach volleyball competition have had anything to do with that?). It dropped later, the game was over and ice cubes were needed again. The Kt/V clearance was lower than usual, less toxins than usual where removed, although the minimum level was reached. Gail attributed it to clogging in the dialyzer. Both Gail and Ginny will be absent on Saturday and we hope Eddie will be there, as they are the top stickers (needle placers) and essential for a successful session. Hopefully the Air and Water Show will not have an impact on his presence, a very handsome and bright single guy he is somewhat of a party animal.
Dr. Schlueter made his rounds, his first since the last lab work. This is the time of the month when he discusses test results, necessary changes etc. with his patients. Arriving at Scott's chair it was discovered that the latest test results were missing from his file. Luckily we had packed our own copy that we always request and handed it to Dr. Schlueter. He commented on the irony of this, we kept quiet. The PTH testing is erratic due to the problems in measurement and low levels are nothing to be concerned about. Lower PTH levels are unusual anyway for dialysis patients, the levels tend to be elevated and are correlated with the phosphor levels. Scott had started to take the lower dosage of phosphor binder and asked Thea, the nutritionist, to schedule a phosphor test next week in connection with the bi-monthly hemoglobin to check the levels with the new dosage. All other blood levels were in range.
Wednesday, Aug 13
This morning we had an appointment with Dr. Garnett, who had seen Scott only once since surgery at the end of February. It might sound a bit strange, but we look forward to seeing him, as we have come on very friendly terms with him and the check up appointments are always a time to catch up on personal events in our lives as well. He had a new intern on his rounds and introduced Scott as "the blue plate special, you will not see a patient like this again". After updates on dialysis, the diet and related issues, the health care situation and our personal lives, a brief exam followed and we left for home.
As the pulmonoligist's office is located in the same building as Dr. Garnett, I had threatened to go up to talk with one of the nurses, but Scott was adamant not to take that course of action. He was right, upon our return home we had a call waiting from Walgreen’s on the answering machine. Scott left a message which was returned almost immediately (amazing!! I know I am being cynical). An appointment was scheduled for next Monday afternoon (it was not possible earlier) for Scott to be evaluated for either a portable concentrator or a HELiOS System.
Finally we are getting somewhere, with baby steps, but steps nonetheless.
Tuesday, Aug 12
I am a patient person, but do have my limits. The morning went by, without the promised call from one of the pulmonoligist's nurses and irritation set in. I got through to one of the nurses and Scott explained the situation to her. She was familiar with Scott's case and promised that either she or a representative from Walgreens would get back to us same afternoon. No call by the time we left for dialysis.
The session went well, Ginny took care of her star patient. Only the blood pressure needed to be brought up to an acceptable level, but this was achieved with just a few ice cubes (chewing on them, just in case anybody is curious what we do with them). Dr. Schlueter was only seen briefly in the distance and disappeared without making his rounds. As he sometimes switches with Thursday, we hope to see him in 2 days. We need to discuss the sudden drop of the PTH (parathyroid hormone) level.
While in the waiting room we got some comments on our dinosaur oxygen system. "I have a really comfortable one at home, which is very light and easy to carry around" Rose explained to us, one of the regulars of Scott's time slot. "What are you up to?" Julie, the social worker asked as she was walking by eying old beat up tank parked next to Scott. We probably look like hospital escapees, as they use the same type of tanks for in patients.
Guess what! There was no message from either the nurse or Walgreens on our answering machine when we came home from dialysis at 10 PM. In sake of my blood pressure I tried to ignore the fact, to be dealt with by the following morning. Scott and I did not even discuss the fact.
Monday, Aug 11
Not much happened on the oxygen supply subject. The first of the dinosaur systems was picked up and we have yet to hear from the doctor's office and/or Walgreens. Oh well, this too shall be sorted out and pass. We were able though to get the small 400mg dosage of the phosphor binder Renagel which was not available at any of the pharmacies we contacted and had to be specially ordered. Scott's phosphor level dropped below the range and requires a much lower binder dosage now.
When we do have time available, that is not spend on self administration, research and learning about new medical issues, we keep up on the (mostly depressing) economy, the news, reading certain magazines and playing a daily Sudoku to keep the brain cells working. At the moment we are keeping an eye on the results of the Olympic Games. Scott is particularly interested and astounded by the incredible success of Michael Phelps and the record times he manages to achieve. Having been a competitive swimmer himself (although not in the Olympics and also some time ago), Scott has quite a number of medals he won, mostly in backstroke and individual medley. He never talks about his medals and awards and I found the box of medals a few years into our marriage when I was looking for something in one of our not so well organized cabinets.
Scott never dwells on the past and rarely talks about it. He concentrates on our present life and issues (for Scott it is never "me" and "my', it is always "ours") and works with positive energy towards the goals. "I am a cork, and a cork does not sink" that is his motto.
Sunday, Aug 10
Our first social outing since the start of dialysis.
We did not venture out too far though. Visiting our friend Linda, who lives in the neighborhood and wanted to introduce her grandson to us. Connor, half a year old, living in the Netherlands with his parents Jennifer (Linda's daughter) and Paul, on his first trip to the US was just as curious to meet us - or so it seemed. A happy, active baby he kept us all entertained and his mother on her toes. As most babies do, he inspected Scott's beard, shortly after which he decided it was time to eat. We were sorry to have missed Paul, who had already left for the Netherlands, but were happy to have the opportunity to spend time with Jennifer and meet Connor.
Back home, after a nap, we deviated from a carb-rich dinner, which we are trying to have lately and shared a skirt steak with corn.
Now we need to collect our strength to face the coming week with some new problems to be addressed:
Oxygen supply
cause of the PTH Parathyroid Hormone level drop
adjustment of phosphor level with lower binder dosageIt seems we are never short of topics to research, as one issue gets resolved and the next is already lining up.
Saturday, Aug 9
At the end of the day we are sometimes (actually more often than not) asking ourselves "where did the time go?", "what did we do?". A lot of time is spent with self administration as I call it, learning about all the new situations we are being confronted with, trying to deal with them and sort them out in the best possible way.
Half a year ago - it seems like eons away - we knew next to nothing about dialysis, how complex the kidneys and how numerous and important their roles in the body are. They not only excrete waste products, but regulate and control blood pressure, glucose metabolism, the process by which red blood cells are produced, filter metabolites and minerals, regulate the electrolyte concentrations, secrete hormones into the bloodstream. etc.
Now that Scott has become anephric (a person with no kidneys) his diet and blood work needs to be closely watched.
We learned and are still learning almost every day something new. In addition to dialysis, we have lately been confronted with COPD, the need for oxygen and are catching up on this topic. Scott has already started to study the different oxygen systems and not by choice we are getting practical examples of their older versions.
It is very important not to loose your sense of humor and perseverance. Thank God we have both, otherwise we would be on tranquilizers already.
The dialysis session went well, with only one adjustment necessary. Blood pressure was cooperating, the Tip Stop bandages are doing their job and are being admired by all the attending nurses and technicians. We zipped home, had dinner, entered all the new data into our logs and went off to bed.
Friday, Aug 8
Our enthusiasm about the new oxygen system was totally dampened when the Walgreens delivery arrived. The three tanks are bigger and come with a cart, however there is no refill system and the empty tanks need to be exchanged by Walgreens as needed for full ones. Meaning after 3 walks in the park we need to make arrangements with them for a new delivery and also with the office of our apartment building as all deliveries need to be scheduled in advance. Gasp!! How far are we stepping back in time? Do we really need this aggravation? The oxygen system we got is - according to an online description of oxygen systems - thirty years old and a dinosaur. At least with the current one we could refill the tanks ourselves, they were also smaller but nonetheless weigh 7 lbs.
The rep at Walgreens could not be reached immediately and after several tries informed us that a new order from Scott's pulmonologist is needed to exchange the delivered dinosaur (she did not refer to it in exactly that manner) with the preferred liquid oxygen system. Those portable tanks are not only much lighter, but last much longer and the refill time is very short.
Scott also wrote a desperate email to his pulmonologist and COPD (Chronic Obstructive Pulmonary Disease) Program Director at Northwestern Memorial Hospital explaining the situation and asking for his support. He replied almost instantly and promised to have the problem resolved by having his nurse talk to Scott and consequently to Walgreens.
Why do we have to go through all that aggravation to get a modern and user friendly oxygen system? Scott has enough on his plate with dialysis and COPD as it is.
A lot of time and energy was wasted dealing with the situation, during which we got several phone calls from friends. I do apologize for not handling those calls in the manner they would have deserved. Scott and I were just so frustrated and upset. 08-08-08 was not the best of days. After a late dinner we just watched a movie, not the opening ceremony of the Games.
Thursday, Aug 7
A perfect summer day again, with low humidity and pollution and a light breeze. We took a long walk through the park and along the lakefront, visiting several benches, just enjoying the day. The oxygen tank, advertised as providing oxygen for 2 hours, never lasts that long and even with turning it off during rest stops we barely made it home after 1 1/2 hours. We greatly look forward to the new system which should be delivered tomorrow.
The dialysis session went well with only minor adjustments near the end. We also got the results from the blood work, which for the most part were satisfactory. The phosphorus level had dropped below the normal range and we asked for a new prescription to reduce the daily dosage of binders. Doing some research online confirmed that reducing the intake of dietary protein while increasing the protein supplements resulted in the drop of the phosphorus level..
The other drop was the PTH (Parathyroid Hormone level) which dropped below the normal range of 101 - 300. Low levels of PTH are associated with bone disease. We will have to discuss the PTH results with Dr. Schlueter next Tuesday.
Wednesday, Aug 6
As we did not have access to the new study on "The Effects of Boiling and Leaching on the Content of Potassium and Other Minerals in Potatoes (p H80-H85) by P.C. Bethke, S.H. Jansky" in the Journal of Food Science I went to the library of Northwestern Memorial Hospital and obtained a free copy.
We both started reading it immediately and found it very thorough and interesting. Needless to say Scott is quite pleased with the fact that potatoes, unless they are broiled or baked in the skin, can be part of his carbohydrate group.
Tuesday, August 5
Another food topic today - homemade pesto
As carbohydrates are playing an important role to get Scott's weight up (and maybe mine too) pasta is a very frequent item on the menu now. For years we made our own basil pesto during the summer following a recipe that had been fine tuned by Scott. Basil was always purchased from one of the downtown farmers market, but always from the same source, Smits Farms, who we found has the best quality and price. Their farm stand overflowing with fresh herbs is a mouth watering sight.
After Scott checked into the sodium, potassium and phosphor levels of the different pesto ingredients and found them to be acceptable in limited quantities, it was decided to make fresh pesto again and I dashed off to the Smits Farms stand at the Federal Plaza market. As soon as I returned home with a load of fresh basil, we made pesto.
At dialysis Scott's assigned technician Eddie, who is very efficient and skilled, had already been instructed on the new approach of using two different needles, blue for the venous and green for the arterial to prevent a collapse of the fistula. The fistula area already known for collapses was also avoided and the session went without problems, at least with respect of the dialysis process. The blood pressure crashed at the end and Edie had to flush back 150 ml of saline solution into Scott's system to stabilize it. Well, the "rainbow needle approach" as Scott calls it, worked.
Being the first Tuesday of the new month with the customary blood tests, we are curious to see what the new results will be. Hopefully they will be back by Thursday and also hopefully, they will be Scott's results and not somebody else's.
Monday, August 4
The topic of today is the potato.
Although a good source of fiber and carbs, but also very high in potassium, an important mineral that helps regulate the heartbeat, conduct nerve impulses and contract muscles. Excess amounts of potassium in the blood are flushed out by the kidneys and for people with kidney disease or no kidney function, dangerous levels can build up in the blood and cause weakness, numbness and even heart attacks. It therefore makes the otherwise healthy potato an absolute no-no for dialysis patients.
Scott has always loved the occasional French fries, potato pancakes and baked potato. It was suggested by the dietitian, as well as many other published articles, to soak the raw, diced potatoes overnight in water to leach out the potassium. This procedure, however, did not seem very plausible to Scott and he embarked on his own research on the subject. And read on what he came up with:
A new study by the U.S. Department of Agriculture (USDA) found that cubing or shredding potatoes, then boiling them, drained the vegetable of 75% of its potassium. However, leaching did little to lower the potassium content, regardless of the potato variety used. The findings, according to Drs. Paul Bethke and Shelley Jansky, suggest that simply boiling cubed or shredded potatoes is enough for kidney patients to reduce the potassium content (provided, of course, you discard the water).
Following is the research article source:
Journal of Food Science, June/July 2008.
The Effects of Boiling and Leaching on the Content of Potassium and Other Minerals in Potatoes (p H80-H85) by P.C. Bethke, S.H. Jansky
http://www3.interscience.wiley.com/journal/120083308/abstractWe will bring this finding to the attention of the dietitian of our dialysis center and hope it will be handled in a beneficial matter for other dialysis patients.
Sunday, Aug 3
A wonderful day and not as hot as had been predicted, at least not by the lakefront. Scott had comfy on the couch after breakfast, but I convinced him that a walk would be beneficial also. We stayed out for well over an hour, meandering through the park to the Lake and walking along the waterfront. After several rest stops in the shade enjoying the scenery, we walked home before the oxygen tank hit the empty area. A glorious long hot shower followed and Scott hit the couch again. Within seconds he was sound asleep.
We caught up on some phone calls in the afternoon, watched a movie after dinner and called it a day.
Saturday, Aug 2
Today's session started out very good with a high flow rate and blood pressure and pulse were in a great range. It was Gail's turn to take care of Scott, she is also one of the top technicians there. During the second half of the treatment the arterial pressure caused problems and its needle needed to be turned several times. Ginny also came over from her station just to make sure Scott was doing OK. He made it through the last hour without having to terminate the treatment earlier and reached a satisfactory result for the KT/V and the processed blood volume.
To avoid the problems with the arterial pressure on Tuesday it was decided to change the setup strategy a bit. One blue and one green needle will be used instead of the two blue ones and they will be facing in opposite directions. There is also one particular area on Scott's arm that seems to be more problematic, even though the fistula looks very strong. He just manages to keep everybody there challenged with new and unpredictable situations.
Friday, Aug 1
My early morning energy was used or wasted, depending on how you look at it, on house chores and laundry. We got ready for the visit of Joe, his Japanese wife Ikumi and their son Jin, who had just turned one on July 25. Joe, the son of a childhood friend of Scott, has known Scott all his life and the two are very fond of each other. The visit from Japan had been long overdue and Joe had called Scott from Japan to arrange this visit prior to their arrival in Chicago. They are both wonderful people and we were very curious to meet their son. Baby Jin took an immediate liking to Scott and even postponed his usual cranky afternoon spell, which had been announced by his parents as a warning. We all caught up on the latest events in our lives, although through the online journal and Joe's emails, there were just details that needed filling in.
The hours flew by and after David, Joe's dad, picked them up from our place, we napped on the couch for a couple of hours. By the time we woke up it was dinner time already and still being tired, we just popped two ready made meals into the microwave.
Hopefully this new month will be easier on Scott than the last.
July 2008