Saturday, July 26, 2008

Hello, World!

It has been awhile since I've journaled anything about dialysis, and that's because everything has been going boringly well. No problems. No surprizes! And that's a good thing.

I've gone totally simplistic. They sparingly tape the needles once they are in and I hold or allow the tubes to lay free. (I am very cautious to keep them from being caught or tangled). It seems that any restriction at all creates discomfort of some kind. When it is time to come off, I hold the site myself, as I've posted before. The top site is usually good with the 'super stopper sphere' they use. (Similar to a cotton ball only it's made of rayon and something.) The lower site is good after I've held it 3-4 minutes. I change to a bandaid and I'm good to go. I do wait until the basic 15 minute waiting time is passed. Some day I may go ahead and leave. I've still not had one bleeding incident since I've been doing this.

One day one of the attendants was getting the stuff to take me off, and she had the clamps. I reminded her that I didn't use them and then commented on me messing with their routine. She said actually she had learned from it, and said they had recently had another patient that bled afterwards no matter how much they taped or what they tried. Then she remembered me, and used less pressure, less tape, etc. and she did fine. So, she learned that the same amount of pressure is not good for everyone.

An elderly friend of ours is on dialysis now, and I visit with him sometimes. He's in his 80's and is finding it difficult to be tied down so long. He has multiple health problems, a 3 in 1 heart monitor/pace maker thingy and diabetes, emphysema, and bronchitis and says he never has any pain. Very fortunate. His age and health prevents him from being eligible for a transplant. He says he is ready to go home.
For those who might not know, he's referring to heaven. It's not a morbid statement. It's the hope and peace of a christian. And I think he's looking forward to it. We tend to think on these things when we face our mortality.

Monday, July 21, 2008

I thought this worthy of a read.


TESTIMONY FROM TONY SNOW

This is an outstanding testimony from Tony Snow concerning
his fight with cancer. Commentator and broadcaster Tony Snow
announced that he had colon cancer in 2005. Following surgery
and chemo-therapy, Snow joined the Bush Administration in
April 2006 as press secretary.
Unfortunately, on March 23, 2007, Snow, 51, a husband and
father of three, announced the cancer had reoccurred, with
tumors found in his abdomen-, leading to surgery in April,
followed by more chemotherapy. Snow went back to work in
the White House Briefing Room on May 30, but has resigned
since, "for economic reasons," and to pursue "other interests."
---------------------------------------------------------------------


"Blessings arrive in unexpected packages, - in my case, cancer.
Those of us with potentially fatal diseases - and there are
millions in America today - find ourselves in the odd position
of coping with our mortality while trying to fathom God's will.
Although it would be the height of presumption to declare with
confidence "What It All Means", Scripture provides powerful
hints and consolations.

The first is that we shouldn't spend too much time trying to
answer the "why" questions : Why me? Why must people suffer?
Why can't someone else get sick? We can't answer such things,
and the questions themselves often are designed more to
express our anguish than to solicit an answer.

I don't know why I have cancer, and I don't much care. It
is what it is- a plain and indisputable fact. Yet even
while staring into a mirror darkly, great and stunning
truths begin to take shape. Our maladies define a
central feature of our existence: We are fallen. We are
imperfect. Our bodies give out.

But despite this -, or because of it-, God offers the
possibility of salvation and grace. We don't know how
the narrative of our lives will end, but we get to choose
how to use the interval between now and the moment we meet
our Creator face-to-face.

Second, we need to get past the anxiety. The mere thought
of dying can send adrenaline flooding through your system.
A dizzy, unfocused panic seizes you. Your heart thumps;
your head swims. You think of nothingness and swoon. You
fear partings; you worry about the impact on family and
friends. You fidget and get nowhere.

To regain footing, remember that we were born not into
death, but into life,- and that the journey continues
after we have finished our days on this earth. We accept
this on faith, but that faith is nourished by a conviction
that stirs even within many non believing hearts- an
intuition that the gift of life, once given, cannot be
taken away. Those who have been stricken enjoy the special
privilege of being able to fight with their might, main, and
faith to live-fully, richly, exuberantly -no matter how their
days may be numbered.

Third, we can open our eyes and hearts. God relishes surprise.
We want lives of simple, predictable ease-, smooth, even trails
as far as the eye can see, -but God likes to go off-road. He
provokes us with twists and turns. He places us in predicaments
that seem to defy our endurance and comprehension- and yet don't.
By His love and grace, we persevere. The challenges that make our
hearts leap and stomachs churn invariably strengthen our faith
and grant measures of wisdom and joy we would not experience
otherwise.

'You Have Been Called' Picture yourself in a hospital bed. The
fog of anesthesia has begun to wear away. A doctor stands at
your feet; a loved one holds your hand at the side. "It's
cancer," the healer announces. The natural reaction is to
turn to God and ask him to serve as a cosmic Santa. "Dear
God, make it all go away. Make everything simpler." But
another voice whispers: "You have been called." Your
quandary has drawn you closer to God, closer to those you
love, closer to the issues that matter-, and has dragged into
insignificance the banal concerns that occupy our "normal time."

There's another kind of response, although usually short-
lived-; an inexplicable shudder of excitement, as if a
clarifying moment of calamity has swept away everything
trivial and tinny, and placed before us the
challenge of important questions.

The moment you enter the Valley of the Shadow of Death,
things change. You discover that Christianity is not
something doughy, passive, pious, and soft. Faith may
be the substance of things hoped for, the evidence of
things not seen. But it also draws you into a world
shorn of fearful caution. The life of belief teems with
thrills, boldness, danger, shocks, reversals, triumphs,
and epiphanies. Think of Paul, traipsing through the
known world and contemplating trips to what must have
seemed the antipodes ( Spain ), shaking the dust from
his sandals, worrying not about the morrow, but only
about the moment.

There's nothing wilder than a life of humble virtue,
for it is through selflessness and service that God
wrings from our bodies and spirits the most we ever
could give, the most we ever could offer, and the
most we ever could do.

Finally, we can let love change everything. When
Jesus was faced with the prospect of crucifixion,
he grieved not for himself, but for us. He cried
for Jerusalem before entering the holy city. From
the Cross, he took on the cumulative burden of
human sin and weakness, and begged for forgiveness
on our behalf. We get repeated chances to learn
that life is not about us, that we acquire purpose
and satisfaction by sharing in God's love for others.
Sickness gets us partway there. It reminds us of our
limitations and dependence. But it also gives us a
chance to serve the healthy. A minister friend of
mine observes that people suffering grave affliction
often acquire the faith of two people, while loved
ones accept the burden of two people's worries and fears.

'Learning How to Live'. Most of us have watched friends
as they drifted toward God's arms not with resignation,
but with peace and hope. In so doing, they have taught
us not how to die, but how to live. They have emulated
Christ by transmitting the power and authority of love.

I sat by my best friend's bedside a few years ago and
saw the sting of cancer take him away. He kept at his
table a worn Bible and a 1928 edition of the Book of
Common Prayer. A shattering grief disabled his family,
many of his old friends, and at least one priest. Here
was a humble and very good guy, someone who apologized
when he winced with pain because he thought it made his
guest uncomfortable. He retained his equanimity and
good humor literally until his last conscious moment.
"I'm going to try to beat [this cancer]," he told me
several months before he died. "But if I don't, I'll
see you on the other side."

His gift was to remind everyone around him that even
though God doesn't promise us tomorrow, he does
promise us eternity, filled with life and love we
cannot comprehend, and that one can in the throes
of sickness point the rest of us toward timeless
truths that will help us weather future storms.

Through such trials, God bids us to choose: Do
we believe, or do we not? Will we be bold
enough to love, daring enough to serve, humble
enough to submit, and strong enough to acknowledge
our limitations? Can we surrender our concern in
things that don't matter so that we might devote
our remaining days to things that do?

When our faith flags, he throws reminders in our
way. Think of the prayer warriors in our midst.
They change things, and those of us who have been
on the receiving end of their petitions and inter-
cessions know it.

It is hard to describe, but there are times when
suddenly the hairs on the back of your neck stand
up, and you feel a surge of the Spirit. Somehow
you just know: Others have chosen, when talking
to the Author of all creation, to lift us up,
to speak of us!

This is love of a very special order. But so is
the ability to sit back and appreciate the wonder
of every created thing. The mere thought of death
somehow makes every blessing vivid, every happiness
more luminous and intense. We may not know how our
contest with sickness will end, but we have felt
the ineluctable touch of God.

What is man that Thou art mindful of him? We
don't know much, but we know this: No matter
where we are, no matter what we do, no matter how
bleak or frightening our prospects, each and
everyone of us who believe, each and every day,
lies in the same safe and impregnable place,
in the hollow of God's hand."

Thursday, July 17, 2008

Donor kidneys removed with single bellybutton cut


CLEVELAND - Brad Kaster donated a kidney to his father this week, and he barely has a scar to show for it.

The kidney was removed through a single incision in his bellybutton, a surgical procedure Cleveland Clinic doctors say will reduce recovery time and leave almost no scarring.

"The actual incision point on me is so tiny I'm not getting any pain from it," Kaster, 29, said Wednesday. "I can't even see it."

Kaster was the 10th donor to have the procedure done at the Cleveland Clinic by Dr. Inderbir S. Gill and colleagues. The 11th was done Thursday. Gill said the technique could make kidney donations more palatable by sharply reducing recovery time.

More than 80,000 Americans are awaiting kidney transplants. Last year, there were about 13,300 kidney donors in the U.S., and about 45 percent were living donors, according to the Organ Procurement and Transplantation Network.

The first 10 recipients and donors whose transplants used the single-incision navel procedure have done well, according to the researchers. They report on the first four patients in the August issue of the Journal of Urology.

Preliminary data from the first nine donors who had the bellybutton procedure showed they recovered in about just under a month, while donors who underwent the standard laparoscopic procedure with four to six "key hole" incisions took just longer than three months to recover.

The clinic says the return to work time for single-point donors is about 17 days, versus 51 for traditional multi-incision laparoscopic procedure.

"For me, that's huge so I can get back to work," said Kaster, a self-employed optometrist.

Patients of the new procedure were on pain pills less than four days on average, compared with 26 days for laparoscopic patients.

"This represents an advance, for the field of surgery in general," said Gill, who predicted the bellybutton entry would be used increasingly for major abdominal surgery in a "nearly scar-free" way.

"Will this decrease the disincentive to (kidney) donation? I think the answer is yes," Gill said.

Drs. Paul Curcillo and Stephanie King of Drexel University College of Medicine in Philadelphia developed a single-incision technique and Curcillo was the first to use the method to remove a woman's gallbladder through her bellybutton in May 2007. They've since used it for a number of different kinds of surgery.

Curcillo said the bellybutton procedure "will definitely make things better" for the donor. "A donor is one of the most altruistic people you'll ever meet. He's giving his kidney up. So anything you can do to make it better for that patient, they deserve it," he said.

Laparoscopic surgery revolutionized the operating room more than 15 years ago, replacing long incisions with small cuts and vastly reducing pain and recovery time. Researchers are now exploring ways to eliminate scars by putting instruments through the body's natural openings like the mouth, nose and vagina to perform surgery.

The method used by the Cleveland Clinic takes advantage of the belly button to avoid a visible scar. Gill said the procedure was approved by the clinic's internal review board as an extension of its laparoscopic surgical work. He has begun training other surgeons on the procedure. It is not used to transplant the kidney into the receiving patient.

Dr. Louis R. Kavoussi, head of the Arthur Smith Institute for Urology of the North Shore Long Island Jewish Health System in New York and the co-author of an editorial in the journal, said the method needs to be studied to determine if patients fare better. "The reality is that nobody knows if this is an advance other than cosmetic," said Kavoussi.

On Thursday, Scott Bolender, 39, of Washington Court House, received a kidney taken from his niece, Chanda Calentine, by way of her bellybutton.

"I'm just looking forward to getting out of bed," Bolender said in a bedside interview Wednesday.

Bolender, the married father of six children, has been unable to work because of Wagner's disease, an autoimmune disease that attacks the kidneys. He has been undergoing lifesaving dialysis since 2005.

Calentine, 30, of New York City, said she was thrilled to provide a kidney for her good-natured uncle and that she expects to do fine with a single remaining kidney.

She also said she was confident in the promise of a "nearly scar-free" post-surgical bellybutton but was prepared for the alternative. "A week ago I got a one-piece (bathing suit)," she said with a laugh.

The procedure involves making a three-quarter inch incision in the interior of the bellybutton and inserting a tube-like port with several round entry points for inserting a camera and other tools into the belly.

The belly is inflated with carbon dioxide to provide maneuvering room. The kidney is then freed from connecting tissue, wrapped in a plastic bag and removed through the navel when the blood supply is cut, shrinking the organ's fist-like size. The incision is expanded to about 1 1/2 inches to extract the kidney after the port is removed.

The procedure would not be appropriate for those who have had multiple major abdominal surgeries or who are obese, Gill said. Both conditions would limit the ability to look around the abdomen and move about instruments.

Kaster donated his kidney to his father, Phil Kaster, 61, of Canal Fulton, who was on dialysis for 10 months.

"When it's family like that, you wouldn't think twice," he said. "I'm glad I'm able to give somebody their life back."