Had my first visit to the Carolina Dialysis Clinic this morning and they inspected my catheter and tested it and it's working perfectly. I learned some of the technique of hooking the catheter up to the solution for dialysis.
I next go back to Pinehurst Surgical for a follow-up visit with the surgeon, then I return to Dialysis Clinic next Friday.
All is well in this amazing adventure I'm on to stay alive. Thanks to Carol Johnson, Mason Cordell, Stephen Lair, Michele and Ryan Widd and Tom Terry for shopping, driving and caring for me in the past weeks.
Well, the Peritoneal Dialysis Catheter is in place, thanks to Dr. Willie Chu at Pinehurst Surgical! It was a flawless procedure and I was able to come home that same day.
Now, it will have to heal for 2-4 weeks as I begin instruction for home dialysis at Carolina Dialysis (which is only 2 block from my house, isn't that nice. And that instruction begins on Monday morning, bright and early.
I feel fine and there is only minor irritation in my gut where the catheter was placed. And that is to be expected. It was a laparoscopic procedure.
So many friends have come by the apartment to wish me well and some even are shopping for me. Margaret's Cantina has even sent over my favorite foods! I am truly a lucky man.
For those of you in the BROADWAY SINGS FOR HABITAT benefit, the show WILL take place, probably in early spring just as soon as we can work out dates with United Church. You will be the first to know.
I am already teaching my students here at home and beginning to coach some of the singes for the benefit. So you will probably be hearing from me soon!
Fewer dietary restrictions than in-center hemodialysis
Direct shipment of PD supplies to your home or travel destination
Infrequent trips to the dialysis center
Greater flexibility and freedom in your treatment schedule
In addition, because PD patients take an active role in performing
their dialysis, they are more involved in their care and more educated
about their conditions. Research indicates that patients on dialysis who
are more involved in their healthcare tend to be healthier and have a
better outlook regarding their treatment.
I went yesterday to my regular kidney clinic appointment, and to meet my new doctor for my kidneys. She turns out to be very supportive and understanding. We discussed peritoneal dialysis and the swelling in my legs. It was her suggestion that I begin a water pill therapy. I have great experience taking Lasix and she decided I should take 80mgs once daily.
Then her attending doctor came into the room and questioned me and decided that I should DOUBLE the dose of Lasix to twice a day. They want me to take off 15 pounds of water weight in one month. This is reasonable.
My main doctor disagrees with this, saying that my swelling in the legs is due to lymphedema.
I am in a quandary as to whom to listen to! I know that I have gained 40 pounds in the last 4 months while eating the EXACT same small amount of food daily. (I really don't eat much. And my clothes still fit but my legs are huge.)
So I don't know who to believe. I think the leg swelling is due to a combination of lympedema, end stage kidney disease and poor posture.
So we are lowering the Lasix today to 20mg.
Bottom line: my main doctor knows my body for 8 years and the kidney doctors saw me for the FIRST TIME yesterday. WHO WOULD YOU LISTEN TO?
You can leave a comment for me if you like. It would be appreciated.
It is better to do nothing Than to do what is wrong. For whatever you do, you do to yourself. Like a border town well guarded, Guard yourself within and without. Let not a single moment pass Lest you fall into darkness. Feel shame only where shame is due. Fear only what is fearful. See evil only in what is evil. Lest you mistake the true way And all into darkness. Se what is. See what is not Follow the true way. Rise. sayings of The Buddha
Monday I had my last appointment with my wonderful nephrologist, Dr. Ryan Sanford. Ryan is moving to Greensboro and going into private practice. All the kidneys in Greensboro be aware! Dr. Sanford is coming to set you right!!
He was always so supportive and gentle with me as I went through the hell of kidney failure. But, together, we both feel we have prevented dialysis, reached a stable situation, and plan to keep it right there, God willing.
I owe most of it to Dr. Sanford, who never gave up helping and encouraging me. Greensboro is lucky to get him!
And Greensboro is not so far away that I couldn't go there to see him if I needed. Onward!
My nephrologist decided it was time to have the port put in place
for Peritoneal Dialysis at home. So he made me an appointment with the surgeon. I diligently went to Pinehurst (where there is a surgery clinic like unto Mars) and met with the Duke-trained surgeon. The first thing he says to me is, "You don't need this put in place until you're ready for dialysis." Whew!! My kidney function, while low, is stable. So this is a good thing.
What, you ask, is peritoneal dialysis?:
So thanks, Nephro. The surgeon also said I was an excellent candidate for home dialysis because I understand the procedure and what it entails, including the dedication to hygiene. And it can be done at night while I sleep!
So I am greatly relieved that I will never have to have hemo-dialysis.
God just laid it all out for me yesterday and I walked through the
windows and doors He opened.
Please excuse the informality of this blog, but it is easier for me to blog this information than to write each of you personally. I went today for Transplant (kidney) workup and, long story short, the doctor convinced me to stop the transplant process. With my history of mini-strokes, my age, and other physical maladies such as weight, surgery is not an option for me. The risks of surgery for me are too great, the possibilities of a major stroke. So, the risks outweigh the benefits. My kidneys are stable and if I keep on my eating regimen and other things I have been told to do, maybe in the future I might have to have dialysis. So the doctor ordered the transplant process to stop. And I am a happy man today.
MIRIAM COOK WALL AND NEWSOM SUMMERLIN, JR. (click on the picture to enlarge)
In the spring of 1955, I think it was April, my mother and Newsom Summerlin, Jr. presented a duo-piano recital at the Auditorium of Sandersville High School.
They played Buxtehude, Rachmaninov and Gershwin - and Mama changed dresses for each section of the concert! The dress in this picture was by Ceil Chapman. For the Rhapsody in Blue she wore a floor-length chiffon dress which her friends studded with hundreds of blue sequins. Could it be more 50's? I ask you?
Regretfully, there are no recordings of either of them playing. Newsom had studied piano with Mama when he was a teenager. They are both gone now. I wonder if they're concertizing in heaven. There's some good music going on if they are!
in the 70's, while the earth was cooling and you could really take a
valium without an act of congress or getting arrested, I worked at
the Harlequin Dinner Theatres in Rockville, Maryland and Atlanta,
One of my happiest times of my life: great
shows, a full orchestra which was mine all mine and wonderful actors,
not the least of which was Larry Shue. Brilliant actor, comedian and
author, most notably of "The Foreigner" and "Winceslas
Larry was truly a man of the theatre:
actor, author, wit, raconteur, ladies man, - you name it, Larry was
it. He told me a story one day backstage about himself, which will
explain the name RICHWAH:
It seems that when Larry and
a friend of his graduated from University, they planned to teach
acting in Chicago. The funny part is that they decided they would
teach their students to do everything wrong, so they wouldn't become
competition for them, the teachers! And the main thing they were
going to teach was to have the students "schwah" the end of
every sentence they spoke. Such as Hamlet's soliloquy "To be or
not to be" would be (in their method) "To
be or not to be-WUH" or "Romeo, wherefore are thou?"
would become "Romeo, wherefore are thou-WUH?"(Try
it, yourself, and you will see how hysterical it is.)Walk
up to a friend and say, "Hello-WUH" and you can't help but
Any way, we all thought this was very, very
funny - and everyone in the theatre company started "schwah-ing"
everything: such as "Hello-WUH", etc. Pam Bierly became
Pamela-WUH (eventually Pamela-WUH Pythis-Smythe-WUH") Anyway,
you get the idea.
And I became "Rich-WUH" or
as pronounced today "Richwah" - and by certain very dear
friends, just WAH. Endearing to me, strange to others, but there it
And it occurred to me that every time we do it, we
remember Larry Shue. Larry died in a plane crash in 1985 while
preparing the script of "The Foreigner" for a Disney Film
that never got made.
Just got back from my Nephrologist. My kidneys are still stable, but we are now checking them monthly instead of every 3 months.
We discussed dialysis, most especially peritoneal dialysis, which is done at home and through a port in the stomach during sleep at night. Here is a picture of what it looks like.
Now, IF and WHEN the time comes, I must prepare for this by having the port put in the front of my stomach. Then every night when I go to sleep I hook it up and the job gets done. Preparation for this type of dialysis can't be done overnight. The port must be in place several weeks in advance. So we will make this decision WHEN and IF my symptoms occur (I don't have any now.) I also don't have to remain a vegetarian but am allowed to eat ORGANIC animal protein. So that's a relief. Just keeping you updated about my situation. It doesn't (nor will it ever) ruin my life. Life is better than the alternative, don't you think?
Pour sherry over crabmeat to marinate; set aside. Melt butter, add onions and green peppers; cook until transparent. Add flour and blend, gradually add milk and seasonings. Cook over low heat, stirring constantly, until thickened. Add egg yolk and cook 2 minutes. Remove from heat; add soft crumbs, crabmeat and parsley. Gently mix and pour into well-greased 1 1/2 quart casserole. Top with buttered crumbs and sprinkle with paprika. Bake at 400 degrees for 20 to 25 minutes. Serves 6.
1 STICK BUTTER (NOT SUBSTITUTES, PLEASE) 2/3 CUP MAYONNAISE (NOT LITE) 2 TEASPOONS FRESH LEMON JUICE (NO SUBSTITUTE) SALT PAPRIKA
Melt the butter over very low heat. Remove from heat. Add mayonnaise and whip with a WIRE WHISK ONLY until well-blended. Add more Mayo for a thicker sauce at this point. Add lemon juice; use more than 2 teaspoons for a more tart sauce. Do NOT return to heat right after adding lemon juice or sauce will separate. Add salt and paprika to taste. Blend well. Serve warm or at room temperature. To reheat, warm very slowly in a double boiler and beat with WIRE WHISK. Delicious with artichokes, eggs benedict, etc.
NOTE: You can make a batch and keep in covered jar in refrigerator to have on hand. Will keep indefinitely.
1 stick BUTTER (not margarine, please) 1 lb. New York Extra Sharp Cheddar Cheese, grated 1 tsp salt 1/2 tsp red pepper 2 cups plain flour Roasted and salted pecans to top the cookies Butter flavored cooking spray
Cream butter and cheese until soft. Sift flour, salt and pepper together. Blend until smooth. Using a spoon (or melon baller) make round balls of cheese the size of $.50 piece. Spray cookie sheet with butter spray and place the balls of cheese about 2 inches apart on the sheet. Then gently press a perfect pecan half onto each ball. Bake in 420-degree oven on the top rack of oven for 8-12 minutes.
The Buddha says: Let go of anger, Let go of pride. When you are bound by nothing You go beyond sorrow. Anger is like a chariot careening wildly. He who cubs his anger is the true charioteer. Others merely hold the reins. With gentleness overcome anger. With generosity overcome meanness. With truth overcome deceit. Speak the truth. Give whatever you can. Never be angry. These three steps will lead you Into the presence of the gods.
THESE DAYS, I TAKE ALL THE WISDOM I CAN GET: FROM ANY SOURCE THE BUDDHA SAYS ABOUT PLEASURE: Do not let pleasure distract you From meditation, from the way. Free yourself from pleasure and pain For in craving pleasure or in nursing pain there is only sorrow. Like nothing lest you lose it, lest it bring you grief and fear. Go beyond likes and dislikes. From passion and desire, Sensuousness and lust, Arise grief and fear. Free yourself from attachment. He is pure, and sees, He speaks the truth and lives it. He does his own work, so he is admired and loved. With a determined mind and undesiring heart, He longs for perfection. He is called "He who goes upstream" When a traveler at last comes homes from a far journey, With what gladness his family and his friends receive him! Even so shall your good deeds welcome you like friends And with what rejoicing when you pass from this life to the next! From DHAMMAPADA - The Sayings of the Buddha
I'VE FALLEN AND I CAN'T GET UP!! DO NOT SELF-DIAGNOSE YOURSELF,
CHECK ANY CHANGES WITH YOUR NEPHROLOGIST FIRST.
like a commercial, right? But it true and it happened to me Thursday
morning last at 5am. I woke and went to the bathroom with my walker
and used the toilet. When I turned to go back to the bed, the walker
didn't make the complete turn with me and down I went. Fortunately,
I missed the side of the toilet bowl and the sharp-edged corner of
the lavatory console. But I was on the floor, with, as it turns out,
several severe hematoma's on both knees and on my left hand.
could not get up. What to do? I tried pushing up against the door
frame, no luck; I tried pulling up on the toilet, no luck. So I
realized I was going to have to call Michael, my friend who has keys
to my locked apartment. I didn't really want to call the EMS because
I knew Michael and/or my friend Tom would come. BUT, the phone was
beside the bed, 15 feet away. So I crawled on my butt and managed to
get the phone and call them both.
showed up in 30 minutes. But if Tom had come first he didn't have
keys. So I crawled again 25 feet to the front door and reached up
and unlocked the door, crawled back to the floor beside the bed and
managed to pull me up and on to the bed. Once in that position, I
could navigate with the walker. They stayed, of course. I went to
the kitchen and very terribly woozy. which I thought was low blood
sugar. So I took some dextrose tablets and the dizziness eased off.
They saw me safely in bed and left. I paged my Dr. and she called
back around 10 and said, come the office immediately.
Michael came at 12:30 and we go to the office. They took an EKG and
found something irregular with my heart, so I was ordered the the ER
for further observation and diagnosis.
took me to the ER where it was discovered that I was completely
dehydrated and LOW IN SODIUM. So I was given 2 IV's of Saline. And
waited to be admitted to the hospital. That occurred about 8am
went to a ward that was not Nephrology, but extremely nice. My
nephrologist had seen me in the ER the night before, so I knew my
“team” was on the case. Plus Dr. Jan had called the ER, and she's
my doctor and friend.
story story short: The Nephrology Team finally visited me en masse,
and said, “Mr. Wall, you are dangerously low in Sodium, and this
explains your dizziness and disorientation, NOT blood sugar. YOU ARE
NOT EATING ENOUGH FOOD, SPECIFICALLY PROTIEN AND YOU ARE DRINKING TOO
the point, I began explaining that I was following Dr. Walser's book,
“12 Steps To Avoid Dialysis”. The head Dr. said, “That works
for rats, that does NOT work for humans. AND, has Dr. Walser
peronally treated you?”
I was ordered the eat more Vegetarian choices, and LIMIT ALL FLUIDS
TO 1.5 LITRES A DAY.
HYDRATION (3-4 LITRES WAS WHAT I WAS DOING per the Walser book's
advice) WAS STRESSING THE KIDNEYS AND DEPLETING THE SODIUM IN MY
POINT I AM MAKING HERE: DO NOT DO ANYTHING YOU LEARN ON THE INTERNET
OR IN BOOKS WITHOUT FIRST CLEARING IT WITH YOUR NEPHROLOGIST!
AM LUCKY, SO LUCKY THAT THIS HAPPENED, BECAUSE I WAS KILLING MYSELF.
am home now and eating about 60 gms of organic vegetarian protein a
day, and religiously measuring my LIQUID intake.
SELF-DIAGNOSE, EVEN IF YOU HAVE 12 MEDICAL DEGREES.
get “Life Alert ASAP”
you, America! And UNC Nephrology, Dr's Ryan Sanford and Jan
Well, I've been eating a vegetarian regimen for 2 weeks today, and counting protein grams for 3 days. Here's the result: I feel like a million dollars! I know I'm losing weight as well. And that's always a big plus.
For breakfast, I had my trusty 1 Hard-boiled egg = 7 gms protein 1/2 cup blueberries = 1gm protein For lunch 1 cup rice cooked without salt = 4 gms protein 1 cup carrots cut like copper pennies = 1 gm protein 1 cup yellow squash cut into slices = 1 gm protein 1 patty of butter, unsalted = no protein gms Total for lunch = 6 gms protein Total for the say so far = 14 gms protein
Will have snack of 4 cups of popcorn made with peanut oil later. about 4gm And some veggies and rice for dinner
My pharmacist just told me how to make microwave popcorn. (All commercial microwave popcorn has TRANS-FAT in excess). Here goes:
Take a minimal amount of popcorn and place it in a paper bag (lunch bag size or the next size up) Then drizzle a small amount of the oil of your choice. Seal the bag with tape and microwave beginning with 2 minutes. You may have to increase the time.
Reading Mackenzie Walser's book "Coping with Kidney Disease: 12 Steps to Avoid Dialysis" I find this information which will answer some of the questions I get asked every day. Most especially, when I tell friends what I cannot eat, they invariably ask, "Richard, what CAN you eat?" Protein is a problem for CKD (chronic kidney disease) so I will list the food HIGH in protein -grams per 100 calories) The correct goal for a CKD patient is 21 grams per day, so: Foods to be avoided: 5 Grams per 100 calories Celery Cabbage Artichokes Whole Milk 6 Grams per 100 calories Beans, green Lima beans American cheese Cheddar cheese 7 grams per 100 calories Lentils Peas Swiss Cheese 8 grams per 100 calories Brussels sprouts Egg Yogurt Cauliflower Asparagus Broccoli Spinach 10 grams per 100 calories Skim milk Mushrooms Buttermilk 11 grams per 100 calories Veal Pork Sardines 12 grams per 100 calories, etc Oysters 13 grams Lamb 13 grams Beef 14 grams Cottage cheese 15 grams Chicken 15 grams Fish 17 grams Turkey 17 grams Lobster 18 grams Scallops 21 grams So, now you know. It's up to you, CKD patients and friends to be aware. Next, I talk about Potassium
For further information about ingredients, this is an excellent site: http://caloriecount.about.com/
Here's what I think about the Duck Dynasty controversy.
I think it was engineered and choreographed by the A&E Network to boost their already bloated ratings. And they certainly have succeeded. Now will everybody SHUT UP?
I have no problem with their success. I am happy for them. It is NOT for me to judge whether what was said was hate speech or not.
I do know that, in this politically correct world, a caring and sensitive person would have said:
"It is not for me to judge what any person's sexual orientation or race is. That is for a higher diety to decide. I may not want to do what they do, but they have every right to do whatever they choose. And I have the right to ignore them and their behavior."
To go any further and try to block what was said, or to punish anyone for what was said borders on facism to me. There was a time in this world that speech such as the Duck Dynasty father has made would be cheered and also in other parts of this world he would mysteriously DISAPPEAR - such as in Nazi Germany or Peronist Argentina or many other lands.
In America we ALL have the right to say what we want.
And in America we all have the right to change the channel if we don't like what we hear.
Have some brains, America. Vote with you wallet. If you don't like what you hear, then don't watch them, don't support their sponsors or their channel.
Personally, I have better things to do with my time and participate in watching trashy reality TV.