BROADWAY SINGS AGAIN!!

UPDATE MAY 21

Dialysis (hemo) continues 3 times a week.

I have lost 75 pounds - mostly fluid.  This is a good thing.

Peritoneal dialysis has proved to be NOT successful with me.

So the peritoneal port in my abdomen is being removed.

A fistula for hemodialysis is being placed in my left arm.  This is a wonderful thing.  The surgery will be June 11.

ALL IS WELL.  Planning a benefit for October 9 & 11 - benifiting Habitat for Humanity at United Church of Chapel Hill.

STAY TUNED.

UPDATE

Yes, I am finally home after 3 months in UNC Hospital and a rehab center down the road.

Peritoneal dialysis proved not to be fast enough to satisfy my doctors, so we switched the hemo dialysis and, so far, we have taken off 80 pounds of fluid and toxins from my body.

We will switch to peritoneal in a couple of months when we have taken off 40 more pounds.

I have so many wonderful friends looking after me, shopping for me and carting me around until I can get back to driving.

Kidney Disease is daunting, but it is NOT tragic.

All is well.

NEW INFORMATION ON HOME DIALYSIS

HOME DIALYSIS CYCLER

THIS CHARMING MACHINE COSTS

$18,000

YES, $18,000

FORTUNATELY, MEDICARE PAYS FOR ALL

END-STAGE RENAL CARE AND EQUIPMENT.

WHEW!!

FIRST VISIT TO DIALYSIS CLINIC

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.

Keep me in  your prayers, please.

UPDATE ON RICHARD

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!

BENEFITS OF PERITONEAL DIALYSIS

 This is what I am about to begin.  On Oct 2, I will have the catheter placed in my abdomen and 2-4 weeks later the dialysis can begin.

 Benefits of peritoneal dialysis

The benefits of PD include:

• Fewer negative side effects (such as nausea, vomiting, cramping, and weight gain) than in-center hemodialysis
• Fewer dietary restrictions than in-center hemodialysis
• Needle-free treatments
• 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.

CONTINUED KIDNEY DISEASE PROBLEMS

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.

WISDOM

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

ALL GOOD THINGS MUST END

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!

HERE'S THE LATEST ON MY KIDNEY FUNCTION (OR LACK OF IT!)

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.

Thanks for being there, and understanding.

TOMATO SHERBET?

From my life-long friend Dick Hudson, by way of the Memphis Country Club

Tomato Sherbet

2 c. tomatoes and juice, pureed

1 c. crushed pineapple

2 oz. cream cheese

1/2 c. cottage cheese

1 c. mayonnaise (or "mynase")

salt, pepper and grated onion, to taste

pinch of ginger

dash of tabasco

Mix ingredients and freeze in an ice cream churn.

NO TRANSPLANT FOR RICHARD

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.

SPRING CONCERT, 1955 - SANDERSVILLE, GEORGIA

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!

WHY THEY CALL ME RICHWAH

Larry Shue

Back 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, Georgia.

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 Square"

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 laugh.

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 is.

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.

We will never forget you, Larry. Ever.

 Love,

 RICHWAH

Ethereal and Magnificent

THIS IS SUBLIME MUSIC-MAKING

It doesn't get any better!

KIDNEY UPDATE

KIDNEY UPDATE (MINE)

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?

BAKED CRAB IMPERIAL

BAKED CRAP IMPERIAL

 

4 tablespoons Butter

4 tablespoons Flour

2 cups milk

1 Tsp Salt

1/2 teaspoon pepper

1/2 teaspoon celery salt

2 Tablespoons sherry

1 egg yolk, beaten

1 cup bread crumbs

1 teaspoon minced parsley

1/4 cup finely chopped onion

Dash of cayenne pepper

1 pound crabmeat, flaked

1 small can mushroom piece

1 small jar pimento

paprika

1/4 cup chopped bell pepper

 

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.

RICHARD'S PERFECT HOLLANDAISE SAUCE

RICHARD'S PERFECT HOLLANDAISE SAUCE

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.
 



 

SAVORY CHEESE COOKIES

SAVORY CHEESE COOKIES

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.

ANGER

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.

R.I.P., Maestro Claudio Abbado

IT DOESN'T GET ANY BETTER THAN THIS.

GREAT WISDOM FROM THE BUDDHA ABOUT PLEASURE

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

WARNING: SELF-DIAGNOSIS AND INTERNET AND BOOKS' ADVICE - CKD AND CAREX WALKERS AT WAL-MART

HELP! I'VE FALLEN AND I CAN'T GET UP!! DO NOT SELF-DIAGNOSE YOURSELF, CHECK ANY CHANGES WITH YOUR NEPHROLOGIST FIRST.

Sounds 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.

I 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.

They 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 waited.

They 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.

So 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.

Tom 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 Friday morning.

I 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.

Long 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 MUCH WATER/LIQUIDS.”

At 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?”

So I was ordered the eat more Vegetarian choices, and LIMIT ALL FLUIDS TO 1.5 LITRES A DAY.

EXCESSIVE 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 BODY.

THE POINT I AM MAKING HERE: DO NOT DO ANYTHING YOU LEARN ON THE INTERNET OR IN BOOKS WITHOUT FIRST CLEARING IT WITH YOUR NEPHROLOGIST!

I AM LUCKY, SO LUCKY THAT THIS HAPPENED, BECAUSE I WAS KILLING MYSELF.

I am home now and eating about 60 gms of organic vegetarian protein a day, and religiously measuring my LIQUID intake.

DON'T SELF-DIAGNOSE, EVEN IF YOU HAVE 12 MEDICAL DEGREES.

And get “Life Alert ASAP”

Thank you, America! And UNC Nephrology, Dr's Ryan Sanford and Jan Busby-Whitehead.

AND BEWARE OF FLIMSY, CHEAP WALKERS MADE BY CAREX

2 WEEKS VEGETARIAN AND 3 DAY COUNTING PROTEIN GRAMS - AND THE RESULT

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