Bob's Blog 3-7-15: On the Production Line

[BobN]

Bob Here.

Having been on home hemodialysis for over two years now, I have to make a confession that became clear after I travelled recently and had to go back in-center for a treatment.

I have to confess that I'm now officially spoiled.

You see, the wife and I are so meticulous about every step when we're treating at home that going back to a center now makes me feel like I'm on a production line.  It's like churn 'em up and spit 'em out with most dialysis centers.  There's not a shortcut they won't take as they move you along the line and out the door to get ready for the next occupant of your chair.

Now, that probably sounds a lot worse than I intend.  I should point out that I was an in-center patient for almost eight years before I started treating at home.  And most of my in-center experiences were good, and I generally got along great with most staff members despite my tendency towards misbehavior when the inevitable dialysis boredom struck during these long treatments.

One time, I was about two and a half hours into my session and it was quiet in my center and I was bored out of my gourd.  The guy sitting next to me had brought some gummy bears to munch on and they were sitting on the table in between us.  He wasn't eating them at the time so I spontaneously reached over, took a few and pegged them at the charge nurse, who was sitting with her back to me about ten feet away minding her own business doing some paperwork.  Then I just went back to reading my book.

She felt the impact, looked up and around, decided nothing had happened and went back to her mound of papers.

So, I helped myself to another one and pinged it off her back.

She looked down at the gummy bears on the floor and over at me, but I wasn't paying any attention.  So, she picked them up and walked over.

"Bob, are you by any chance throwing gummy bears at me?"

"Gummy bears?" I asked, looking like she had asked me if there were rattlesnakes coming out of the ceiling.

"Yes, gummy bears," she said, holding out the evidence and nodding at the package on my neighbor's table.

"Those aren't my gummy bears," I said.

"Uh huh," she said and walked off.

Now, you don't have to call the gummy bear police on me, my neighbor was awake and watched the whole scene with a look of bemusement.  In fact, he had a whole 'nother package, and instead of risking assault charges, we decided to take turns tossing them at a nearby wastebasket.

We were keeping score, but we must have lost count as we ended up accusing each other of trying to cheat and laughing like crazy men.  The nurse looked over a few times, but just shook her head and resumed her paperwork.

The point being that despite my childish behavior, I became real close friends with that nurse and we keep in touch to this day.

Hey, there's no accounting for taste, right?

Anyway, back to the production line approach to treating in-center. 

I take great care setting up my machine at home.

This deliberate approach serves two purposes. 

One, I hate alarms during treatment, so I make sure I get as much air out of the system as possible during the "snap and tap" procedure after the system has been primed.

Two, and I can't emphasize this one enough, I'm generally a disaster-waiting-to-happen when it comes to dealing with any kind of machinery.  I've been known to cause malfunctions just by walking in a room.  So, I take great care getting the machine ready to avoid setup alarms, electrical shorts, floods, and the wife having a coronary watching me work.

The techs in-center are very casual about such details.

I went in-center recently while travelling to visit the grandkids.  The tech setting up my machine gave the kidney a couple of pats and asked if we were ready to go.

"Are you sure you got all the air out of there?" I asked.

She looked at me like I was part of another species.

"Uh, I think so," she said, but she did pat down the cylinder a few more times.

"Do you think you should drain it a little?"

She was really taken aback.  "Oh, sure," she said, complying with my request.

"You know," she said sitting down, "I've been doing this for twelve years and you're the first patient who has ever asked me about priming the cartridge."

I tried to make a joke out of it.  "Don't feel too bad.  I was one of the first ones to be kicked out of a dialysis center during a treatment too.  Ha ha ha..."

Her look said she wasn't really sure whether I was kidding.

So on we went.  I put my own needles in, so there was no problem there.  This center didn't have a home program, so many of the techs had never seen a patient do self-cannulation.  I had a crowd gathered around to watch and of course I hammed it up big time after they went in, taking bows and so on.

The fact that I place my own needles saved me from having a tech or a nurse whom you know nothing about coming at you with 15-gauge sharps.  (Some home patients use buttonhole needles, which aren't quite as sharp.)

The last time a tech put my needles in, it was like whammo-bammo, before I knew what was happening both needles were in.  No asking where I wanted to be stuck, no "shouldn't we have dinner first" moments at all.

"Hey," I said.  "Take it easy with those things.  This is dialysis.  Not roto-rooter."

Back to my most recent experience, I like my taping to be just so and I'm also aware that once the needles go in, most in-center people just slap on a couple of pieces and move on.  So my new friend was coming at me with a huge piece of tape.

"Wait!" I said.

She stopped mid-slap.

"Uh oh, what now?"

"Oh, it's just that I'm particular about how my tape goes on."

"Hmmm.  Why doesn’t that surprise me?"

So, I gave her instructions on how I like to be taped. 

She said, "Okay, I'm gonna start the treatment up.  Is there anything else?"

I laughed.  "No, everything is great.  Thanks."

I managed to behave myself during the treatment time, but the next challenge that I knew was coming was being taken off.

Again, I'm used to the wife helping and she's very gentle and detail oriented when I'm being taken off the machine.  But I also know how different it is in-center.

Once your session is done, you quickly become yesterday's news, and the center will do everything short of just wheeling you out into the street, chair and all, to get rid of you as quickly as possible so they can move on to the next patient.

So, my tech friend comes over and starts whipping off the tape.

I've even had someone just pull the needles out with the last piece of tape, which may be a great time saver, but has also occasionally resulted in a waterfall.  The kind you really want to avoid.

"Whoa whoa," I said.  "Take your time."

She stopped removing the tape and gave me a "What now?" look.

"Sorry," I said.  "I've had needles come out accidentally before and I'm just trying to avoid that."

Now, that was a little bit of a fib.  The people who yanked out my needles while removing the tape were doing exactly what they intended to do.

"Besides," I said, again trying to inject some humor into the situation.  "I'm only having one treatment here.  Once I'm gone today, you'll really miss having me around.  So now, you probably want to work real slowly, huh?"

She rolled her eyes and began proceeding more carefully with the tape removal. 

At about that moment, she looked like she'd miss me about as much as a toothache.

"Before my needles come out, we usually count to three to make sure we're both ready," I said.

Although this is true, I have to admit I was only screwing with her at this point.

But she did what I asked and I got out of these without any further mishaps.

So, some of the many advantages of doing home treatments are that you can go at your own pace, do things your own way, and avoid bringing out homicidal tendencies in dialysis techs.

Thanks for reading.  Take care.

[Deanne]

Hilarious, as always. However, I just saw that you posted this at 2am my time, 5am your time? Do you sleep?

[willowtreewren]

Reminds me of the good ol' days when we were doing home treatments! 

Enjoyed it.

[PrimeTimer]

Something tells me you were a lot of fun at the office. 

[kristina]

Thanks again Bob for the giggle, I do enjoy reading your thoughts, they always provide me with a much needed giggle ....
Thanks again from Kristina.
P.S. ... and please keep up your wonderful "fighting spirits with a twinkle in the eye", because it is very much needed...
Thanks again...

[Charlie B53]

I can only hope that If/When the day comes that I have to make the switch from PD to Hemo, that I will be able to keep my sense of humor as well as you have.

Thanks!

[BobN]

Deanne, Aleta, PT, kristina, Charlie, thanks.

Deanne, I admit I've never been much of a sleeper.  And after working corporate for 32 years, getting up early is deeply ingrained.  It's pretty bad when you consider getting up at 5:30 "sleeping in."

[Riki]

The taping thing is big with me.  My fistula is high pressure, so my needles can and will pop out on their own.  One nurse will even use the plastic tape on top of the paper tape, just to make sure the needles stay put.  I remember the first time we realized that secure tape would be an issue with me.  Thankfully, it was at the end of the run and I was disconnected from the machine.  The nurse, who'd only been there a few weeks, proceeded to take all the tape off one of my needles, except for one small strip across the top of the needle.  She turned her back for only a second, to grab the bandaid waiting on the table, and the needle just flew out.  She jumped back, trying to get out of the way (out of instinct or self preservation, or maybe both), as the blood spurted everywhere.  Then, me, while watching my own blood spilling all over the floor, and me, and the chair, could do nothing but laugh like a crazy person.  I ended up having to borrow a shirt to go home in, and I now wear a protective hoodie, just in case.

[Michael Murphy]

I save these to read in the dialysis center.  I think the sudden bursts of laughter they cause cause the the staff to look at me funny. However if they can't take aj joke.  Thanks for making me laugh and for disturbing the staff.

[BobN]

Riki, Michael, thanks.

Michael, keep laughing brother.  It's cliche, but it really is the best medicine.

[PrimeTimer]

Riki, Michael, thanks.

Michael, keep laughing brother.  It's cliche, but it really is the best medicine.

That reminds me, in order to produce more endorphins, my husband and I swear that someday we are going to break down and finally buy the video collection of the old Carol Burnett Shows and laugh til our sides split.

[noahvale]

*

[jeannea]

Noahvale, I was going to say the same thing. I've watched some of the episodes.

[PrimeTimer]

That reminds me, in order to produce more endorphins, my husband and I swear that someday we are going to break down and finally buy the video collection of the old Carol Burnett Shows and laugh til our sides split.

FYI, depending on where you live and service provider, MeTV Network has "Carol Burnett and Friends" on M-F at 11 pm (Eastern).   This syndicated version of the "Carol Burnett Show" is only 30 minutes, but features the best sketches. - http://metvnetwork.com/shows/carol-burnett-and-friends

MeTV has a great variety of popular shows from the 50s through the 80s.  Go here to find out if in your area - http://metvnetwork.com/wheretowatch/

noahvale; Thank you, thank you, thank you!! We don't watch a lot of TV and so sadly did not know about MeTV. We do NOW! This is wonderful! Thanks, you just made our day er, evening!

[BobN]

PT, noahvale,

Great suggestion.  Some of the best tv ever.

I wish today's TV producers would pay attention.  As in, it doesn't have to be vulgar to be funny.

[PrimeTimer]

Aside from BobN's posts, about the only thing these days that has brought on any sort of spontaneous laughter is the Geico insurance "screaming scapegoat" commercial. Pretty sad when you find yourself channel surfing just to watch a screaming goat, on a "production line no less"! Uh oh, just now a picture formed in my mind of nurses and techs...screaming like goats.