Bob's Blog 7-5-14: Dialysis Loves Company

Bob Here.

Speaking of dialysis relationships...

Wait. We were, weren't we?

Oh yeah. Last month, I discussed the insanely close interactions we have with our attendants and nurses. You know...three to five times per week? Hours at a time? Our sex lives should be so good.

I didn't include the sometimes adversarial affiliations we develop with nutritionists and social workers. Unfortunately, my rapport with these mostly well-intentioned folks has been impaired by my tendency to instantly slip into "obnoxious smartass" mode as soon as I see them approaching. They require a post of their own.

But, perhaps the closest relationship we build in our dialysis regimen is with our fellow patients. Especially when you do in-center hemo and sit co-suffering with the same person every treatment. I mean, at three times per week at an average of four hours per treatment, you're spending the equivalent of 26 full days per year with these people. Talk about getting to know somebody. Sheesh.

Besides, these people are going through the same miserable process that you are. What could be better grounds for bonding?

And it's not like you're meeting under the best of circumstances either. In the course of a single week, you might have an intimate discussion with your neph about your deepest, darkest medical secrets; have to call for someone to push on your foot to relieve a cramp; get the riot act read to you by the nutritionist because your phosphorous number is getting close to your area code; and get into a loud argument with your spouse on the phone over who was supposed to do the dishes that night. All within earshot of your dialysis neighbor. Not exactly coffee at the Ritz, right?

Now, it's not like you're intentionally snooping on someone else's business. But when you’re within four feet of each other, and you can't exactly get up and leave the room, you're just bound to hear some of these personal details.

I wrote previously about a young man who sat next to me pretty consistently for a while in the first center I was in. His girlfriend was often there to keep him company, which is all very nice and everything, except that she had the unfortunate tendency to rat him out when he was giving answers that were less than truthful to a doctor or a member of the center staff.

There was a time when he was having trouble getting his phos under control. His number just kept on going up, to the point where it would have to look way down to see the start of double digits. (The normal high of the range is 5.5 mg/dL.)

I'm paraphrasing here, but when called to task by his doctor, he shrugged and said something like, "Huh. Don't know how that could have happened. Must be a bum test."

Then the GF, who apparently knew something about blood chemistry, piped in.

"You drink milk through a garden hose, you put cheese on everything. Even fruit. When your beer buddies are over your idea of health food is ordering spinach on your pizza. And don't even talk to me about chocolate. You almost singe-handedly but M&M Mars out of business."

She went on with this diatribe for several minutes with the doctor staring him down and nodding knowingly.

Of course, being his chair neighbor, I had a front-row seat to the exchange. He would occasionally look to me for support, but all I could do was shrug. Then we both laughed a little, which really set his little sweet-cakes off.

"THIS ISN"T FUNNY. I READ UP ON THIS. HIGH PHOSPHOROUS IS THE NUMBER ONE KILLER OF DIALYSIS PATIENTS. YOUR ORGANS WILL BE HARDER THAN YOU MOTHER'S BUNT CAKES. IS THAT WHAT YOU WANT?"

The he put on his best hang-dog look and admitted defeat. "No honey," he said.

Then the doctor and nutritionist had a serious pow wow with him on how to get his number down.

Now, obviously high phosphorous is no laughing matter and I was glad he was getting help and agreed to change his ways. But after the smoke had cleared, he seemed pretty embarrassed. We were sitting alone quietly for a while (the GF had left), I turned to him and said, "Do you know why the guy didn't report his credit card stolen?"

He looked at me a little confused. "No. Why?"

"Because the thief was spending less than his girlfriend."

Then we were both cracking up. We went on to exchange a few more girlfriend jokes, most of which are way too offensive to be repeated here.

We were laughing so hard that at one point the nurse came over to ask if we were ok.

My neighbor got all serious. "We were just discussing ways to get my phosphorous down," he said with a completely straight face. The nurse nodded, not looking for a second like she was buying it. When she walked away, we started howling again.

Fortunately, the guy worked to get his phosphorous number down from the stratosphere, but I had to laugh about their future interactions with the staff when the GF was present. Whenever anyone asked him something and he was considering giving an answer that wasn't entirely accurate, he'd look over at his honey and she would give him a look that could peel the paint off the walls. Then he would hang-dog again and tell the whole truth.

When I first retired and went on the first shift (early morning), I sat next to the same guy every day for a couple of years before I started on home hemo.

At first, we didn't interact much beyond the "Hi, howyadoin" phase. But as time went by, my neighbor was witness to what I gracefully call some of my "airhead antics." Depending on my mood, these could include general crass behavior, telling a stream of bad jokes, pretending I forgot how to speak English, falling asleep in the middle of a conversation, and overall harassment of the staff to the point where they wanted to wheel my chair out into oncoming traffic.

His reactions were usually pretty muted, the most extreme being a brief snort of laughter. Usually, he wouldn’t even look up from the book he was reading.

Then one morning, I came in and he was already on treatment. I said my usual "Hi howyadoin," and he said flatly, "Livin' the dream."

For some reason, this hit me as extremely funny. Must have been his delivery.

Anyway, I just started cracking up. And after a while, it became infectious and he started laughing too. This would continue basically for the entire treatment that day. We would calm down, then a nurse or attendant would come over, ask how one of us was doing, and we would answer, "Livin' the dream," and we would both start roaring all over again.

From then on, we would always exchange common catch phrases at the start of our sessions.

The discussions would go something like this:

Me: "Mornin'. Howyadoin'?"

Him: "It's a marvelous day for a moondance."

Me: "Yeah, that's the ticket."

Him: "Are you talkin' to me?"

Me: "Where's the beef?"

Him: "Some things are better left unsaid."

We would only stop when we were laughing too hard to continue.

Then, another day:

Him: "Hi howyadoin'?"

Me: "Champaign wishes and caviar dreams."

Him: "I get no respect."

Me: "Don't have a cow."

Him: "Go ahead. Make my day."

Me: "I want my MTV."

Him: "Well, kiss my grits."

It got so bad that the staff, who were generally in the dark about our unique method of conversing, started getting included as well.

An attendant came over to get my neighbor started, everyone completely serious.

The attendant would say something like, "All set to go?"

And my neighbor said, "Let's get ready to rumble." Then he and I would start cracking up, with the attendant totally not seeing the humor.

Or, someone would come over to see how I was doing during treatment. They would ask, "How you doing over here Bob?"

And I would say, "Well, I don't think we're in Kansas anymore." More gales of laughter.

I'm pretty sure that after a while, the staff was convinced that our tacos had just gotten soggy.

One day, we were sitting there minding our own business when a substitute nutritionist, who looked like he was about twelve, came over and started giving my neighbor a hard time about his between-treatment weight gain. Honestly, he knew that he put on too much fluid and we all know that's not good. But he was a big guy and he was genuinely trying to reform his ways.

But this kid was determined to get his lecture in and every time my buddy tried to interject something, he got talked over. After a while he just gave up and let the kid talk.

After the lecture was over, and the child went back to playing in his sandbox or whatever, the neighbor was sitting there somberly.

I looked at him and said, "You know, they name streets after that kid."

"Huh?"

"You know...One Way."

This got us both laughing again.

I said, "You know, if you stand close enough to that kid, you can hear the ocean."

We were both laughing heartily when we realized that the kid nutritionist was still standing within earshot at the nurses' station. He was giving us both looks that could kill. Of course this made us laugh even more.

So, it may not make for the best staff relations, but having a good neighbor can make in-center dialysis treatments much easier to get through.

Thanks for reading. Take care.