In my past blogs, I have written about all the yard work we accomplish on our 15 or so beds around our home in Pecan Plantation, Granbury, Tx. I have also mentioned how each evening a deer cluster munchs their way past our newly planted crepe myrtle trees and how fauns in particular like to munch on the budding leaves. I did obtain some “guaranteed to work” spray from Amazon that fauns ignore. I captured on video a group the other night and that’s what the video below is.
Tag: alarms (Page 8 of 43)
Here’s the deal. My supply order arrived as advertised this morning, right in the window advertised. But it was not “my supply order,” but one Fresenius decided. Seems like they are no longer supplying the cassette boxes with 20-foot-long supply and drain lines in a 10-count box. They now supply 14 cassettes with 15-foot-long lines. I need at least a 20-foot drain to reach the toilet where we drain the cycler overnight. Did anyone bother to ask me what I needed? Hell no.
I called Fresenius Supply and was told I now have to order drain line extensions that come 28 to a box. Ok, I can do that, but wait, such drains are not listed as something we as mere patients can order. The voice on the other end of the phone at Fresenius couldn’t believe that we could not order drain extensions, went off the line, came back, and acknowledged that we presently could not order them.
Fresenius is FUBAR. It is obvious they made a business decision to modify cassette packaging. Let’s see. We’ll chop the lines down but increase the number of cassettes per box and charge more. Ok, and if patients need a longer drain line we’ll sell it to them (actually whomever is paying the bill) and make even more money. Not once have I ever been asked my opinion about anything having to do with MY treatment from a supply perspective. Fresenius is acting as if they are a government that always knows what’s best. Some democracy, isn’t it? Makes Hogan’s goat look like a precision machine!
Six of the last seventeen nights I have experienced cycler alarms. But I am not alarmed no pun intended. In each case, I had the cycler line kinked under my body. By merely shifting my body and straightening out the line, the alarms cleared.
My wife has noticed that where supplies are delivered by Fresenius which are scheduled for today BTW over time the carts they use and the load on them has started to stretch and hump up our hallway and bedroom where we store dialysis disposables. The wheels on their cart are small, on the order of six inches or less which by necessity places lots of weight on a small area creating enormous pressure on the carpet and underlayment. She wants to get new carpeting but we have come up with a solution to this problem.
Our running toilet of yesterday has been solved – at a cost of $150.00 for a plumber. Here’s the deal. The toiler started running from time to time. Our son installed a new flapper value. The toilet continues to leak down after flushing. I installed a new flapper valve and a seat. The toilet continued to lead down. The plumber came, and installed a new flapper which fixed the problem. What is the difference – the flapper valves we were using were plastic and somewhat ridged; his was rubber and more flexible. For this knowledge $150. Go figure.
My peritoneal dialysis treatment is boring, in the groove, doing what it is designed to do – keeping me alive. What more can I say? My weight hasn’t varied by more than 1.5 lbs for weeks. My glucose is right in there. My BP this morning, without drugs keep in mind, was 103/70. The only exciting thing going on this week in the PD world is supply delivery on Wednesday.
For those of you experiencing difficulty my condolences. Right now PD is a piece of cake with added protein.
I read a blurb in yesterday’s WSJ about a meme in use mostly by the younger crowd using the word “Ohio.” I was born and raised in Ohio, Springfield to be exact, where on a very cold Sunday evening, about 8 PM at 525 Galagher St, I was born. My parents were working-class people, neither of which had graduated from high school. My father quit school in the sixth grade to go to work on the railroad as a bridge carpenter water boy. My mother had a daughter at 16 and later in life earned a GED and went on to become a LPN.
My mother in particular embodied in me the importance of an education although not achieved on her part. I think the class distinctions in working in a hospital made it clear to her that along with education potentially comes wealth. So back to “Ohio.” I queried Perplexity about this new lexicon with the following results which have not much to do with peritoneal dialysis per se but do with me, and that’s what this blog is all about. The lead graphic, BTW, is of an Ohio Buckeye.
The use of the word “Ohio” among younger people, particularly in memes and social media, has become a cultural phenomenon, often characterized by absurdist humor and a sense of irony. This trend seems to have gained momentum particularly during and after the COVID-19 pandemic.
Cultural Context
- Absurdist Humor: Many memes portray Ohio as a bizarre or desolate place, often exaggerating the idea that “nothing” exists there. This aligns with a broader trend of using place names in humorous, often nonsensical contexts, similar to the “can’t have shit in Detroit” meme. The phrase “only in Ohio” has emerged, suggesting that only the most outlandish events or scenarios could occur in that state[4].
- Generational Influence: While the origins of these memes can be traced back to earlier discussions about Ohio, they have notably evolved with the influence of Gen Z and younger audiences. Many younger people, including those in Gen Alpha, engage with these memes without a deep understanding of Ohio itself, finding humor in the absurdity and randomness associated with the state[4].
- Global Reach: Interestingly, the humor surrounding Ohio has transcended U.S. borders, with international audiences also finding the memes amusing. This has led to a perception that Ohio represents a kind of cultural shorthand for the bizarre or unexpected[4].
Conclusion
Overall, the word “Ohio” has become a versatile meme that encapsulates a blend of absurdity, irony, and cultural commentary, particularly among younger demographics. It reflects a playful engagement with regional identity, where the state is humorously depicted as a place of strange occurrences and minimal significance, resonating with audiences who appreciate this style of humor.
Citations:
[1] https://ohioauditor.gov/publications/docs/AlongTheOhioTrail.pdf
[2] https://en.wikipedia.org/wiki/Ohio
[3] https://www.rrcs.org/Downloads/Ohios%20historic%20Indians%2038%20pages.pdf
[4] https://www.reddit.com/r/GenZ/comments/1cieukp/why_are_people_acting_like_ohio_is_gen_alpha_slang/
[5] https://www.midstory.org/the-forgotten-history-of-ohios-indigenous-peoples/
[6] https://civ.ohio.gov/decisions-and-publications/informational-brochures/6-age-discrimination
[7] https://singout.org/should-have-been-done-long-ago-ohio-part-4/
An author named Andy Andrews has a book out about an individual who is a “noticer.” Here’s some detail on the concept:
The concept of being a “noticer” refers to the ability to observe and pay attention to the small, often overlooked details in one’s surroundings and daily life. Here’s a more detailed explanation of what it means to be a “noticer”:
Heightened Awareness:
Noticers cultivate a heightened state of awareness, constantly scanning their environment and attuning themselves to the subtleties that often go unnoticed by others.
They are keenly observant, taking in the sights, sounds, smells, and sensations around them with a level of sensitivity that allows them to perceive the world in a more nuanced way.
Attention to Detail:
Noticers have a natural inclination to pay attention to the small, seemingly insignificant details that others might overlook or dismiss as unimportant.
They might notice the way the light filters through a window, the unique patterns in the bark of a tree, or the slight changes in someone’s facial expression.
This attention to detail allows them to gain a deeper understanding and appreciation for the world around them.
Curiosity and Exploration:
Noticers are inherently curious individuals, constantly driven to explore and discover new things. They are not content with simply accepting the surface-level appearance of the world.
They actively seek out opportunities to learn, investigate, and uncover the hidden layers of meaning and significance that lie beneath the obvious.
This curiosity leads them to ask questions, seek out new perspectives, and engage in deeper exploration of the world and the people in it.
Mindfulness and Presence:
Being a noticer requires a certain level of mindfulness and presence in the moment. Noticers are adept at staying focused on the present, rather than being distracted by the past or the future.
They can fully immerse themselves in the here and now, allowing them to fully absorb and appreciate the richness of their experiences.
This mindfulness and presence helps noticers to derive more meaning and fulfillment from their daily lives, as they can savor the small, often overlooked moments that others may miss.
Empathy and Connection:
Noticers often possess a heightened sense of empathy, as their attention to detail and nuanced understanding of the world allows them to better relate to the experiences and perspectives of others.
By noticing the subtle cues and expressions of those around them, noticers can more readily connect with others on a deeper level, fostering meaningful relationships and a greater sense of understanding and compassion.
In summary, being a “noticer” involves cultivating a heightened awareness, attention to detail, curiosity, mindfulness, and empathy – qualities that can enrich one’s life and deepen one’s connections with the world and the people in it.
I submit to you, that to be at the zenith of peritoneal dialysis, we must become astute “noticers.” As a side, it is obvious to me that PhDs have this mindset to some extent in that by their nature, PhDs are trained to see patterns or behaviors or associations that are not necessarily self-evident. That’s what we are trained to do, sometimes largely through statistics, but not always. This ability often is the starting point of research that ends up going down many rabbit holes but in the end, is very productive.
For example: After its initial approval for type 2 diabetes, Ozempic has since been approved for additional indications:
In 2021, the FDA approved Ozempic for the treatment of chronic weight management in adults with obesity or overweight with at least one weight-related condition.
In 2022, the FDA approved Ozempic for the treatment of cardiovascular disease risk reduction in adults with type 2 diabetes.
We are still plugging away at getting more Proteins into my diet to bring up my lab albuminn reading. Our son, who is on a rather strict Keto diet, recently recommended the cereal Magic Spoon, which is available at both Amazon and WalMart. It comes in four flavors, is low in carbs, and has zero sugar and grains. The peanut butter-flavored variety has 14 G of protein, counting milk.
Post markets a hi-protein cereal advertising 20 g of protein. I bought two of these to try. Lastly, there is a granola cereal with something like 14 g of protein. I tried it this morning and didn’t think too much of it.
I happened to stop by the already-prepared salad display at WalMart and found some salads with 17 g of protein in them so I bought several. I also bought cube steak, filet mignon, bacon-wrapped tenderloin, and a package of 93/7 hamburger patties to round out this week’s protein as a start.
BTW, my weight this morning was 141.0, hanging in there. In the dentist’s chair yesterday afternoon having my teeth cleaned my blood pressure was 110/66. Keep in mind this is without any BP meds for some time. As I write this blog at 1710 on 8/20/2024, the temp outside is 108. See lead graphic. Yes, it is warm in North Texas.
I have previously blogged about my recent low lab albumin reading, about albumin itself, and how much daily protein is the norm to raise it. This blog is a little about what we are incorporating into my diet as a result.
I am eating a serving of smear case daily, usually with my evening meal along with a healthy serving of a fruit like strawberries. This provides about 21 g of protein. with supper plus. I have this along with a fortified drink with the stuff Fresenius provided which is another 16 g for a total of 37 g of protein for supper.
For breakfast, I’m having a cereal such as mini wheat (5g), a heaping tablespoon of peanut butter (4+g), and a Brazil nut (1/2g) along with 6 oz of V8 (2g).
For lunch, it varies. Today I’m having a shake consisting of vanilla powder with 31 g of protein, a little 2% milk, strawberries, and sucrose sweetener.
If you add this up, you’ll ascertain that I’m right at 72-80 or so as the recommended amount to raise albumin. I have labs on 9/6/2024 so we’ll see.
Those of you following this blog know that recently my labs indicated a low albumin reading of 3.1. To increase this reading to the desired over 4 result, it has been recommended by my dialysis team that I increase my protein intake. But the nagging question of how much protein to shoot for, and what is “enough” were not addressed. I should probably have quizzed my team’s dietician about this but I didn’t. This blog delves into the question posed below to Perplexity:
My albumin is 3.1. I’m on peritoneal dialysis. What is the maximum protein input per meal and day that I should input to bring albumin up and how long should it take?
Given your albumin level of 3.1 while on peritoneal dialysis, here are some recommendations to help increase your albumin:
Protein Intake Recommendations
- Daily protein intake: Aim for 1.2-1.3 g of protein per kg of body weight per day[2][3]. I weigh roughly 64 Kg. So my daily allotment of protein is 77 to 83 g.
- Per meal: Try to include 20-30 g of high-quality protein at each meal[4].
Strategies to Increase Albumin
- Include a protein source at every meal and snack[2].
- Focus on high-quality protein foods like lean meats, fish, eggs, and dairy products[4].
- Consider protein supplements like Greek yogurt, protein powders, or renal-specific nutrition drinks if recommended by your dietitian[4].
- Eat your largest meal when your appetite is best[1].
- Have protein-rich snacks between meals and before bed[1].
Timeline for Improvement
Albumin builds up slowly in the body. It may take 3 weeks or more of consistent, adequate protein intake to see an improvement in your albumin levels[1]. However, individual responses can vary, so continue working closely with your healthcare team to monitor your progress.
Remember to balance your protein intake with other aspects of your renal diet, such as phosphorus and potassium restrictions. Consult your nephrologist and renal dietitian for personalized recommendations tailored to your specific needs and medical condition.
Citations:
[1] https://www.stjoes.ca/patients-visitors/patient-education/a-e/PD%203904%20Albumin.pdf
[2] https://www.kidneyfund.org/article/dietitians-guide-protein-people-dialysis
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372871/
[4] https://www.davita.com/diet-nutrition/articles/advice/15-kidney-friendly-protein-foods-for-keeping-albumin-up
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5678603/
[6] https://my.clevelandclinic.org/health/diseases/22529-hypoalbuminemia
[7] https://www.efsa.europa.eu/sites/default/files/efsa_rep/blobserver_assets/ndatolerableuil.pdf
[8] https://www.kidney.org/kidney-topics/ckd-diet-how-much-protein-right-amount
My Dialysis Team Meeting took place as scheduled this morning. We had a meeting that did not resolve my low Albumin reading from my latest lab. Recall that it dropped from 3.6 to 3.1 and an acceptable reading is over 4. We discussed six ways from Sunday what may have changed in my life and/or lifestyle to merit this change with no conclusions. As often happens in medicine, we’re now going to wait and see what my labs are as a result of my next scheduled lab on 9/6/2024. I will be doing an adequacy test at that time also so there will be a lot on the table.
One unique aspect of the meeting was that my dietician provided me with a 32 oz bottle of LiquaCel to try out as a protein supplement. My nephrologist also approved my use of protein powder to improve my protein intake. I’ve included a PR-type video below from the company that makes LiquaCel to familiarize readers with their products.
