Am I there yet?

I would like for you to think with me, do you remember taking a family vacation or trip and within about 15-20 minutes of the trip you would ask are we there yet and your parents answer would come back not, yet we just started and every, so often you would ask the same question until you had finally arrived at your destination. As a child, many times, we may have been impatient because we wanted to get to our next destination. Being a dialysis patient and waiting on a transplant, sometime you may ask the same question. Am I there yet? 

Life is the Classroom, experience is the teacher, and we are the student.

Anthony E reed

Waiting for something as life changing as a transplant can be painstakingly slow and can be easy to be inpatient waiting for a kidney transplant. I have said many times that dialysis is the training ground for many that seek a Kidney transplant. Why is this, you may ask?

 Dialysis teaches one lesson for all that have to sit in the classroom to learn, and that lesson is learning to be patient.

Going to dialysis is more than just going in, sitting in a chair for 20 or 30 minutes and treatment would be over. Most treatments for an In-Center Hemodialysis patient last about 4 hours. Once you are hooked to the machine, you need to stay in that chair for the full time to receive the best treatment possible so that you could feel your best and be ready to grab your dream. There a few times I would look at the clock after what felt like forever and realized that only 15 minutes had passed. If I had made this a habit instead of keeping my eye on the goal of finishing my treatment, discouragement would set in, and I would want to come off the machine early. Which would not have been in my best interest and I would have paid dearly for leaving treatment early. (If I would not have had my full treatment I would have gained fluid and well I would have cramped. Check out “Tuna Sub of Consequences” for more information.)

So what does dialysis and waiting on a transplant have in common? They both teach patience. If you are on the transplant list it can take up to 1-13 years and for some even longer. Now there are some ways to receive a kidney faster, by advocating for yourself. But even then it still takes time. I remember when I started dialysis. The nephrologist set up my transplant appointment and I went to start the process. I was hoping that they would say when I got there that they had a kidney for me, but of course this was not the case. They instead started to do some test to see if I was a good candidate and then gave me a wait time of 5-9 years unless I had a living donor step up which could cut my wait quite a bit. 

Did I learn how to be patient, you ask? Well, while I still do not claim to be the master of being patient, here are some of the lessons that helped me on my journey and still help me today.  

  1. I am one treatment closer to my transplant.- I got in the habit of saying this at the end of every treatment. Even though I did not have a donor and still had a few years on the waitlist, it still was true that treatment was one less that I had to do. 
  2. Take time to smell the roses.- This is kind of ironic, right. Well, think about how many times we get in a hurry to get our answer or achieve that dream we are working towards. Many times we don’t take time to smell the roses and enjoy the small things of life. They are there so that we don’t get bored on our journey.
  3. Keep your eye on the goal.- This is an important part of learning how to be patient. If you get your eye off the goal, no matter how far you are away from it. You will stray away from the path and will be further away from your desired results. No matter what, you must keep your eye and mind on the goal. 

Yes, both dialysis and waiting on a transplant taught me how to be more patient. Even though this was not the easiest way to learn this valuable trait, it is still a lesson I cherish. So next you ask Am I there yet? Remember these lessons for I believe they will help you on your journey. 

Until next be encouraged for you are one step closer to the next peak.

“ I Don’t Know About This?”( A Patient’s Initial Dialysis Treatment) Pt.21 The Call Out

Pt .21 The Call-Out 

“ So AW how was your food talk with Beth?”….. AW replies,” Mon I tell you brother, she kinda broke my heart when she told me about the Starfruit. How it would pretty much be talking to my rave der Boy!” ….. “ But she’s very knowledgeable about her profession. I can dig it.”, “ Now I’ll just have to process me changing my diet since I’m on this Dialysis thingy!” ( as she looks at the machine up and down as the lights blink and different sounds)….. Dwelyn I see all your coworkers and yourself moving back and forth, up and down, side to side, and I think I saw someone do a cartwheel Mon!” LOL ( as she chuckles hard) . “ Do you all have enough people here to work Mon?”, “ This Place be busy boy!”….. I replied with laughter ,” Yes AW ,we are missing a person today. Her name is Jade. She had to miss work today.“…… “ Ah I see. What happened to her?”

(At the very beginning of this story I mentioned we had a Call-Out, and we were short one Technician today.) Jade has been with us for about 3 years. She transferred from out of state to start a new life for her and her daughter. She was originally from Chicago,IL . The Windy City. She surely missed the excitement of the city, but there were also incidents she wished she could forget . Jade was gorgeous and a beautiful soul inside out. Her father was an African American paramedic in the city of Chicago who was killed in a shoot out during an emergency call when Jade was 13 her mother was born in Berlin Germany and was a nursing assistant for years with the aspirations of becoming a registered nurse. Unfortunately Jade’s mother fell ill and passed away two years prior to Jade moving to Phoenix. Jade had this defined beauty about her that was ravishing. The most admirable thing about her was her demeanor . It was so peaceful and welcoming. That made her a beautiful soul to us and our patients. It was her gift.

( As Jade sits on the side of her bed in the dark. Her 7-year-old daughter Indigo lay beside her in sleep . Snoring lightly … Dressed in her school clothes of her favorite outfit that resembled a princess, backpack and favorite toy of an African American doll suited up as a Nurse. Today was picture day for Indigo at her school, but unfortunately Indigo is feeling under the weather. Jade is dressed in her hot pink scrubs, crying hopelessly thinking about the horrible luck she has been having this past year. Head held down as if she was all alone in the world. Heart beating rapidly. Hands shaking nervously. Tear drops have fallen to the wooden floor forming a dense puddle of tears. There were even drops on her new nursing clog shoes . Her school books and backpack beside her on her right . Her lunch bag on her left. Purse strapped across her body. From the early 03:00 am call in she’s attempting to make. Looking at her cell phone with despair and guilt , moonlight shines through the window bouncing off of her cheek bones of tears as well. She has just entered the nursing program at the local community college in which she was so determined and dedicated to achieve this goal in her life to provide for her daughter and herself. She only wanted the best for her child Indigo. To have her not want for anything and to be proud of her mother. To be an inspiration was the priority. Jade was a definite Team player who was always willing to help and worked countless hours since she was the breadwinner and provider of her household. She lived in a one-bedroom apartment with her and her daughter. The apartment was about 20 mins away from the KidneyTrails Dialysis Clinic. There was a bus stop two blocks away along with the metro system where Jade had access to public transportation. They both shared a bedroom due to the fact Jade couldn’t afford a two-bedroom apartment. Her kitchen was the size of a two-person walkway. The refrigerator is not heavily full of food but just enough for them both. Indigo loved mac n cheese. So Jade made sure she kept that in place for her. The table in the kitchen consisted of designed place mats Indigo made in school. Indigo was very creative. A future artist in the making. Jade’s school books and laptop are also in the kitchen on a small desk she got at the local thrift store. So you can just imagine toys and girls and women’s clothes everywhere throughout the apartment. Jades scrub and her daughters dress up in attire scattered about throughout the apartment here and there. Jade would always read to Indigo before putting her to bed at night and then go out to the living room to study afterwards. Late night early morning studying was a norm for her. It was okay because Jade was humble, and she knew the outcome of finishing school and having a job, I mean a career as a Dialysis Technician made her feel a part of something, and she could make a difference, and it also gave her peace. The patients loved her and she loved them. Patients would actually be sad when she wasn’t at work. Some days we would offer her a ride to work, or she would catch a cab or public transportation to work. The struggle was that her time to report for work was too early for public transportation, and sometimes she wouldn’t have the funds to afford public transportation. It happens. We all have been there. We as a Team had her back. I remember picking her up one morning as she was walking to work occasionally. I tell you she couldn’t catch a break, but she never gave up. She definitely maintained her composure. She kept a positive attitude as much as she could. 

Here’s the text message we received from Jade prior to coming to work this morning. 

Jade:

“ Good morning team. I called Carmen our FA earlier. So very sorry to be writing this , this early in the morning. I will not be in today due to me not having someone to watch Indigo. She’s not feeling well due to her having a high fever . I hope it’s not COVID-19. I’m also having car trouble. It’s hard for me right now with all the things going on in my life. Juggling school, being a single parent, managing my household, no social life, trying to make ends meet, and not to mention my endless car issues….. things have been a bit overwhelming for me. Unfortunately I will not be in today. Dicyn I hope you will understand and if you can close for me tonight, I’ll make it up to you. Team I’m so very sorry please forgive me. “ 

Dicyn:

So sorry about your car. That can be very stressful. Not a problem. I’ll get Denym to close with me too. Keep us posted. If you need a ride let me know.

Denym:

It’s okay Jade. We got you. 

Ashley:

Aww man. Bummer. We totally understand. No worries.

Dwelyn:

Hey there it’s cool. Sorry for what’s going on. We are here for you. Stay strong. And we got you.

Juan:

It’s all good Jade. We will still maintain Cool Vibes. 

Jade:

Thanks guys. I really appreciate it. I’ll still try to get there later on after the first turnover. Love you guys. You’re the best.

Kidney Trails Kind KNOWte:

We all have a story. We all go through things in life that may seem easy to you and an endless task for me. Vice/Versa. Some days we are always starting over. Some days we feel like giving up. The saying goes,” There’s nothing more addictive than our past. In this case ,Jade is trying to shake that addiction. The ability to Finish.

The Call

By Jonathan E. Traylor, Sr.

Host – Hope with Jonathan

Transplant:

A surgical procedure in which tissue or an organ is transferred from one area of a person’s body to another area, or from one person (the donor) to another person (the recipient).

I guess you’re never truly prepared for “The Call” no matter how much you prepare yourself for it. I can only speak on my experience but I had been told that it would come at a time that I wasn’t thinking about it and that’s exactly what happened to me. A casual day and we was fixing to leave and my phone rang and I didn’t answer, then a message followed. I thought it was a call for possible tech assistance and suddenly my wife got a text message that I needed to call back and soon! I called back with urgency…Hello? …Yes, It was “The Call”!

I had been through a lot in a short amount of time, it was a life altering season of change. I had survived a near death experience, woke up on a dialysis machine, my diet was completely changed after a lifestyle of eating what I wanted for 41 years I decided to completely adapt to the Renal Diet, I was on fluid restriction, 32 ounces a day was all that I was allowed to consume, I had started with a central line in my chest and then progressed to a fistula for my hemodialysis treatments, I had lots of issues with dialysis treatments, infiltration, bruising, chronic fatigue, low blood pressure, just to name a few, I progressed to home hemodialysis with my wife as my caretaker, we learned an incredible amount of information in 3 weeks of training, I had experienced all of this in 13 months right before “The Call..

My Father who lived in Louisville, Kentucky {I was born and raised there and now I currently reside in Kerrville, Texas} had sadly passed away in his home on August 12th, 2019. I had just been released from the hospital around 3 weeks prior and was adapting to life on dialysis, while I was fighting to live my Father was losing his battle and ultimately passed. I wasn’t healthy enough to travel and I was very weak still and regrettably missed his funeral, this was one of the hardest decisions in my life that I have ever made, still to this day I don’t think that I have ever properly grieved, I have to remind myself that he’s gone, one of the many reasons I fight so hard against kidney disease, because I felt like my moment was stolen, but I had to continue in the fight if I wanted to survive and with the promise of one day I’ll get my opportunity to see my Father again in Heaven, I continued on awaiting …”The Call”.

Kerry Edward Traylor 1-10-52 – 8-12-19

“The Call” came on a Friday and I didn’t answer. I thought it was a call of a possible tech issue but it wasn’t, it was a lifeline. The day was busy we was in a hurry and was rushing to leave, everyone has been there more than twice. My wife had got a text as well and it seemed urgent and so I stopped and called the family back, little did I know that my life would be forever changed. I was informed that a friend was passing away and the family had discussed about direct donating his kidney to me, you see he was a registered donor and because of his unselfishness and willingness to be a donor in my heart he’s a Hero and I am now and forever will be grateful for his gift of love! Our families had grown up together attending the same church and events for many years, it was a bittersweet moment for sure. Do I take the kidney? Should I be happy or sad? I must say I was both but while I was rejoicing with the thought of life without dialysis, others were dealing with the agony of loss and sorrow. I was lost and I had too reach out to several mentors and advocates for advice and they all told me that someone was going to get the kidney and it was offered to you so you should take it. I listened to the advice of my mentors and took the Gift of Life!

On August 11th, 2020 I received my new kidney in San Antonio, Texas at Methodist Specialty and Transplant by way of direct donation from Louisville, Kentucky. My transplant team is amazing and my surgery was very successful. On July 11th of this year I will be 11 months post transplant and I must say that I feel amazing. I have tons of energy and I am able to exercise at least 5 times a week, I definitely think that exercise plays a vital role in your health especially if you’re a kidney patient. My labs have been excellent and I’m dialysis free and I’m grateful and humbled each day because I know so many do not share my same story. I often have a sense of grief for taking the kidney because I know so many out there that need one, the need is so great and many out there suffering with this disease are awaiting “The Call”.

I often wonder about my donor family and their decision to direct donate to me, I wonder if its ok for me to be happy while I know they are sad and missing their loved one. We communicate by text and by social media and they keep up with my progress with my current posts. I want them to be proud of me and know that I am doing my best to take care and preserve my gift and words could never serve justice to express the gratitude for choosing me, it would have been easy to let his kidney to go to someone else but they choose me and I’ll never be the same. The important aspect of organ donation is that people need to remember that you not only saved me but you saved a Father, a Son, a Brother, a Uncle, a Cousin so many different roles that one person plays and the effects of organ donation are positively endless. I’m so grateful for “The Call”.

Jett, MacKenzie, Melissa and Jonathan Traylor

In closing, I imbedded myself into advocacy since my transplant and dove head first into helping share for others in need, looking back I was sharing for others even when I was in need as well. I knew that what I went through and all that I endured in a short period of time happened to me for a reason, I knew I had to do more and get involved on a greater level and I became involved with non profits and involved with patient mentoring, I’m still learning but I have some great mentors in my life guiding me. I was able to start Hope with Jonathan in August as well and I have interviewed many who are in need, the experience has been amazing and rewarding. It’s an honor to share other Warriors Stories, with the need so great and many who need a platform to share their story our goal is for them to receive “The Call”. I plan on helping and being involved with advocacy until my last breath and I truly feel like I’ve embraced it, I have accepted it and walking in my “Calling” I’ve answered “The Call”.

By Jonathan E. Traylor, Sr.

Host of Hope with Jonathan

” I Don’t Know About This?”( A Patient’s Initial Dialysis Treatment) Pt.20 featuring Beth Shanaman

As I make my way back to AW from documenting my other patients while we wrap up Change of shift. AW seemed to have had an interesting conversation with Elisia Marchena. …” Well AW, How did it go learning about CMS Regulations?”…. AW replies ,” Man the information was heavy, Mon, but it was very interesting. It amazes me what is all involved in this Dialysis stuff.”……. “Question for you Dwelyn!….” Can we eat here? “ I’m starving!!! ……” Well it’s funny that you ask that. ……and just as I started to turn my body to head to the offices in the back, one of the lovely Dietitians was making her way to the Jamaica Pod. We call her Vibrant Beth…. We call her that because she is so full of life and always smiling with such a glow about her. She’s definitely one of a kind. As she walks towards AW and me………she replies “ Dwelyn how are you doing? I replied….” Hey Beth, I’m doing grrr……….and before I could finish, Beth replied…….” Ahhhhhh I see a new Faaaaaaaccccceeee! 

RDB: Good morning Mrs AW.  I’m Beth, and I’ll be your Dietitian here at dialysis.  How are you doing and have you worked with a Dietitian before?  

AW: I just feel overwhelmed and want to do everything right.  I’ve only been eating foods that I saw on the menu at the hospital because I didn’t know what to eat.  Some family members have been telling me to cut out this or add this, and I saw a Dietitian in the hospital, but I just couldn’t keep my mind on anything except that I was going to have to do this dialysis.  Can you just write me a menu, and I’ll follow that?

RDB: I promise that my job is not to take away every food you love, it’s really to find a way to fit your diet and lifestyle into meeting goals for your lab values and feeling your best and healthiest… Let me answer any pressing questions you have about the diet before I jump in to telling you what I know.  

AW: You aren’t going to take away my chips and soda?  

RDB: Nope, I may steer you toward chips that aren’t going to give you as much salt or potassium, and a soda that won’t raise your phosphorus, but there is room in your diet to still have things that you love.  There is really only one food that you cannot have on dialysis…starfruit.  

AW: What is that… I don’t even know that food.  Why can’t I have it?

RDB: Starfruit is a tropical fruit that looks like a star when you slice it.  You see it a lot on fancy fruit trays, but most people don’t eat it every day.  It has a chemical in it that doesn’t come out with dialysis, so it could cause brain damage or death.

AW: Well, I won’t miss it since I’ve never had it.

RDB: Now about that menu.  I know that sounds fast and safe if I just tell you what to eat, but you will have lots of time with me for teaching and learning.  What I really want to do is have you know what to do or choose or eat in any situation.  If I tell you to eat: oatmeal, a tuna fish sandwich and spaghetti.  You might do that for a few days, but after that you will get exhausted of that and maybe those were not things you liked to eat, and then you won’t know what things you can change.

RDB: Today we will talk about a few things, and I’ll ask you some questions to get to know you better, so I can do a better job teaching you what are good alternatives if something doesn’t fit into your diet.  I have this 3 ring binder of information…but I don’t want you to sit down and read it…it’s a lot to take in.  What I have in here is just the basics.  If you want to read the chapter on Getting Started” it will tell you an overview of what to do.  Then each time I come to see you I will bring another chapter, so we can go over each part of the diet “in bite sized pieces”…. Dietitian humor… I know…corny…get it…corny.

RDB: Ok first let’s talk about how you are feeling?  Are you having a big or small appetite?  Are you having any nausea or vomiting?

AW: I was sick all the time, but it has gotten better once I started dialysis, and now I feel like I can eat again.

RDB: How about any problems with constipation or diarrhea?

AW: Nope, thank goodness for that.  

RDB: Do you have any issues with chewing or swallowing?  Are your teeth painful or do you find it hard to chew?

AW: Nope I’ve got good teeth and can eat just fine.  

RDB: How about weight loss?  

AW: Yes, in the hospital they started to treat me, and they just kept making me skinnier and skinnier.  (see episode 1)

RDB: That happens sometimes.  As the kidneys stop filtering well, you can build up poisons in your body that make you feel tired and forgetful and food doesn’t taste right anymore.  

AW: Yes, all those things happened to me!

RDB: When that happens you might lose weight, but at the same time you may be retaining fluid.  A lot of times you may not realize how much weight you’ve lost because of that fluid.  Then, when they remove the fluid in the hospital, you are left with weight loss that you didn’t know you had.  My goal is to have you feeling better and eating well so that the weight loss stops.

RDB: I sometimes say that the kidneys are like the muffler on the car.  You put gas in the car and the car uses the gas as fuel.  The parts of gas that the car can’t use, is what the muffler filters out as exhaust. Your kidneys do a similar thing.  You put food in your body as fuel.  The parts of food that your body can’t use, the kidneys filter out and send out as exhaust in your urine.  If the muffler (your kidneys) doesn’t work well, then you back up exhaust.  Dialysis is like a temporary muffler until you are able to get a transplant.  Is that something you are thinking about?  

AW: Yes!!! I really want to get better and get a transplant.  

RDB: Wonderful!!  Let’s start talking about what you like to eat, so we can get you closer to that goal.  Can you tell me about you and your family and what your diet looks like?  If I was to come over to your house in the morning…are you eating breakfast and if so what do you eat?

AW: I’m not great in the morning…mostly I just start with coffee…can I still drink coffee?  

RDB: You bet.  Here are the things we want to think about for coffee…you want to keep the size of the coffee to a lower volume (don’t have a great big 24oz (0.91 kg) coffee), just a cup is perfectly fine.  And do you take anything in your coffee?  

AW: Nope, I just drink it plain, no cream and no sugar.  

RDB: That is fine…if you added cream, we would talk about options for this and how it impacts phosphorus…but we’ll get to that later.  What is the next time you eat?

AW: I like to have a kind of brunch at 11am and then dinner.  Most days I eat eggs with onions, peppers, and tomatoes with a type of bread that I grew up eating.  

RDB: That is perfect!  

AW: But at the hospital they told me I can’t have tomatoes.

RDB: First, I’m thrilled that you are cooking at home.  That is the best way to know you are not having too much salt.  You are right that tomatoes are higher in potassium, but if you are just adding a few into your eggs, this is still OK.  If you were to eat a heavy tomato-based sauce, that would be a bigger concern for me.  

AW: You mean like spaghetti?  I thought you said earlier that spaghetti would be something safe to eat.

RDB: Aha…good catch, let me explain further…if you are going to make spaghetti from a jar or from scratch… I want you to add everything but the kitchen sink to it.  Add in zucchini, mushrooms, garlic, basil, onions, and ground meat…all things that will thin out the tomato part of the dish.  

AW: Oh I see…the tomato sauce might be high, but if I add to it then I can stretch my meal, but also each serving will have less potassium in it.  That’s smart!!!  

AW: What about fish and seafood?  I eat a lot of that at home.  I like to make brown stew fish and peppered shrimp.  My grandkids love it when I cook foods that I grew up eating.  

RDB: I’m delighted by your food choices…we all tend to gravitate to comfort foods that we grew up eating when we aren’t feeling good.  Both of these foods are great.  Again, it’s so good that you are feeling strong enough to be cooking, and that you are cooking at home which reduces salt intake.  Seafood and fish are both healthy protein foods and getting enough protein on dialysis is one of the most important things.  Protein foods (meat, fish, seafood, eggs, tofu, beans) are what help your body heal, they build muscle, and they help boost your immune system.  I’m thrilled with how you are eating.  See we aren’t taking away foods you love…just looking at ways to make them fit into the diet.  

AW: I’m getting a little tired (and hungry) thinking about all this cooking and good food.  Can we continue at another time?

RDB: You bet.  I’m here at the dialysis unit much of the time, and you don’t have to learn it all at once.  I’ll keep checking in on you and seeing when you are ready to talk about all the things with the diet.  In that “Getting Started” chapter in the binder I gave you it will give you the very basics of: protein, potassium, phosphorus, salt and fluid.  We will go over each of these in time.  But it sounds like you are already eating and cooking well.  My phone number is on the front of that binder, so please, please call me if you have any questions that come up.

AW: Thank you so much Beth… I really thought I was going to have to change everything that I eat.  I feel so much better that I’m still going to be able to eat foods that are important to me.

Tuna sub of consequences

After the last story, I wrote Good times in Dialysis Part 2. I wanted to write about another experience that I had in dialysis. Not only will I share this story, but also the lesson that goes with it.

Life has so many lessons for us to learn, and sometimes they come from some of the oddest sources. Hence, the title the Tuna Sub of consequences. As a dialysis patient, there are some rules that you need to follow if you expect to live a healthy and happy life, and many of these rules apply to one portion of being a dialysis patient. The Renal Diet. 

The Renal Diet can be a challenge to learn, much more to follow, for there are things you can eat and things you can and can’t eat. In fact, if you want a little better insight of this check Our CDO blog Trail Food for once you read some of these blogs you will understand a little more about what lies in store for a dialysis patient.

It was a normal day for me. I went to work, did my job, ate my lunch and got ready to go to dialysis. Once in dialysis I grabbed my weight which my weight gain in between treatment was pretty normal and so treatment started. 

Once on the machine, I busied myself with my normal routine. Grabbed my drawing pad, put my earbuds in and was drawing and jamming out to my music. Treatment went well up until about the last 30 minutes of treatment. I started to feel a cramp start in my foot. This was not unusual, for sometimes this happened, and I was usually able to work it out by tying my shoes tighter. But this one was different. I was able to get it calmed down for a few minutes, and then all of a sudden it hit the cramp going from my toe straight through my body up to my nose. Now, if you have ever had a Charlie horse, imagine one 10 times worse. That is exactly what happened. My whole body cramped up and I could not work it out. I called spunky (Nurse) over, and she started to push against my feet to try to help with the cramps along with giving me a little fluid. It got so bad that asked to be taken off.

. Once off, I was able to get up and walk around, but I was so sore that it was hard to walk. After the cramps settled down, Spunky asked what I had eaten that day. My first response was nothing bad, but then it hit out of the blue. I had not taken my lunch and I went out to eat at a sandwich shop, which was not unusual, but I usually got a veggie sub without tomatoes and cheese. This time I got the tuna sub and I did not think about it, but the tuna had so much salt that it affected my treatment. Looking back, who do I blame for the cramps? The care team, the sandwich shop, the machine?  No, I had one person to blame, and that was me. I knew that anything with a high salt content could give me cramps, but I ignored it and did my own thing. To which I paid dearly for. Though it was a hard price to pay, there are two lessons that I learned from this experience. 

  1. You harvest more than you plant. Whatever you do, good or bad, you may reap 10-fold. So be careful what you plant.
  2. Listen to the teachers. My care team knew that If I ate something with a lot of salt in it, I would pay dearly. By listing and adjusting my order to the usual veggie sub, this more than likely would not have happened. Listen and listen well. 

I have learned these lessons and applied them to my everyday living and have benefited from them. In fact, I have learned the lesson so well that to this day I have not touched a tuna sub since.

Before you go don’t forget to subscribe so you dont miss any new and exciting content and be encouraged on your journey for you are one step closer to the next peak.

Anthony E Reed

CEO/Master Kidney Coach/Speaker/Podcaster

Taking Joy in the Journey Part 4: The Joys of My Journey

By: Wills Porter

In Part 3 of this blog series, I wrote about a few of the challenges I have faced throughout my transplant journey. These challenges included school, navigating insurance and overcoming the bigotry of low expectations. While I believe it is important to reflect on the challenges one faces, I think it is equally important to recognize the joys of the journey. Only then can you truly appreciate life. Focusing on the joys of the journey is exactly what I want to focus on in this post.

Joy #1 Camp Independence

Anyone who knows me knows that Camp Independence has a special place in my heart. In many ways, this camp molded me into the person I am today. You see, before I went to this camp, I thought I was the only one who had received a transplant. In school, I felt out of place. Only a small number of my peers actually knew the challenges I had overcome. In my view, I was different and that was not a good thing. In fact, I was ashamed of my transplant story. Then one day, my parents told me I was going to Camp Independence. They said it was a camp for other kids like me who had transplants. I was a bit nervous to go to camp for the first time, but I figured I would give it a try.

When I arrived at Camp Independence, I met the camp director and my cabin group. Everyone was so welcoming, and, in some ways, this new environment felt like home. Everywhere I looked, there were people who had transplants or were waiting for transplants. Even some of the counselors had received transplants. As a camper, I took advantage of every opportunity I had. I became the classic camp kid. I did every activity, I was loud at spirit time (durring lunch), and I stayed up till midnight. I know… I was a renegade. While I enjoyed all the camp activities, it was not these activities that impacted me the most. Rather, it was who I met. For the first time ever, I got to talk with people my age who had similar life experiences. Needless to say, I had a great time. I had so much fun that my camp shirt from that year has a massive dirt stain that never washed out. To this day, I return to Camp Independence and I still stay in contact with some of the people I met that first summer.

I was once asked what keeps me going back to camp. After all, I have been attending this camp for 15years. What I find so fascinating and joyful about this camp is that I have seen the camp from the perspective of the camper and as the counselor. I have been the camper who stayed up until midnight. I have also been the counselor who has been able to mentor and speak life into campers. To me this is the greatest joy of all. As a counselor, I do my best to help each camper know that they are cared about and included. My campers know that I value them and that their future potential is not defined by their medical challenges. As a counselor, I have had many conversations with my campers about listening to people who speak life and drowning out the noise of everything else. Above all else, I want each of my campers to take joy in their own transplant journey, just as I seek to do every day.

Joy #2 Transplant Games

Imagine you are taking a trip with a bunch of friends for a week. On this trip you are going to compete in various events and meet people from across the country who all have a personal connection to donation/transplant. This is the transplant games.

Team Georgia Logo

My first games were  in 2008. This particular year, Team Georgia (and all the other teams) were meeting in Pittsburgh, Pennsylvania. Wanting to make the mot of the games, I immersed myself in everything that the games had to offer. I went to the opening ceremony, I met with other teams from across the country and I made sure to collect al the team pins. Beyond all the festivities of the games there was one event that stuck with me the most. That was meeting the donor families. Growing up, I knew the importance of donor families and the admirable decision they made to donate life. What I didn’t realize was that there is a difference between hearing about it and personally meeting donors. That is something I will never forget. I heard so many stories of how families found hope in tragedy. I learned about people I had never met. Yet, it was in these interactions that I felt like we were really all one big family. Sure, we may have different tastes in food, music and come from different backgrounds. However, there is something about the donor/transplant experiences that unites. I believe it is this unity that makes the donor/transplant community so unique and special. Sometimes you jut have to see it and experience it to understand. By the time the games were over, I had medaled in a few of the track and field events, and I knew that I wanted to go back to the games. I just did not know how long it would be until I returned.

Transplant Games Texas

My chance to return to the Transplant Games came in 2014. This specific year the games were held in Houston, Texas. Yes, Texas in the summer. This time, I had trained a lot more and prepared myself to compete in the 5K race, the 800 meter and other track events. The opening ceremonies were pretty hot, but our team did not let the heat get the best of us. After opening ceremonies, a few members of our team went to get some Texas BBQ. Others went to the Quarter Century Club Events (a club for those who had their transplants for 25 years or more). After the first day the real games began. The first event was the inaugural 5K race. My dad and I ended up both running in the race  and I turned in a fairly good time. I didn’t want to go all out in the race because I knew I had a few more days of running competitions ahead of me. The next day was training day at Rice University’s track. When I arrived for practice, I met a few people from other teams and got straight to practice.

While a lot of that day was spent training and acclimating to the heat of Houston, I also took in the experience. From the track you could see a few buildings in downtown Houston. While admiring the large buildings in the distance, I also thought about a few of my transplant friends that were not with our team. Unfortunately, since competing in the 2008 games, I had lost a close teammate and friend from Camp Independence, Victor. Victor was one of those guys who commanded your attention because he had such a fun personality. In that moment of taking in the experience, I decided to dedicate my time at the games to Victor. That next day I medaled in a good bit of events and even got to see my transplant mentor, Edward Drake II. After the longer than expected awards ceremony, my family and I went to the convention center to get ready for the basketball events. I literally went from the track at Rice to warming up for basketball. I ate dinner in one of the courtside chairs before meeting the team. We ended up winning one of our games, but we lost the second and were eliminated. The rest of the week, I enjoyed the game festivities and saw a few of my friends compete in other events. Presently, I have not been back to the games since then, but I hope to again return to the games.

Take Pride and Joy in Your Journey

In this post I have talked about just two of the many joys I have experienced in my transplant journey. While I think these are important to mention, I think it is more important that I ask you, the reader, a question. That question is: do you take pride and joy in your journey?

Now, I know that many of you have experienced (and still experience) many challenges in your donation/transplant journey. However, I would encourage you to also focus on the joys. Whether it is spending time with your family, becoming involved in the donation and transplant community or just celebrating the small victories in your life, take joy. Life is not always easy but if you look at life like an adventure and have joy, you may just find your reason for living. You may just find that there is an entire community ready to support you and help you along your way.

The 3 C’s of Compelling Storytelling

The 3 C’s of Compelling Storytelling

When it comes to storytelling, you want to captivate your audience at every stage; hook them in, tantalise them with the details and have blown them away by the end, making sure they always remember you.

Here are my top tips – which I call the ‘3 C’s’ – that will help you tell compelling stories while public speaking.

  1. Create Some Conflict 

Conflict is a story’s beating heart. Don’t believe me? Have you ever listened to a story where everything is going well at every stage, that then finishes with a happy ending? How do you think you would react? You might feel pleased with the result – but will it have sustained your interest throughout? 

There’s a reason that stories are never told this way. 

Any great story needs conflict – it helps the audience feel that the happy ending has been earned.

A great example of this is the story of Aron Ralston. You may not have heard of him – but you will have heard his story, made famous around the world with the hit film ‘127 Hours’.

Aron had been climbing in Utah for around six days, by himself, when disaster struck – a boulder fell on his arm, trapping him with limited supplies, no phone, and worst of all – nobody knew where he was. 

With every detail in this story, the tension builds. The audience is spellbound, on the edge of their seats, wondering – is he going to make it?

He managed to keep himself alive with sheer willpower, eventually being forced to cut off his trapped arm with the small knife he had in his backpack to escape his fate.

You may not have an example quite this extreme – but you can replicate the effect that this story has

Ensure there is conflict when you are telling a story – your audience will become invested in the outcome, and you will have their attention from your first word to your very last.

  1. Present a Crossroads 

In the hit movie ‘The Matrix’, the title character Neo is presented with the opportunity to take either the red pill, or the blue pill. If he takes the red pill, he will learn an undeniable new truth about the reality he lives in – a truth that would change everything. Or he can take the blue pill – the safe option, where he continues with life as normal, in ignorance of how things really are. 

Hearing this dilemma, the audience automatically thinks – What would I do?

Try to always help your audience put themselves in your shoes when telling a story. 

Describe a difficult decision that needs to be made in the context of your story. Explore the benefits and drawbacks of each path that can be taken at the crossroads – and hint at the outcome for each choice. 

The more your audience are thinking about how they would act, the more invested they become in what happens next. So, think about creating a crossroads in your next story – it will make your audience listen even more closely.  

  1. Bring your Characters to life 

Believable – and therefore relatable – characters are critical to in compelling storytelling.

Include as much detail as you can to really bring each character in your story to life. What do they look like? What are their hopes and dreams – and what are their fears?

Once your character is believable, they can become incredibly powerful – as the audience will see themselves reflected in your character. 

In my award-winning Toastmasters International competition speech, I include the world-famous writer, Maya Angelou, as one of my key characters. You see, Maya Angelou had an incredibly difficult childhood – which resulted in her not speaking for five years. 

Now, there is no doubt that she faced a terrible situation. But within this trauma, Maya Angelou found her greatest gift – her ability to write. And when asked about this time of her life, she said something that all of us can relate to:

“You may not control all the events that happen to you, but you can decide not to be reduced by them.”

In this one sentence, Maya’s wisdom and authority as a relatable character becomes clear to the audience.

Now, you may not have experienced the same kind of trauma as Maya Angelou. But – the wisdom that she provides can be applied to the struggles and challenges that anyone can face in their life. 

Create vivid characters who can have this kind of influence – it will bring your storytelling to life in a whole new way.

Kyle Murtagh

Presentation Skills trainer/Public Speaking Coach/ UK& Ireland Public Speaking Champion.

Editors Note: To find out more about Kyle visit his website Confidence By Design – Enhance your Presentations and also check out his book the 5 pillars of effective public speaking by clicking this link The 5 Pillars of Effective Public Speaking: Your Unrivalled Guide to Presentation Excellence and Public Speaking Confidence: Murtagh, Kyle: 9798668175857: Amazon.com: Books

“ I Don’t Know About This?”( A Patient’s Initial Dialysis Treatment) Pt. 19 … Medicare and State Compliance Survey featuring Elisia Marchena

A.W. — Who is that young lady over there with the clipboard? She looks like she is about her business, haha! I noticed earlier when we walked in before I sat down.

D.W. — Yes she is! We are being surveyed today by the Department of Health. She is here doing a Medicare and State Compliance survey. You will see her throughout the day, looking through cabinets, checking our medications and basically observing what we do on the treatment floor and how we care for you all. She’s also a part of our Education Department, we have also worked alongside each other on a few different occasions. She and I actually meet with New Hires monthly to tell them about our Kidney Trail Koulture.

A.W. — Oh, well I need to let her know that you all do an excellent job here! She can wrap up her stuff early because she won’t find any nonsense around here!

DW — We all wish it were that easy. Medicare is the main reason why we are able to take care of our patients; they pay for most of the treatments, so they want to ensure that you all are truly getting the best care possible. Wait, here she comes. I will be back shortly.

DW- Elisia how’s everything going? I see you are making your rounds on the treatment floor today. 

E.M. — Yes, hello Dwelyn. How’s your day going? Well , I hope. 

DW — I see you made your way over to Pod Jamaica Mon!!, please let me know if there is anything I can do for you. I’m gonna leave you here and let you introduce yourself to our new patient. AW ,it’s her first day.

E.M. — I sure will, thank you kindly. By her being new to the establishment. Her feedback will be very much appreciated. Thanks again Dwelyn, I’ll see later on throughout the day.

A.W. — Excuse me, ma’am. May I talk to you?

E.M. — Absolutely! How may I help you?

A.W. — I just want you to know that everyone here is very nice. They take excellent care of me. I’ve had so many questions since I started dialysis and everyone is so knowledgeable, patient, and kind. You have no reason to give them a hard time today!

E.M. — Thank you so much for sharing that with me. May I ask, what is your name?

A.W. — My name is AW. 

E.M. — It is a pleasure to meet you, my name is Elisia. I can assure you that my intention is not to give the staff a hard time. I understand how difficult it is on the team when a surveyor is in the building. 

A.W. So what exactly do you do Elisia?

E.M. — Well, several things. I arrived here this morning and the first thing I do upon arrival is to let CMS know that I am on-site at a facility, and I need certain information from them in order to conduct the survey. They usually respond with the information by the following day. I then meet with the clinic manager or facility administrator and let them know the reason for my visit. I will be here for 3 days conducting a Medicare and State Compliance survey. 

A.W. — Oh, are those two surveys?

E.M. — Yes it is.  The two surveys are very similar, yet conducted based on two different rule sets. Medicare has rules that apply to every state, and State rules are specific to Arizona. 

A.W. — Oh I see. So what are you looking for and what are you writing down on that little clipboard you got there?

E.M. — Well, usually I begin the survey on the treatment floor. I am checking specifically for good infection control practices which include no expired medications or supplies, frequent handwashing and glove changing to name a few. I am also ensuring that you and all the patients are safe which means your access must be uncovered, your lines must be visible, and your eyes must be visible as well. 

A.W. — That makes sense. The staff here always tell me to wash my hands when I arrive and when I leave. I always tell them that they don’t have to tell me that because I know that there are all kinds of germs out there and the last thing I want is to get sick because of my own negligence.

E.M. — I commend you for taking your health into your own hands! That is excellent that the staff encourages you to wash your hands, and thank you for letting me know. 

A.W. — So what else are you looking for here?

E.M. — I will also interview a few patients and staff. If you don’t mind AW, I would like to ask you a few questions as well a little later. Would that be ok?

A.W. — Yes of course!

E.M. — Great, thank you! I also observe specific practices such as catheter care, and the staff’s overall infection control practices. Sometimes you will see me walking around or sitting down. I am watching everything they are doing from start to finish. I have to ensure that before I assume anything, I know all the facts because I’ve observed the action from start to finish, simultaneously writing down notes, times, and who I’ve observed. I will leave the floor for a few hours, and usually I will return during turnover. Day 1 of the survey is a lot of floor observations. Day 2 is some floor observations but also a lot of paperwork.

A.W. — Paperwork? Are you looking at our charts?

E.M. — Yes ma’am. Legally, any CMS and other regulatory entities are entitled to review patient medical records. It is a part of your admissions for the facility to disclose this information to you.

A.W. — I don’t know, perhaps they did. I signed a lot of papers the first day I came here.

E.M. — Yes, I understand. I will review your treatment sheets making sure that all the documentation is accurate and true. Also, I will look at your doctor’s orders and look to see that all the orders are being followed, and your treatment sheet reflects the same information as your prescription for dialysis. 

A.W. — Wow, that is a lot of work you have on your plate! Well I’m going to take a nap now. When will you be over here to ask your questions?

E.M. — I will come back in about an hour if that is alright with you?

A.W. — Yes, that works with me!

“ I Don’t Know About This?”( A Patient’s Initial Dialysis Treatment) Pt. 18 Featured Character Edition

Kidney Trail Kind KNOWte:

“ If you remember in Pt. 7 of this story, I mentioned as AW is waiting for me to return back from getting Eric Cirignano our Biomed gentleman she is observing the room/tx floor and notices more characters in our story. Let me take you back………..This Ladies and Gentlemen are the Kidney Trails Tales Features for this story.

AW

Annie R. Williams, African American female age 47, Type 2 Diabetes, history of hypertension, newly matured left lower fistula access. First Initial Dialysis Treatment. Originally from Spanish Town, Jamaica, raised in Patterson,New Jersey by way of Toronto, Canada, now residing in Phoenix, Arizona for fifty six years now. Mother of six kids, grandmother of four.

Dwelyn,CCHT 3

Dwelyn Williams, African-American

Male age 44, has traveled the US residing in 28 states, 22 years of combined modalities and leadership within the field of Dialysis. Originally from Fayetteville,North Carolina. Now Residing in Phoenix, Arizona 2 years now, college student, father, grandfather. CCHT/ Preceptor/ Level 3 KidneyTrails Dialysis Clinical Educator , Instructor for the Kidney Trails Academy. Author for the KidneyTrails.com

Dicyn,CCHT 2

Dicyn L.Williams, age 19, African American Male. Graduate of the Kidney Kollaboration Training Institute with a 98.4 GPA average. Originally from Fayetteville,North Carolina, residing in Phoenix, Arizona. Loves Spider-Man, continuing his education to become a RN, inspired KidneyTrails Guest Author enrolled in the KidneyTrails Academy for Dialysis Technicians, third year in Dialysis. ( introduced in Pt.15…..Meet The Team/ Can You Relate)

Denym ,CCHT 2

Denym P. Williams age 18, African American Male . Graduate of the Kidney Kollaboration Training Institute with a 98.2 GPA average.Continuing his education for Vascular Access Technology . Loves, thinks…. he’s the Hulk. Originally from Fayetteville,North Carolina , residing in Phoenix, Arizona..,. Enrolled in the Kidney Trails Academy for Dialysis Technicians , third year in Dialysis. ( introduced in Pt.15…..Meet The Team/ Can You Relate)

Elisia Marchena , Regulatory Consultant/Kidney Educator

Elisia Marchena,age 37, Caribbean American female descendant of Barbados , KidneyTrails Dialysis Clinic Lead Educator ,Regulatory Consultant , President of the local Chapter for Dialysis Technicians here in Phoenix, Arizona. Residing in Phoenix for eleven years now. Guest Author for the KidneyTrails.com . Originally from Staten Island,New York. ( introduced in Pt.17& featured in Pt. 19)

Ashley, Dialysis Tech 1

Ashley “Smash “ McGinnis, Caucasian female,26 years of age, originally from Prescott, Arizona residing in Phoenix, Arizona, first year in Dialysis,Guest Author of the poem “ My First Year”for the KidneyTrails.com, loves mountain biking, consistent reader, continuing her education to be a Dietician/ Kidney Coach.( introduced in Part 10&10.2)

Nicole, Dialysis Tech 1

Nicole ,26 years of age, Caucasian female , originally from Denver, Colorado moved to Phoenix, Arizona three months ago, just finished training at the KidneyTrails Dialysis Clinic , attends the local University studying biology. ( introduced in Pt.12&13)

Eric Cirignano, CEO of Bion

Eric Cirignano, 40 year old Caucasian male, owner of Bion formerly Biomedix, contracted Biomedical Technologist for the Kidney Trails Dialysis Clinic, originally from Boston, Massachusetts, residing in Phoenix for 4 years now. ( conversation with AW in Pt. 8)

Anthony Reed

Anthony Reed , 32 year old male, Guatemalan American, Master Kidney Coach and Lab / Transplant Coordinator for Kidney Trail Dialysis Clinic , originally from Guatemala, raised in Richmond, Virginia, residing in Phoenix, Arizona for 8 years. ( introduced to AW in Pt. 11)

Mrs. Ruth

Mrs.Ruth 56 year old African American female, ESRD, history of hypertension, CHF, 12 years on Dialysis, originally from Newark,New Jersey, residing in Phoenix, Arizona for 12 years. ( Sitting next to AW in chair 6, Pt.3&7)

Mr. T

Mr. T , 62 year old African American male, ESRD for 10 years, history of glomerulonephritis , originally from Detroit,Michigan,residing in Phoenix, Arizona for 25 years.( sitting next to AW chair 8 ,Pt.3)

Mrs. Aonani

Mrs.Aonani , 77 year old Samoan female, Type 2 Diabetes, ESRD for 28 years, wheelchair bound, one leg amputee, originally from Samoa , grew up in Honolulu, Hawaii, residing in Phoenix, Arizona for 11 years. ( Conversation with AW in Pt.7)

Mrs. Baykonberning

Mrs.Baykonberning 66 year old female , Latin American originally from Havana, Cuba, ESRD ,Type 2 Diabetic , right upper fistula ,residing in Phoenix, Arizona for 2.5 years, walks with a cane for now due to a recent hip replacement ( Pt. 10.2 site being held by Ashley and discovers Ashley’s note that fell to the floor)

Juan,CCHT 3

Juan , 22 Mexican American male, 6 years in Dialysis , soccer goalee for the Arizona Rattlers Division 1 Soccer League, Spanish Interpreter Liaison for the KidneyTrails Dialysis Clinic. Originally from Phoenix, Arizona and currently residing in Phoenix.( Introduced in Pt.15 “ Meet The Team/ Can You Relate)

Jonathan Traylor

Jonathan Traylor ,32 Caucasian male, originally from Louisville, Kentucky. Residing in Kerrville,Texas host of the famous podcast “ Hope With Jonathan”, Kidney Life Coach, Author / Partner with the KidneyTrails.com….. Renal Warrior . ( introduced in Pt. 17 and upcoming feature)

Mr. Johnson

Mr.Johnson , 48 year old Italian American male , Right chest CVC access, awaiting a call from transplant any day now. Originally from Queens,New York.( mentioned in Pt. 12 treatment being discontinued)

Ms.Ketana

Ms. Ketana 28 year old , Asian American female , originally from Tokyo,Japan but raised in Oakland, California…. moves to Phoenix, Arizona after her husband passed away, CVC access, Diabetes Type 2, CKD , once did Peritoneal Dialysis prior to Hemodiaysis. ( Talking on the phone in Pt.7)

“ I Don’t Know About This?”( A Patients Initial Dialysis Treatment) Pt. 17

As Nicole stands beside me with excitement, I explain to AW about each simulation device, and they both are intrigued. Nicole with anticipation, and AW with uncertainty. “ AW, let me show you this graft simulation. This is different from what you have. This device is designed to educate our patients and our new hires about what a graft access is and maintaining it. A graft is in artificial tubing placed inside a patient’s arm.”, As I cut open the simulation as if I were a surgeon of some sort, AW’s eyes were beyond gigantic. This simulation was put together by myself and another colleague in our Education Department. “ AW, some patients have grafts due to the observation from the surgeon and depending upon the anatomy of the patient. As you can see, it’s like a horseshoe, and it’s seemingly a little harder than a fistula. My colleague and I used those very lines that are on your machine, not used of course, fresh in the packaging. Then, if you look closely at the pump segment, the lines within there are a little wider and thicker than the other lines. We mixed food coloring and red dye to give it a life-like effect on those that are being trained. …..AW’s eyes were still bright-eyed and bushy tailed. Now take a look at this fistula device. If you notice, it’s a little more similar to your arm. It’s more slender and longer. The diameter isn’t as wide as the graft simulation. Instead of placing a more hard type of demonstration as you see for the graft. We used more slender lines of the package like the ones you see that are attached to your arm accessing your fistula now. We used a longer piece of the tubing, tied it to a blue string fiber and a red string fiber. We wanted to paint a vivid picture of an artery tied to a vein…” LOL”, as you can see we are no surgeons, but we try…….” Hmm mm Dwelyn, I kinda get it somewhat. These things are definitely life-like. They look scary but real, or should I say Real Scary!” As she chuckled. Nicole says,” Mrs. AW , I loved cannulating these devices. Especially when the fake blood would squirt out… Hee Hee!”, “ AW and myself both chuckled at Nicole as well.

“Now AW , let’s take a look at this CVC( Catheter Simulation), as you noticed……” Wait Dwelyn!” AW replies ,” What is that hanging on that dummies chest?” “ It looks like a wishbone !” Lol, AW, as I was saying, this demonstration is a bit different from the other two devices. Tell me what you’ve noticed is different?”….. AW, pauses… “ Well I see a little fake blood , it’s in the chest, more stuff that looks like surgery…….wait, where are the needles???? “….” Exactly AW… most patients have a CVC if they don’t have a fistula or graft, or they’re being prepared to have one established. “ “ Huh?? AW, replied….” Why would a patient have both? Why would they be getting one, dear boy? Established??….. There’s a lot going on here. !!!”” , Well let me explain. See if a patient has a CVC, and not an arm access, the goal is to coach and prepare a patient mentally to go to the next step and have surgery to get access placed in their arm , chest, or leg……” WAIT a minute!!!….. Timeout. Before you go any further, let me see if I’m understanding this correctly!”, bare with me. So you’re saying that with these access thingy’s , they can be put or placed in other parts of your body other than a persons arm?”, “ Meaning someone can actually get stuck with a needle in their leg and chest?” “ Oh boy you are crazy, you have been working too long and hard man!” You be jiving me!”” ( All Nicole and I could do is just laugh endlessly) . “ Yes, AW, this is correct. In my years of being a Dialysis Technician , I’ve witnessed all sorts of accesses from patients I’ve had the privilege to take care of.  ” So Dwelyn , do patients decide what kind of access they get? “… Well, not exactly to the best of my knowledge.” “ Some patients may have certain health issues that allow only a certain type of access. That’s up to the surgeon’s assessment.”, AW replied,” Okay, I guess that makes sense. “

“Moving right along. Let’s take a look at this Pancreas. “, “ AW, do you know what the relationship is between your kidneys and your pancreas? 

Pancreas- a large gland behind your stomach which secretes digestive enzymes into the duodenum. 

“In which your pancreas makes pancreatic juices called enzymes( an example of an enzyme is Amylase, which breaks down starch into sugars. Like let’s take for instance Macaroni or a type of pasta noodles) “, “ AW replies ,” Oh Dwelyn I love macaroni and cheese!” ,” So I guess it’s bad for me, or I can’t have it all the time?” …. I reply by saying,” That is possibly correct , but I’ll have to have you talk to our Dietician. For clarity, of course. 

“So your Kidney- is a bean-shaped organ that’s the size of your fist that’s located just below your rib cage on the side of your spine adjacent to another. Now, a healthy kidney could filter about half a cup of blood every minute of your life, while removing wastes and excess water to make urine.”

“ Dwelyn , get to the point man.” , “ I have 2 more hours , I believe, for my Dialysis.”, “ What’s the connection between the pancreas and kidney?” ,” You be draining me with too much information, Mon!” As she chuckles. 

“Okay, sorry…..Hee Hee…!”.  Well I call this a Kidney Kollaboration……. ,” There’s this thing called Combined transplantation that is performed for those individuals who may suffer from kidney failure as a complication of those who are insulin dependent diabetes mellitus…….. Also,……

As Denym walks by and is talking to Nicole , he gives her a stack of envelopes. “ Hey Dwelyn, I’m here to pass out these envelopes to all our patients. It’s a Majestic Monday here at the KidneyTrails Dialysis Clinic, inside these envelopes are numbers, and these numbers represent a wonderful prize. A chance to win a iPad, EarPods, $50.00 gift card, and with an addition from one of the gifts, the winner gets to choose only one and will receive a Guest Appearance on the famous podcast show ,” Hope With Jonathan “, if they get the number 8 in their envelope!”….Sweeeeeeet

“ Hmm, I love podcasts. I listen to podcasts regularly here on my iPad, and to win another iPad or $50.00 as a gift card would be nice. So, Nicole, give me an envelope.!” ,” Sure thing AW!”….. As Nicole hands AW one of the envelopes……….” Yikes!!!!! ( as she is bumped by Ashley , she spills the box of envelopes , and the first envelope AW grabs , swiftly drifts out of her hand……and as she sees the cloud of envelopes soaring throughout the clinic floor, she sees the young lady from across the way that was in business attire. That young lady was Elisia Marchena.