The Doctor With X-Ray Eyes

No, he's not a mad or evil doctor, although in keeping with the eerie and bloody theme of my Halloween week that certainly would be appropriate.

Actually, Dr. Michael Neuwirth is a very friendly and forthcoming fellow – and since he's the man who someday will insert a semi-permanent tube through my belly and into the peritoneal lining of my abdomen, his cheerful personality makes me happy, too.

Karen and I met recently with Dr. Neuwirth (no relation to the actress Bebe – I know because I asked, which should give you an idea of how our conversation went), the chief of interventional radiology for Carle Clinic. I'm not sure, but I think "interventional" in this case is medical-speak for "I'm gonna stick something in ya."

This meeting was simply a consultation, a "how you doin', glad to meet you" session. None of us have any idea when I will need to begin dialysis – the kidney function numbers will tell us that – but people around here are big on preparation and information, so my nephrologist, Dr. Attia, set up this get-together so I would have an idea of what to expect.

Whenever it happens, the operation will be an outpatient procedure performed while I'm under heavy drugs (yay!) and take about two hours to complete. I get to pick the side where the catheter will live, but Dr. Neuwirth says most people prefer the right side. (Which makes no sense to me, since most people are right handed.)

"I go in four fingers to the right of the belly button and two fingers up," he explained. "That's where I do it. I use ultrasound to look for the entryway in. I insert a needle and watch the needle the whole way, as it goes through the skin into your abdominal cavity. Then I insert a wire and the tube goes in over the wire.

"This is all done with image guidance, so I see what I'm doing the whole time. I don't just open you up, stick a tube in and close you up. I do this with X-ray vision."

He's done this procedure hundreds of times, he says, and I feel really good about the fact that when the time comes, Dr. Neuwirth will be performing the surgery. I don't know, I guess you could call it....

Wait for it....

A gut feeling.

My Halloween Horror

Imagine this: You wake up in the middle of the night, as you do far too many nights, to go to the bathroom. One second you're sitting on the can, thinking about nothing in particular. You begin to cough.

The next thing you know, you're on your hands and knees on the bathroom floor, surrounded by blood. There's blood on your clothes, blood running off your hands and down your arms, blood dripping off your chin. What the blazes is going on here? you think. Suddenly, you realize the blood you're immersed in is yours!

You clamber to your feet, look in the bathroom mirror and discover there's a huge gash above your right eye – and you have no idea how it got there!

Sounds like the beginning of some hackneyed Halloween fiction, right? Well, it actually became fact for me in the wee hours of Tuesday morning, necessitating an overnight stay for observation in St. Mary's Hospital in Decatur, Ill.

What we now believe happened is, I blacked out while seated on the toilet, pitched forward and bounced my head off the corner of the bathroom sink – missing my right eye by no more than an inch – then came to on the floor. For someone who's never passed out before in his life, and coming on the heels of Saturday's terrifying out-of-body experience (see "Death," Oct. 26), I was quite frankly scared a-plenty.

                     Me in St. Mary's Hospital, Decatur, Ill.

    The offending gash – superglued, not stitched! Ain't science sumthin'?

Of course, nothing similar occurred Tuesday night in the hospital. Karen, who spent the night with me, watched over me like a loving mother hen and insisted on walking me to the restroom anytime I had to go, and besides, you know whatever's wrong with you instantly feels better when the doctor's around. Except for the swollen right eye (that's something to see, isn't it?), a stiff neck and bruised knees, I feel pretty fine, everything considered.

Here's the best thinking now about why this happened: I've had a horrible cough for more than a week, but when I begin coughing uncontrollably (which happened in the bathroom Tuesday) the oxygen literally cuts off to my brain for a moment and causes me to black out. Or, the medication prescribed to help ease my coughing spells, Benzonatate, has dizziness as one of its possible side effects. Or a combination of the two. The doctors don't believe I have whooping cough (which would make me feel about 95 years old), but they have decided to treat my condition as if it is, because my symptoms are similar.

Whatever, as I check out of St. Mary's today, I can't help but think about how much differently this incident might have played out if I still lived alone, and to be soooo grateful for my new family: a wife who cares passionately, a father-in-law willing to be awakened from a sound sleep at 5 a.m. to drive to the hospital, and a mother-in-law willing to get on her hands and knees and clean up the bloody bathroom after we departed.

My mother-in-law, Linda, said yesterday, "Things like this are the reason we are supposed to be living together." I think she's very wise.

Death

I have gone back and forth over whether to share this with you today. But I haven't been able to stop thinking about it since it happened, so perhaps writing about it will prove cathartic. Let's see.

I experienced one of the most terrifying moments of my life over the weekend. It was a moment, too, no longer than that, and unlike anything that's ever happened to me before.

As I may have told you, I've been suffering from a chest cold of some kind for a week or so, distinguished by a bone-rattling cough that sends shivers down my timbers. It's been exacerbated by the fact that, because of my delicate kidneys, there's virtually no cough or cold medicine I can take for relief. On Saturday night, after hacking every 15 seconds or so while trying to fall asleep, I finally got out from under the covers and sat on the side of the bed in frustration.

Suddenly my coughs began coming in rapid-fire succession, one on top of the next, so quickly I could not catch my breath. My body began to shiver. My head pounded. I gasped for air. It felt like a giant ball of energy was gathering steam in the center of my body and trying to burst through the top of my head. I lost control of my bladder.

I actually thought I was about to die.

I felt my spirit trying to leave its mortal shell, and my body fighting to keep it inside. The two have been together a lifetime, you see, and breaking up is hard to do. I have never been around anyone at the moment of their death, but from what I've gleaned from people who have, what they have witnessed is very close to what I encountered.

The moment passed as quickly as it arrived, and I stumbled to the bathroom to clean up and make sense of what had just happened. I thought back to when I was a teenager and accidentally jumped into a lake much deeper than I expected. As I sank lower and lower into the darkening water, I was certain I would never see daylight again. My feelings then and now were eerily similar.

I thought about the suddenness and the inevitability of death. It's coming when it comes, and despite our  most meticulous plans there's not a doggone thing we can do to delay its arrival. I've always been a spiritual person and a practicing Christian, but I thought about how much closer I've grown to God since my kidney diagnosis and how guilty and hypocritical I feel about needing a serious life challenge to renew my faith.

I feel better today, and hope to be completely well by week's end. Thanks for the reminder, Lord. We are Yours, and in Your care. Today is a great day. I plan to live my life to the fullest until Saturday night's fever is more than a false alarm.

A Tree Blows in Decatur

If a tree falls across your driveway overnight and there's no one to hear it, does it make any noise?

Well, it certainly does the following morning. I had another topic in mind to share with you today, but the wild-eyed looks of excitement on the faces of Emma and Madison quickly convinced me that more pressing matters were at hand.

"The tree! Look at the tree!" they wailed in unison.

Well, it was something to see, all right. (That's my mother-in-law, Neena, and our new puppy Sophie surveying nature's revenge.)

Thank the good Lord no cars were damaged (we have four around the house now on a regular basis), nor the brand-new bedroom addition that was just completed for Karen and me. But a single tree branch threw our entire day into a tizzy. Who's going to drive the girls to school? Who's going to move who's car? What about Neena's trip to the doctor this morning? How are we going to cut this monster branch down to size? And what are we going to do with all this WOOD?

Much to my amazement, my father-in-law, Larry, a rugged "man's man" kind of guy if ever I've met one, does not own a chain saw. He's working the phones today, trying to find one he can beg, borrow or rent.

John Lennon has been receiving a lot of credit lately for having once said, "Life is what happens while you're making other plans." I don't know if he said it or not, but it surely does ring true today. My plans have been instantly reordered by forces much greater than you or I.

And watch for our huge blowout sale on firewood, coming soon.

Mr. McFarlin Goes to Washington – Sort Of

I was shocked to say the least to receive a call Wednesday afternoon from Sally Joy, public policy consultant for the National Kidney Foundation of Michigan. Although we have never met, Sally knew way more about me than I did about her due to the first-person account of my crummy kidneys in the current issue of HOUR Detroit magazine.

(If you haven't seen the article, you can read half of it online at Best Foot Forward. HOUR only posts half its stories on the Internet during the month the magazine is on the newsstand to bait you into buying it, those sneaky rascals.)

Anyway, apparently the article has made me this year's poster child for kidney disease in Michigan, which I find the height of irony because my new medical insurance in Illinois won't pay for the tests needed to keep me on Michigan's donor list for a possible kidney transplant. Sally asked if I would consider appearing before the Michigan Legislature in Lansing next April 28 as part of the Foundation's annual Diabetes and Kidney Day.  

"I'd like you to talk about reducing risks for diabetes, high blood pressure and kidney disease by making smart choices about lifestyle behaviors," she wrote in a confirmation e-mail, "and taking the medications you have been prescribed that manage the health conditions you may have. Of course, a good dose of 'your story' intertwined is mandatory!"

Oh, that shouldn't be a problem. I KNEW there was a good reason to do this blog! I'll have my testimony in Lansing written, rehearsed and polished to a high gloss repeatedly before April rolls around.

"Is it going to be anything like Mr. Smith Goes to Washington?" Karen asked. "Probably," I replied, "but I promise not to filibuster, cheese off the legislators or pass out in a dead faint before I'm through."

The end of Sally's e-mail gave me an unexpected dose of hope as well. "Best of health to you," she wrote. "I hope that in April 2010 you're still living with a stable creatinine [level] and un-hurting feet. – Sally, kidney failure 1985 and a working kidney transplant since 1986."

Twenty-three years with a transplanted kidney? No wonder her name is Joy.

Sick and Tired

I caught a bug this week. Not in the literal sense, although there seem to be millions of bugs available for catching out here in the wilderness.

Sometime Monday my throat began to feel like I had been gargling sandpaper. Then the sweats began, followed in close order by chills, stuffy nose and a cough that makes my whole body shudder. No, it's not the swine flu, but it certainly makes me feel like a porker.

I know how this happened. In between moving out of Champaign and into Decatur, I was also trying to find time to write six stories last week on deadline. I was working late hours, deep into the night, and not taking very good care of myself. Now, voluntarily quarantining myself in bed Tuesday and today and feeling like warmed over doo-doo, I'm paying the price.

I certainly don't want to infect the in-laws, school-going girls and tiny new puppy who live here with me. (Karen's out of town on business this week, so she's immune from my plague.) Ironically, I was afraid that the girls might bring home some deathly virus from their classmates that would find its way to me. Instead, I'm the carrier. And what's worse, with all the medication I'm taking regularly for my kidney distress, there's virtually no over-the-counter cold medicine I can take that won't cause further damage. So I sniff, drip and honk. A lot.

All this is making me think, though, about how much better care I will have to take of myself in the future when (not if, unfortunately) my dialysis regimen begins. Sterility and consistency are such vital parts of the whole Peritoneal Dialysis routine – hooking myself up to a machine every night through a catheter implanted in my body, one of the few downsides of the procedure is the threat of infection at the connection site.

As my lifestyle changes to accommodate my health care needs, I'm going to have to become much more organized and regimented in terms of when and how long I work. And if you know me, that'll be like asking me to become shorter so I won't have to worry about big and tall sizes. I've always contended, "You can't control the muse! You have to write when the inspiration hits you!"

Well, my muse had better buy a watch.

Sophie

Say hello to the newest member of our happy new little family in Decatur, IL: This is Sophie, a 10-week-old Lhasa Apso puppy Karen drove 90 minutes into the country to acquire Monday night. (And if I think I already live in the country, you can only imagine where Karen ended up having to go!)

We promised the twins, Emma and Madison, that we would get a puppy for the household after Karen and I moved and got settled in. (That's Emma's right hand hovering affectionately in the photograph.) And although we are faaarrrrr from settled in, we realized after making a few preliminary calls that the cool puppies tend to be snatched up quickly once ads are placed in the newspaper. He who hesitates has an empty leash. So once we saw the classified for home-raised Lhasa Apsos, we leaped into action like the A-Team.

Our new addition had to be a puppy, too; we didn't want to have to deal with an older dog's bad habits. If our dog's going to have any bad habits, by gum, she's going to get them from us!

You can only imagine the response when Karen arrived home with this little hairball in her arms. "Is that our puppy?" Maddie squealed with delight. After watching the whole family, including my mother- and father-in-law, interact with her, I have no doubt Sophie will be the most loved and attended-to puppy in all of central Illinois, if not the nation.

For her part, Sophie was very slow to warm to us. Karen was told that she didn't have a lot of interaction with people because she had been promised to a family member who eventually decided against taking her. (How can that be?) I got to thinking how extraordinarily traumatic this whole experience must be for a dog. One second you're hangin' in the barn with Moms and the rest of the litter, not a care in the world, and the next you're swept up by some stranger, tossed into the back seat of a car and driven away to parts unknown. It's a doggie kidnapping!

She was shy, and I'm betting she was terrified. But the girls couldn't keep their hands off her, of course. And I actually saw the bonding moment when, while in Madison's arms, Sophie realized we weren't holding her for ransom and might actually be OK people. Her tiny tail began wagging, her tongue slithered out into licking position and her chubby little bod began waddling with a lilt in her step.

We all need those bonding moments, when it suddenly hits us that we are loved, we are protected, and none of the people surrounding us are going to let anything cause us harm. Welcome home, Sophie.

A Moving Experience

                          A Swarm of a Few Good Men Descend Upon Our Home


Well, our move from Champaign to Decatur, Ill., Saturday could not possibly have gone smoother. Six (count 'em!) husky, prairie-strong young men – Ryan, Jeremiah, Rick, Mark, Alan and Michael – from Harvest Bible Chapel where my in-laws are members drove the 50 miles from Decatur to our apartment with pickup trucks, strong backs and cheerful attitudes.

It wasn't so much that they volunteered their free time to haul the furniture, beds and appliances of near strangers on a Saturday morning, though that was remarkable enough. It was the way they did it. You know how sometimes you agree to help out with a big, physical task on the weekend, then dread having made the commitment once the weekend arrives? Not here.

Every one arrived with a smile on their face, goodwill in their heart and a tangible sense of camaraderie. These guys clearly enjoyed being in each other's company, and it showed. Many hands didn't just make light work; they made lighthearted work. We were completely finished in less than four hours, including the one hour for transportation.

Words cannot even begin to express my, and our, appreciation for their efforts. I was deeply touched, and thankful. And the next day at church, they were still happy to see us! Imagine that. The simple acts of caring and compassion, the willing spirit; this is how being a Christian manifests itself in daily life.

And when Emma looked Karen in the eye Sunday night and asked, "Now are you going to be living with us forever and ever and ever?" all the sweat and muscle aches seem justified.

Busting a Move

Knock, knock.
Who's there?
Chaos.
Chaos who?
Total chaos.
Oh, I've been expecting you. Come on in!

No, it's not funny. And I'm not laughing. As the crowning blow to this dizzying rollercoaster of a year (and month!), this is the weekend of the Big Move.

On Saturday, at least four wonderful men from Harvest Bible Chapel in Decatur, Ill., where my in-laws are members but we are not, will make the 50-mile trek to Champaign-Urbana to help Karen and me move from our Champaign apartment to the basement of my in-laws' home. I feel like such a slacker whenever I say or write those words, and I've had some fun watching the reaction of my friends. "Yes, we're moving into Karen's parents' basement," I'll say, mournfully. "You know, times haven't been good...."

Actually, they've been very good. The real reason we're relocating is to help take some of the parenting pressure off my in-laws, Linda and Larry, as we all try to raise Emma and Madison, the 9-year-old twin girls entrusted to their care. (And, although we don't talk about it as much, to provide some family assistance in case my condition worsens or I receive a kidney transplant and need continuous care.) The basement has been remodeled, a new bedroom and closet space constructed, and it's all quite nice and cozy.

Now, I can't begin to tell you how impressed I am that Harvest Bible parishioners would give up a chunk of their weekend to help essentially two church visitors move their household. I don't know a single person on earth who enjoys moving in any fashion, and as far as I'm concerned this is Christian charity in action and we are extremely grateful. But if you count the year I spent in a Ferndale, Mich., apartment before marrying Karen and coming to Champaign, this will be my third move in two years. I am plumb sick of moving.

On top of it all, after writing four feature stories on deadline this week, today is the first day I've had time to assist Karen with packing and organizing. One day to prepare for a major life change. Whoopee.

Since our lease in Champaign doesn't expire until the end of the month, our plan is to move the furniture and big items out Saturday and keep a TV and air mattress here so that Karen and/or I can spend the last two weeks cleaning out the place. This actually doesn't sound too bad to me; in Ferndale, I slept on an air mattress in my living room every night, even though I had a bed in my bedroom, because I wanted to stay close to my 50-inch TV. I've never claimed I was sane.

So at least until November, I'll be living in two cities and not completely entrenched in either one. Meanwhile, I'll be packing, discarding, recycling and working steadily. Chaos, as long as you're here, hand me that empty box, willya?

Prescription for Terror

Yesterday I visited one of the most frightening places in my new lifestyle: the drive-thru prescription window at Walgreens.

I had run out of Zemplar (sounds like the evil planet in a Star Wars spoof, doesn't it?), my Vitamin D supplement, and dropped off the empty vial the day before to have it refilled. It's the ultimate in convenience; you don't have to get out of your car, or even turn down the radio, for that matter. Just slow down long enough to toss the vial into the bank-teller-like drawer and speed off. After all, your name, address and the name of your drug are already on the container. What do they need you for? Walgreens goes so far as to send an e-mail alert when your prescription is ready for pickup, so you don't waste a return trip. All very smooth and easy.

The scary part comes when you go back to get the medication. Even though I have an insurance plan that greatly reduces the cost of most of my prescriptions – often no more than $10 – some of my drugs are so expensive that even with my deep insurance discount, the price is enough to make me swallow hard and break out in a mild sweat. And because the price isn't included on the label, it's always a guessing game how much any particular drug is going to cost. It's The Price Is Right, sickness or health edition.

I place my debit card in the slot, look mournfully through the glass into the pharmacist's eyes, and pray I can come closest to the actual retail price without going over my bank balance. The prescription and the card come back in the drawer. The receipt says $45.

Forty-five dollars! For these little bitty pills? If I knew what was in them, I'll bet I could make them myself for half that much! Shaking my head and wiping the sweat from my brow, I slowly place my debit card back in my wallet and suddenly remember that my Renagel, the phosphorus blocker, is about to run out, too.

It's at least twice the price. Horrors.

Do or Die-t

Our new nutritionist, MaryJean, prescribed a 1,500-calorie-a-day diet for Karen and me if we plan to lose weight in a steady, healthy manner. (In case you missed it, I need to dump around 30 pounds in preparation for the procedure that will insert a catheter next to my belly button for a form of kidney dialysis.)

I tried to explain to MaryJean that I can do 1,500 calories just by poking my head into the refrigerator, but she suggested a slightly stronger form of self-discipline may be required.

The major problem with trying to diet while working at home is that food is never more than a few steps out of reach. Like the old Richard Pryor routine about cocaine, sometimes when I'm very quiet I swear I can hear the food calling out to me from behind the cupboard doors.

"Yo, Jim! Jimbo! Got some mighty tasty chips in here. Bar-be-cue, too, just like you like!"

"Hey, what about us pre-cooked bacon strips? You know you want some of this, Jimmy Mack!"

"Don't forget about us sardines! We're packed tight, but we taste right!"

Great googly-moogly, do I love to eat. Sometimes I think I really just like to chew. Maybe if I could develop a cud, or Karen could bring home a chew toy from PetSmart, it might serve as a reasonable substitute.

Karen found a Web site called MyFoodDiary.com where you can input what you ate for breakfast, lunch, dinner and between-meal snacks and the site will calculate the amount of calories, fat, sodium, etc., that you consumed. We tried it for the first time today.

My breakfast was a piece of cake – well, not literally, but it was a simple computation for MyFoodDiary – a bowl of cereal with soy milk and a cup of decaf tea. I breezed through lunch as well, a simple garden salad with modest embellishments, and even the single serving of Skittles I had for an afternoon snack (thanks a lot to whoever brought over the Halloween candy!) wasn't too damaging.

But when Karen got home from work she appeared too pooped to poach, bake or broil, so we decided to GO OUT for dinner. Ooooooh. After some deliberation, we decided on Outback Steakhouse. We could order grilled chicken, rice, maybe a few shrimp on the side and a modest salad. We'll drink ice water, not pop. I mean, how bad could that be?

Yowza! Did we learn a first-night lesson! We blew the entire 1,500-calorie wad, and more, on that simple dinner alone. I feel like I should just relegate myself to bread and water, but I probably can't do the bread, either. This is all so new to both of us.

And will someone tell those sardines to shut up?

You'll Eat Nothing, And Like It

On our own initiative, Karen and I obtained a referral and made an appointment last week to see a nutritionist. I have not been ordered to begin a restrictive, "pro kidney" diet yet, but we figure I will at some point so I might as well get in the habit.

Besides, in order to have the permanent catheter needed for Peritoneal Dialysis inserted into my abdomen, I've been told by my nephrologist that I probably need to lose about 30 pounds of belly fat. (All my pants seem to agree.) Karen has lovingly decided to go on the diet with me, so I won't begrudge my lettuce while she's downing cheeseburgers.

We have tried to make better and wiser food choices to coddle my damaged kidneys, but Karen has found that the diet information she's researched on the Internet seems to be wildly contradictory from site to site. We decided to go to one professional source that we can actually look at and talk to, and abide by what the nutritionist says.

So we met with an effervescent wisp of a woman named Maryjean who asked me to come with a list of everything I'd eaten in the previous 24 hours, read it, then shook her head a lot. Obviously we'll need to eat less and exercise more if we intend to lose weight, but there's so much less to eat, too.

We received a list of foods that are naturally high in potassium, which is Kryptonite for kidneys, and generally should be avoided. That list includes:

Tomatoes
Tomato juice
Tomato paste
Spinach
Potatoes
Carrots (raw)
Baked beans
Squash
Potato Chips
Mushrooms (raw)
Artichokes
Lima beans
Broccoli
Melons (all kinds, including water!)
Peaches
Orange juice
Bananas
Raisins
Avocados
Brussel sprouts
Radishes
Peanut butter
Nuts
Scallops
Sardines
Cocoa
Hot chocolate
Dates

What's left, you ask? We asked, too. Maryjean smiled sweetly and talked about creative food alternatives, most of which sounded to me like eating wallpaper paste.

I don't think I'd mind so much having medical issues if I could at least eat what I wanted. The two best things I do in life are eat and sleep, and one of them is about to be severely compromised. I've said it before and I'll say it again: I foresee a steady diet of chicken – baked – and rice in my future.

Pill Popping

Back home after a jolly and fulfilling Homecoming weekend at my alma mater, Hope College, I'm putting away my rectangular lime-green traveling pill case until it's time to go wandering off somewhere again.

Karen gave me the plastic pillbox last Christmas as one of my stocking stuffer gifts. I laughed, but I also understood immediately the thoughtfulness behind her present. She knows I have to gulp a bunch of medications and supplements every day in my current condition, and being the extremely organized person she is (she's a FranklinCovey trainer, you know), she wanted to help me do so as efficiently as possible.

I can take them without water now. So adept have I become at swallowing pills that, except for the front-loaded morning dosage that can be as many as 11 pills at once, at the appointed times throughout the day I just pop 'em in my mouth like breath mints and let them slide down my throat. This is not a skill I wanted to become proficient in, but if practice makes perfect I should be nearly immaculate.

I've talked about my medications before but never in much detail, so I thought I'd like to introduce them to you.

Every day I take:

25 mg of carvedilol, a non-selective beta blocker to control my high blood pressure (thought to be the primary cause of my kidney distress), twice a day;

10 mg of prevastatin, to reduce my total and LDL cholesterol;

800 mg of renagel, used to reduce levels of phosphorus in people with kidney disease, at every meal;

100 mg of allopurinol, intended to decrease the levels of uric acid in my body and prevent a recurrence of searingly painful gout, twice a day;

160 mg of Exforge, also prescribed for treatment of high blood pressure;

25 mcg of Vitamin D, a supplement to replace the vitamin that healthy kidneys naturally produce to maintain proper phosphorus and calcium levels in the body;

one-half of a Centrum Silver multivitamin, as my kidney specialist was concerned about the potential effects of taking some vitamins at their full potency (it's bad enough that it's a Centrum "Silver," but then only half a pill? Boy, does that make you feel old!);

100 mg of Vitamin B-1, which I added on my own. I read somewhere that it could help in the treatment of kidney disease, and my doctors, while skeptical, admitted that it couldn't hurt.

In addition, every other day I also take:

0.6 mg of colchicine, also prescribed to prevent my gout from flaring up again, and

1 mcg of zemplar, (and I'm taking this off the Web site), "a synthetically manufactured...active form of Vitamin D indicated for the prevention and treatment of secondary hyperparathyroidism in chronic kidney disease."

It's quite an assortment. I don't know how AIDS patients feel, but I can empathize. If you didn't think or feel that you were sick, pouring a pile of pills into your hand every day certainly will serve as a reminder. When I travel for more than a few days, it takes me almost a half-hour to sort all my medications and supplements, recall the proper dosages and stick them in their appropriate Monday-through-Sunday slot in my neon green pill case.

I guess it's that shade of electric green so I won't lose the case.

Not that I wouldn't like to.

A Place Called Hope

I'm on the road again today (does it seem to you I've been traveling a lot since I started writing this blog? It does to me!). I'm traveling with Karen to Holland, Mich., on the shores of Lake Michigan to attend Homecoming at my alma mater, Hope College.

This weekend has taken on a different significance for me since I was asked to serve as a member of the college's Alumni Association Board of Directors a year ago. I feel much more connected to the campus goings-on and my fellow alums as a whole, though I will spend an entire day trapped in a conference room for meetings. But I am that guy who really enjoys going back to the old school, catching up with friends of a bygone time, reliving old memories while creating new ones.

I think it's kind of cool to have gone to a college named Hope. I remember getting razzed a lot about it as a teenager when I chose to attend there – "Hey, 'hope' you get accepted! 'Hope' you graduate!" – and while the lure of a large university was powerful, I knew then that I made the right choice. I still know it today.

One of the main reasons I went to Hope, I must admit, was to be closer to my parents, who where quite elderly at the time. But there's something about a small school that's more embracing, more caring. More sincere. When my favorite English professor, Jack Ridl, retired a few years ago, he sent me a handwritten note to thank me for the role I played as one of his students and congratulate me on my success as a journalist. How many people who've been out of a university for 35 years receive a letter like that?

Maybe it's symbolic, too. Like that lady says in the Cancer Treatment Centers of America commercial, "Hope is everything." And as time and my kidneys pass away, hope is a commodity that cannot come in great enough supply.

Poison or Hanging?

At my kidney specialist's suggestion, I recently visited a local office of Da Vita, the nation's largest chain of dialysis clinics, to attend an educational session on kidney failure. I had gone through this "Kidney 101" tutorial once previously in Detroit but Karen had not, and I thought it a good idea for us to experience the process together.

We were greeted by a very knowledgeable and attractive registered nurse named Dawn who led us to a private conference room and played one of those hokey "Your Kidneys and You" movies like you might have endured in sixth-grade health class. At one point, Dawn even strapped on a heavy rubber body apron, almost like a fat suit, to demonstrate the relationship between the kidneys and a form of blood cleansing called Peritoneal Dialysis, or PD.

                                                            Dawn and me, at Da Vita

Dawn was very nice and patiently answered all the questions Karen posed. I tried to be my usual nonchalant and amusing self, but let me be honest with you: The specter of what is inevitably going to happen to my body gives me the shivers and makes me more than a bit queasy.

Because to manually replace the function my kidneys perform in cleaning my blood, I either have to have an operation to graft one of my veins to an artery, creating what's called a fistula, so my blood can be pumped out of my body, filtered through a machine and returned – that's called Hemodialysis – or have a tube inserted in my stomach into the lining of my abdominal cavity, where a special solution will flow though to cleanse my blood. That's PD.

Both processes have their advantages and disadvantages, but from where I sit now, they sound like the difference between being asked, "Would you prefer poison, or should we just hang you?" We have decided to go with PD, which is administered in the home and I eventually can do by myself. (Hemodialysis demands actually traveling to a center like Da Vita three times a week, spending eight hours at a shot.) It seems like the lesser of two evils.

I know either method will be for my own good, and will be necessary in order for me to keep living. But they both sound horrific and ominous. The operation was a success, but we lost the patient; I think he passed out.

Sick

Karen stayed home sick from work yesterday. It's not the swine flu, but it might as well be; I called it the "whine flu," which I thought was just hilarious. She didn't seem to share my sense of humor.

That means I stayed home from work, too. Wait, that's not exactly accurate. I always stay at home; I just stayed away from work.

I love having my mate around the house all day, even in her sniffly condition, but from my perspective she could not have picked a worse time to fall ill. I have at least five big stories due over the next 10 days, and having someone else in your space when you were anticipating being alone can be disconcerting. The fact you know that someone else is hurting and you want to be there for them can divert your attention even more. I didn't even have time to write my blog to you yesterday.

I got frustrated and a bit peevish. Then I reminded myself that nobody chooses the time or the way they wish to get sick. I certainly didn't. And these blasted kidneys do qualify me as sick, I also have to remind myself, even though now most of the time I feel just dandy. 

The time will come, I fear, when Karen will be doing the Nightingale thing for me on a far longer basis than I am in helping her to tend to a simple cold. And work, I've found as I've matured, always seems to have a magical way of getting done if one perseveres. It shouldn't get in the way of showing a little compassion and a comforting spirit when the one you love is sick.

I need to keep that in mind, and pray that she will, too. You know what they say about payback.

Sunday Is a Day of Rest

Tell somebody you love them today.

The Man From Glad

On the road again today, driving back home to Champaign from Detroit. Can't wait to see my wife's smile and sparkling blue eyes again. You know, when we were dating, I would always play the Elton John song "Blue Eyes" at some point while traveling to see her, sing along with gusto and get all geeked up to be with her. (I'm not sure she knows that.)

These long road trips are wearying but necessary, since most of my major clients are still located in Motown and many of the stories I write demand I be here for research and interviews. When I think about it, though, I'm glad I have the ability to make these treks.

When I go on dialysis (which will be sooner than later, so I'm told), the journeys will be more challenging – I'll have to lug along a suitcase-sized blood cleaning machine along with several large bags of filtering solution – but I'll still make them. I refuse to let my condition define my lifestyle.

Besides, I remember a couple of years when I couldn't seem to land a job if my life depended on it and was living in Detroit too broke to afford a car. You want to talk about desperation, I was the definition. Detroit, for all its wonders, must have the worst public transportation system of any major city. I've always believed it was by design: We make the cars, and by thunder, everybody here is going to buy at least one.

So even something as unremarkable as having a late-model American automobile to drive on these multi-state commutes makes me glad, and thankful. I'm also glad to have:

The most remarkable wife any man could hope for – funny, smart, beautiful, organized and a more knowledgeable sports fan than I could ever hope to be;

In-laws who are genuinely good and nice people, and who have accepted me into their lives;

Emma and Madison, the twins, who keep me active, engaged, and constantly fascinated;

A friend like Larry Kaplan, who has reserved a room for me at his condo in West Bloomfield, Mich., providing me a place to stay and work whenever I'm in Detroit;

More assignments than I could have dared to wish for in this troubled economy, and most important,

My health, now and for whatever form it may take in the future. Because, like the old folks say, when you've got your health, you've got everything.

How can one man be so blessed?

I'm In, But Only Halfway

I mentioned at the beginning of this journey that my prime motivation for doing a daily kidney diary was the magazine assignment I received from HOUR Detroit to write 2,000 words about my condition.

It was an excruciating experience – I've spent a 35-year career writing about others from the detached perspective of the third person, and disclosing personal details about a serious illness was as weird as it was agonizing – but the response to the piece was overwhelming. I was flooded with letters and messages from friends, long-lost acquaintances and total strangers who were moved by my openness, saying prayers for my good health, diagnosed with kidney disease themselves or keen to tell me about someone else who was. It made me think that documenting my own case beyond the magazine article might be of some help to others.

Still, I wanted you to see the HOUR story so you could read the impetus behind my journal. And Thursday, with the change in the calendar, the October issue of the magazine has become available online. You can see the story, titled "Best Foot Forward," at this address:

http://www.hourdetroit.com/Hour-Detroit/October-2009/Best-Foot-Forward/

Ah, but here's the rub: You can only read half the article online now. HOUR management, those sneaky rascals, posts a portion of their stories on the Internet until the current print issue leaves the newsstands. The online articles are teasers, really, to encourage you to buy the magazine. So you're just getting into the feature when suddenly you read: "There is more to this story. If you wish to continue reading, please pick up the current issue of HOUR Detroit at your local newsstand, or check back when the current issue leaves the newsstands."

It's frustrating, but shrewd marketing. Half a story is better than none, I suppose, though that's cold comfort to those who don't live around Metro Detroit. Ah, well. Take a look at the "first installment," if you like, and tell me what you think.

Friends

I had a delightful dinner in Detroit last night with media consultant and former TV producer Lori Weiss, who still looks as lovely and beguiling as I recall her in my memory, even though we haven't seen each other in years. I consider her a dear friend and confidant, but different cities, jobs and schedules have prevented our paths from crossing.

That got me to thinking about friends and what tricky and unpredictable beings they can be. You can go years without speaking to some friends, then pick up the conversation as if you just stepped away for a moment when you finally reunite. Other friends require careful nurturing, like orchids; leave them unattended too long and they wilt and fade away.

Maintaining friendships often needs to be an active, conscious activity. That's one of the hardships for me in returning to Detroit: I'm usually there no more than a few days at a time, and there's no possible way to touch base with all the friends who want to reconnect with me. Somebody always gets left out of the mix, which leaves both of us disappointed.

This made me realize – no, that's not right: I always knew this, but last night reinforced it – how fortunate and blessed I am to have a group of lifelong friends. People tell me this is extraordinarily rare, but I'm very proud of the fact that my closest buddies from high school – Walker, Byron, Eddie, Tom, Frank and Bummer (no, that's not a misprint) – remain among my closest pals. The old crew is an extremely important element in my life.

Last April, when I was preparing to move from suburban Detroit to Champaign, Ill., and my body was wracked by gout (more about that horror later), Frank, now a successful businessman in Ann Arbor, heard of my physical dilemma and volunteered without hesitation to help me pack, use one of his fleet of trucks for the move and, with his wife, Lisa, drive my stuff to Illinois on their own time. If I ever doubted that God brings angels to us in our times of need, this incredibly selfless act set me straight.

One of the reasons I so enjoy my six-hour drives from Champaign to Detroit is that it allows me time to call all the friends I swear I have no time to contact during my very busy workdays. I'll open my cell phone, pick a letter at random under "Contacts" and call the first person whose name I see.

It absolutely amazes me that we have more means of communication today than at any time in recorded history, yet often find it harder than ever to remain in touch. You know and I know that "I'm too busy" stuff is poppycock, but we all use it as our rationale. Everybody's busy; trust me, your friends are thinking the exact same thing right now. Pick up the phone.