Giving Me the Finger

WHAT THE HECK IS THIS?

Not long ago I woke up to find the ring finger of my right hand bent back like a brown "C," as if it was pointing back at me, or preparing to flick something away. Even worse, it was locked in that position. And it hurt! I grabbed it with my other hand and tried to straighten it out. After hearing a small but audible "click," it was back in its normal position.

Now it's happening to the same digit dozens of times each day. Since I use that finger, along with its nine close friends, to do important things like write, make money and deliver these messages to you, this is no minor inconvenience.

It's an incredibly weird feeling when a part of your body doesn't respond to your mental commands. When it locks, I stare at my finger  and think, "Bend! BEND! I, your master, ORDER you to return to your regular place!"

Nuthin'.

Like I did when I learned I had kidney failure, my first move was to the World Wide Interweb to do some fast, intense medical research. What I have is actually quite common, Google tells me. O, fortunate me.

It's called "trigger finger," or stenosing tenosynovitis. We'll just stick with "trigger finger." And according to the American Academy of Orthopaedic Surgeons Web site, even with all the advances in modern medicine nobody seems to know exactly what causes it. Marvelous.

Here's what the orthopods do know:

• It happens when the flexor tendon, which controls the movement of your fingers and thumbs, becomes irritated or actually gets caught for a moment on a tiny nodule growing in the sheath that keeps the tendon in place.

• It is more common in women than men. (Lucky, lucky me.)

• It  occurs most frequently in people between 40 and 60. (Check.)

• It is more common in people who have certain medical conditions, lilke rheumatoid arthritis or diabetes. (Wait a minute: I've got diabetes, too?)

(Oh, no. It's probably the kidney thing. Never mind.)

• It may occur after heavy hand use or activities that strain the hand. (You mean, like typing millions of words over a 35-year career?)

Fortunately, a woman at our church, Theresa Miller, is a well-known physical therapist in the area. Unfortunately, she couldn't hold out much hope.

There is no "cure" for stenosing tenosynovitis, Theresa told me, and the best treatments are rest, perhaps some heat, and anti-inflammatory medicines. Occasionally a doctor will inject a steroid medication DIRECTLY INTO THE FINGER to help relieve the pain. (I'll need a moment here.)

As a last resort, surgery may be recommended to prevent permanent stiffness. In any case, the options don't sound particularly sunny.

Karen has become very adept at massaging the sides of my finger in just the right places when it locks to ease it pack to full extension. Theresa suggested a special finger splint to aid in the resting process, and I'll likely pick one up the next time I'm near a medical supply outlet. So in the future, if you should read anything I write that suddenly starts missing all its "Ls" and "Os," it's probably because I'm trying to finish my w rk whi e wearing the sp int.

Parking With the Pastor

I have returned, tired but inspired, from "Harvest University," an intense three-day conference in Elgin, Ill. It was hosted by Harvest Bible Chapel, the exploding string of Bible-based churches worldwide that has a branch in Decatur, Ill., which I am proud to attend.

At a Harvest church, everybody works in service to God's glory; I am a member of the Hospitality Team at Decatur, and in between the University's exhilarating worship services I took workshop courses designed to help me do what I do better.

The church was founded in 1988 by Pastor James MacDonald, a simply amazing man of God. Funny yet fearless, passionate and unapologetic, he is one of the finest Biblical scholars and ministers it has been my privilege to hear.

I'm always thrilled to see him preach in person, so I was anxious to get from the hotel where 17 of my fellow Decatur parishioners and I were staying over to Harvest Elgin for the final day of classes and Pastor MacDonald's closing sermon. Because we all had checked out of the hotel and were going our separate ways at the end of the conference, I was driving by myself.

About a quarter-mile from the church, I found myself stuck alongside a bald, burly biker in a black leather vest who was slowly putt-putt-putting his Harley in the right-hand turn lane leading to the entrance. "This guy can't possibly be going to Harvest University!" I grumbled. "What the heck is he doing in my way?"

I had the option of either slowing waaaay down and slipping in behind the motorcycle or hitting the accelerator, gunning it a bit and zipping in front of him.

Did I mention that I drive a 2011 Camaro?

There was no option. I stepped on the gas, made a sharp right and pulled in front of the biker. "That's more like it!" I grinned.

I looked in my rear-view mirror to make sure I hadn't cut him off too severely. "Man, does that face looks familiar," thought I.

Then I took a closer look. The joy-riding biker was none other than...Pastor James MacDonald.

Oh, Lord.

Scanning his eyes in the mirror for any trace of anger, I felt relieved that (a) he seemed OK and (b) thankfully no one from my church witnessed my moment of sheer idiocy.

I was half right. The moment I opened my door after parking in the Harvest lot, my pastor in Decatur, Tony Caffey, was standing next to my car. "You know you almost ran over the founder of our church?" he asked.

I heard the raucous laughter of my fellow Harvest Decaturites in the background.

Well, perhaps an apology might be in order.

As I entered the lobby I spotted MacDonald – he's a hard man to miss, especially in a black leather vest – surrounded by members of my church. I walked over and shook his hand.

      A grinning Pastor James MacDonald with Harvest Decatur attendee Lori Nelson, apparently uninjured.

"I'm really sorry about cutting you off," I said.

"That was you? In the Camaro?"

I nodded sheepishly.

"Man, I couldn't help but check out that car! That is one sweet ride!"

Saved by the sports car.

As we later learned, MacDonald was dressed as he was because the church was giving a new Harley to assistant senior pastor Rick Donald for his decades of faithful service to the church, and MacDonald actually rode the bike into the sanctuary to present it to him. I don't think that was the bike he was riding into the parking lot, but I can't be sure. Had I cut my steering wheel a split-second sooner, I might have ruined a thoughtful, expensive gift and derailed a marvelous closing sermon from MacDonald. Harvest Holy Enemy No. 1.

The takeaway for me that day? God's grace even extends to impulsive drivers. And you can't judge a biker by his "vest"-ments.

Making a PACt With Baxter

I spent a few days not long ago in scenic Waukegan, Ill., home of Baxter Healthcare worldwide, where I made my first appearance as a member of the company's Patient Advisory Committee team, or PACt. (As a professional editor it drives me batty that the "t" isn't capitalized too, but I try hard not to think about it.)

As another wonderful outgrowth of these wacky blog blatherings, I was invited last year to sit on the patient panel for Baxter, the company that manufactures my dialysis machine and supplies, in the off chance I might have something to contribute.

These meetings are highly confidential, as deep-dark details of products in production and yet to come are discussed freely. I could tell you some of the things we talked about, but then Baxter would have to kill me.

No, seriously.

In fact, it was kind of funny. Before the PACt confab, I was asked by my great and good friend, Trisha Daab of Baxter, to speak to the global marketing group she recently inherited. She wanted me to crank up my standard song-and-dance routine to a new audience and share firsthand feelings and experiences about being a kidney patient on Peritoneal Dialysis (PD). Sadly, the corporate workers who manage and market Baxter's goods almost never get to talk to the end users whose lives depend on their labors.

After that lively session I opened my laptop to check my e-mail. Because the PACt meeting was to be held in the same conference room, I left my computer open to mark my seat.

Minutes before the PACt was about to convene, one of Baxter's marketing bigwigs walked over and gently put his hand on my shoulder.

"Uh, Jim," he said warily, "you are aware that these PACt meetings are confidential?"

"Of course," I replied.

"Oh, OK. I saw you had your laptop out and I wanted to make sure."

Dude, this isn't like a baseball game where I need to cover the play-by-play action of the meeting as it happens! If I was going to reveal company secrets, don't you think I'd have enough sense not to do it inside the company? I was mildly offended! But apparently some of the bigger wigs at Baxter were slightly ruffled by my unvarnished honesty in describing my Baxter-sponsored trip to LA to speak to their annual sales convention (see "Shelter From the Storm" here).

I'm told somebody even asked if there was a provision in my speaking agreement with Baxter that gave the company any editorial control over this blog! I will not be censored! I cannot be controlled or muted! I will always tell the truth of kidney disease, dialysis and my life as I see it, without compromise! You loyal Just Kidneying readers deserve nothing less!

(The strains of "The Battle Hymn of the Republic" should be coming up in your mind right about now.)

For me, the best part of the PACt meetings was the opportunity to meet and interact with everyday people who have dealt with the same affliction that I have – and in some cases, suffered far more pain and damage. It's a comforting feeling to know somehow that you're not alone in this sickness, and a blessing to realize that as bad as it feels sometimes, it could be far, far worse.

The most surprising part of the day was the realization that, of the dozen or so participants relating their experiences with Peritoneal Dialysis, I was the only one who uses the Baxter "FlexiCap Disconnect Cap with Povidone-Iodine Solution" on a daily basis.

You see, the way the Baxter PD cycler works is, old dianeal solution is drained from the peritoneal cavity surrounding your innards, fresh solution is pumped in, then it "dwells" in your body for a couple of hours to attract and filter out all the impurities it can. During the "dwell" period, the cycler is essentially inactive.

Guess I had some wonderful and understanding dialysis nurses to train me, led by my Angel Who Walks on Earth, Diane King: I was taught that if you're careful and maintain sterility, there's nothing wrong with detaching yourself from the machine, capping off the fluid tube with a FlexiCap and going about your business during that time.

                                    The "FlexiCap Disconnect Cap With Povidone-Iodine Solution" at Work.

During the day I run errands, have lunch, work out – just so I'm back and reattached to the cycler before the next drain begins.

When I said this out loud to my fellow advisors, they looked at me like I just fell out of Uranus. "Oh, NO!" they cried. "You must only use your FlexiCap in the most extreme of emergencies!"

Really? Really, folks?

After that, I pretty much just PACt it in.

Until the next advisory meeting in June, that is.

A Donor Has Been Found!

If there's one thing I have learned through this amazing kidney journey, it's that nothing should amaze me.

You remember the story of the anonymous Detroit gentleman, a stranger to me and in terminal condition, who read about my situation and designated that one of his kidneys be given to me upon his passing? (If not, you can read about it here.) That selfless donation had to be declined for numerous reasons, but now, astonishingly, another potential organ donor has stepped forward:

Charlie Sheen.

Apparently during all my coverage of Sheen's tribulations with Two and a Half Men as TV critic for the Detroit Metro Times, one of his people, Stan Rosenfeld, came across Just Kidneying while Googling my name and brought the blog to his attention. In the call I received last night, Sheen says he feels moved to make sure I'm "WINNING!" in my quest for a transplant and is in the process of undergoing a blood test to make sure we're a type match. Even if we're not, he feels the tiger's blood surging through his veins will be enough to overcome any incompatibility issues.

The real issue, as it was with the man from Detroit, will be the overall health and condition of his organs. Charlie believes his kidneys are sufficiently pickled to be well preserved for transplantation, and as a "rock star from Mars" he thinks it's highly possible he may have a third or fourth extra kidney inside him anyway.

We plan to meet in person backstage during his live tour stop at the Fox Theatre in Detroit Saturday to seal the deal, at which time I will tell him what I'm about to tell you now.

Happy April Fool's Day, everybody.

Jimmy Springs a Leak

Why they waited until the day of their mutual birthdays to decide they had to buy presents for each other, I'll never understand. But the twins, Madison and Emma, pleaded with me to drive them to the mall on a recent Friday after school. Happily, in January I bought a 2011 black Chevy Camaro (feel free to oooh and aaah below) because I decided to fully enjoy my only midlife crisis, so I'm pretty excited to drive anybody anywhere these days.

The girls love to shriek and cavort from its back seat over the sheer power of the Camaro's mighty V6 engine – which, come to think of it, may have been the reason they waited until they were sure I would be the one to ferry them in my "rocket car," as they call it. They have even bestowed it with a nickname: 'Black Betty." I'm thinking seriously of getting a vanity license plate for it this summer that will simply read, "BAMALAM." Those who get it will get it.

Happy Black Man With Snappy Black Car  

Anyway, we're in Decatur motoring down Martin Luther King Boulevard en route to the mall (why do bad things always seem to happen on MLK?) when I decide to call The Wife on my Droid and let her know where I'm headed.

"Gadzooks!" (or something like that) I think to myself. "My phone is wet! How can that be?"

Then, in fast order, I realize the right side of my jeans, my leather jacket and, yes, my underwear are soaking through, too. I pull back my jacket and unleash a spout of liquid shooting straight up into the air – all over the interior of my brand-new beautiful car. Worse, that liquid was quickly identified as warm body juice; the joint where my catheter connects to its external tubing had cracked, and the dialysis fluid that should have been circulating around my peritoneal cavity was suddenly circulating around my Camaro.

As the girls squealed and pointed, I grabbed the leak with one hand and steered the car into a church lot, no easy feat when you're driving a stick shift. I put the rocket car in park, leaped from the vehicle and attempted to cap my gusher. The twins, trying to be extremely helpful, grabbed everything they could find to stuff the leak: used paper tissues on the floorboard, a dirty rag on the backseat. I think I even remember seeing an old PayDay wrapper in all the confusion.

Praise God we were less than a mile from my DaVita dialysis clinic. Doubled over like a gunshot victim in a TV show and working my car's clutch with whichever foot was closest, we sputtered into the DaVita parking lot. It was nearly 5 o'clock on a Friday, but I prayed someone would still be there who could help.

Prayer answered. There has been considerable flux and turnover among the Peritoneal Dialysis nurses in Decatur, and Karey was virtually a PD rookie, but she happily agreed to give my catheter repair a try. While she called Champaign for advice and inspiration, I waited anxiously. When you have a manmade hole in your body with a tube hanging out of it, you are repeatedly warned that infection is a constant danger. Peritonitis. Can be fatal if unchecked, you're cautioned. And we've just slapped every filthy thing we could find on top of it to stem the tide. We did everything short of blow on the tube to hold the water back! If the catheter gets infected, or needs to be removed, my days on PD could be over.

Emma and Madison, for their part, were wonderful, supportive and encouraging. It took nearly an hour for the emergency patching to be completed, and the girls busied themselves by watching TV in the clinic lobby, talking up patients coming in for their treatments, and taking a semi-guided tour of the facility. (That is, peeking in the open doors.)

Madison and Emma, Acting a Fool at the DaVita Dialysis Clinic   

"Jim," Madison enthused, "this is the best birthday ever!"

I'm sure Maddie doesn't know the meaning of hyperbole yet, but for some reason I had a hard time believing that.

Finally the leak was sealed, temporarily; I had to journey to Champaign the following Monday for the permanent fix. As she was putting on her best finishing touches, Karey asked, "Why didn't you use your clamp?"

"What clamp?"

"Do you have a little white clamp they gave you to tie off the fluid line in case of emergencies?"

Sheepishly, I reached into my jeans pocket and pulled out the small pillbox I carry to hold my mealtime medication. I opened it. Yep, there it is, all right. A little white clamp. Good thing I have that, in case of emergencies. Hey, I could use some emergency training!

As we walked back to the car, I heard a small, tentative voice behind me.

"Jim," Emma asked, "can we still go to the mall?"

What could I say? They had done so well, been so helpful, reassuring and patient. Off we went to the mall.

"But remember, ladies, my underwear is still soaking wet!" I announced. "So please shop as quickly as you can!"

Ever try to make two 11-year-old girls shop quickly?

Ever go through a mall walking like John Wayne?

P.S.: The Wife watched me the entire weekend like I was planning an escape, looking for any hint of fever or discomfort, but I came through with flying colors. No peritonitis. No infection. God is good. All the time.

Shelter From the Storm

What I'm feeling is something close to survivor guilt. I'm sitting on the king-sized bed in my room at the majestic Four Seasons in Westlake Village, Calif., a room with a chandelier and a mini-bar. I'm scheduled to speak here Thursday morning to offer a "patient perspective" (read: provide the morning entertainment) for Baxter Healthcare's annual national sales convention.

Baxter flew me out to LA and is putting me up at the Four Seasons for two days to give a 15-minute presentation. God bless America.

But back home on the prairie of central Illinois, weathergeddon has arrived. Sleet. Ice. Snow. All together and in various combinations. We're expecting the locusts and frogs by Friday. Chicago is anticipating at least two feet of snow, much of which will be covering my new black 2011 Camaro (love that car) when I return. That's if I can return.

The airports aren't flying. The roads are shut down. The Midwest is closed for the week, frozen into suspended animation. The University of Illinois, where The Wife works, has closed all three of its statewide campuses for the first time in 100 years. This is serious.

I feel like I should be united with my family, battling shoulder to shoulder against the cruel elements, the sporadic power outages, the bone-chilling cold and paralyzing ice. Then I stroll down the richly appointed hallway to the elevator and down to the sushi bar at Onyx, a restaurant in the Four Seasons, where I order a "Hawaiian Volcano," possibly the best thing I've ever put into my mouth, and I break into bursts of uncontrolled giggling. Decatur, Ill., seems very far away.

The "Hawaiian Volcano" sushi roll at Onyx in the Four Seasons Westlake Village, Calif., maybe the single best thing I've ever tasted.

I came so close to not making it here at all. When the dire weather predictions began filtering through last weekend and Wednesday, the day I originally was scheduled to fly out of O'Hare, was targeted as the day all heck would break loose, my family encouraged me to get out of the house and drive to Chicago as early as I could on Monday. (They said it was because of the oncoming storm, but now that I think about it....) The people at Baxter's travel department, so incredibly helpful, understood my concern and paid the change fee to book me on an flight early Tuesday morning.

Which, of course, I missed.

I stayed at a Holiday Inn Express near the airport, but missed my shuttle ride by seconds. By the time I got to O'Hare 30 minutes later, the best United could do was put me on standby for the next flight at 10:30 a.m. I had a little breakfast, went to the gate and waited. And prayed. And hoped.

The 10:30 flight, the update screens said, was completely sold out, and I was seventh on the standby list. Passengers were rushing the gate like U.S. Embassy workers getting out of Egypt. In my mind, I was contemplating the best place to have lunch at the airport.

Then, at the very last moment, I heard, "Passenger McFarlin!" I grabbed that boarding pass like it was a winning lottery ticket and dashed to the last seat on the 747. God is good, all the time. I was meant to be here, I guess. I swear I could see the storm clouds moving in as our plane was climbing above them.

I don't necessarily feel pressure, but I'm thinking I need to be really good Thursday morning to justify Baxter bringing me here and out of the frozen tundra. I'm going to try very hard not to giggle.

Who You Callin' Ugly?

The Decatur Ad Club, which I joined last year to increase my local business connections and get out of the basement occasionally, held its first "Ugly Sweater Christmas Party" this week. Because I wanted to be perceived as a participating member of my new group and share in the holiday spirit, I decided not only to attend, but to jump into the competition with both feet. Or sleeves.

I rummaged through three local thrift shops looking for potential knitted nightmares, but came up empty. (I subsequently learned that Ugly Christmas Sweater Parties have become such the rage that you need to start shopping for appropriate garments around Labor Day or pay outrageous last-minute desperation prices to online merchants. To my surprise, my dear friend Laura Foti Cohen has a Web site/blog devoted to ugly Yuletide sweaters and similar follies at hellishholidays.com.)

I shared my disappointment with The Wife upon returning home, and probably shouldn't have been surprised by her response. "Oh, honey, you don't need to go shopping for ugly sweaters," Karen cooed. "You already have at least one great candidate in your closet."

(As infuriating as it is to have your wife call out anything in your wardrobe as hideous, men take note: women will almost always think any clothes you bought without her guidance or held over from previous relationships are pitiful and offensive.)

She dashed into the closet and hauled out my "rainbow sweater," a multi-striped, hand-me-down crewneck I usually wear around the house for comfort's sake. "This is the one!" she declared, to my chagrin. Then she cheerfully set about making it even more gruesome, if that's possible.

She sewed a few old Christmas ornaments around the neck of the sweater, including a curiously effeminate little elf she said was one of her earliest childhood holiday decorations. Then, for the coup de grace, Karen attached a string of battery powered Christmas tree lights around the sweater's collar with a remote control switch that could conceal under my clothes to switch on, off or on flicker mode. (The preferred setting, of course.) I was girded for battle.

Because she'd now spent time and care in the preparation, Karen became invested. "I hope you do well, honey," she said, coupled with a facial expression that added, "Don't you dare come home without winning this thing."

The party-slash-contest was held in the library room of the Decatur Club, the city's hoity-toity downtown meeting address. I took a cautious look around the room. The competition was scattered about, and potentially formidable, but I felt confident I could compete. (Some of the challengers are pictured below.) I flipped the switch on my ring of necklace lights to "flicker."

Illinois Congressman Bobby Schilling, who was attending an affair next door, agreed to come over with two of his colleagues and serve as judge. He was wearing a Christmas tie that, had it been knitted and sprouted sleeves, easily could have given me a run for the money.

Schilling to me: "That is one damn ugly sweater."

Me to Schilling: "Thank you, Congressman. And the same to you."

Schilling and his associates conferred, votes were cast and – I WON! I WON! I received a small framed plaque that now holds a position of prominence on our mantle, a chocolate Santa (no jokes, please) that I gave to our 10-year-old, Emma, a PEZ dispenser (don't open it – collector's item, you know) and a miniature ugly sweater that supposedly doubles as a decorative bottle warmer.

Best of all, I got to feel a little bit closer to some people here in Decatur, my address now and for the foreseeable future, with the holiday spirit.

And I got to go home that night.

 I didn't think this one was particularly "ugly," just interesting. Or should I say, "festive"?

I thought this was my stiffest challenge, especially with the antler accents.

         Ladies and gennemen, THE WINNAH!