Kidney Dialysis Clinical (Write Up)

I recently had a long day of clinicals at a kidney dialysis center.  This was my first time being thoroughly exposed to the world of kidney dialysis. I worked with a variety of nurses as well as dialysis technicians and a nephrologist or two. The first nurse I worked with showed me around the clinic, introduced me to staff and briefly informed me about the details of kidney dialysis treatments that were provided there.  It was a slightly overwhelming realization as I watched an entire room full of people—of both genders and all ages (but mostly older) sitting on reclining chairs whose bodies were hooked up to elaborate machines.

The kidney dialysis machine happened to be a bulky contraption positioned right next to the patient. Some patient’s had venous and arterial catheters inserted into different sections of their subclavian artery used for hemodialysis access. Other patients had either a graft or fistula in their arm where a vein (such as the basilic vein) and artery had been anastomosed. A catheter would be inserted into this graft or fistula to facilitate blood exchange. The catheters inserted into the patient’s body lead out into a confusing, serpentine display of flexible plastic tubing. The nurses were kind and taught me how to set up the hemodialysis machine. They observed patiently as I threaded the tubing through all the necessary facets and compartments of the machine.  This act reminded me of threading my sewing machine. There was a cylindrical container (AKA “Artificial Kidney”) that had a densely packed mesh-like fabric inside of it. The patient’s blood would flow from the bottom of this cylinder to the top.  The patient’s blood would pass through the mesh-like reticular structure inside the artificial kidney and sludge and waste products from the blood were funneled out and escorted through a tube and eventually into a draining system. I became mesmerized by this entire process.

 Never before had I considered the exquisite workings of the kidney and its incredible yet indispensable function. I became saddened and dismal, realizing that so many human beings were on kidney dialysis 3 times each week for a period of 4 hrs each appointment. This was something that rarely made it out into the media—something that fully functional human beings outside of the medical field were unaware of. It made me realize how much quality of life would be impacted, but still, they had a few days of the week that were available to do other things. However, since dialysis treatments took a good chunk of the day (3days a week) and this did not include the trip to and from the dialysis center, dialysis patients would have a difficult time managing a full time job. This also made me reflect on the importance of organ donation.  

The nurse pulled me aside and informed me about the differences between hemodialysis and peritoneal dialysis. I learned that peritoneal dialysis could be done via a home machine and could be used while the patient was sleeping (at night).  Patients using PD had a permanent tube inserted into their abdomen from which dialysis would take place. Because the peritoneum (the serous membrane that lines the abdominal cavity) is rich with capillaries and therefore blood flow, the waste products in the blood could be filtered out into this peritoneal space.  A type of solution known as “Dialysate” was used with this form or filtration. The Dialysate solution would be pumped into the peritoneal space. Next, the peritoneum and the solution would act as a filtering mechanism for the body’s blood. Waste products from the blood would be filtered out of the body along with the Dialysate solution.

At the kidney clinic I was informed that many (if not most) of the individuals who were on kidney dialysis had underlying health conditions such as diabetes and hypertension.  These chronic conditions were well known to cause damage to the vessels—in this case, the kidneys in particular. Diabetes increases the speed of blood flow into the kidney. This increase in blood flow causes the kidney glomeruli to work harder; scarring and hardening can be a result.  I learned that diabetic nephropathy is a leading cause of kidney failure in the United-States.

Other experienced professionals at this facility included dieticians and social workers. I was shocked to learn all about the dietary restrictions of those on kidney dialysis treatments. Nutrients that were monitored included the patient’s intake of: phosphorus, sodium and potassium. Also, fluid restriction was a necessity for dialysis patients. (I learned that those on dialysis usually do not urinate as their fluids and wastes are removed during each 4 hr treatment.)

Thankfully I was able to get a tiny amount of hands-on experience. I was able to flush the venous and arterial subclavian catheters of one patient and also able to administer heparin. The day was a long one with some bouts of monotony, but I definitely learned a lot about kidneys and kidney dialysis.

When I LOST MY FAITH

Below is an excerpt from my journal back at the beginning of 2009 when I was deconverting from Christianity (losing my faith).

            When I thought back about it, it was true that everything in my life could have happened without the intervention of a supernatural entity.  I had never once had a “spiritual” encounter, seen Jesus physically, or audibly heard God speaking to me.  Likewise, never did I see Allah, fairies, Vishnu, angelic beings, leprechauns, the Virgin Mary or Thor.   The senses that God supposedly had given me to investigate every possible aspect of my life, happened to be the very same senses, when candidly applied, had never given me any access to the supernatural realm.  

           After all, I had never seen something like a miracle—an event that actually defied physical laws.  It didn't matter how much I prayed or how intense my faith, there was never the movement of a mountain, or, even on a far more diminutive scale, the revision of my psychologically damaging acne scars and horrible skin conditions.  In fact, the events in my life as well as in the lives of others seemed to unfold exactly as they would from an entirely physical, genetic, environmental—natural perspective.  As I looked more closely at the (natural) world, where people were born, their genetic traits (looks, intelligence, health) as well as a dash of luck—all physical entities, are really what appeared to be some of the most important aspects of one’s (a persons) life—and these aspects really were what created the inequalities that were observed in the world.  Everything became easily explained by physical, material reasons, not by supernatural and/or Biblical reasons.   When I began to flesh out the dogma and ideology of religion and the entrapment's of spirituality and the supernatural, life and its circumstances could be explained in a purely natural manner.

Religion became superfluous to reality.  It may have offered comfort to the mind, but ultimately it did not offer the truth about reality that we could actually know, and that is what I was looking for. Religion gave us conjectural possibilities taught us to more thoroughly examine our motives, but it never provided incontrovertible answers. There would always be exceptions as science marched forward. Most of the time, religion would give overly simplistic answers to very pressing, significant issues such as how best to wield science for moral issues (the welfare of humanity—in all its multiplicity of circumstances) as well environmental and climate issues.)

         The world just makes more sense without gods (or god)—without viewing it from a supernatural context.  Humanity cannot even agree on single religious philosophy or much less how to properly form a family.  Thus, the existence of religion more likely attested to the varied expressions and dimensions of the human mind and its mystification with the natural world—so many people grappling with their various levels of experience, education and intelligence.

           In a sense religion is the human attempt to find meaning in themselves as they grapple with their higher brain functions of the pre-frontal cortex and its ability to judge the meaning of life/existence.

MEN have the UPPER HAND in FINDING a DATE/RELATIONSHIP?? (long-term, that is)

Is DATING and eventually finding a LONG-TERM PARTNER a NUMBERS GAME? Is the competitive advantage in the gender where the demand is greater than the supply? I know there are a LOT more factors to consider here but I thought this was kind of interesting. 

Note: This video addresses the dynamics of heterosexual relationships only.



http://finance.yahoo.com/news/more-americans-forgo-marriage-as-economic-difficulties-hit-home-153146122.html

Quotes below taken from the most recent article above

"Put simply, for today’s never-married women, a “good” man is harder to find."

"Among never-married adults aged 25 to 34, the number of employed, available men per 100 women has dropped to 91 in 2012, from 139 in 1960."

Other Links:

Below is a very recent article/video link about how women in a certain age group are outpacing men in the area of monetary earnings. 

https://finance.yahoo.com/news/why-young-women-are-more--ambitious-010259891.html

We PREFER our PHONES over other People?

Every time I go out to dinner with my husband I find myself making observations. I often spy tables of young, 20-somethings gathered together rapt in lengthy, exciting conversations about particle physics, astronomy, transhumanism and its moral and social implications. These characters are immersed in delightful exchange and solving life’s riddles with the uninhibited giddiness that only a young brain with a dash of absinthe could achieve.

 I’m only kidding, of course.  What I actually see happening all around me is a new social phenomenon of sorts. While people still make the effort to go out to dinner with their “friends”, the eating part of the experience is the only thing they are doing together. For instance, I see people sitting physically beside each other at these tables. Their corporeal bodies are roughly 6-12 inches away from the individual sitting next to them; their minds, however, couldn't be further away from each other. Instead of a head and neck projected upward, attentive to the speech of their friends, the head and trunk of their body is projected downward, absorbed into a gadget with a flashing screen—a far more tantalizing prospect.   This is a rather new social occurrence, the latest trend in gathering that may be here to stay. I call it the, “Let’s get together and ignore each other” phenomenon.

A new realization has burgeoned. An awakening has swept across humanity. People have finally realized that other people (friends, family, acquaintances) in their 3-dimensional form have very little to offer so they have naturally turned to the 2-dimensional universe within their phones.  Why engage with the 3-dimensional imbecile sitting next to you when you can watch far more perfect people on the internet?  Why deal with the awkward blathering of the junior high-school drop-out sitting beside you when you can listen to perfectly knowledgeable speech from a PhD on the interface of your phone?

Just kidding again! Rarely do I see people using their phones to listen to presentations offered by scientists or to learn the etymology of words or even research global happenings. Instead, they are on a quest to far more sophisticated searches, like the latest picture of Kim Kardashian after shedding her baby weight or opening facebook to declare “I’m out to dinner with friends” while they ignore their corporeal friends to look at pictures and statuses of their facebook friends.

Is life really simply better when you’re in cyberspace? Have we created a society where external stimulation could never compare to the stimulation of the inner-world, the internet? Does the stimulation provided by the internet (like that of a fast food restaurant) appeal more to our base desires? Are there statistics to even back up this suggestion?

I think it is because of this: The internet offers the user unlimited options. The internet is, quite frankly, the apex of choice. Don’t like the way someone looks sitting beside you at the table? Find someone on the internet that looks better. Don’t appreciate the limited humor abilities of your friends at the table? Find a comedian on the internet with more skill, better delivery and more original content. Don’t enjoy listening to disheartening or bland discussions about a television show, dream or someone’s recurring medical problem? Find a youtube video or open up facebook to find far more exciting postings that actually engage your attention—as if the content was customized just for you!

Without a doubt the internet offers the individual options that could never be found in the real, 3-dimensional world. With more options, we are more apt to find exactly what we are looking for. Once there we can tune out the obnoxious chatter of the 3D people sitting beside us (they are doing the same thing to us, mind you.)

Perhaps the internet is just making the real world appear far more boring by comparison. Or, in a slightly different vein, it is making us, as people, more boring individuals.

How to Fail at Almost Everything and Still Win Big-- Book Review (my thoughts)

 I just finished the book, “How to Fail at Almost Everything and Still Win Big” (2013) by Scott Adams (the famous creator of the popular comic strip Dilbert). Yes, I’m a fanatic for self-help books especially those written by people who are measurably successful outside the domain of simply being a “Self Help” author/writer.

I love Adams’ comedic yet accessible writing style. The book is filled with insights on how to be successful in your everyday life—despite one failure after another. I was shocked to learn that when he first started making his comic strip, the feedback he got via email (in the early 90’s) was excessively critical. Despite the criticism he received (for what he calls his “poor drawing skills” or perhaps the content of his comic) he had one person push him on and tell him that he was good enough the way he was doing it and that he didn’t need to make any changes, that he should maintain his style. I really liked hearing that because often times we cave in to criticism and constantly change in response to the pressure of others.

 I think one of my favorite points in the book is the Big Five Factors of Happiness which he suggests are: a flexible schedule, imagination, diet, exercise and sleep. Out of these I think imagination is the component I never paid very much attention to. Yet, as I reflect on it, I can honestly say that the seasons in my life where I’ve daydreamed and entertained intensely robust, fantastical imaginations, the better my life was (at least temporarily). Adam’s suggests “Simply imagining a better future hacks your brain chemistry and provides you with the sensation of happiness today.” and “Being happy raises your energy level and makes it easier to pursue the steps toward real world happiness.”

It’s as if certain positive images and thoughts can rearrange your thinking and free you up to seeing possibilities you never before thought were possible. This could translate to a more successful life.

It can’t hurt to entertain positive thoughts because such thoughts can bring us to new highs. When we are happier, we may take more risks and try more things. Such decisions could result in something bigger or better happening to our lives as opposed to stagnation.

You can choose to think poorly of yourself, your abilities and your potential or you can choose to think highly of yourself (this is probably a false dichotomy here). Thinking about yourself with a higher regard will be better for your overall success and achievement in this life.  We all know that this life is very short; we are constrained by time and the state of our health. Thinking negatively takes you into a state of being a pessimist. Pessimists are known to miss opportunities that optimists are able to see more readily.  If our life on this earth is already short, why would we waste time going down a path that leads to fewer opportunities when we could go down the path that presents us with more?

I am probably the ultimate pessimist. I’m trying to reframe my thinking with glasses that have flower petals attached to them, or however the cliché goes. I can envision only sunshine.  

This book also mentions the importance of richly delusional affirmations. For instance, in Adams' words an affirmation would be something akin to, “I, Scott Adams will become rich.” I’ve decided to put this affirmation thing into practice in my own life. It can’t hurt, I suppose. Declaring that you will become rich on a daily basis may sound grandiose but it is certainly better than the alternative, “I, Renee, will become poor.” And, if a person is thinking negatively on a daily basis, isn’t it almost like they’re doing just that?

But, just to keep a skeptical approach to this whole “positive affirmation” business, allow me to finish with another quote from his book, “ The reality is that if affirmations somehow steered the universe like magic, science probably would have discovered that force by now.” 

What Makes a Relationship Work? (VIDEO)

2 or 3 specific relationship tips I have discovered over the years. These are critical to first starting a relationship and then keeping it going, long-term.

HUMOR, What makes something funny??

"Being able to laugh in life reduces anxiety that, if anything, comedy may actually be good for your health."

                             Quirkology

Interesting HUMOR factoids I've collected over the years

“The top jokes all have one thing in common—they create a sense of superiority in the reader.”

 “The observation that people laugh when they feel superior to others dates back to around 400 BC and was described by Plato in the Republic.”

 "Because of the animalistic and primitive associations, Plato was not a fan of laughter. He thought that it was wrong to laugh at the misfortune of others and that hearty laughter involved a loss of control that made people appear to be less than fully human.  Plato was so concerned about this that he advised citizens to limit their attendance to comedies."

"The more superior a joke makes a person feel, the harder they laugh."

"Hitler was sufficiently concerned about the potential use of humor that he set up special “Third Reich Joke Courts” that punished people for many acts of inappropriate humor including naming their dogs, “Adolf”

"A year long study of 1,200 examples of laughing in everyday conversation revealed that 71 percent of women laugh when a man tells a joke and just 39 percent of men laugh when a woman tells a joke."

"People with high social status tend to tell more jokes than those lower down the pecking order."

  "Females are more likely to rely on self-disparaging humor"

"The animalistic release of a victorious roar at other people’s misfortune is still alive and well in the twenty-first century."

"According to Freud, jokes act as a kind of psychological release valve that help prevent the repressed pressure from becoming too great—in other words, a way of dealing with whatever it is that causes us to feel anxious."
 

"The most basic form of a joke is a simple pun—we find these jokes funny because of incongruity.  In many jokes there is incongruity between the set-up and the punch-line."
 

"People who have damage to their right hemisphere of their brain are less able to understand jokes."

"When people see or hear another person laugh they are far more likely to copy the behavior, start laughing themselves and therefore actually find the situation funny.  This is the reason why so many comedy programs carry laughter tracks."

"Professional comedians tend to come from relatively low income families and to have been unhappy children and thus their performances may represent an attempt to compensate for their difficult early experiences by gaining the afternoon of an audience. There is considerable anecdotal evidence to support this idea."

 "Woody Allen once said that the need to be accepted was one of his primary motivations for being funny."

"W.C. Fields once explained why he liked making people laugh: “At least for a short moment, they like me.”
 

"Some performers admitted that they were intensely curious about people and behavior how they would endlessly watch others go about their lives until they found some idiosyncrasy that could form the basis of a new joke or routine."

Seymour and Ronda Fisher noted that there were parallels between social scientists and comedians they argued that both groups are constantly on the prowl for novel perspectives on human behavior.
 

“Frame your mind on mirth and merriment which bars a thousand harms and lenghthens life.” William Shakespeare

My Turn:  I try to use humor while recounting a past event. 

"One time when I was 11 I was embarrassed to wear my glasses for the big family slide show. I already looked hideous at that age and wearing glasses only magnified the horror of my appearance. All of my Aunts, uncles, cousins, parents, brothers, great uncles, great ---aunts--you name it-- were present. Half-way through the slide show my grandfather happened to notice that I wasn’t wearing my glasses. Suddenly, he stops the slide show. Then he loudly announces to the large consanguineous group “The slide show is being stopped until Renee puts on her glasses.” He said this with the austerity and despotism that would have given Hitler an erection.

Every single Aunt, Uncle, cousin, brother, etc turned around and stared at me in silence. Then my Dad piped up, “You better listen to Papa and put your glasses on, he means it!”.  I’ve never been so embarrassed in my life. For the slide show to continue I had to put on my glasses—but it was worse now because everyone in the room was staring at me. There was a growing impatience in the familial crowd—either because they wanted to see how terrible I looked in my glasses or because they were anxiously waiting to see more slides of the Grand Canyon and the evidence supporting Noah’s Global flood.

 At first I refused, but then I realize that I didn’t have any options so I put on my glasses.  My cousin, thin, blonde, and well developed for an 11 year old, starts laughing at my face. I feel terrible. Meanwhile, I’m sobbing like an abused duck and the slide show continues with my Grandfather describing the layers of the Grand Canyon, Noah’s flood and how this all relates to his personal relationship with Jesus"   

    --By Renee

"Humor is incongruity plus another amusement."

"Photons have mass? I didn’t even know they were catholic."

“Why was the Amish girl stoned to death? Too Mennonite!”  Christopher Hitchens

“The face of a child can say it all, especially the mouth part of the face.”

There are two rednecks in a field:

Hey, you wanna play twenty questions?

Sure, lemme thinka something

Got it?
Yeah, got it. Ask me.

Is it a thing?

Yeah.

Can you fuck it?

Yeah.

Is it a goat?

Yeah.