First Post-Transplant Halloween

AS WE SIT AND WAIT FOR THE FIRST ANKLE-BITERS

Unbelievably slow here in Broadmoor Court, it's 8:00 pm and we have only had one pathetic group of rugrats so far. So, it gives us a rare opportunity to comfortably review our first Hallow'd We'en (or whatever) since the major events of earlier this year. Suffice it to say, this peculiar annual celebration was way beyond suitable observance for me. I couldn't get outta my own way in the old days, let alone put on a costume and go out begging for candy in the neighborhood. Glad to report it was a bit livelier this time. Not a wild riot in the streets by any means, but a nice way to easily break back in.

AN EVENING OF FOOD, FUN, AND VIDEO

Friday we were graciously included with the Henrys at the Frates home for a delicious dinner. Before and after the meal we enjoyed a screening of few favorite Frates presentations. These included Academy Award -winning animations, and a truly cool piece called Playing for Change featuring musicians in locations all over the world playing the same songs, blended together. Most enjoyable, as were the incredible short ribs on a bed of polenta, and Sue's housemade cheesecake. The company wasn't too bad either.

THE ACTUAL HALLOWEEN SOCIAL EVENT

We journeyed to San Ramon to the lovely home of Cheryl's travel buddy, the famous Honolulu Lu and husband Rym. Again, an impressive spread of eats, nice folks, cool costumes (including a right-on Russell the Scout from Up). The host and hostess's young twin granddaughters were both dressed to match Mommy, and it was quite adorable. Very nice, and it was fun for us to appear as a sort-of angel (Cheryl) and an Orthodox rabbi (Yours Truly).

As of 8:30 pm Halloween night, we have had a total of seven candy-beggars, the last two being obnoxious teenagers who should know better. At least they could dress up a bit more than low-riding pants and black Megadeth t-shirts. Whatever.

So we leave you, woefully overstocked with really good candy, looking forward to a busy and productive Monday. As always.

Bob/Irv

Special Two-for-One Format: Buy One, Second is Free

ACTUALLY THE FIRST ONE IS ALREADY FREE, SO WHY NOT READ BOTH?

And the first one involves a truly fun wedding we attended on Saturday. Since our Tauck Tour went away, we became once again free to join our Fremont cousins Norm and Patty H. at the wedding of son Elliott to a lovely lady, Alicia. Norm graciously reversed our original RSVP, and we were officially added with a table assignment, a place card, and full privileges. We knew this would be a kick when, as soon as they stood at the pulpit, both Alicia and Elliott started giggling at each other. Alicia turned her head frequently to the guests, smiled, giggled, and shrugged her shoulders in happiness. It was a total scream, and really added to the fun atmosphere that would become even more evident at the reception.

After dinner, the DJ started right in with loud, driving tunes that were completely unfamiliar. Immediately the dance floor was filled with gyrating 20-somethings, many old classmates of Elliott from....CHICO! No wonder this was already at Level 9 on the party scale! We could not help but jump in and boogie to our fullest, yet limited capabilities. It rocked! We went at it so hard that my glasses lost a screw and my lens fell off. Serious! The highlight had to be Alicia up on top of a large speaker, in her gown, dancing like a star with all the moves. A strobe light added to the spectacular effect. And many rushed back-and-forth to the bar to catch the Playoffs. When the Giants won their way to the World Series, the whole place got even nuttier. Truly a most cool experience. Thank you thank you Norm and Patty, and certainly the Germano family for allowing us to join you for this celebration.

FEAR AND LOATHING ON 9 LONG

Not really. My apprehensions based on an unpleasant stay on the kidney/liver transplant floor back in May were ungrounded. I received great, friendly care from everyone. The kitchen mistakenly sent me a clear liquid breakfast yesterday morning, a major irritation based on my menu indicating French toast. After a few aggravated-sounding pleas, the correct tray arrived within minutes. Pretty good considering some of the antiquated procedures still in place within hospital food service. But, equipped as I was with iPhone, Mac, books and magazines, I was suitably occupied. We did get discharged, but the usual slow exit procedures were three times longer than usual. Seems the doctor writing the discharge order knew diddely-squat about insulin pumps, and for some reason did not notice the detailed suggestions made in my chart by the outstanding diabetic nurse-educator. So "early" turned out to be 3:30 pm, and the usual traffic-choked trip was repeated yet again. Oh well.

The medical results were some major drug changes, the biggest deal being yet another prednisone "taper". I started today at a humungous 180 mg, which will be gradually reduced to my original 5 mg around December 2. My blood sugar is astronomical, and I feel a bit trembly. My great hope is that I will not attend any more of my famous "me only" Prednisone Parties, which faithful readers may recall from earlier this year. No thank you, I need the sleep.

After consulting with my excellent endocrinologist at Muir, I made some insulin pump changes. Just now before lunch, my glucose came down rather well, so I am encouraged about that. I will be following up at UCSF with both the heart and kidney clinics in two or three weeks.

So that brings it up to right now. Never a dull moment anymore, and I wouldn't want it any other way. Cheryl is not 100% behind that, however. But stay tuned, it's always a laff riot around here.

Bob/Irv

"I Can See for Miles and Miles and Miles and Miles and..."

YES, I REALLY CAN

It is a bee-you-tea-full day here in The City, as viewed from the ninth floor, Long Hospital, UCSF Med Center. We once again left home Monday morning at about "o- dark-fifteen" or so, placing us directly in a serious Bay Bridge jam. We were essentially on time here, and for a change the Kidney Krew was in a huge flap to get me in and out fast. After the required four hours of flat bed rest in the Limited Stay Unit, the word from pathology was minimal rejection due to tubulitis. I Googled tubulitis and got 1.75 million matches, all of which were in Medicalese and therefore totally intelligible.

This morning, the largest doctor entourage I have ever seen gathered in the hall. Now I know how Custer felt. Drs. Tomlanovich, Stack, Chandra and other hangers-on entered, filling my room. Dr. T. told me it is a mild case of interstitial rejection, affecting the membranes of the actual little dudes in the kidney that filter the blood. It makes them swell, hence "tubulitis". This is opposed to vascular rejection which affects the blood vessels and is worse. The level of rejection is basically level one, not terrible but they would rather have "0" of course. They are considering a med change and will get with the heart tx docs to get to an answer. Pretty confident I will be gone tomorrow. I asked him since I am hanging here more than two days basically for three 20-minute treatments, could this be a home health deal, and he said yes it could. They definitely wanted the biopsy and figgered to just keep me and stick the stuff in while I am here. Whatever.

Well, alright then. my Tubulitis and You 101 lecture is now over, and you are dismissed. Surprise quiz tomorrow (how izzat a surprise?).

MY ICC BUDDY'S PROGRESS

I went up to 10 Long to say hi and visit David E. in ICC. He is the gentleman I have been seeing to help keep him focused and enthused about his proposed heart/kidney transplant. It is now public that the esteemed surgeon Dr. Hoopes (who does all hearts including Yours Truly) is leaving for U of Kentucky. Pretty soon too. And when he goes, so goes heart transplants at UCSF until a suitable replacement is recruited. This will probably not be like when 15,000 people apply for three part time positions at Target. My fear was that David would be left out, and he is better now but still in great need.

He looked great today, sitting up in a chair with no lines or oxygen going to him. He just casually mentioned he was having "the operation" today. My jaw dropped 16 feet, although I am only 5'9" tall. Ouch! But seriously, I had to ask incredulously "you're getting a heart and kidney TODAY?" I was pretty happy and relieved about his organ offer.

I went back up to 10 ICC after dinner, and asked at the desk if he was gone yet. To my dismay, the nurse sadly said "No". I dragged myself to his room, and met his daughter who was to be his main caregiver. He told me it was happening until his labs were not acceptable. Incredibly, he was amazingly OK with it, but he did admit to major disappointment when he got the refusal. Dr. M. asked me last week not to mention Dr. Hoopes' departure, so I am not sure whether David knows about that. It would then be necessary for him to get another offer and be healthy enough for the surgery by this Sunday, since as of November 1st., Dr. Hoopes is history. I encouraged both of them, naturally, but I am damned worried about what will happen next month.

A SHORT BUT SWEET VACAY TO THE MOUNTAIN

We did get away last Wednesday after labs were drawn locally. Our trusty S2000 was packed to the gunwales (what is a gunwale, and do I really have them?) with important stuff, enough to sustain a very small army for a pretty short time. We missed the Bro' for lunch in Lodi and headed for Apple Hill. After the required apple donut and a bag of Fujis, we pointed East and North for North Shore, with the top down and the heater on. Excellent accommodations at the Red Wolf, which included an early-evening S'more extravaganza, luckily without the threatened singing of campfire songs.

Dining experiences ranged from dismal to slightly above mediocre, but the worst is worthy of a heartfelt (HEARTfelt...get it?) warning to all. DINING AT JACKSON RANCHERIA CASINO CAN BE HAZARDOUS TO YOUR HEALTH! I am not only talking about the ciggie smoke in the (barn-like) casino. No no. With visions of Vegas-level opportunities for eating, we avoided the buffet and headed for the "Food Court". Here we found a dark, dismal hallway with maybe three fast-food type establishments and one cart selling Nathan's hot dogs. These austere stainless steel-decorated counter service establishments were staffed by inattentive employees who all either hated life or had very sore feet. After consuming our lunches, we realized the motivation. These casinos don't have shows, Bobby Flay restaurants, fancy fountains, or in fact anything but gambling! They obviously are intent on getting your face quickly fed and returning you directly to the slots. And mere moments down the road was Jackson itself with several better-looking dining emporiums. We learned a lesson there, boys and girls.

We continued down the hill as rain drops commenced. We had a nice visit with Gary in Lodi at Buy-4-Less, where everyone should go to get fantastic grocery values, of COURSE for things they don't have at Trader Joe's. Sorry, Leslie and Chris, I almost lost my head. More rain followed us to El Liverito but we were secure in our little roadster, top up, wipers slapping time ("Me and my Bobby McGee") and thoughts of poor Lucy waiting anxiously for our return. After a pet or two, she viciously attacked my arm with claws and toofs, so I knew I was truly home. Maybe it will stop bleeding by tomorrow.

So as usual, I have talked your ear off. I can see it, right over there on the floor, near the couch. You'll be OK. It's not my fault. It's that damn prednisone again....yeah, that's the story...damn prednisone. And concentrated IV prednisone to boot.

Helplessly Hoping for French Toast Tomorrow Morning,

Bob/Irv

An Optimistic Excursion to Puzzle Palace on Parnassus

INTO THE LION'S MOUTH, YET AGAIN

Picking up where I left off yesterday, I quickly completed the 11:00 am ultrasound. I was handed a rather cryptic little envelope to take to the kidney transplant doctor. I cheated by opening it, and saw a bunch of hieroglyphics with "abnormal" circled several times. My confidence was not bolstered.

We got quickly in front of Dr. Lee, the transplant nephrologist I had seen during my ordeal last May. He was not unhappy with the ultrasound, since while abnormal it was the same abnormal as five months ago. He sent me to the lab with a stat order, and after the draw, we enjoyed a pannini and a walk up and down Irving Street.

As instructed, we returned to the kidney transplant clinic. The results of the labs were very much improved over last week, so he felt a biopsy was not needed. A biopsy would have entailed at least a 1-2 day inpatient stay, and if there was considerable rejection, it might have been as long as five days. Needless to say, that would have totally sunk even the smallest efforts to salvage a brief vacation. He asked me to get labs Wednesday morning in Pleasanton, after which time he was OK with us heading out of town for a short excursion. If anything evil were to develop, it only takes a phone call to send us back toward San Francisco.

SO, UH, BOB/IRV...WHAT IS THE PLAN NOW??

Our current thinking involves bringing the S2000 to Lodi first, in order to "do" lunch with Bro' Gary. Then, per his suggestion, motor briskly on back roads up to Apple Hill for some stops at the various orchards for apple this and apple that before heading to Tahoe's North Shore for a couple of days of fall foliage therapy. We will be back in time to attend the wedding of our Cousin Elliott in Fremont - a silver lining to our previously cancelled tour. So, there you have it !

Cheryl just this very moment scored accommodations at the Red Wolf Lakeside Lodge ( I believe a Caples and Sharon and Jeff Johnson favorite) so we are set for takeoff once again. To Infinity, and Beyond...

Bob/Irv

Ready, Set.....Stop

SEEMED LIKE A GOOD WEEK

We breezed through our obligations last week, intent on wrapping things up in anticipation of our Dream Vacation on Tauck Tours' American Canyonlands. Our Wednesday visit to UCSF was not only successful medically, but one more positive and, yes, enjoyable few hours amongst our gracious and concerned caregivers. Good news from Urology, a brief visit to the Cath Lab, and some time spent with our two heart and kidney transplant buddies on 10 ICC preceded a trouble-free ride home.

I went to Concord (Centre Concord?...what is up with the spelling at Concord City Hall?) on Thursday solo, this to help staff a CTDN information table at the City of Concord Employee Benefit Fair. I love talking to anyone and everyone about transplantation and the importance of donor registration. One attendee actually said she was hesitant to register since "they will let you die so they can have your organs". You can see why we are so anxious to dispel poppycock like this. It was then a pretty quick turnaround, as I joined our friends Bart and Barbara to attend TRIO in Mountain View. Cheryl had to continue her work day responsibilities and did not attend.

BUT WAIT, HOLD THE PHONE.....

Literally. We were wandering around the drug store Friday evening around 6 pm, getting those last few vacation needs and topping off the prescriptions in preparation for our departure Sunday morning. My cell rang, and it was our (substitute) coordinator, Karen. "Bad news" she said. Seems that my latest lab numbers had just arrived that day, and the kidney function (creatinine to be specific) was not pleasing. In conjunction with some elevated blood pressure, they were afraid of possible rejection. Since this was to be ascertained via ultrasound and biopsy, the strong suggestion was to appear at UCSF Monday morning and possibly Tuesday. Everyone was concerned about possible problems out there in the National Parks, and even though we had the requisite travel insurance, any medical evacuation would be problematical. Unlike my adventure in Long Beach, there are few suitable airports in places like East Nowhere, UT.

My initial reaction was "Screw it, we're going anyway". Karen spoke calmly and intelligently as I hung my head pathetically in the "Dental Needs" section of CVS. Cheryl was somewhere else in the store, and when she found me by the toothpaste I shooed her away towards the pharmacy. I was worried she would be demoralized. Karen suggested I discuss it with Cheryl, and that she would call me back in a bit to get the decision.

I shoulda known, my dear wife's first reaction was "OK, just think of all the cool things we could do instead!". She said we didn't have to endure packing, schlepping, or airports. We could do a few movies, catch up on delinquent race-watching, go to Monterey or Tahoe or Florida....all pending results of whatever vile testing UCSF had in store. Further, she could safely say that the Grand Canyon would probably be there a while, so we had several opportunities in the future to visit before budget cuts caused it to be sold and re-developed into condos. Sometimes I cannot believe she doesn't rag like me (huh?), but she writes it off to "that's just the way I am". You may be surprised to learn, however, that my ragging only lasted about 18 minutes this time, not five years like before the transplant. Those who may have known me a while may recall some protracted periods of ragging in the past, for questionable reasons, many automotive in nature. I can safely say that a meager $2.5 million worth of transplantation, plus the immense influence of Cheryl L. Moss, has turned this puppy around.

ONWARD AND UPWARD

Our first decisive move was to stroll about 50 feet from CVS to one of our favorite spots to consume (reasonable) quantities of food and (unreasonable, and unspecific) amounts of adult beverages. Following a pleasant visit to balmy and busy Downtown Liverwitztown, unable to avoid a stop at the frozen yogie dispensary, we began to hatch (ouch..how do chickens do this?) some plausible alternate plans.

My initial brilliant idea was for Sunday, and it included meeting a buncha Chaws and Schnurrs for a brunch 'n' movie frenzy. We successfully executed our mission, in time for those among us who needed to view important but futile sporting events. And yes, you need to see The Social Network although I would stop short of "one of the best movies of all time" as I have seen it described. This delightful outing was followed by another excellent jointly home-prepared dinner and a rousing evening of The Amazing Race and another disgustingly fascinating helping of Hoarders. If you haven't experienced this unwordly reality show, do give it a try. You will never think your home is disorganized or dirty ever again.

As I blog, I am anxiously awaiting a call from the heart transplant administrative assistant, who will hopefully have news, whoops, I mean nooz of our fate these next few days. We can only hope for the best.

Aha, doth I heareth yonder phone a-ringing? For sooth, I believe I do! "hello...yes, it's me...yeah, hi...11:00 am?...we'll be there!" Off to the races, as I always say.

Later on, dudes,

Bob/Irv

Mea Culpa

I am deeply sorry to have missed a very, VERY important entry on yesterday's blog, specifically regarding the list indicating my favorite Italian things. How could I NOT have included a major hero of mine, Mario Andretti! Sorry, Mario.

Special (Day After) Columbus Day Edition: Forza Italia!

".....AND THESE ARE A FEW OF MY FAVORITE (ITALIAN) THINGS."

Apologies to Julie Andrews, since she wasn't singing about Italian stuff in that show. But I have never known exactly what Columbus Day means to me, a schmucky Jewish guy with no known Italian connections or traits. Yeah, yeah, I have been told Italian mothers are just like Jewish mothers ("What, you don't love me? Eat, eat.....Ess, ess....Mangia, mangia!"). And so we did, and still do. We love our mothers, and we want to please them, so we clean our plates. So I guess whether it is rigatoni Bolognese or stuffed kishka, there are a lot of similarities after all. And, I understand that if you get mad at a relative and disavow them, in either culture, it is permanent, the end, get outta my life, never darken my doorway again. And guilt? Don't get me started!

So I started thinking, hey, Bob/Irv, you love a lotta Italian things, and if it weren't for ol' Chris (Columbus, not Chaw) we wouldn't even be here to enjoy them. And in all honesty, this country should be named Columboland after the great navigator. But some dude by the interesting moniker of Amerigo Vespucci mapped and named our great land America. Yeah, yeah, I know it really should be named Vespucciland ("God bless Vespucciland, land that I love") but that would take up way too much space on a bumper sticker.

But I digress (so what else is new?). Below I have listed some of my favorite Italian things, in no particular order, with appropriate descriptions where necessary:

+ Pizza from Melo's
+ The Leaning Tower of Pisa
+ Nardi steering wheels (had one on my '64 Porsche)
+ Mona Lisa
+ Webber carburetors (ditto '64 Porsche)
+ Marcello Mastroianni
+ The Italian Job (the first one, with Michael Caine)
+ Florence
+ Pirelli tires (next year's exclusive tire supplier to Formula One)
+ Salade Caprese
+ Piazza Navona
+ Gnocchi
+ Autodromo di Monza (location of the Italian Grand Prix for over 50 years)
+ The Sistine Chapel
+ Cannoli
+ Sophia Loren (my second most favorite thing from Italy)

+ and last, but as many would guess, my FAVORITE Italian thing...... Automobili e Scuderia Ferrari!!

Do you have any Italian things you really like? Betcha do. Please send them to me here at the Transplant Trib (via Comments on the blog, email as listed in the right column, or on Facebook) and I will gladly publish them here. If you wish to contribute anonymously, please indicate such. Hey, guys 'n' girls, the FAQ thing didn't exactly set any records, so get on that computer of yours and Go Italian!

B-B-B-BUT WHAT ELSE IS SHAKIN', BOB/IRV?

Oh, not much. Had a great trip to UCSF last Thursday, where we visited two heart/kidney transplant dudes. One, David, is still pretty ill, and goes on waiting. The other, Fred D., is an old buddy from cardiac rehab in Livermore, who had a successful operation a week ago Monday. We also saw and heard the Blue Angels practicing above The City, an extra big deal for David, who was able to see the action from his 10th floor room in ICU. Very cool.

Friday was unusual, to say the least. Reminiscent of my famed diabetic melt-down in an important meeting back at Mt. D, I stupidly "stacked" insulin after dinner. I started to swing and sway as I was going to bed, and weakly asked Cheryl to help me. Unfortunately, she was fast asleep and didn't hear me right away. The next thing I knew, I looked up from my bed at what seemed like a dozen big guys (and one not-so-big girl) in dark uniforms asking me if I was OK. Seems Cheryl could not contain my violent writhing and arm-waving, so she had to resort to 9-1-1 for the first time in history. The firemen (firepersons?) couldn't hold me down either, but finally succeeded in getting some glucose into me. Someone said my blood sugar was 26. Anyway, I came right around, refused a ride to ValleyCare, and returned to bedtime activities.

We attended an excellent CTDN training session Saturday morning with no ill effects from the outside-catered lunch (despite the same sandwiches Sweet Affair has been making for about 72 years; what's up with the sprouts?). It took place in a conference room on the lower level of John Muir in Walnut Creek, so I was able to visit upstairs in the kitchen briefly. As at Concord Campus, it was truly great to see those who were there. Nice bunch, now as when I was there for six years.

As always, I have overstayed my welcome in your heads. Pardon the crap outta me!

Bob/Irv

You Can Never Go Home Again, Right?

A LONG-ANTICIPATED VISIT TO JOHN MUIR HEALTH, CONCORD CAMPUS

I had a brief appointment with my ophthalmologist last Tuesday. Her office is located across the street from JMH (see above), but I am sure many still know it as Mt. Diablo. For those who are not familiar with my career history, I managed the food service there from 2001 to 2005. I departed sadly, with kidney and heart issues and depleted ability to discharge my duties effectively. Although I have been back, most occasions have been as a patient, in order to repair my dialysis access. Due to confidentiality requirements, I really did not see any of the staff during those stays. I did stop by once for a brief visit during my journey to transplant, but back then I did not feel particularly sparkling, so I am sure it was not very memorable for anyone. And that was quite a while ago.

Over the last few years, my ex-boss Sandi and Chef Alison have encouraged me to come and see the staff. They said there were often inquiries about my health. My dear wife has urged me to go, as well as good friend Charlotte, and more so since the transplant. Seeing as my current mood is greatly improved, to say the least, I decided this trip to Concord was a prime opportunity.

I have been irrationally hesitant since February's miracle, for reasons I may not even fully comprehend. But other's opinions seemed to indicate that whatever my hang-up is, it might be a valuable experience to drop on over. I checked with everyone about coming Tuesday, and it seemed like a good time. I sucked it up and decided to go for it.

Chef Alison met me at the front entrance and walked me to Cafe Diablo. Sandi was at Walnut Creek that day, but my successor Eugene was there. Quite a few employees came out from the kitchen to join those already on break when word got around I was there. Everyone, including Eugene, seemed glad to see me, and were interested in the nature of my transplant and transplantation in general. It was, in a word, outstanding. Next, we stopped at the dietitians' office, and it was very cool to see them again, too.

I had expressed an interest to Sandi to see the Director of HR, Julie A. We had done a lot of great work together and been on a few committees. I was even sitting right next to her in the infamous Joint Commission Accreditation meeting during which my blood sugar took a steep dive, and I had to be carted to the ER. Julie was not immediately reachable, since her duties are numerous and her time valuable. That's why I was amazed when she found me in the dietitians' office! It was great to see her, and when she said "You made a difference when you were here", it really meant a lot to me.

After a quick trip through the kitchen, I said my farewells and headed out. I grinned all the way home. Quite a day.