Tuesday, November 26, 2013

The Reason for the Season

Last year, before Thanksgiving 2012, I'd gone to one of my monthly nephrology visits.  They were monthly at that point because my kidney function was declining so fast that they wanted to monitor me very closely, just in case I had to go on the waiting list for a transplant.  Well...we all know that "just in case" did happen.  But last November, the path forward wasn't so clear as it is now that certain events have come to pass.

I met with one of the doctors at my team practice.  He read off my lab work and told me that my kidney function had dropped below 20 percent.  It didn't hit 15 until December, but in November it was 20 percent.  This was the first time I had heard that the "two years from now" timeline I was given earlier in the year, probably didn't apply anymore.  Ben and I had been engaged for eight months already and we hadn't exactly added "kidney transplant" to our wedding planning checklist.  I remember my doctor giving me the news and immediately trying to analyze the expression on my face as I tried to hold off hot tears drops building just beneath my eyelids.  I didn't cry but he knew that I wanted to.  I hate crying in doctors' offices. 

He asked me if I was close with my family. I said told him that I was and still am.  He said to talk with my family about everything over the holiday, to talk with Ben, and to trust God.  He tried to reassure me that everything would be okay.

This November, yesterday to be accurate, I went for my just-a-few-weeks-past-six-months check up at the hospital.   I saw people I hadn't seen in a while, my favorite nurses and coordinators.  My surgeon.  A lot has changed in the last six months.  I went from being wary and uncertain about the people who said they would help me get to a place where I wasn't worrying about health to incredibly grateful for my small hospital family for coming through on their promise.  I have a lot to be thankful for.  If I were to name every sing daily miracle that I am blessed to witness, I'd be writing for days.  Probably weeks.  But I'll just list two.

I'm thankful for my health.  Because once it's gone, you learn just how much you took it for granted.

I'm thankful for my family, and great friends who over time have become part of my family.    You make this second chance at life worthwhile. 

Happy Thanksgiving.  Don't forget to thank the ones you love for loving you right back.

Friday, November 22, 2013

A Low-Sodium Thanksgiving...or not.

Ah.  'Tis the season to eat and eat and eat.  But after writing that I thought to myself, "Jewel...when is it NOT the season for you to eat and eat and eat?"  I live to eat and do a few other things as well, but mostly I think about food, look at food, cook that food, and eat that food.  Which is why living with kidney disease can suuuuck sometimes.  So many dietary rules and regulations.   When I was first diagnosed, my doctors told me I had to start watching my salt intake, and stick to a low-sodium diet.  There is sodium in EVERYTHING, and most of our favorite foods contain lots of it.  Most sources recommend that people with kidney disease or high blood pressure follow a no-salt added procedure when cooking their food at home.  That means, when you cook something, don't add any additional salt.  Sure if what you're making requires cheese or milk or maybe even Italian sausage (high salt by the way), then add it in.  But don't add any other pinch of salt.  I've only been sort of adhering to this rule because A) I don't have kidney disease anymore! I should get a break sometimes; and B) some stuff really needs an extra kick of salt for me to digest it.

Next week, people on low-sodium diets face one of their biggest challenges yet:  how to enjoy a Thanksgiving meal without raising your blood pressure and wanting to blow your brains out because you're tired of adding up sodium milligrams in your head while at the feasting table.  Here are my rules for eating, if you're not hosting Thanksgiving, and cooking if you are:

1.  Salt some things, don't salt others.  If you're hosting Thanksgiving, and actually want people to come back for another holiday, please DO salt your turkey.  I know that sounds crazy coming from me, but there are some holiday traditions that are best done traditionally.  When I first started my diet, my family went hard core no salt.  And one thing I discovered is that most meats taste better with SOME salt on there in the form of actual salt, a sauce, or cheese.  You can get away without salting like crazy if you're making beef.  But everything else, just tastes like a piece of plastic if you don't help it along with some seasoning.  For Thanksgiving, add some salt to the turkey, however much you want.  It's the turkey for goodness sakes! You can go back to eating bland roast chicken the next day, I promise.  

What you don't have to salt:  vegetables.  If you're making something like sauteed kale, green beans, peas, corn, anything with fresh vegetables, you don't need salt.  In fact, I eat most of my vegetables without salt. I add pepper.  With all the other salty foods on the table, I promise you won't even notice.

2.  Don't do packaged!  Second easiest way to avoid extra sodium is to get acquainted with from scratch dishes.  Potato spuds in the box, Stove Top dressing, creamed corn in the can, vegetables in the can, frozen macaroni and cheese...all processed.  All with buckets of salt.  Buy REAL potatoes, look up a stuffing recipe, thaw some frozen corn, and buy your own cheese and some noodles.  It's Thanksgiving, OK.  You'll have all day to cook, hopefully.  No excuses to not attempt the real stuff.

3. Go easy on condiments.  Do you really need to pour gravy and hot sauce ALL over your plate?  No.  You don't.  Yes, gravy is hard to resist.  And I put hot sauce on most things.  It's fun and spicy and makes me sweat.  Do like you would do in a restaurant: pour your gravy in a small dish, and use it for dipping.  Or pour it on one item on your plate, not four.  Plus...that's gross if you're pouring it on four.  Everything in moderation.

4.  Don't stress.  Thanksgiving comes but once a year. And you have the rest of your life to calculate how much salt is in a serving of homemade baked ziti.  Trust me.  I'm six months out from transplant, and I still do it.  Enjoy your time with family and friends, and just be damn thankful that you get another holiday to celebrate. Life is too short to worry about how much salt was put into the homemade dinner rolls.  That said...maybe don't eat five dinner rolls. Settle for two.  With unsalted butter if available.

Thursday, November 14, 2013

More than six months without coffee and I haven't killed myself or anyone else...yet

I may have mentioned this before...oh, I don't know, six months ago, but I quit coffee.  Cold Turkey.  I know what you're asking:  are you out of your mind, Jewel?  Well, yes and no.   

In April, just a few days before my kidney transplant, I sipped on a nice hot cup of delicious coffee provided by my job.  If you knew where I worked, then you'd immediately be jealous because my job basically has it's own cafe with different flavors of hot and iced coffee...and SNACKS...and they are all delicious.  I had been sipping on possibly the second of my typical three, three and a half cups that I usually downed during the day, when I felt a shooting pain run through my gut.  It threw me off for a bit.  It really startled me as most shooting pains do. I sat at my desk and pondered why my stomach could possibly be upset with this liquid black gold; this precious drink that keeps me running like a well-fueled worker- bee at my desk just type, type, typing away and not sleep, sleep, sleeping on my keyboard.  I took a beat, a few seconds to allow my body to regroup and settle itself, and proceeded to take another sip of my coffee.  Another shooting pain.  And this time, the pain rocketed up to my neck, briefly latching onto my gag reflex.  

My stomach was hurting and I was actually about to throw up my coffee.  My COFFEE.  

This really upset me because I don't like coffee--I love it.  And at the time it wasn't that I simply wanted my coffee--I needed it.  I can recall too many nights spent at one of the  coffee shops at my university.  At that time I was still pretty new to coffee and its wonders.  Too scared to try it black or with just cream, I grew fond of the chocolatey java mixes known as Mocha.  A few years later, I expanded my palette and added vanilla lattes to my roster of super cups.  On trips to Puerto Rico and Hawaii, I sought out cafes to try their best local brews. I remember waking up at 2 A.M. with Ben to drive to Maui's dormant volcano to see the sunrise. We took along two friends--two strong cups of Kona coffee.  And it was a beautiful sunrise because I was able to open my eyes and take it all in, instead of squinting beneath droopy eyelids.

When I started work after college, four years ago, I stupidly treated myself to a medium cup of Dunkin Donuts blend every morning. I say stupidly because I realized a year later that buying coffee everyday is quite an expensive habit to have.  When the company I work for was bought out by another larger company, were were provided with a whole "cafe" of different flavored coffees all made for us throughout the day.   And it's FREE.  


Because of my husband's and my penchant for staying up insanely late on weekdays (with our heads hitting the pillow at midnight or 1 A.M.), and my incredibly poor kidney function just six months ago, you can imagine how mornings and me are not friends.  No, we do not go together like "rama lama lama ka dinga da dinga dong" (GREASE reference for those of you cooler than me).  Hell, to me, is asking me to wake up early every day for the rest of my life.  Can you tell I'm not a parent nor am I emotionally and mentally mature enough to be one right now? 

Before my transplant, I was definitely one of those people who'd scream "DON'T TALK TO ME!" when walking to the employee cafe in the mornings...until I got my coffee.  Then, once I had that warm cup of java in my hand, I became all softness and light, sweet and contrite...until about 11 A.M. when my first crash of the day hit.  I'd grab another cup of coffee and I was all good to go until the post-lunch crash, then I'd grab my third cup.  Around 4 PM sometimes I'd fill half a cup with some Earl Grey, just to give me that extra push to 5:30.  Ridiculous, I know.  Who needs coffee to make it through the last hour and a half of a workday? I did.

Looking back, I won't go as far as to say I was a crazy coffee addict.  There are more people in the world who drink a lot more coffee than I did.  But the coffee wasn't really doing me any favors.  Sure, it has antioxidants according to whatever MSN Living post you're reading today, but those antioxidants didn't really keep my kidneys from failing.  To make matters worse, on the weekends, when I wasn't at work and just an elevator ride from four different blends of hot coffee, I had to suffer through headaches, yawning, and drowsiness on Saturdays and Sundays because I was too cheap to go to Starbucks and didn't want to be tempted by McGriddles at Mickey Dee's while buying coffee for a buck.  But there was always Monday, I thought.  I always had Mondays at work to look forward to, not because I was SOOO eager to go to work but because there would be coffee.

One guess how I reacted when my transplant coordinator told me to quit coffee after my transplant.  No idea?  Well, my face dropped.  Not just my jaw, but my entire face slid onto the floor.  In fact, my head just started spinning trying to picture my life without coffee.  No, I thought.  Impossible.  I didn't sign up for this!  I signed up for a kidney transplant!  Not TORTURE!!  

You know me--Drama Town.

Now, to be fair, she didn't say that I should completely stop drinking coffee forever, just for about six weeks after my transplant while I was still monitoring my urine output.  Coffee is a diuretic, which means it causes urination more often than if you just drink water or juice. This can really confuse things when you're trying to measure the urine output of a new kidney.  There is some research that coffee can have some affect on your kidney function, however, none of my doctors ever told me to kick my coffee habit in the 10 years that I lived with FSGS.  My coordinator was mostly telling me to avoid caffeine, including black tea or breakfast tea and Chai, so that I could more accurately measure how well my new kidney was working.  

Well, let me tell you, it was easier to quit coffee and black tea than I thought it would be.  Here, want my recipe for quitting coffee and caffeine?  I'll give it to you!
  • Add 10 minutes of shooting pains in your stomach while you're trying to do work in the office;
  • Sprinkle on about six minutes of nausea;
  • Fold in 10 years of kidney disease; 
  • Mix, then bake.  Frost with a layer of impending kidney transplant, then
  • For the topping, line about a thousand dollar bills on top, you know, because medical procedures aren't cheap;
  • Then finish it off with \beautiful frosted calligraphy, in red, with the phrase "I really don't have time/can't afford for anything else to be wrong with me right now so I guess I can't finish this coffee."  
And Viola!  You've successfully quit coffee.  

Since the day that I threw a 3/4 full cup of Sugar Cookie blend with half and half into the garbage can, my life has mostly been the same.  I still have to wake up early for work.  And I still stay awake until midnight.  But, that's without ANY caffeine.  I drink GREEN and HERBAL teas now.  With no caffeine.  And I make it through the day, without crashing, without complaining, and without screaming.  I make it.  

I'm pretty sure I can drink coffee now if I wanted to, or black tea, since I'm not monitoring my urine output.  But I'm too scared I'll relapse. I still have dreams about drinking coffee.  And I love the smell of a freshly brewed cup (someone else's) just a little too much.  Way too much. 

I'm recovered coffee drinker, but you know how it goes.  Once a coffee-addict, always a coffee-addict. 

My new homies--the tea section at my job.

Sunday, November 10, 2013

Somebody's Godmother

The doubts started with a middle name. And a question, or more like a quiz, testing my knowledge of my nephew (on my husband’s side) for whom I would be his Godmother. 

Before the pop quiz, I was probably what most people would describe as a little too enthused about being a Godparent, especially nowadays where more and more people in the country are moving away from bestowing such a title.  But over the past year, alongside with me battling kidney failure which was testing my own relationship with God and others, I felt like I might have a lot to give if I was to become someone’s Godparent.  I’ve had trials. I’ve had tribulations.  I know things.  I know bedtime stories.  I have...some money.  But inquiries into my Godparent qualifications were clearly further down the list on the “do you know your Godson pop quiz.” And The first essay question posed to me by my father-in-law.  What is my future Godson Ryker’s middle name?

Of course I knew the middle name, I said.  Ummm, it’s…um…it’s…”

No matter how many times I ummed I couldn’t think of it.  How did this become my first test as a Godmother?   Who uses middle names anyways? I never use my middle name.  I don’t even remember some of my family members’ middle names.  Middle names are where women’s maiden names go to die.  Middle names are those names that outgoing seniors prefer not to have read aloud when they walk across the stage at their high school graduation.

I know his first name.  And his last name.  What is the big deal, I thought?

Question two:  Did you prepare a speech, my father-in-law asked.  Again, my response started with Um.    

I went home that night thinking about all the things I didn’t know:  his middle name, a potential speech requirement, how to turn a pumpkin into a carriage and make Cinderella’s dreams come true.   Lying in bed, staring at the ceiling I could feel little thought-seedlings taking root and sprouting little buds, each one opening up and releasing the very pungent aroma of “You’re not good enough” and the fragrance sequel of “They’re going to regret asking you to be the Godmother” 

I flung my body to its other side, facing Ben’s back, and asked him if he thought I’d be a terrible Godmother.    He muttered something that sounded like a yes and then went back to sleep.

In the days that followed, I Googled as much as possible about Godparents and what I was supposed to do.  I even hashed out a few strategies I could use on my journey to induction into the Godmother Hall of fame.  The first of which being to buy ten kiddie shirts from Baby Gap on the 9th of every month, to commemorate the monthiversary of his baptism.  The second: Stuff a build-a-bear once a month, each one with different occupations to inspire my little Godson to be a fireman bear, a baseball bear, and astronaut bear...or even just a bear if that’s what he chooses to do for his future occupation.  Every kid wants to be an animal at some point.  

I also planned to go to Costco once a month and buy one bulk-sized bag of candy and wrap it in a box and ship it to my Godson so that he knows how much I love him.  This will eventually lead into a lesson on how to avoid crying while getting your cavities filled in hell...also known as the dentist’s office.  Yes, these were all good strategies I thought.  I was so proud of myself.  There’s no way this baby was going to have an absent Godmother.  This baby will know how much I love him because he’ll have a closet full of clothes to outgrow in the next month., and enough build a bears to form a seven-nation army of stuffed animals, and enough candy to guarantee he’ll never have to go to bed without dessert.  Yes.  I will buy his love. Because that’s always worked.

And then I started feeling depressed again because the truth is that I am one financially challenged Godmother who should probably be applying the cost of that Costco-sized bag of candy to my college loans.

I was back to where I started, throwing myself a pity party for being a terrible Godmother before my duties have officially begun.  

While at brunch one day with some friends, I told them what I’d been struggling with.  I’d been working myself into a panic over whether I would be a good Godmom.  I wondered allowed if this is how REAL parents feel: like they’re not going to measure up.  Do they worry that that their kids are going end up making mistakes like getting suspended from junior high or skipping school to drink before the football game?  Do they worry that their kids will end up blaming their actions or inactions for their relationship issues, or financial issues or emotional issues?  In my situation, I worry that because of some inaction or action on my part, this baby will grow up with some warped perception of God, the Bible, church-folk, possibly because I still fall short in my relationship with God...because I still haven’t memorized those six Bible verses that I said I would memorize, because I still haven’t joined a serving team at church after saying I was going to do it 10 months ago.  And because sometimes I still say that grace over dinner that I learned with I was four (God is great, God is good. Let us thank him for our food)

“I was reading somewhere,” my friend Ann recalled, “that the best thing that you could ever do for your child, is pray for them.”  

Could that really be it, I wondered?  

The week leading up to my Godson’s baptism, I prepared my G-son’s little gifts and purchased tissue paper and bags.  No card though because I couldn’t find one worthy of NOT throwing in the trash.  During one free night I had, I decided to do some journaling, and jot down some thoughts. Unexpectedly, I started to write what was beginning to look like a list of wishes and hopes for my Godson.  A prayer even.  A prayer that Ryker grows into a man who knows God and knows Him well, and will choose to have a close and personal with Him someday.  I prayed that once he learns to walk, while it’ll start out as a crawl, and then a little staggering through the living room, and eventually a run down the sidewalk near his house, that God will walk with him ordering his steps.   Boys will be boys, and Ryker is no exception.  I hope that even when he’s in the midst of “being a boy” and getting dirty and skinning his knee, and dating that girl, and doing that keg stand if he so chooses too, that he will remember that he is a child of a God that loves unconditionally, and forgives, even when Ryker feels he’s not worthy of it.  
I also asked God to help me give Ryker good advice when he asks for it, and keep my mouth shut when he doesn’t.  More than anything I ask that God help me to lead Ryker to Him during every challenge, victory, upset, and happiness in life.

The day of the baptism arrived.  And Ben, my sister, and I arrived super early, half an hour early.  This is not us.  We’re usually half an hour late. While waiting for everyone else to show up we explored the inside of the sanctuary, stopping at the “stations” depicting different scenes from Jesus’s crucifixion.  And of course no baptism is complete without a sisterly rendition of “The Blood Will Never Lose It’s Power” and “Oh Happy Day” in a cold empty church.

Eventually the crowd arrived--grandparents, parents, aunts, uncles, and my Godson, all dressed in white, ready to have water poured on his head.  I held him until the ceremony began and PRAISE THE LORD he did not cry.  First Godmother mission accomplished.  Pat on the back.  

Then the baptism ceremony began, and a book was read aloud about a mom who was crazy in love with her baby boy, which eventually ended up telling the story about a mom who has some serious boundary issues.  Just kidding but not really.  It was a sweet book...up until the point where the mom entered her grown son’s house through his bedroom window to rock him to sleep (he can’t be married, clearly).  

After the reading it was time for action to begin. Ryker and I walked up to the front of the church, where a stone basin with water sat.  I was prepared for my second Godmother duty of the day….to hand the child off to the priest so that he could pour the water on his head.  That was the plan right?  I’d memorized the middle name.  I even thought about a few lines for a speech.  I bought gifts. I prayed.  I held the baby.  My role for the day was just about over.  Oh, except for the part where the priest asked me to lean the baby over the basin. This was part of the plan that I hadn’t Googled or prepared for. And I definitely didn’t pray about it.

As I started to lean Ryker over the basin, several scary visions flashed before my eyes.  An image of Ryker’s head hitting the concrete basin appeared.  Then I saw myself unintentionally giving Ryker a full water baptism.  It was then that I made my first  “Godmommy” decision to delegate my first real responsibility to the Godfather.  And he dunked the baby and I was thankful.  I didn’t want to be the one to blame for giving Ryker a concussion as soon as he received the Holy Spirit.  

I looked on as the water hit his little scalp and he wiggled.  I felt a bit sad that I couldn’t do this one thing that I was expected to do as a Godmother on the day of his baptism...along with remembering names, and buying candy and giving advice.  But I felt like I was doing what I was supposed to do in that moment.  I thanked God for that moment.  And I sent up a prayer asking God to show me how to be a good Godmother to Ryker, how to be a good role model for him, and how to pray for him. And how to play with him and love him and teach him about God, and how incredibly awesome and wonderful and GOOD God is.

I also prayed that Ryker would not remember how I bobbled him over a sink filled with cold November water before he could even swim.  Amen.