9.30.2009

Blood Will Tell

As you grow older some things begin to become more commonplace. For instance, you may still feel like you are 25 years old until you do something really physical and your body unleashes all sorts of ways to tell you that you are not quite as young as you may feel. Those sorts of things just seem to happen more often as your age increases. You also find that while you may have at one time felt bold enough, strong enough and invincible enough to never darken the door of a doctor you now find yourself no longer willing to take unnecessary chances so you find yourself paying more frequent visits to your local neighborhood doctor.

Recently, I had such a visit. I should back up to provide a bit of context. This most recent doctor’s visit wasn’t to my regular doctor. Several years back, my body was inhabited for a time by a kidney stone. I’m a big boy, I can handle tough things. I’m only reduced to tears when someone nearby is chopping onions or when my favorite college football team loses. I like to think I can handle me some physical pain when I need to do so. Sometimes with pain, you just grit your teeth, suck it up and go forward. If it doesn’t kill you, you are made stronger. Kidney stones on the other hand, well, they truly are bad news. I have only had two attacks of these in my life. I hope I never have another. With the last attack, I broke into a sweat. I twisted my body in various ways in order to find relief to no avail. I laid on the couch, on the bed, on the floor. I would have laid on a bed of nails surrounded by angry, hungry wolves if I could have located such just to ease the pain. I also became physically ill with this attack. And I hurt. And hurt. And hurt.

Many of my fellow kidney stone sufferers will claim the pain you feel is comparable to the pain a woman feels in childbirth. I won’t go there. I can’t go there. I do know the pain I have felt with kidney stones is the most intense physical pain I have ever felt and that would include surviving a car wreck or two, a bike ride gone bad that saw me slide face first down some pavement and a few headaches that would not let me lift my head off a pillow. I also know during this last episode I took two heavy duty prescribed painkillers with a glass of water and it did not ease my pain one bit. Those pain pills may have as well been Skittles. A few days and literally hundreds of glasses of water later, the pain and the stone went away.

The kidney stone episode though led my regular doctor to eventually direct me to a kidney specialist in order to make sure there was no permanent damage and to make sure my kidneys got back to a normal functioning place. So, now, every so often, despite not having any more kidney stone attacks since those horrible summer days a few years back, I visit this doctor as well as my regular doctor.

This doctor runs blood work and then sits down with me and goes over how I am doing and reviews the blood work results. This, of course, takes all of maybe five minutes. Getting to this place though often takes hours. On my last visit to this doctor, I ended up spending close to two hours total in the office. And I spent maybe a grand total of five minutes with the doctor. And if I’m fine, I’m okay with that, I would rather the doctor spend time with someone who really needs his expertise than for him to be sitting with me when there doesn’t seem to be anything wrong with me. Still, those few minutes during this visit were memorable for me.

Of course, the actual visit begins with the typical pleasantries and greetings followed by some general questions about my health. This is followed by the doctor poking and prodding my stomach, sides and back and then listening to my body through a stethoscope. One of the things this doctor always asks is how much water I am drinking. I know I do not drink enough water. I try. Well, some days, I try harder than other days, but I do try. I just know I have never consumed enough water to feel comfortable answering this question for this doctor because I know no matter my answer the amount I say will not be enough to please the doctor. He’s a kidney doctor. Water keeps the kidneys flushed. I could be consuming enough water to make the levels on a nearby lake drop daily into a drought stage and I feel like it would not be enough to ever answer this question adequately for this doctor.

Since the doctor had my most recent blood work results in his possession, one of the things we discuss is the results of this blood work. This is always one of those hold-your-breath moments because you never really know how it’s going to go. I had some weird results from this blood work one time before regarding my liver. Again, it happened once and now my regular doctor always checks this one specific result as if he were combing for clues at a crime scene. The one bad result was a shock then but between that check and the following check the results improved and have never reverted to that one time anomaly. Still, that one time just adds to the apprehension that the results which seem to be transcribed in some code similar to early attempts at creating a written language will bode ill for me.

The doctor indicates my blood work doesn’t show anything out of the ordinary and we continue to discuss things. Then, sort of as an aside to the whole conversation, the doctor mentions one thing that was just a bit off about my blood work. I braced myself, fearing bad news, knowing it likely meant having to drink more water and then to submit to more blood work or even more detailed testing. The doctor then revealed to me that the blood work indicated my phosphorous level was a bit low. I imagine a puzzled look came across my face. The doctor asked me if I knew how to correct this. I relayed to him I did not know. He said correcting my phosphorous level was through diet. I momentarily braced myself again for bad news. No doubt, this meant drinking even more water and adding bland, colorless vegetables to my diet. He then asked if I knew what foods would boost my phosphorous levels. Again, I had no clue as I was reeling just a bit from this news, anticipating the hammer to fall on my regular routine of life. The doctor laughed a bit and then told me the foods which would help me raise my phosphorous level were foods he normally would not ask kidney patients to consume…dairy products such as milk, ice cream and cheese.

I think for a moment I went totally blank until the voice inside my head blurted out into the halls of my mind, ‘did I just understand my doctor to say I need to be drinking more milk and eating more cheese and ice cream?’ I reached up to my beard and subtly tugged on it in order to make sure I was conscious and not in some dream state still sitting in the waiting room. I then heard the doctor chuckle a bit and say something to the effect that asking a patient to intake more dairy goes against everything he, as a kidney doctor, prescribes most of his patients. I told him I thought I was up to the challenge of getting my phosphorus levels up to where they need to be, especially if this diet was the answer. As he continued to talk though, I briefly considered asking him for a note that I could show to my wife detailing my low phosphorous levels and how the remedy is to eat more cheese and ice cream and drink more milk because I just know she would have trouble believing a doctor would say such in this day and age. Or maybe I need the note because I know she would have trouble believing I hadn’t made up such a thing.

The next thing I know, the doctor is leaving and ushering me out of this room and down the hall to take care of the co-pay. There is some discussion as to when I need to return for a visit before I am eventually out the door on this day.

I phone Jennifer and give her the good news. I am fine. Well, except for the low phosphorous levels. I then begin pleading with her to begin filling the week's grocery list with all sorts of cheeses and different flavors of ice cream. Even over the phone lines I visualized her rolling her eyes at me all the while wondering if she could somehow get through to my doctor and explain to him that his diagnosis will leave me begging for cheese on every piece of food to be served in our house for the next three weeks and how his plan to raise my phosphorus level goes against her loving concern for me to eat healthier.

My mind though raced with the possibilities the rest of the day. Chocolate milk. Chili cheese fries, chocolate chip cookie dough ice cream, milk shakes, Cap’n Crunch cereal…with lots of milk, of course. Lasagna, nachos covered in queso, macaroni and cheese, banana splits, cheese whiz, triple dipped ice cream cones. Wow! I haven’t been this concerned with, ahem, getting healthy, in a long time!

Since that diagnosis I can say I have worked to up my phosphorous level. Milk, cheese, ice cream. Hey it’s tough, but you must do what you must do in order to get those numbers right. Iced coffee? Hey throw in some extra cream if you got it. Grilled chicken sandwich? Hey, if you don’t mind, add a few slices of cheese to that if you can. Cheetos? Do these come in an extra cheesy flavor?

I sit here now content that my phosphorus level will soon return to the level it belongs while looking at my calendar and the month ahead. Another busy one. Some work stuff, some fun stuff. Oh, and then there’s one day marked off for some sort of an appointment. Yep, a doctor’s appointment, a visit to my regular doctor. And yes, it’s one where there will be more blood work. And the realization that another needle will soon pierce my skin and remove some blood which will find it's way into a small tube to be transported to the lab and tested and eventually reported back to my doctor and to me makes me almost stop eating the moose tracks ice cream I have in my hand. It does dash my dream of a hamburger with six slices of cheese later today. Somehow, I already know, the results of that blood work will be, you guessed it, the fact that I need to cut back on my dairy intake. And, when that moment arrives, I will be struck with the realization that all along I should have been drinking more water.

9.16.2009

I'm With The Band

It’s a Friday night in the South. The shadows of summer are present but still fall far enough away from me so I don’t realize how close autumn is on my heels. As the sun slips behind the mountains, the trees, the horizon, crowds in towns near and far gather to watch their young gear up to knock the slobber out of each other up and down a football field.

It’s been a dozen or so years since I spent anytime near a high school sporting event. Then, one of my nieces hit the basketball hardwood for a team that would make regular trips to the state championship tournament. It has been even longer since I spent a Friday evening sitting on a slab of concrete underneath giant blinding lights gazing out onto a football field. I spent a few Friday nights here not as a player but as a fan.

I recall going to games when my brother and sister were in high school. Then the field was within walking distance of our home and we would go to watch the hometown team try to pull out a win. I remember getting a bit caught up in the whole atmosphere of the event, the smell of concession stand food, the energy the cheerleaders provided through some practiced choreography and unified encouraging, the different set of characters from the area who gathered for a few hours all in the name of football, the chaos of two teams vying against each other on the green stage below, all set to a soundtrack provided by the marching band. And about as soon as my skin became comfortable with the cool fall air settling in, the game was over and I found myself hanging on to Daddy’s hand as we crossed the main thoroughfare walking home and into the soft velvet black of the night before reaching our home’s front door long after my regular bedtime.

There’s just something unique about having someone you know out there on the field or the court. It adds heightened tension and drama in keeping your interest in the game during the evening. If the team on the field is the school you attended then throw in a bit more apprehension and expectation. If they are playing an arch rival then bragging rights and reputation get thrown into the mix. Soon, you are really invested in who wins and who loses.

Jennifer and I have spent some time this year back underneath the Friday night lights. This time though is different for me than times before. I’m not sure I know anyone all that well involved in the game on the field. I don’t have a deep-seated rooting interest in the team whose side I sit on since I did not attend school here. The rivalries are present but since I did not grow up here I am not intimately acquainted with all the folklore associated with them.

Still, though, we will have someone on the field tonight. Our nephew is in the marching band. He’s following in the footsteps of his parents, his aunt and his uncle. Now his parents are band parents like their parents were at one time. The grandparents are here too, delighted beyond description as they watch their pride and joy in his sharp-looking uniform. Behind their smiling faces are the memories of long Friday night band trips, pranks, performances and a million other moments that parents store in their hearts and would not trade for all the money in the world.

This side of a football game is a new experience to me as I learn the protocol and traditions of a marching band. I suppose to ease my learning curve, Jennifer allows me to explain the game of football to her from time to time although most of my explanations somehow end up with her understanding the concept of what I’m saying but not fully understanding why football can be so enjoyable, maddening, frustrating and satisfying all at the same time.

I am no athlete yet I have almost always had a rooting interest for one of the two teams on the field or on the court at the games I attend. I now find that I still rise to my feet when a running back breaks out of the backfield or a receiver makes a remarkable catch but I have discovered I am more aware now than ever of the much broader atmosphere of what is happening at this event than at any other game I have ever attended.

The smell of popcorn, hot dogs and hamburgers hovers invisibly in the air. The cheerleaders show off their gymnastic abilities and cheer a catchy ditty in unison to fire up the home crowd. The sounds of cowbells, giant plastic clappers and air horns now fill the air throughout the game. Looking around, one can get a good microcosm of the community where we live… family, friends, neighbors…seemingly average people just like ourselves with the exception of one or two folks who just give off a creepy vibe. The game goes on a few feet away, Friday night warriors racing to outscore each other before time runs out. And the band still provides the soundtrack to it all. Now though I sit in the stands waiting for halftime, searching up and down the lines of uniformed band members trying to find our nephew so we can watch every step, cheer every song, and marvel when the show is over at how the time sped by again this week.

It’s a Friday night in the South and deep in my gut, I feel a churning, a warm burning sensation down in my belly. I sense the anticipation. Soon, Jennifer and I will head out in the car and sit in traffic to park in a lot which will mean a good ten minute walk to a ticket stand. After a ten minute wait to get our tickets, we’ll venture past all the vendors to find a seat near the band. Then for the next two hours, we’ll listen to marching band versions of songs by Santana, Fleetwood Mac and Led Zeppelin along with some obscure song that we recognize but to which we can’t remember the title. Now and then I’ll spot a play on the field that I wish I could see again on instant replay but I am just as soon distracted by the orchestrated sounds ramping up the intensity of the environment around us. I hear the growl of the tubas, the power of the trumpets, the majesty of the woodwinds and the rhythmic pounding of the drums as it all comes together in a crescendo of sound and emotion. I look across the field and into the night sky veiled from the dark of the night by the intense bright lights and I can feel time slipping away and before I know it today’s shadows have caught up with me and slipped by but not before I feel the shifting of time and generations.

On Saturday morning, I will unfold the newspaper. I will locate the sports section and look up the game’s score to see who won and who lost, all the while humming a song I heard the band play the night before.

9.03.2009

From Around Here

My hometown is tucked away in the mountains of Georgia. Until about twenty years ago, getting to anywhere from there was a real struggle because the roads were all two-lane, remote and curvy. Then, a new four-lane highway came through between there and the northern-most suburbs of Atlanta. When this happened, other people began to discover all the small towns and communities along that four-lane road, including the little town my family has called home for over a hundred years.

Now, twenty years down the road, so to speak, when you visit there you will run across a fairly wide group of people from various places. Older people have retired there from Atlanta and Florida. Yep, many people elsewhere retire to Florida, but the Floridians have to go somewhere when they retire and they have discovered the Southern Appalachian mountains where they build houses on sides of hills amid the tall, brittle Georgia pines. You’ll also find folks from other parts of the country and world there. And while it isn’t exactly the big overflowing melting pot that America is, it more likely resembles a bowl of soup or stew with a couple of exotic spices and maybe a dash of hot sauce thrown in for kicks.

While it’s been many years since I lived there I have often returned there over the years. On one of those trips back several years ago, I was sitting in a local restaurant with my Mom and Dad. I began looking around and noting how I felt I could tell who the locals were, who the transplants were and who the tourists were just through a few moments of simple observation. So, I began to amuse my parents by telling them who grew up there, who moved there after living a life somewhere else before living there and who was just passing through. I’m not sure I was totally accurate with what I was talking about the times I tried this, and I'm not sure in a grander scheme of things if it really mattered. I do know as I did this, I felt most at ease guessing who was from my hometown.

Maybe it was their Southern accent I heard that gave them away. And if you are Southern you know there are so many…big city word alert…nuances, in Southern accents, that sometimes only your ear picks up that the accent someone else has may be the same Southern accent you carry around in your own voice, that it may have germinated and aged to perfection on a mountaintop or down in a valley between two hollers over the course of the passing of generation after generation. Maybe it was the clothes they wore that gave them away. Nothing fancy, denim and maybe a Western style shirt for the man topped off with an Atlanta Braves cap and maybe denim and a simple blouse accessorized with a plain pocketbook (yes, pocketbook, not a purse) for the woman.

Maybe it was those things. I though like to think it was the look on their faces that gave them away or more to the point, the look in their eyes that gave them away. I want to think it was that momentary meeting of my eyes with their eyes that somehow transcended any words that might explain the connection we share and into an unspoken recognition that we were born and raised in this same small community. It’s kind of like being somewhere else totally away from that town and running into someone you do not know but when you look them square in the eye you just know without anything being said that this person grew up in the same little town, the same county you did. And when he speaks you more fully understand without it having to be said that he knows where the high school kids park on Saturday nights to get into a little mischief and that he knows the preacher who performed your wedding ceremony and that he knows the same slick-rocked creek banks and shady, muddy lake nooks to catch some fish just like you do.

I was reminded of all this in the last week or so when I came across a lady who spoke with a Southern accent like mine. As I processed the accent, I wondered where this woman was from but only for a second. Her eyes seemed to look a bit deeper beyond cursory eye contact and into a place that seemed to ask, ‘how’s your Momma and all the rest of yuns doing?’ And as I looked at her trying to place in my mind if I knew her I found that she reminded me of one of my aunts in her younger years.

Now, I have no idea where this lady is from originally. I suspect she’s hails from some small Southern town not too far away where folks still number foggy mornings in August to determine how many snowy days we’ll have in the winter and where homemade pies are still baked then cooled by the wind as they rest in the window sill of a kitchen and where a local can spot a newcomer to the area with just a mere glance.

But briefly, she came from my hometown. I could see her enter a restaurant just off a main street in that little town and begin digging into her gigantic black pocketbook in an effort to find an ink pen to write down the address of an old friend she just ran into in the parking lot. I could see her sitting at a table drinking a cup of black coffee with her family. I could hear her talking about going to a gospel singing with her cousins the next weekend or figuring out when she would have time to string, break and can the fresh green beans waiting on the porch back home.

Projection spurs the imagination.

While my hometown changes, it sometimes doesn't seem to resemble the place stuck in my memory. It also seems I lose a bit more of my own accent with each passing year. Maybe all those changes are why hearing an accent that matches my own catches my ear and makes me pause even for just a brief time. Maybe I find a bit of comfort in thinking that the accent that comes out in my own voice when I'm excited or around home folks still echos back in that mountain town where the locals can talk to one another and without words tell anyone observing that they are 'from around here'.