Sunday, June 21, 2009

Father’s Day


I will see my father on Father’s Day.

I wonder what other people are doing to celebrate. Picnics, BBQs, cakes, golf dates, bike rides, opening presents.

We might do some of that — I have a card and a gift and my mom might get a cake.

One thing I do know is how we will spend part of our day:

He and I will gather in the afternoon or early evening for his three-hour in-home dialysis treatment just as we do every other day. Just as we’ve been doing for almost two years.

First we will set up the machine that cleans his blood. It’s about the size of a small refrigerator. We’ll open the door and install a cartridge, then hang a bag of saline. We’ll connect a series of lines, made of surgical tubing, which ultimately get connected to my father. We’ll start the machine to get the saline running through the cartridge and eliminate air bubbles. That takes about 20 minutes.

Then one of us will lay out gauze pads, Bandaids, two fat needles, alcohol and betadine wipes, adhesive tape to secure the needles, syringes to fill with saline, and one syringe we’ll fill with the blood thinner heparin. My father usually heads to the kitchen at this point to make coffee.

The machine will chime, alerting us to a few more things we need to do before he is ready to hook up. Then my father will wash and prep his left arm, the one with the bulging fistula (an artery-vein) that winds its way up between his inner wrist and the crook of his elbow.

He will sit, inserting one needle, then the other. For each, once we see the blood pulsing through the base of the narrow surgical tubing connected to the needle, I’ll secure it with a Bandaid then connect it to the tubing that snakes through the machine.

We will start the machine, ramping up the cycler to our cruising speed of 460. If all goes smoothly — no alarms, no need to remove tape and adjust the needles — I can work on my computer just a few feet away for the next three hours. Sometimes I read or get him something to eat, pour him some coffee or fetch him some paperwork since he’s confined to a chair.

He will take regular blood pressure readings and record that with information from the machine onto a log sheet. He might watch the news or do a crossword puzzle. He might nod off for a bit or work on his laptop. He’s been enjoying discovering Seinfeld through re-runs. I laugh too.

We always talk. Some days more. Some days less.

Last weekend he asked, “What did you do today? It was a nice sunny day.”

“I went for a bike ride,” I said, a little taken aback at his interest, and for a moment I felt a tinge of guilt, a fleeting self-consciousness at my energy and freedom. Not that he would want me to feel that way. Maybe he just wanted to talk about something other than dialysis or the news.

I thought how nice it would be if he had gone for a bike ride, too, with me or not. I don’t know the last time he went for a bike ride.

My father gets around. He shops, keeps in touch with his friends, goes to a weekly conferences related to his profession, though he’s retired. But he's also tired. Dialysis takes up a lot of energy and, especially, time. More for him than for me.

Sometimes I think he feels guilty for taking my time. For relying on me.

He shouldn’t. This is my commitment. I’ve made this part of my life.

And the truth is, though I don’t like that he has to be on dialysis, I like being able to help, being someone he can depend on after so many years of me depending on him. And I even find comfort in my routine of being there every other day. It anchors my weeks.

So, yes, I will see my father on Father’s Day.

It’s not what many people will do this day. But I don’t care.

I will give him a silly card and some fancy coffee that we will share in coming weeks and a book I think he’ll like.

And we will talk. We will talk of sunny days and things other than dialysis.

Saturday, June 13, 2009

Morton's F'ing Toe


Mother F!

I stood in the crowd of people wanting my friend to shut the F up! It’s not that she was saying anything that embarrassed me so much as she was infuriating me because she might be right.

I did not want to hear it. I did not want to hear it. I did not want to hear it.

Worse, as she said it she was standing there in these stupid “sensible” shoes:

“You probably have Morton’s Neuroma. That’s what I have. I can’t wear high heels anymore.”

Shut up. Shut up. Shut the F up.

I’m usually not this bad about denial. But in contemplating my possible future with heels, I’ve taken to telling people lately that I’d rather give up drinking alcohol for the rest of my life rather than give up high heels.

I had a kind of reckoning last New Year’s Eve after my left foot was screaming in such pain it might has well have been throttling me by the neck begging for mercy. I knew then I had a bigger problem than I wanted to admit.

For days afterward my toes, specifically the middle toe and the one next to my baby toe as well as those joints below them, alternated between numbness and pain when I walked even in bare feet.

I swore off heels unless absolutely necessary. (And yes, it is necessary sometimes.)

I tried them again — a pair of boots this time — a month or two later, for just a couple of hours, and sure enough, the pain emerged. It was not so bad because I didn’t wear them too long but I could see this was not something that was going to go away nicely.

I tried again a couple of months later, after finding myself unable to resist a pair of shiny brownish-red boots on sale for like $30 (Christ, they were originally $175!). I wore them, with hopeful caution, to a birthday dinner with friends. I mean, I was in them maybe three or four hours, most of that time sitting.

By the end of the night, the combination of walking and toe squeezing got the best of my foot. Sitting with my legs crossed under the table, I could not believe such an isolated and specific pain in my foot would cause me to want to scream, to be incapable of focusing on anything else, to feel damn near ready to throw up.

Desperate for some relief, I bought some shoe pads at Nordstrom and proceeded wearing heels only as needed, mostly wedges, taking care to notice which shoes I could handle and which I could not.

The night my friend in her “sensible” shoes declared this to me a month or so ago, I was wearing a slightly chunkier heel of maybe three inches, a sort of rounded-toe Mary Jane wingtip-style. I think we got on the topic because she was admiring my heels. I probably brought up my foot pain obsession.

Oh, how I hated that term: Morton’s Neuroma. It sounds like cancer.

Of course, I went home that night thinking, how could she possibly know what my problem is? She probably is so mad she has it she wants everyone else to have it, too. Pick on someone else, I thought.

Then I Googled it.

My god. I could have drawn the picture with the big red blob indicating pain exactly where I felt it. And the description was right on. It’s a nerve issue.

I read that you can treat it by numbing the nerve with cortisone injections.

I later asked my dad, a doctor, if he’d heard of it.

“Morton’s Toe?” he said. Ewwww. An even grosser term, I thought. “Sure,” he said, offering up yet another treatment option. “They cut the nerve.”

I immediately wondered how much that cost.

Don’t look at me like that. I’m only five-foot-three and half.

I suppose they do that if it’s bad enough. I’ve been contemplating seeing an orthopedic surgeon or podiatrist ever since. Though I do fear they’ll look at me with disgust when they realize my reason is so I can wear heels.

What’s interesting is that, as I’ve been sharing my self-diagnosis with some friends, several seem to know what it is. “Morton’s Toe?” they say, proffering up the hated words.

Some of them have since decided they have the exact same thing.

Clearly, this is far more common that I realized.

Regardless, I have a dilemma. I still need a proper diagnosis, then have to determine what I can or can’t afford to do about it.

Now as I look with equal parts nostalgia and fear at my collection of pointy-toe stilettos and heels of four inches or more, I'm thankful for summer with its mostly open-toe wedge-style sandals and espadrilles.

For now, I am doing my best to defy Morton and his stupid Neuroma Toe.

But I’m no dummy. I always have a second pair of "sensible" shoes in my car (they’re actually kinda cute), just in case. Which, let’s face it, is what any sane podiatrist will tell women today anyway:

Wear walking shoes on the street or from the parking structure, then slip the heels on at your desk or destination. Only wear as needed.

And yes, they are needed.