Challenging morning  at dialysis. The needle insertion (cannulation) was extra painful and the pain continued for the duration of my treatment (three hours). All the usual fun activities I brought along with me for entertainment became unenjoyable and ultimately, pointless.

My husband got the attention of a nearby technician. The tech checked my machine and determined that I had a good needle insertion and a good flow (whatever that means). The pain was overlooked, it seems. I then asked for an ice pack. He inquired (he's new to this unit, I think. And has decades of experience and has demonstrated competence in his profession, so I was/felt in good hands) with other staff, then comforted me with what I requested.

With nothing to do but complain about my discomfort, (as I pat my fistula arm trying to relieve some of the burning sensation), I closed my eyes and surprisingly, slept through most of the agony.

I sit here now at our local library - I love this place. Here is where I feel...free and fulfilled. My daughter (age eleven) is here with me --utilizing a library computer nearby completing her academics.

I'm sure it is obvious I'm not {feeling}100%. Dear daughter is assisting me greatly in walking, gathering & preparing my activities (laptop, yarn, lip balm, blanket). Staff here have known my family and I for decades. My kids were raised in these libraries ~ all are like a second, third... home.

I'm kinda stumbling around. Requesting people come to me as I'm too fatigued (probably due to this morning dialysis) to walk around. I forget basic things often, so here, I feel safe asking for help with the simplest thing. Example: how to connect to WI FI. My husband has told me numerous times, and I have remembered half of those times. And today, I needed help with the same question.

On top of a painful treatment this morning, also I received my monthly lab results. Blah!

About 98% of my the time, since I've been on dialysis, I've done exceptionally well. Dutiful in adhering to requirements. But now that my appetite is increasing and my love of big glasses of iced water, I have been poorly self-managing and failing miserably, in my opinion on this damn Renal Diet. "I want [need] bananas, potatoes, tomatoes, avocados, oranges, nuts, beans...and a Pepsi every now and then!"

This month, my phoshorus  was high (6.0). It's suppose to fall between 3.5-5.5. High phoshorus causes bone disease, itching, deposits in joints/blood vessels/skin. I need to take a binder with meals and snack. Avoid high phosphrous foods (milk, cheese, dairy, dried beans, nuts, chocolate and colas).

And my PTH was 823.0. Again, it too was high. It's suppose to fall between 150-650. High parathyroid hormone (PTH) puts me at risk for bone disease. Oral or IV Vitamin D may be given during dialysis to lower my PTH levels. I can keep my phoshorus controlled by taking binders and avoiding high phosphorus foods.

My calcium  was low, 7.9. Normal range is between  8.4-10.2. I need to talk to my dietitian or physician about ways to increase my calcium level.

Thankfully, my albumin, potassium, hemoglobin, URR (Urea Reduction Ratio), Kt/V (dialysis adequacy) were all normal.

Meeting the standards required in order to properly maintain optimal health is an arduous journey. Each day I struggle through some sort of obstacle, yet each day, I manage to successfully survive.

All of this is a matter of discipline and knowledge. Doing the work physically and mentally to come out on top. As it is, there is very few people in terms of fellow patients to look to for inspiration. From what I observe each Monday, Wednesday, Friday morning, we all are struggling. And some look worse than others.

All my life, I have rarely shown pain or weakness. Have tried not to reveal too much personal vulnerabilities in the presence of possible predatory types. But THIS disease and the death of my daughter have caused me to reveal even more of my humanness. Yet at this age, I've surrounded myself with quality people so I won't need/want to "mask" too much.

I know my kids are learning how to endure through "my" endurance and stamina and resilience. Out of a magnitude of lessons, they are learning to choose their friendships/relationships wisely. For you will see who is who in your darkest hour.

They are learning to maintain their health - through nutrition and fitness. They witness me go to the gym and push through flexible limitations. They witness me take up and on good distractions such as crochet/knit/blog, etc.

Whenever I feel like giving up I remind myself, "they" are watching and learning - from me. Who knows who else have observed something in me and gained inspiration from what they know of my journey. Who knows which dialysis patient (or staff) may be watching, observing and learning from me. After all, I can't be the only People Watcher.