Three Beautiful Things 05-30-2024: Acceptance and Tranquility, Chicken Wings and Maryland Memories, Leave the Shopping to Walmart

1. I might have written this same sentiment when I was so cautious and spent so much time indoors to avoid exposure to Covid: it's a good thing I don't get antsy or stir crazy. I'm not a wall crawler if I stay indoors. I was content today to get caught up on NYTimes crossword puzzles, to nap, to make salads, and take it easy. 

If I'm eager about anything currently, it's to keep my activity under control so that the surgery site can heal. I don't want setbacks. Taking it easy now will help me kick into more vigorous action sooner than later, but it's going to be a while. 

It's no use fighting this inactivity with restlessness and impatience. 

My body needs me to be accepting and tranquil.

2.  To help build tissue and repair what was damaged by the May 11th's surgery, I have greatly increased the amount of protein I eat. Early this evening, I fried a package of party chicken wings. I didn't eat every wing I cooked, but I could have! The wings were almost naked, but I flavored them a bit with Old Bay Seasoning, reminding me of the Old Bay wings Debbie and I enjoyed on occasion at the Old Line Bistro in Beltsville, MD -- may that glorious watering hole and source of joy in our lives rest in peace. 

3. With Debbie working and with me unable to drive, it's been a huge help that Walmart instituted the option for customers to shop online and then drive to the store and have the groceries delivered to the car. Debbie and I worked together to submit a list of groceries this evening and when Christy drives me to Spokane for labs Friday morning, we will pick up the order on our return trip. 

This option was a boon for Christy, too, following her second knee replacement surgery. 

I'm very grateful that we have this service available here in the Silver Valley.

Three Beautiful Things 05-29-2024: Positive News from Dr. Khokar, Goodbye Bengal Spice Tea, My New Kidney's New Home

1. Okay. Okay. Okay. Yes. It's a bit wearying to have to travel to Spokane at least twice, sometimes three, times a week for labs at 7:30 a.m. Until the stent comes out of my bladder in mid-June, I am prohibited from driving, so I depend on Debbie, Christy, or Carol to transport me. Debbie and Christy have been fully cooperative, patient, uncomplaining, and absolutely reliable. Carol will drive me this coming Monday and I expect she'll be just like Christy and Debbie, great company and a great driver. 

The thing is, I enjoy these appointments. 

The phlebotomists at the lab are cheerful, efficient needle pokers. They are eager to answer my questions and send me home with supplies so I can bring a urine sample with me from home and not have to produce on the spot. 

The one day a week I go to the transplant clinic and meet with transplant team members is especially enjoyable and reassuring. 

Today, I met with nephrologist, Dr. Anwar Khokar, who'd come to Sacred Heart from Minneapolis to help the clinic cover appointments. He liked most of what he saw in my lab results, especially the fact the my creatinine levels continue to come down, to improve. He increased my dosage of magnesium supplements and prescribed me a one time powder to mix with water to bring down my potassium levels. 

Throughout our conversation, I felt very good about what Dr. Khokar said about how my new kidney is functioning and about the progress of my recovery. 

2. I had a quick conversation with Gina, one of the transplant team pharmacists. I asked her if I could be drinking Licorice Spice and Bengal Spice teas out of concern that there might be ingredients in them that would interact poorly with my medication(s). Immediately she nixed the Licorice Spice tea. She took a picture of the ingredients list on the Bengal Spice tea box and messaged me later in the day that it has ingredients which interact poorly with Tacrolimus, one of the immunosuppressive drugs I take, and so my longterm relationship with this longtime favorite tea of mine has now hit the skids. 

3. Nurse Jenn is on vacation this week, so I talked next with her colleague, Nurse Angela. 

I asked Nurse Angela to remind me how long certain restrictions like not spending a lot of time in public places or not being able to go to the Fitness Center were going to last. I told her I was not having any problem with these restrictions, but that the timetable wasn't quite clear in my mind. 

When she responded, two vitally important facts that I'd heard before, but that hadn't really sunk in, took hold inside of me. 

Here is fact #1: Upon receiving a new kidney, the transplant team pumped a very high volume of a mighty antirejection/immunosuppressive drug into my bloodstream. 

This mighty drug, on the one hand, keeps my system from rejecting this organ that invaded my system from outside my body and, on the other hand,  it wipes out my immune system for about three months. 

I don't have to quarantine myself at home during these three months, but I will avoid crowds. I asked Nurse Angela about recreating at casinos. "Not for at least three months -- and, if you do go, wear a mask and stick to the non-smoking areas." (My first thought was one of gratitude for the fact that the Wildhorse Resort in Pendleton is 100% non-smoking!) 

Right now, I can make masked trips to the store -- I'm more likely to do so once I can drive -- and do other similar things in less crowded public places as long as I take precautions. 

I'll lie low.

When I asked Nurse Angela about exercise, she reminded me that it takes about three months or so for the surgical site to heal and to grow tissue to protect my new kidney. She explained how my native kidneys are, by nature, protected by our anatomy, but that my body needs time to build similar protection for this new organ just to the left and slightly above my groin. As far as exercise, for at least three months, I'm limited to walking. No biking, swimming, huffing and puffing on, say, the NuStep machine; no yoga; no activity that involves twisting, lifting, or anything that would jar the kidney's new home. 

The post-transplant picture keeps getting clearer to me. It's a lot to sort out. So much has to do with the new environment in my body -- the efforts to keep my immune system from rejecting the new kidney and my efforts to provide my new kidney with a peaceful home and to provide plenty of calories, protein, and other nutrition to the surgical site so that my body can not only heal, but perform the new construction it is undertaking. 

So far, the new kidney seems to be doing well.

It needs an accepting and protective home. 

That's really what this time of recovery is largely about -- as I understand it. 

My new kidney simply needs me to be accepting, disciplined, and patient. 

I can do that.

 

Three Beautiful Things 05-28-2024: Day Napping, Bill Walton Testimonials, Debbie Improvises in the Kitchen

1. It's imperative that I drink a high volume of liquids every day and the only drawback to taking care of myself this way is that I don't sleep a lot at night. Today, I felt the effects of my erratic sleep schedule a bit more than usual and I didn't fight the urge to return to bed and sleep a while during the day.

2. When I wasn't refreshing myself with some catch up sleep today, I didn't do much. My chief enjoyment came from cruising online looking for videos of people who knew Bill Walton and told stories about being touched by the loving light of Bill Walton's eternal magic carpet ride through life, by his curiosity, generosity, and enthusiasm for, well, just about everything. 

3. Debbie quickly threw together a pasta dinner using canned green tomatoes and mushrooms that rocked my world tonight. I added spinach leaves to my helping, let the leaves cook down, and so I added a little of my own innovation to Debbie's ingenious dish. 

Three Beautiful Things 05-27-2024: Bill Walton Electrified Me, Ed and I On the Patio, Debbie's Superb Stir Fry Dinner

1. In the springs of 1970 and 1977, I was young, eager to be fired up, in love with the National Basketball Association, deeply impressionable, and full of enthusiasm. It might be that all of this enthusiasm and love makes my evaluation of the 69-70 New York Knicks and the 76-77 Portland Trailblazers unreliable. If so, so be it. But here I go: I thought those two teams played a style of team basketball that was as close to basketball perfection as was possible. 

The hub around which the perfection of the 76-77 Trailblazers turned was Bill Walton with his peerless court vision, absolute selflessness, uncanny ability to make pinpoint passes out of the pivot, ability to score in the key as needed, and his dedication to defense and rebounding, often leading to dynamic outlet passes, triggering the Blazers' blinding fast break. 

I've been replaying Bill Walton performances all day today, saddened by the news that he died of cancer, and relishing my memories of watching him, when healthy, play all facets of basketball at a superior level, a level that more than entertained me, it moved me. 

I'm not at all into discussions of trying to determine who was the greatest of all time in any sport. 

I don't care if Bill Walton was, for an electrifying stretch of time between 1976 and 1978, the greatest center of all time or not. 

His play moved me, gave me chills, goosebumps, rushes of adrenaline, joy, moments of disbelief, and the pleasure of seeing the game I loved played as well as I could imagine it. 

It's a grievous loss that he's gone, somehow only made bearable by the joy I've experienced today remembering his best days as a player. 

2. Ed swung by today and we sat out on the patio and yakked it up for a while. He's the first person outside of family and medical personnel I've visited with since May 11th. I enjoyed his visit a lot and was happy to know that things are going well for him and that he could see that I'm feeling good, looking healthy, and healing up a little bit more every day. 

3. Debbie made a remarkable chicken stir fry for our dinner tonight. She used wheat noodles she'd picked up at Trader Joe's and seasoned the chicken, vegetables, and noodles with a perfect measure of chili garlic sauce. She also made some extra chicken pieces and put them in a container, knowing that I've been wanting to add protein to my daily salads and now I can do just that! 

Three Beautiful Things 05-26-2024: Night and Day, The Enigmatic Mountain Lion, Stent Removal Education

1. I'm grateful that my good fortune in life makes it possible for me to treat the days and the nights somewhat similarly. Night time is not, for me these days, a time of restful sleep. When I do sleep, it's restorative, but it never lasts long because I visit the bathroom so frequently. To make up for not sleeping as much at night as I'd like, I am spending longer periods of time in bed during the day, napping, reading, and resting. I'm aware, at the same time, that I also need to move around, walk, keep my blood flowing, especially through my legs. So I don't just stay in bed. My favorite way of being on my feet is to work in the kitchen, either preparing food or doing light cleaning. 

I don't know if, with time, I'll have fewer interruptions during the night. If not, well, I'm determined to roll with whatever my situation will be and figure out positive ways to deal with, as they say, the cards I'm being dealt! 

2. Soon after the May 11th surgery, I commented in this blog that I hoped to find a book (or books) on animals to read. I am strongly drawn to books (and documentary films) that explore the wonders of different animals. Over the last few years I've read about beavers, buffalo, eels, octopi, whales, salmon, and a bunch of other creatures on land, in the air, and in the water. 

Kenton Bird responded to my post about animal books by asking me what I like to read. A friend of his, David Johnson, helped Maurice Hornocker, a wildlife biologist who has dedicated decades of work to studying the cougar, write a memoir about his tireless quest to understand the mountain lion. 

The book's title is Cougars on the Cliff. Kenton sent me a copy, signed by David Johnson. 

I began reading it Saturday night and continued today.

So far, it's an astounding story, chronicling the brutal winter conditions in huge expanses of the Middle Salmon River drainage and primitive areas where Horonocker, the men he started his work with, and their eager hound dogs go in search of secretive, sly, shy, wily cougars and began their years and years and years of study.

This book, like so many I've read about other animals, works to alleviate common fears. It works to set the record straight about what dangers they do and do not present in the wild. As is so often the case with wild animals, the mountain lion had been regarded as a menace and its populations were decimated by bounty hunters and other trophy seekers. 

Maurice Hornocker set out, in his research, to determine if the mountain lion really is the menace, the threat, that it was reputed to be and, right now, I am reading about the earliest days of his dedication to learning more about the cougar and, again, the brutal winter mountain conditions he hiked in, tracked cougars in, and endured in order to engage in this lifelong effort. 

3. When I received a new kidney, the surgeon put a stent from the kidney to my bladder. Sometime in mid-June, I'll go to the transplant program's urologist and have the stent removed. When Nurse Jenn removed my catheter about ten days ago, she explained that removing the stent would be a similar procedure.

Today, I decided to look into this procedure more fully and I read up on how the stent is removed and even found a YouTube video that showed the instrument the doctor will use, a cystoscope. The cystoscope has a tiny camera on the end of it and so I went on a video journey to the center of someone's bladder and watched as the doctor clamped onto the stent and easily pulled it out -- not that different, once clamped on to, from what I experienced when Nurse Jenn removed my catheter. 

I like knowing what to expect in this whole transplant process and everything I learned today about the removal of the stent reassured me that the procedure doesn't take long and will not involve much discomfort, if any. 

Three Beautiful Things 05-25-2024: Rest, Produce, Protein

1. No trips to Spokane. No labs. No appointments. No problem. I didn't sleep much overnight, but continued my travels on the well-worn path to the bathroom. So, today, I spent a few hours, off and on, back in bed, resting, napping, relaxing. 

2. Debbie spent a generous amount of time in the kitchen this afternoon cleaning produce and chopping vegetables and strawberries so that these items will be ready right away for me to make salads and do other things with. I joined this produce preparation party and washed and bagged all of our lettuce, spinach, kale, and arugula. Later in the day, I made a fresh green salad and having everything ready to go elated me. 

3. To help me consume plenty of protein, as highly recommended by the transplant team, Debbie prepared a generous hunk of salmon for her and me and I swear I could feel its wealth of protein going to work to help heal and build my body.  

Three Beautiful Things 05-24-2024: Christy Drives Me to Spokane and Back, Blood Tests Look Good, Being Active at Home

1. I knew going in that if I ever had kidney transplant surgery that a key piece of the recovery would be regular, possibly frequent, trips to the surgical lab at the Sacred Heart Outpatient Health Center for blood work.  I knew that on some of those days, if I spent my recovery days in Kellogg, it would mean driving an hour or so to the medical center, spending no more than fifteen minutes checking in at the lab and having my blood drawn, and then turning right around and heading straight back to Kellogg -- with possible stops in CdA or the Smelterville Walmart. I have to have this blood work done at around 7:30 a.m. because it's crucial that I take my morning meds at 8:00 and I have to have this blood drawn before I take my pills. 

Because all but one of my blood draws and my urine sample are analyzed in house, the results are available very quickly. This wouldn't be true if I had the blood work done at a lab in Kellogg or Coeur d'Alene. I'm fortunate that Christy is both available and willing to drive me to Spokane at this early hour only to turn right around and return to Kellogg. I'm immeasurably grateful. 

2. The one analysis that can't be done in house goes to Labcorp. It tests the level of Tacrolimus in my blood. Tacrolimus is one of the immunosuppressive drugs I'll take for the rest of my life. It's crucial, especially in these early days after the transplant, that I'm neither taking too little nor too much of this drug. 

The results of the Tacrolimus level in my blood are ready in the afternoon.

Nurse Jenn then calls me with instructions as to whether I need to adjust the dosage of the Tacrolimus.

She also reviews the other blood tests with me. 

When Nurse Jenn called this afternoon, she, in essence, told me things are stable or improving. 

I'll stay with my current dosage of Tacrolimus and test my levels again on Wednesday.

My creatinine levels continue to trickle down, a positive sign.

My magnesium levels are low, but with supplements and diet, we are addressing that. 

I'll return to the medical center on Wednesday for 7:30 a.m. blood work and meetings with members of the transplant team and see where we go from there. 

3. I had fun early this evening cooking a HelloFresh meal of chicken cutlets with dill sauce accompanied by steamed green beans and boiled potatoes. Cooking meals doesn't tax me. It doesn't require lifting anything over five pounds. It's great for my spirit and morale. It makes me very happy to be able to do light tasks around the house -- very light and very occasional loads of laundry, food prep and cooking, keeping the dishwasher emptied and then loaded, and keeping cutting boards and countertops clean. 

It's important that I move around, that I don't sit or lie around all day. The transplant team has made this very clear to me and I'm happy to comply. Debbie has done so much to help me over the last two weeks while also teaching nearly every day. The end of the school year is a challenging and demanding time for teachers. Debbie's been tired. I'm especially happy that I can cook for her, lighten her load a bit, and that doing so is compliant with the transplant team's urging that I be moderately active at home. 

Three Beautiful Things 05-23-2024: Oh! No! Did I Blow It?, Vegan French Dip Sandwiches, Protecting My Abdomen in the Laundry Room

1. As I've mentioned before, while my abdominal wall heals after being sliced open during transplant surgery, I must limit my lifting to five pounds for another two or three weeks (or so). 

Today the USPS delivered a small box to our porch and, in a moment totally lacking in thought and caution, I lifted it. 

Mild panic set in.

I saw on the box that it weighed EIGHT POUNDS.

Visions of the collapse of my abdomen flooded my imagination. I pictured myself being helicoptered to Sacred Heart Medical Center for emergency hernia surgery.

I was sure I could feel my guts beginning to spill out around my waist, certain that in a brief moment of carelessness I'd set my recovery back irreversibly.

I wondered if I'd have to go back on the transplant list.

For a few hours, I obsessively focused on how my abdomen felt around the incision site, felt the area to try to determine if things were intact.

Turns out I'm fine. 

Still, I'm on guard: NO MORE CARELESS LIFTING! 

2. Once I regained my sanity and felt my psychological equilibrium restored, I took out a HelloFresh bag that's been in the fridge for over ten days and, for lunch, made myself two vegan mushroom French dip sandwiches. 

Now I felt discomfort in my lower regions not from lifting EIGHT POUNDS, but from overeating. 

But, I think it was good overeating. 

Those were pretty healthy sandwiches and I made them on pretty healthy oat sourdough bread and the discomfort of vegan gorging didn't last long. 

3. I was very careful about the weight of the light clothes I decided to launder this afternoon. I carried them to the basement free of anxiety and my abdomen, once again, seemed intact when I started the washing machine. 

Later I did another load. This time I laundered three towels and a couple other items. Two of the towels were kind of wet and a little bit HEAVY! 

In my newfound vigilant mindset, I divided this small load in two and made two trips to the basement. 

When I removed the wet HEAVY towels from the washing machine, I took them out ONE AT A TIME, doing my best to guarantee that I didn't lift more than five pounds. 

While those items dried, I once again felt the area of my incision, hoping against hope that I'd not find any bulges or areas of tenderness. 

I didn't. 

My laundry efforts succeeded without a life flight from Kellogg to Spokane. 

So, just in case you were wondering, I now know there are moments during kidney transplant recovery that can be, well, whack. 

Three Beautiful Things 05-22-2024: A Note on Sleep, Assessing My Progress with Dr. Murad, Meeting with the Pharmacist, Wrapping Up with Nurse Jenn

A sleep note: At this moment, it's 7:30 on Thursday morning and I'm about to write about what happened on Wednesday. In yesterday's blog post, I wrote about how little sleep I'm getting, largely because of frequent nocturnal visits to the bathroom. Well, I went to bed at 8:45 Wednesday night and, instead of the four hours of sleep I've been getting lately, I logged 7.5 hours of sleep. I was awake for 1.5 hours because of bathroom visits, BUT those visits came at 90 minute intervals. I had been getting up as often as two or three times an hour and to have these 90 minute stretches of sleep was a boon -- and, as an added bonus, I had entertaining and fun dreams all night long! 

1. Debbie and I hit the freeway soon after 6 a.m. and rumbled to the Outpatient Health Center at Providence Sacred Heart Medical Center in Spokane so that I could have blood drawn and meet with three members of the transplant team.

My first meeting was with nephrologist Dr. Murad who immediately jumped on his computer and went over the results of the blood work I'd just had done. 

My creatinine levels continue to trend downward, just what we want, and, in fact, they've come down far enough that I can now take Valcyte seven days a week instead of the three days I had been taking it. Valcyte is used to prevent disease caused by a virus calledcytomegalovirus (CMV) in organ transplant recipients. It's a virus that can lie dormant in a person's system and then reactivate. When dormant, it hides. My donor had CMV in his system and I'm taking this medication in case the virus had hidden itself in the kidney of his that I received. 

Dr. Murad wants me to work on elevating my magnesium levels in my blood. He talked with me about foods like beans, almonds, dark chocolate, low fat dairy products, spinach, and others that are rich in magnesium. He also started me on a magnesium supplement regimen. 

As he had when I saw him in April, Dr. Murad instructed me to be sure to protect my skin from the sun by wearing sunscreen and with my clothing. The immune suppressing drugs I will take for the rest of my life leave me vulnerable to skin cancer caused by sunlight and I have to be vigilant about protecting myself. 

Since being admitted for surgery on May 11th, my consultations have been with three transplant nephrologists: Dr. Poudyal, Dr. Khan, and Dr. Murad. 

I love talking with them. 

Each of them is witty, solicitous, eager to explain things, warm, and positive. They are patient answering my questions and precise in their knowledge. When I come into the clinic, I am not aware in advance which doctor will go over things with me, but I'm stoked to say that I am equally happy with each of these nephrologists. 

2. I'm also very happy with the two pharmacists who are working on my case. Until today, Debbie and I worked with Gina. Today, Stephanie helped us out.

One of Gina and Stephanie's primary responsibilities is to make sure Debbie and I understand the medications I'm taking, the dosage, and when to take what. 

Key to this effort is the filling of the pill box. 

Until today, Debbie was responsible for my pill box, but I assumed that responsibility this morning. 

Stephanie sat with me this morning, and watched as went from one pill bottle to the next and put the right amount of pills in the right place in the box. 

I did it! 

So, now, not only will I fill the pill box myself, monitoring the inevitable changes that will occur in the future, I, along with Debbie, have passed the pill box tutorial and Stephanie and Gina now trust us to fill the box correctly at home without their oversight. 

Stephanie also went over handouts with me detailing what pain relievers I should never use, emphasizing that the only safe one is Tylenol, straight Tylenol. We also went over a list of over the counter medications and I learned which ones I can use and which ones interact badly with the medications I'm taking and must never be used. 

3. Our visit ended with a visit from Nurse Jenn, a spirited, positive, buoyant, knowledgable pro. Jenn reminded me that she'd be calling me this afternoon about the one blood result still to come in and whether that result signified a need to change the dosage of one of my meds. 

I asked Jenn how long I would be restricted to lifting no more than five pounds. It'll be about another three weeks and now I know why. When the surgeon made the incision in my lower belly, in order to open a space for the new kidney, he had to cut through the abdominal wall. It takes a few weeks for that abdominal wall to heal and if I overdo it by lifting too much weight, I risk incurring a hernia. 

I also was curious when the stent that goes from my new kidney to my bladder would be removed. Once it's out, I can drive a car again. It'll be mid-June. Nurse Jenn is waiting to hear back from the urologist's scheduler, but I didn't need a precise date. I was just wondering, within myself, when I would no longer have to rely on others to transport me. 

I return to Spokane on Friday, May 24th for another blood draw.

Then, on Wednesday, May 29th, I return again for labs first thing in the morning and then a round of meetings at the transplant clinic with team members again. 

I wish I didn't have to rely on others to drive me to these appointments, making me especially grateful today that Debbie transported me and accompanied me during the visits with transplant team members. 

On the way home, Debbie stopped at Pilgrim's Market in CdA and brought back a bag of good stuff including dark chocolate, kefir, cashews, almonds, a couple of beers (not for me!), trail mix, oat bread, and other great items. 

Upon returning home, we both collapsed in our respective rooms and took long, deep, refreshing naps. 

Three Beautiful Things 05-21-2024: Up All Night, Irregular Sleep, Cooked Up a Storm

1. I'm doing my best to surrender to the fact that it'll be a while, I hope, before I have long stretches of sleep at night. For many, many years now, I've had to get up and go to the bathroom frequently all through the night. Years ago, I decided to make this potential source of frustration a source of gratitude. Many people suffering from kidney disease and failure cannot produce urine. 

I always have. 

So, even of it were four in the morning and I was making my third or fourth trip to the bathroom, I uttered thanks that my diseased native kidneys were functioning. Now, not only am I up once or twice an hour through the night, I am also relieving myself in a plastic bottle and keeping a record of how many cubic centimeters I create every twenty-four hours. 

My gratitude for this (I do hope) temporary inconvenience is even more profound now. 

My new kidney is working. 

2. Yes. I'm up and down all night. The last few mornings, at around 4:30, I've decided not to go back to bed, but have stayed up and begun my morning routines, recording vitals, drinking coffee, working puzzles, and continuing to visit the bathroom. 

My Fitbit tells me I'm sleeping about four hours through the night, so as the day progresses, I'm adding to that total with naps, knowing that I need restorative sleep as I recover. I'm grateful that I am at liberty to have these unusual sleep patterns right now, that they are not a bother to anyone and that there's nothing to keep me from focusing on taking good care of myself. 

3. You'd think that since my sleep is out of whack and I'm a bit sleep deprived that I'd be crapped out. 

Not the case. 

Tonight, I fixed Debbie and me a meatloaf dinner with garlic mashed potatoes, roasted Brussels sprouts, and a thyme sauce for the meat. 

Yes, it was a HelloFresh meal, but it required quite a bit of attention to detail with several parts of the meal all underway at the same time. 

And, sure, I got a tuckered out a bit, but not only was it a delicious supper that came at the end of what had been a long day at school for Debbie, but I recovered quickly from whatever minor fatigue I felt, really happy that on Day 10 of this transplant progress, I was able to not only cook up a storm, but enjoy doing it and eating it. 

Three Beautiful Things 05-20-2024: The Decision to Stay in Kellogg, Christy Drives Me to Spokane, I Cook Dinner

1. In order to enroll in the transplant program at Providence Sacred Heart in Spokane, I not only was exhaustively tested to assess my fitness for a transplant, I (often along with Debbie) met with transplant team members for educational sessions, always with the opportunity to ask questions. 

One of the most important points in these sessions was the program's mandate that I be close to the transplant clinic and hospital in the weeks (the number to be determined) following the surgery. 

In the immediate aftermath of the surgery, once discharged from the hospital, I would be required to report at least twice a week for lab work and for visits to the clinic after one or both of those lab draws. If need be, I was told, I could be told to come in more often than that.

The question for Debbie and me and for the transplant team was whether Debbie and I would stay in Spokane or would we commute from Kellogg. Kellogg's distance from Sacred Heart is right on the cusp of how far away they want transplant patients to stay after the surgery.

Debbie and I, for the last five and a half years, assumed that after surgery I would be in no shape to be traveling between Spokane and Kellogg. We assumed we'd be staying in a h/motel or a house in Spokane.

But, then, I came out of the surgery feeling pretty strong. 

I was awake most hours of the day. I gained mobility before long. I was alert. My stamina was good.

Debbie and I agreed: let's give staying in Kellogg a try and if it turns out to be a bad idea, we'll temporarily move to Spokane. 

Last Thursday tested our decision. 

I had to be at the Outpatient Health Center at 7:30 for labs and then, starting at 8:30, we'd have two or three hours of meetings with members of the transplant team.

Would I hold up? Would the drive to Spokane be too much? Would I be tired and have difficulty focusing during the meeting with team members?

I had no problem with any of it.

Staying in Kellogg works. 

I haven't had any complications requiring me to return to the hospital (knock on wood). 

Debbie hasn't missed much work and I've been fine for the hours I've been home alone. I can tend to my medical routines. I can cook. I can take care of myself. 

This is working out really well.

2. Now, the one thing I cannot do and won't be able to for at least another month, is drive a car.

Therefore, I am dependent on Debbie or Christy for transportation to Spokane for my labs and for visiting the clinic.

This morning, Christy swung by at 6:00. 

She drove me to the Outpatient Health Center and parked right across the way. Christy didn't have to accompany me to my blood draw, and, even better, didn't have to use the cramped, dingy, confusing parking garage! 

We were back on the road shortly after 8:00 and in Kellogg not long after 9:00.

I saw the results of these labs shortly after arriving home and they look good.

The one result that isn't in yet concerns the level of one of my medications in my blood. Nurse Jenn called me late in the afternoon and said that result got delayed. We should have it Tuesday morning and she'll call me again and let me know if I need to adjust the dosage of this medication. 

3. I thoroughly enjoy cooking dinner for me and Debbie, especially when she's working. It's uplifting that for me to cook is no problem. My energy in the kitchen is strong. 

So, tonight, I fixed a HelloFresh corn chowder accompanied by a small baguette sliced in half, buttered with an Old Bay and butter mix, and toasted in the oven. 

It was a solid meal and I was very happy that I easily felt strong enough to prepare it for us. 

Three Beautiful Things 05-19-2024: Restful Day, Crossword Catch Up, Preparing for Monday's Trip to Spokane

1. This was one blissfully uneventful day. Because I am up frequently during the night to go to the bathroom (a good thing) and have been starting my days much earlier than usual, I returned to bed a couple of times today and napped. I showered. I further established my independence my pulling on my own compression socks! I fixed myself breakfast and lunch. I continue to feel really good. 

2. I continued catching up on New York Times crossword puzzles. I have more work to do on the Sunday puzzle and then I'll tackle Monday's puzzle on Monday and pull even. 

3. On Monday morning, I'm due at the surgical lab at Sacred Heart for blood work at 7:30. Christy will drive me over. The trip requires some planning. I have to take my meds at 8:00 a.m. after the blood draw. I  need to carry one of the bottles I pee in so that I'll have a record of my output if I have to go. I need some food and a dose of the anti-fungal wash I swish in my mouth after I eat. I'll be in a public place so I need to cover my face. I'll carry sanitary wipes. 

I made a list, revised it, checked it at least twice, made final revisions, laid things out, and I'm confident I am prepared to make Monday morning's trip with all contingencies covered. 

The best part of this preparation? 

I can do it all myself! 

No one, especially Debbie, has to concern themselves with doing anything for me or helping me out. 

I very much appreciated that Debbie fixed those burgers on naan bread again tonight, but it's also good to know that I have plenty of energy to prepare food and can get back to making dinner for us while Debbie is at work. 

Three Beautiful Things 05-18-2024: My Immeasurable Gratitude, Injury Stays in Our Bodies, Time on My Hands!

1. I might want to repeat this over the next days and weeks: I'm immeasurably appreciative of and grateful for the support so many people have expressed to me over the last week leading up to and after last Saturday's transplant surgery. I've loved reading all the encouraging comments, emails, and cards and have taken every Facebook response of "like", "love", and "care" to heart. I've especially enjoyed having sweet memories of my relationships with all of you return. I'd love to respond individually to all of these words of encouragement and support. I understand that I can't, so I'll have to let this and other blanket statements of gratitude suffice. Thank you again and again.

2. I've thought a lot today how our bodies just don't forget and it seems that nothing that happens inside of us is ever really finished. I suffered pulmonary damage in a Zinc Plant accident back in 1973 and all through the years on the transplant list, going for regular visits with the transplant team, I continued to be x-rayed, scanned, tested, and examined to make sure that my respiratory system was up to supporting this transplant. It's what led me to those thirty-six sessions of rehab and it's what got me going regularly to the Fitness Center.

In addition, I wasn't done with bacterial meningitis when it cleared up back in the months after I fell ill in November of 1999. 

It's highly likely that the antibiotics that saved my life in 1999 were also the source of the damage to my kidneys. Much of the legacy of the meningitis inside of me in the years following this illness eventually cleared up: the fatigue, depression, headaches, and other impacts.

The kidney damage remained. 

In other words, both the Zinc Plant accident and my bout with bacterial meningitis have continued to live in me all these years. Neither medical event was ever over. 

3. Today was Saturday. It's been a week since the transplant. I'm confined to staying in the house except to go to Sacred Heart about twice a week. It's time for me to get creative about filling up my hours at home. I'm feeling the temporary loss of routines like shopping for food, going to the Fitness Center, running errands, and other things. I'm starting to cook more again. It's about time to get back to reading. Once I get the tv moved out of the Vizio room, this would be a good time to watch movies. I'm still getting caught up completing last week's NYTimes crossword puzzles. 

And, on Monday and Wednesday, I'll be going back to Sacred Heart for labs and another check up with the transplant team on Wednesday. 

I'm adjusting. 

I have quite a bit of time on my hands! 

Three Beautiful Things 05-17-2024: Chronicling My Renal History, A S-L-O-W Day, Debbie Fixed a Unique and Awesome Burger

1. I began monitoring my kidneys' chronic disease back in January of 2005, while living in Eugene, when I visited a nephrologist, Dr. Zakem, for the first time. I had just, in December of 2004, begun to see a new primary care giver, Dr. Ghandour. I had been feeling awful for months. He ordered a comprehensive series of tests and discovered that my kidney function was low. None of the symptoms I had been experiencing back in 2004 were related to the kidney disease he discovered, but my long road toward eventual transplant began over nineteen years ago.

I never have experienced kidney disease symptoms. If it weren't for what my regular blood work unfolded, I would never have known I was ill. Kidney disease can be that way, an almost phantom illness.

The disease progressed slowly over the years. If you've read this blog, you know that my kidney function, while key numbers were poor, remained stable. 

I was listed for transplant in Baltimore back in the spring of 2015.

I've been fortunate over the last nine years on the transplant list. I've never been on dialysis. I never stopped producing urine. 

The transplant on Saturday was what's known as a preemptive transplant. For several years, the hope has been that I could receive a third kidney before this disease progressed to the point that I needed dialysis.

Now, after the surgery, one of the chief concerns of the transplant team is that I continue to produce urine.

I now log my urine output, along with logging every drop of fluid I drink. 

I am drinking about 200 ounces of fluid during the day and producing about the same amount of urine all through the day and night.

All through the night, I'm back to the bathroom, urinating in a bottle, logging it, grateful that this aspect of my kidney function and my recovery is going so well. 

Yes, I would one day like to enjoy a rarely interrupted night of sleep, but if that happens, it won't be right away.

I will continue this voluminous intake and output of fluid for another three weeks. 

2. Things slowed way down at home today. 

Debbie can leave me alone. 

She worked. 

I didn't have much to do. No trips to Spokane. No labs. No meetings. No toting around a catheter bag. Nothing scheduled. 

Fortunately, I'm able to get up and walk around with only the mildest of discomfort at the incision spot.

And I can cook! 

I fixed myself a delicious breakfast of potatoes and eggs and another delicious lunch of pasta, butter, lemon juice, and roasted panko. 

I'm eating plenty of fresh fruit and vegetables, drinking milk at every meal, and eating yogurt. 

Saturday, I'll carry a light load of laundry (under five pounds) to the basement and get it washed and dried. 

I'm taking it easy, as ordered, but I'm also under orders to keep moving around, keep showered, and to do whatever light tasks I can. I can load and unload the dishwasher, keep counter tops and cutting boards clean, and do other small chores around the house. 

It's working. 

3. Debbie had this superb idea to make us each a hamburger using naan as the bun. 

I loved this burger. It was light and flavorful. The small chopped salad she served me with it was perfect. 

So while I could have made my own dinner, I never would have come up with this idea. 

Debbie and I are working very well together as I continue to improve and adjust to life with a new kidney.   

I'm very grateful. 

Three Beautiful Things 05-16-2024: Dr. Khan Was Ebullient, Nurse Jenn is Superb, Getting Meds Straightened Out

I want a detailed documentation of my recovery from transplant surgery. This blog is where I keep a record of such things. If you are reading this, you might find it more detailed and, dare I say, tedious than you want to read. On the other hand, possibly you'll find it interesting. Here I go.

1. I was up shortly after 4:30 this morning going through my morning routine of emptying my catheter bag and charting my output overnight, weighing myself, taking my blood pressure, pulse, and temperature, and making a cup of coffee. Shortly after six, having packed up the blood pressure cuff, all my medicines, pill box, and our thick binder of information, instructions, and charts, Debbie and I piled into the Camry and drove to Spokane.

I checked in at the surgical lab on the fifth floor of the Providence Outpatient Health Center and a most friendly and concerned phlebotomist pulled a few vials of blood out of my arm.

Debbie and I had plenty of time in the downstairs lobby to eat breakfast. At around 8:20 I checked in at the transplant clinic where I had my temperature taken, got weighed, and had my blood pressure, pulse, and oxygen saturation measured. 

After a bit, Dr. Khan, transplant nephrologist, strolled into the examination room. 

He was ebullient. 

A chief measure of kidney function is the level of creatinine in the blood. 

My creatinine levels have come down significantly since I was admitted into the hospital on Saturday.

The new kidney is working. 

Dr. Khan also loved hearing that I'm not in pain, that I am actively participating in tasks around the house, and that I'm not dependent on Debbie to do everything -- not by a long shot. 

We also had a very good conversation about blood pressure. I'm at a stage known as "permissive hypertension". I came to this visit concerned that my systolic numbers have seemed high. Pre-transplant they would have been. But right now, higher blood pressure is a benefit to my new kidney and Dr. Khan is very pleased with my blood pressure numbers. 

What a relief. 

He was also very happy with the volume of urine I've been producing and determined that I no longer needed the catheter.

Having the catheter come out is a mixed blessing, in a way. Yes, it will be much better for my ease of getting around not to have to lug the catheter bag around the house, but the catheter also allowed me to sleep through the night since I didn't have to get up to go to the toilet. 

Now, I'll be back to frequent visits to the bathroom during the day and all through the night.

For the next four weeks, I'll pee in a container to measure my output and record how much urine I'm producing over each 24 hour period. 

Dr. Khan wants me to increase my fluid intake and work to produce clearer urine.  If I do things right, I'll hit the fluids (coffee, milk, water, soup, juice, etc.) hard during the day and try to taper off starting at 5 p.m., with the hope that I won't be up and down so much at night if I reduce my intake later in the day. 

Remarkably, I don't return to the clinic now until Wednesday, a very good indicator of how confident Dr. Khan is the progress of my recovery. I'll go to Spokane again on Monday for labs and will have labs drawn again on Wednesday before the Wednesday meeting with the transplant team. 

2. After Dr. Khan consulted with me, I met my permanent transplant nurse coordinator, Jenn. She removed my catheter without incident, gave me a water bottle with instructions to hydrate so that I could urinate before I left. After I urinated, Jenn did an ultrasound scan of my bladder and the results were positive. I'm emptying it sufficiently.

Jenn talked with me at some length about what I must and must not do now that I've had this transplant. 

Jenn was less strident about Copper than the nurse I talked with in the hospital who left me with the impression that I should avoid all contact with Copper. 

Not so.

I can be in Copper's company and pet him, as long as I wash my hands afterward.

BUT, for the rest of my life, I am not to clean Copper's litter box and I'm to avoid being around litter box dust that Copper might stir up. (This is lousy news for Debbie -- and, when she travels later on, I'll need to recruit help with Copper's box.)

I have other restrictions: only very light lifting; no driving for about five weeks; I'm to stay out of the sun, but if I must be out, I'm to wear sunscreen, cover my arms and legs, and wear my wide-brimmed hat; I cannot return to vigorous exercise for three months. 

Lastly, Nurse Jenn explained that the lab results for my Tacrolimus (anti-rejection drug) levels would arrive in the afternoon. Jenn called me this afternoon and instructed me to reduce my dosage of this drug.

3. Our third consultation was with the pharmacist who meticulously guided Debbie through the process of filling my pill box and reviewing what medicines I take when and the dosage. We pulled the stool softeners. We also pulled the two pain meds, neither of which I've needed or used. Dr. Khan added a medication to my regimen and Debbie dashed over to the hospital pharmacy and picked it up. 

A couple final thoughts about these visits with the transplant team:

First, Nurse Jenn emphasized that because this transplant program is small, it's not only staffed by attentive professionals eager to be of help, it's also very flexible, an important fact if we ever run into problems being able to meet an appointment. The program only performs about 40-70 transplants a year. This is in stark contrast to the transplant program I originally enrolled in back in Baltimore. The staff is not inundated with patients and Nurse Jenn encouraged us to call in right away if any problems arise. 

Second, Debbie and I were very happy with this visit to the lab and the clinic, much as we were very happy with my hospital stay. 

With every conversation, we achieve a clearer understanding of what we need to do to advance my recovery, gain confidence,  and know what to do to make our way through the next several crucial weeks. 

Back home, Debbie went to Pinehurst Elementary School and worked with her students in the afternoon. 

I had no problems taking care of myself and, when Debbie returned home, she fixed us a salmon and vegetable dinner. I complimented it with a bowl of fruit and yogurt and some cottage cheese and fresh pear. Our meal was in keeping with the dietician's recommendations. 

We both hit the hay pretty early. I got rest, but not a lot of sleep. 

I made frequent trips to the bathroom all through the night and twice filled the container for my output. 

Three Beautiful Things 05-15-2024: Transitioning to Post-Surgery Life at Home, Family on the Patio, My Post-Transplant Diet

1. Today was my first full day at home after leaving the hospital. Before having this surgery, I had expected to have a much rougher time once I arrived home. I thought I'd be fatigued. I thought I'd need intensive help with caring for myself. I thought we'd be staying in Spokane. I thought Debbie was going to miss a lot of days of school.

I know for many transplant patients, it is rougher than it has been for me. 

But, I've been fortunate. 

I don't need Debbie to be at home with me every hour. In fact, she went to work for half a day today. I'm capable of caring for my catheter, preparing food, monitoring my blood pressure, temperature, water intake and urinary output, along with other monitoring I'm required to do, and taking my medicine on time. I never went in to lie down in bed today and walked around the house as needed and then a little more. 

Am I a bit anxious about being at home?

Yes. 

It makes me a bit nervous that I might forget to do something. I need to be extra cautious about the freshness, cleanliness, and cooked level of the food I eat. I don't want to screw that up.

I'm becoming more at ease with these new demands and I'm definitely in the first stages of developing new routines and certain kinds of discipline.  

2. For a while now, probably weeks, I will be living much like I did in 2020 as the pandemic grew. I can't be in public places, outside of medical facilities. Outside of family, I'm asking friends not to visit me. I'll wear a protective mask in the medical facilities and if I meet with anyone, except Debbie, indoors, they will need to wear a protective mask. 

This evening, Carol, Christy, and Paul came to our patio and we all saw each other for the first time since I had surgery. It was a good get together, not solely focused on transplant facts, figures, and updates, but also involving different things going on for all members of our family. 

3. Because of all the fluids the transplant surgeon had pumped into me and all the fluids put into my body after the surgery, I gained about seventeen pounds with this surgery.

It alarmed me at first.

I came into the hospital on Saturday weighing fewer pounds that I had in ages, having lost right around thirty pounds since November thanks to my exercise regimen and the way I was eating. 

And, then, PRESTO, over half that weight, so it seemed, was back again -- in a day!

The transplant team's dietician encouraged me to go off of the eating regimen I'd been on while losing weight, to stop tracking my caloric intake, and focus on increasing the amount of protein I eat and to fix myself meals balanced between fruits, vegetables, starches, fats, carbohydrates, and sources of protein. I will now drink a glass of milk with each meal for calcium. I'm to stay away from processed foods, limit my sodium intake, and make sure the meat I eat is cooked all the way through and make sure I clean the produce I eat. 

No more raw fish meals: I'll miss sushi. I just learned this past fall that I enjoy ceviche. It's out. I doubt I'll be able to dine at another crab feed. My food safety information had warnings about crab. No cheese made with unpasteurized milk. I'm going to need to determine if the milk in the blue or feta or brie cheese I enjoy has been pasteurized. If not, I can't eat it. 

This isn't a huge change for Debbie and me. We don't rely much on processed foods. I don't want to, but I can let go of sushi.  My diet going forward will be a matter of emphasis, especially as I focus on eating more protein which I'll do largely by eating eggs, nuts, dairy products, tofu, fish, chicken, and some other meat products. 

And I've got to remember to clean my produce and keep cutting boards and countertops clean. 

Three Beautiful Things 05-14-2024: Discharge Means Our Work Begins, A Day of Education, Getting Settled at Home

1. Dr. Khan visited me around 8:30 this morning and, having reviewed my blood work, my urine output, and evaluated my comfort level, he determined, in keeping with what I'd been told was a possibility, that today was my discharge day.

This was great news. Debbie and I both know, that at the same time the news is great, a lot of discipline and focused attention on my recovery gets underway at home. We not only need to follow a strict regimen of medicine, but I need to eat healthy meals, stay out of the sun, not have visitors (outside of family) for a while, and we need to be alert to any complications that might arise involving, especially, infection, illness, signs of rejection, and other things. 

So, from my perspective, the hospital stay was the easier part of this process with professionals on hand to take care of the things we are responsible for now. 

We will be reporting back to the transplant clinic, starting Thursday at 7:30 a.m., so I can have blood work done and we can have further education sessions and meetings and I can be further examined. The transplant team will determine on Thursday whether I need to return on Friday or if I'll be all right over the weekend and return early next week. 

In other words, the next couple of weeks will be crucial to my overall recovery. 

I have great faith that Debbie and I understand what is required of us, are ready to carry out all that we are told to do, and that we'll make this work. 

I'm very happy that I'm able to have an active hand in the things we need to do. 

I'm mobile, clear-minded, able to administer my meds to myself, and do other things that need to be done, with Debbie's help. 

I came into this thinking I'd be totally dependent on Debbie for at home care. 

I'm not. 

We are both involved in the care I need and, again, I'm happy that I'm not feeling a bit helpless.

2. Ours was a day of education at the hospital. A parade of transplant team members came to talk with me, and later, Debbie. I talked with a transplant coordinator. The dietician. A financial person. A social worker. We had a longish session with the pharmacist. Maybe others came in! 

Much of what these professional told us, we had heard before during appointments over the years leading up to the surgery itself, but, it was really good to go over these things again and to nail down just what is required for us to do in my post-transplant life. 

3. We had an uneventful trip home. I'm not to remain still or seated or lying down for long stretches of time during the day, so, as instructed, we stopped at the Huetter Rest Area between Post Falls and Coeur d'Alene so I could get out and move around a bit. 

Once home, we got settled in. 

Debbie fixed me a superb vegetable scramble and I fixed myself a bowl of chopped apple and plain yogurt. 

We began monitoring my liquid input and output. I took my Wednesday evening meds. 

I was keyed up a bit and stayed up until after 11 and went to MyChart and read in more detail the doctors' and nurses' notes about my hospital stay. 

I settled down, finally, and enjoyed a good night of sleep.  

Three Beautiful Things 05-13-2024: Possible Discharge, Transfer Out of ICU, The Comfort and Inspiration of Music

1. As I write this, it's Tuesday morning. I've had labs drawn and my guess is that the results of this blood work will determine whether I'm discharged today. If these blood tests follow the pattern of previous ones over the last two days, if my creatinine levels are coming down and my GFR is continuing to improve and since my blood pressure is great, I'm not in pain, and I'm able to get up and around, I'd say chances are good the doctor will have me discharged this afternoon. That will be an hours long process of learning what will be required of me, and of those looking after me, at home, including a schedule of when I need to return to the transplant clinic for labs and check ups. Debbie is my primary support person in all of this. 

2. I was transferred out of ICU this morning. I no longer need the more concentrated attention I was getting in Intensive Care, so today I had longer periods of time to myself. A transplant coordinator and a pharmacist visited me to begin the discharge process. I'm learning about my lifelong meds routine and about the dangers of too much exposure to the sun. I now have a thick notebook of information and instructions for life after transplant, with special emphasis on what Debbie and I will need to keep track of and chart over the next couple of weeks. 

I walked today out in the hallways, accompanied on each walk by a different nurse. It felt great to move and it's encouraging that I'm able to pull myself out of bed, get on my feet, and walk without much wobbling. All of this is possible thanks to my surgery incision/site healing up. It's doing splendidly. 

3. Having Spotify and my earbuds on hand today uplifted me considerably. I posted on Facebook last night that I brought a Peter Himmelman album back into my life, one I hadn't listened to in years, but I felt it calling me Sunday night/Monday morning and I answered its call. I'll repost what I wrote on Facebook here about how Peter Himmelman moved and comforted me. 

I turned to another source of pure delight and listened to a wide range of J. J. Cale performing songs and watched him and Eric Clapton and others perform together on YouTube. 

Here's what I wrote on Facebook last night: 

Nearly thirty years ago, I twice heard Peter Himmelman perform in concert, first in Seattle when Bill Davie opened for him and then again in Portland where I joined Peter Himmelman on stage and met his request that I do an interpretive dance. 

At that time, I listened over and over again to his From Strength to Strength album and as Sunday night drifted into Monday morning and as I drifted in and out of refreshing sleep, suddenly that album came to mind.  

When I was hospitalized in 1999 with bacterial meningitis, I found strength and inspiration listening to Peter Rowan and Jerry Douglas as well as the Oyster Band with June Tabor. 

Today I found similar strength and teared up listening to Peter Himmelman after a long absence. In particular, I felt the power of these songs: "Woman With the Strength of 10,000 Men", "Impermanent Things", and "This Too Shall Pass." 

That's all. 

I just had to put this down. 

That album connected me a lot in my life nearly thirty years ago and it's been moving today to return to it (thank you Spotify) and have it connect me to thoughts and feelings I have about recovering from Saturday night's surgery.

I don't know what spirit move me to resurrect Peter Himmelman in my music listening life. I'm going to call it holy. 

Three Beautiful Things 05-12-2024: Overwhelming Support, Recovery Continues Apace, Soon Out of ICU

 1. Thanks to Christy and Carol's posts on Facebook, word began to get out that the kidney transplant surgery went very well and the response was overwhelming as people posted positive reactions, promises of prayers healing vibes, and words of encouragement and joy that things are going well. I can't thank each person individually, but am trying to get blanket statements of gratitude out into the world so friends and family get some idea of how their support buoys me. 

2. My recovery continued apace Sunday under the care of Nurse Jane and, in the evening, Nurse Brian. My bloodwork confirmed that my new kidney was working. My creatinine levels are coming down and my GFR has been steadily improving. I did fine at mid-day eating some jello, drinking bullion, and sipping on apple juice. By late afternoon, I was able to eat almost all of my dinner, the first solid food I'd eaten since Thursday night at 10:00!

Nurse Jane recruited a helper to get me on my feet for the first time. Gradually, I was taking less medicine via IV and began to take meds orally. 

Debbie arrived and sat with me for several hours. I was not great company! I continued to sleep off and on, which was good, and Debbie got to see first hand that I had a really good day today.

3. I will be transferred on Monday out of ICU and into a regular room. I have no restrictions now, so once I'm transferred, I'll begin some physical therapy, mostly focused on getting me up and walking. I might learn some exercises, too. 

It's POSSIBLE, not guaranteed, that I'll be discharged on Tuesday. We'll see how Monday goes!

Three Beautiful Things 05-11-2024: "Report to Sacred Heart ASAP", Surgery Prep, The Surgery Aftermath

 1. Shortly before noon, after waiting for about sixteen hours, a transplant coordinator in New Jersey called me. His message: You are going to have a new left kidney. Report to Providence Sacred Heart as soon as possible." That was about it and Debbie and I pulled ourselves together and hit the road. 

2. Once we arrived at Sacred Heart and I got situated in a room, I was inundated with medical pros doing a variety of things: putting an IV port in my arm, about a dozen or so blood draws, a COVID test, and other things. Then another long wait to report to PreOp. Once transported to PreOp, the surgeon visited us and so did his nurse and after a bit the anesthesiologist dosed me with a drug that took me almost entirely out of this world and I was transported to the surgery room. 

3. I don't know how long I was unconscious, but I woke up to feeling intense pressure in my bladder while a tech performed an ultrasound on the new kidney to make sure the surgeon had inserted the new kidney into my belly without any leaks or other problems. 

I kept hearing excitement. Everyone in that room enthused about how well the surgery went. The ultrasound confirmed their joyous news. 

By about 12:30 Sunday morning, I was comfortably ensconced in my Intensive Care Unit bed and put under the care of Nurse Brian. 

The intense bladder pressure lessened. The surgery site was painful only if I moved, so when I lay still in bed (which was easy), I was comfortable, without pain. 

The surgery left my mouth very dry. Nurse Brian gave me ice chips and small sips of water to moisten my mouth, but not too much at once out of caution that I keep from throwing up.

I alternated for the rest of the night between sleep and being treated in different ways. Nurse Brian encouraged me all through the night that I was "rockin' this transplant" and that my recovery already was moving along speedily. 

I kept thinking of all the trips I've made since November to the rehab gym and to the Fitness Center and concluded that working out prepared my body very well for this surgery.

Three Beautiful Things 05-10-2024: Possible Transplant, Fun Day Trip to Montana, Pasta for Dinner

1. Today began with a couple of phone calls from two different transplant coordinators. A kidney that looks like a match for me might be available. I should find out more about what's next some time Saturday morning. Originally, it looked like I'd know today around noon, but there was a delay with the donor, so I was instructed to begin fasting at midnight and await a Saturday morning phone call.  

2. Diane, Stu, Ed, Joni, and I had a fun time traveling together to Trout Creek, MT to check out the vacation rental house about seven miles out of town that we've reserved for a 70th birthday party -- details forthcoming. We unanimously and enthusiastically approved of the house after our walk through. After our inspection, we went to the town of Trout Creek itself for a fun lunch at the Wayside Bar and Grill and then we returned to Kellogg where Ed and I yakked over a beer at The Lounge. 

3. I made Debbie and me a zucchini spaghetti dish featuring a white sauce and roasted panko and chopped green onions on top of the pasta. I had a lot of fun making this dish. It was my attempt at a variation of a Hello Fresh meal and making different parts of the dish without packets.  

Three Beautiful Things 09-09-2024: Transplant Limbo (Again), Breaking in My Wok, *House of Games* (1987)

1. It's 8:30 on Friday, May 10th. 

As I write this blog post, I'm on standby again for a possible kidney transplant. If my daily blog posts stop appearing tomorrow, it'll be because I got called into surgery.  

UPDATE: Soon after I wrote the above sentences at 8:30, a transplant coordinator called me. The whole process has been delayed. Now the plan is for me to start fasting at midnight. The transplant coordinator will call me, I'd say, around 9:00 a.m. to tell me whether things are working out or if the transplant procedure had to be canceled. 

2. Today was a day of just getting things done: recycling, shopping, monthly blood draw for the lab that serves the transplant program, and, most important, seasoning my new wok.

I took my time seasoning the wok and then I made a killer stir fry with onion, tofu, broccoli, red bell pepper, green beans, and mushrooms. I made a Szechuan stir fry sauce and I cooked a pot of jasmine rice enhanced with green onion, ginger, and sesame oil. 

I have a lot to learn about cooking with the wok, but as a first attempt, Debbie and I both thought this dinner was very delicious. 

3. I finished watching House of Games, a neo-noir psychological crime movie from 1987. It features Lindsay Crouse as a psychiatrist and author who meets a con man played by Joe Mantegna and for reasons having to do with her own psychological profile, joins a sting operation. It's a dark movie. I found it both riveting and perplexing. David Mamet co-wrote the script and directed the movie. The script features Mamet's trademark minimalist style. Over the last forty years, I've never been able to decide what I think of his scripts -- and, in the case of this movie, I'm undecided about what I thought of the story -- on the one hand, it was a bit like watching a dark, noir version of The Sting. On the other hand, it seemed to be mining some deeper aspects of human behavior and psychology and I'm uncertain just what the movie was getting at.   

Three Beautiful Things 05-08-2024: Facebook's Finicky Filters, Sprinkler System Running, Copper Gets Friendly in the Vizio Room

1. I've grown weary of having the artificial intelligence at Facebook reading my daily posts providing a link to this blog as spam and taking them down. 

So, regretfully,  I'm done using a URL shortener and providing friends with a convenient way to click right to my blog. 

I'll still post on Facebook that I've posted a new blog entry, but anyone interested in reading will have to type kelloggbloggin.blogspot.com in that long rectangle at the top of their browser and visit my entire blog. 

At a later date, I'll try posting the link to my daily post again and see if the Facebook robots continue to read my posts as misleading, as spam.

2. Keith from Peak Sprinklers came by this afternoon and got our sprinkler system on line. The system needed one minor repair and a few sprinkler head adjustments. Now it's ready to go. I'm not sure when I'll start watering the lawns. 

3. Debbie has been really wiped out this week. This evening, again, she went to bed very early.

Once again, Copper got to spend more time than usual in other parts of the house. 

I retired to the Vizio room and watched about forty minutes or so of the movie, House of Games. 

I'm into the movie, but what I was really into was having Copper, for the first time ever, jump up on the arm of the chair I was sitting in and be close to me. 

Once or twice I thought he was going to (finally) come on to my lap. He didn't, but he spent quite a bit of time on the chair's arm, letting me pet him. 

I'll finish the movie some time on Thursday. 

Will Copper join me again? 

I hope so.  

Three Beautiful Things 05-09-2024: Ah! J. J. Cale!, Fixing Ramen, Copper Enjoys Bonus Time in the Living Room

 1. Over the last, oh, five years or so, I've become increasingly enthralled with J. J. Cale. I always knew he wrote songs like "Cocaine" and "After Midnight", songs Eric Clapton covered. I also knew he wrote "The Breeze", a song Lynyrd Skynyrd made popular. Back in about 2019, out of the blue, I purchased J. J. Cale's double CD entitled, Anyway the Wind Blows: The Anthology. I started playing it a lot on in the Sube, especially on a few road trips, and one by one its songs got inside me, seriously grew on me, and I found YouTube videos of him performing, whether solo, with one of his bands, and with Leon Russell or Eric Clapton among others. I was hooked. 

Today I dialed up J. J. Cale's anthology album while I exercised my legs and arms and wind at the Fitness Center. 

I hardly noticed my muscles getting tired or the rate of my breathing increasing. 

J. J. Cale enthralled me. 

2. I had a blast cooking a new, for us, HelloFresh meal tonight. All I had to do was boil and drain Chinese noodles, run cold water over them, make a delicious broth, and sauté some mushrooms and cover them in soy sauce. Combined, the broth, mushrooms, and noodles formed a deeply delicious bowl of ramen. 

It worked! 

3. Debbie arrived home from school exhausted, much more tired than usual. The long phone call she had last night in addition to a challenging day in the classroom wiped her out. She and Gibbs went upstairs to bed much earlier than usual.

That meant Copper got to spend more time than usual in the living room and kitchen.

He wandered around a bit, hopped into a plastic box that's on the floor, and meowed at me some. Soon he relaxed, curled up on the rug not far from where I sit in the evenings, and was content. I put wet food in his bowl in the kitchen for him. He nibbled at it and returned to the rug. 

When I gathered myself and cleaned up to go to bed, Copper didn't immediately follow me into the bedroom the way he usually does.

He stayed in the living room longer. 

He didn't want this evening of bonus time in the living room to end. 

Three Beautiful Things 05-06-2024: Copper's Change of Venue, Cardio and Weights, Enjoying the Movie *The Lincoln Lawyer*

1. Copper wanted a change of venue this morning and demanded that I let him in the Vizio room. No problem. (He didn't have to be so bossy!)  He likes the chair in that room and seemed content to spend the day relaxing on it. With the bedroom vacant, I pounced on the opportunity to change the bed's sheets, a simple task made even easier when Copper isn't present to insist on being on the bed while I strip it and put fresh sheets on. 

When he returned to the bedroom late this afternoon, I thought I could see a glint of gratitude in his eyes, as if he were thanking me for not messing up his sleep and rest by changing the sheets with him in the bedroom. 

2. Until today, my focus at the Fitness Center has been on the cardio machines. I worked out on one for forty minutes today, listening to the Allman Brothers' stellar album, Brothers and Sisters, and then to selections Spotify selected on their Allman Brothers Radio channel. I then worked out on about a half a dozen weight machines, concentrating on my shoulders, back, abdomen, chest, and arms. 

3. Debbie told me she planned to have a long telephone conversation this evening in the living room so I retired to the Vizio room and watched Matthew McConaughey and Marisa Tomei in The Lincoln Lawyer. For some reason, clips from that movie have been showing up frequently on Reels on my Facebook page. In those clips, McConaughey bringing his character, Mick Haller, to life fascinated me. Enough time had passed since I first watched this movie that I'd forgotten all the plot details. 

It was just the kind of movie I was in the mood for. It's a solid and entertaining crime and courtroom drama. I enjoyed how McConaughey animated the contradictory character of Mick Haller, a lawyer working out of his 1986 Lincoln Town Car, who is by turns shrewd and gullible, unethical and conscientious, and dissipate and responsible. 

Afterward, I randomly selected a couple episodes of Chopped and tried to commit to memory some of the cooking techniques and insights the contestants and the judges articulated, but I'm not sure they ever really stick in my mind. 

Maybe I should take notes. . . . 

Three Beautiful Things 05-05-2024: Mixing Maple-Bourbon Smashes, Kentucky Derby Family Dinner, Lively Yakkin' at Christy's

1. I experienced today as a BIG day in our family. Christy decided to plan what I thought was an ambitious family dinner centered on the cuisine of Kentucky since this was Kentucky Derby weekend. Christy assigned us each a course for tonight's dinner and it was up to each of us to read up on Kentucky food and drink and figure out what we wanted to make. 

Christy assigned me to make tonight's cocktail. 

I thought making mint juleps seemed too predictable. 

I looked at Kentucky cocktail recipes and liked what I read about a Maple-Bourbon Smash. 

It was a moderately involved cocktail, requiring me to squeeze fresh orange and lemon juice and to muddle orange wheels, but I made the drinks at home and carried them to Christy's house, using a casserole baking pan as a tray. 

Here's what I did: in each glass I combined maple syrup, orange juice, lemon juice, and bitters. I stirred these ingredients before dropping a half an orange wheel into each glass and muddling it. I then added a couple ounces of Bulleit Kentucky Straight Bourbon, put ice cubes in the glasses, and topped each cocktail with seltzer water. 

2. I have trouble keeping track of every detail of the food offerings at family dinner. I always depend on Christy's family dinner Facebook photos and descriptions to get things straight. 

As I write this post, Christy hasn't posted her family dinner pictures and descriptions, so I'll do the best I can, but I'm sure to have some details either mixed up or wrong! 

To our Kentucky family dinner, Molly contributed just a bit larger than bite-sized crustless sourdough sandwiches featuring a blend of cream cheese, dill, sour cream(?), and other tasty ingredients. Her contribution got dinner off to a delicious start.

Soon, it was time to dive into the main course featuring Debbie's butter lettuce salad with bourbon vinaigrette dressing, Paul's cheese wafers, Christy's spinach cheese bread, and, the heart and soul of this meal, Christy's Kentucky Hot Brown Macaroni and Cheese. 

If my memory serves me correctly, Christy originally wanted to make a popular Kentucky Derby Day entree called Hot Brown, a combination of turkey, bacon, and cheese sauce served over Texas toast -- it's a kind of Kentucky version of Welsh Rarebit. If I heard Christy correctly, she concluded this dish was too complicated for her to make in her small kitchen -- and maybe too complicated to fix for six people.

Therefore, Christy learned about another "Hot Brown" Kentucky dish:  Kentucky Hot Brown Macaroni and Cheese. She made it. It, along with the salad, wafers, and bread, was awesome, combining to make this one of my favorite family dinners ever. I'd love to return to a similar dinner one day -- but maybe we'll have to wait for next year's Kentucky Derby! 

But, wait! 

We weren't done yet! For dessert, Carol made a splendid butter cake with a bourbon icing. So we had a bourbon cocktail, bourbon vinaigrette on our salad, and a bourbon-y dessert. 

Especially for us bourbon lovers, this whole meal was out of sight, but it was out of sight for all the rest of the food, too. This dinner was flavorful, comforting, and innovative. 

Let's just say IT WORKED! 

(My apologies in advance to the other family members if I got anything wrong in this summary. If I learn I did, I'll go back and make corrections, but for those of you reading this post via email, you won't see the corrections unless you were to go to my blog at www.kelloggbloggin.blogspot.com -- but why would you do that! Just trust my description is pretty close to accurate!)

3. Do you have an internal voice in your head that you listen to, that tells you to be quiet some times, that advises, admonishes, encourages, and does other things in your mind?

This was a topic of an involved conversation at dinner tonight. 

So was the Fitness Center. And the evolution (some would say the devolution) of language. We talked a little bit about the Kentucky Derby. Debbie talked some about her work. We told stories, both fictional and non-fictional, about the history of our food offerings. (Okay. I'll own up. I'm the only one who made up a fiction about my offering.)

As always, our discussions were wide-ranging, peppered with laughter at times, but also serious. 

There's always a lot going on for the six of us enjoying dinner in Christy's living room.

Three Beautiful Things 05-04-2024: Solo Strolling in Wallace, Diane Joins Us at The Lounge, Spicy Vegetables

1. I got up this morning wanting to exercise in a different way. I decided to walk the streets of Wallace, get some steps in, and see how things were in this morning in the Center of the Universe. I'll return to the Fitness Center on Sunday or Monday. 

The Center of the Universe was quiet and very slow around 11-12 o'clock. 

I was a nearly solitary figure. 

I stopped in at Todd's Bookstore, in the mood to possibly purchase a book about animals. The bookstore has a small selection of books, but of high quality! I wasn't moved to purchase any of them, but liked what I saw a lot. (I didn't see any books on animals....)

I wasn't in the mood for grabbing a bite to eat or drinking anything in Wallace I might have ordered some chicken wings, munched on a taco, or enjoyed a coffee drink or even an early in the day beer or cocktail if I'd had company, but I just didn't feel like sitting anywhere by myself. 

I was content to be alone, with my thoughts, on foot.

2. Back in Kellogg, later in the afternoon, Debbie and I headed up to The Lounge. Diane texted me while we were there and before long she joined us. It was great. Diane's been out of town and she told us all about her travels to Arizona and Mexico. Diane and I are working on details for the 70th birthday party later in the year and I think we can iron it all out early this coming week. 

3. Debbie is doing some rearranging in the kitchen, so plates, glasses, cups, and other things are out of the cupboards. I wondered, as we were sitting there (and before Diane we heard from Diane), if it wouldn't be easier for us to have some Wah Hing food rather than fix a meal at home. 

We agreed it would.

Our dinner was awesome -- we shared an order of pot stickers and split an order of Vegetables Szechwan Style. I loved the spicy heat of the vegetables and how they were stir-fried just right, cooked through, but still with a crunch. 

Our Saturday late afternoon/early evening session at The Lounge was superb. I drank a lot of soda water after having one VO and water. Only having one cocktail worked especially well for me.  

Three Beautiful Things 05-04-2024: Trip with Debbie to CdA, We Love Daft Badger, Finally -- A Wok

1. Debbie had a 4:00 spa appointment in CdA this afternoon. She asked me to drive her to it. No problem. We piled into the Camry at 7:00 this morning, I drove her to work, and then picked her up at 3:15 for an easy drive. While Debbie was meeting her appointment, I wandered around Costco, looked at some clothes, didn't buy any, picked up a few pantry items, looked for a wok, didn't see one, and, by then, it was time for me to head back to the spa and pick up Debbie.

2. We then made a very smart move. The spa is just a few blocks east of Daft Badger and we decided to go over with the idea of enjoying a beer together. I knew, however, if I were going to drink a mighty craft beer at Daft Badger, I also needed to eat -- and Debbie agreed!

I ordered a 12 oz glass of  Daft Badger's mightiest IPA, the Daft Bounty, weighing in at 9.0% ABV. It had been many many weeks since I'd drunk an Imperial IPA, but I looked forward to tasting Daft Bounty's aggressive pine and grapefruit, hints of sweetness, and its pleasing bitterness. The beer came through! I very slowly made my way through the beer and then our food arrived.

We split this week's sandwich special, a chicken torta. I'll quote the eloquent words of the menu to describe this most pleasing and delicious special:  A Mexican style sandwich made with tender chicken on a telera roll with a house-made pico de gallo, an avocado spread, refried beans, and Monterey Jack cheese.

We also split the garbanzo bean salad that came with the sandwich. 

Everything about our visit to Daft Badger was perfect. 

My beer and Debbie's Blood Orange IPA were most satisfying. Our server was friendly, attentive, and responded perfectly to our request to have some time to enjoy our beers before we ordered our food. 

In addition, Daft Badger is a most comfortable and handsome physical space. I hadn't been to Daft Badger for quite a while and, today, I marveled anew at its simple, efficient, and attractive use of a relatively small area and how this brewery and eatery can serve a good number of people but not feel crowded. 

I credit all of this -- the great beer, the delicious food, and the superb environment to the genius of Darrel Dloughy. What I see at Daft Badger is a vision of a brewery and eatery tucked comfortably in a residential neighborhood that is integrated into its surroundings and mindful of being a good neighbor to the people who live nearby and that produces superb craft beer and perfectly conceived and executed menu items. It embodies the best in what a locally owned business deeply invested in the culinary and cultural well being of its city can be. 

3. Since Christmas, I have been sitting on a gift card from Amazon. This evening, I consulted Wirecutter, the product testing site at the New York Times, to find out what woks they had tested and what Wirecutter recommended. It turns out I liked the sounds of their #2 recommendation. Yes, it cost more, but it's pre-seasoned and is heavier than the their top choice. So I ordered it along with an iron wok cover and two long-handled utensils, a wok ladle and a wok spatula. 

It's about time I made this move. 

The only thing that's held me back is my aversion to adding new kitchen stuff to our small kitchen space or to our storage shelves in the basement. 

Tonight, though, I overcame that aversion, trusted that I would figure out a good way to store the wok in the basement, and threw aversion to the wind and made the order! 

Three Beautiful Things 05-02-2024: (A Note About Facebook's Spam Filters), Cardio and Dickie Betts, Chicken Dinner Redux, L. A. Riots Podcast

A note: Over the last week and a half, the spam filters at Facebook have, about four times, found it in violation of Facebook's community standards when I post that my most recent blog post is up. Each time, the notification that my post has been removed has told me that I am trying to get likes, follows, and shares in a misleading way. 

I'm puzzled by this development. I'm going to see if it's not so misleading if I just say "Here's my most recent blog post" and leave out the advance notice of what three things you'll find in the post, should you click on the link. Each time a take down has happened, I've reposted the blog post link and presented it in a different way than when it was taken down. These reposts have not been flagged by the spam filters. 

A person can always find my blog by going to www.kelloggbloggin.blogspot.com. I also email my daily posts to about fifteen people and would be happy to add anyone to my email list who would like to read my blog posts this way. 

Cheers! 

This spam filter thing is a nuisance to me, but not a big deal. 

It's puzzling, but hasn't moved me to rant! 

1. Today, I once again worked out on three cardio machines. I mentioned yesterday that I increased the amount of time I exercised. Today I increased my time and the number of calories burned just a bit. Once again, listening to Lou Simon's Jukebox Diner helped make performing repetitious tasks an enjoyable experience, especially when he and his callers remember the life and genius of Dickie Betts. 

2. At Debbie's request, I pretty fixed a very similar dinner to last night's. We had some party chicken wings left over, but I seasoned and baked two regular drumsticks. We ate all of our teff Wednesday night, so today I roasted baby Yukon potatoes in the same pan with the drumsticks. I covered both the potatoes and the chicken with sesame seeds. We had some sautéed vegetable left from Wednesday, but we needed more so I repeated what I'd fixed on Wednesday with one change: tonight I scattered chopped green onion over the vegetables when they were done cooking. 

It all worked! 

3. It's an intense podcast. We listen to about one episode per week. But the series of Slow Burn episodes focused on the Los Angeles riots of 1992. The series began with an episode devoted to what happened the night police officers beat up Rodney King and how the incident came to be videotaped. 

The second episode examined the murder of fifteen year old Latasha Harlins thirteen days after the Rodney King beating by Soon Ja Du in the convenience store belonging to her and her husband. At trial, Soon Ja Du was found guilty not of murder, but of voluntary manslaughter and the judge suspended her prison sentence and instead placed her on five years probation with 400 hours of community service and fined her  500 dollars along with Latasha Harlins' funeral costs. The outrage over this light sentence and the failure of an appeal attempt contributed to the targeting of Koreatown during the 1992 riots. 

Tonight we listened to the third episode. It focused on the Los Angeles Chief of Police Darryl Gates, the overall nature of policing under his supervision in Los Angeles, and the efforts to remove him from office after the beating of Rodney King. 

Three Beautiful Things 05-01-2024: Removing Clutter, Cardio with Lou Simon, We Ate the Remaining Teff!

1. It's so easy. The transfer station is easy to drive to, rarely very busy, and simple to negotiate once I get there. Our cardboard, seltzer cans, and newspapers needed to be cleared out of the garage and so I took them up and recycled them. I never tire of this job or of keeping the garage as free of clutter as possible. 

2. I increased the time I spent on the three cardio machines I huffed and puffed on today at the Fitness Center. Lou Simon's Jukebox Diner show on the Sirius/XM app is perfect to listen to, especially for longer periods of exercise. The show runs for four hours and features a great mix of songs, phone discussions, and requests. I always learn stuff I never knew -- not all of it sticks in my memory, but at the moment I'm listening to it, it's a lot of fun.

3. Debbie asked me to build tonight's dinner around our left over teff. So, I seasoned a package of party chicken wings with salt, pepper, Old Bay seasoning, and red pepper flakes and baked them. I warmed up the teff and I sautéed a large pan of mixed vegetables. I seasoned the zucchini with tarragon and peppered the white onion, but let the flavors of the mushrooms, spinach, green beans, and red bell pepper express themselves -- which they did very tastily! 

  

Three Beautiful Things 04-30-2024: Stability, The Nook and Home Again, Sun-Dried Tomato Spaghetti

1. If you read the blog post I wrote yesterday, you know that my instability over the years has been on my mind. Actually, it always is. It's a state of being I do my best to ward off. I do my best to foster stability in my day to day life and not give in to swings in temperament or into stupid, even destructive, behavior.

One area in my life that has been almost miraculously stable has been my renal and pulmonary health.

Today, I met the next of my every six months appointment with Dr. Jespersen, a pulmonary specialist. 

I carry infection in my respiratory system from the Zinc Plant accident that I luckily survived in 1973.

For years, the damage to my lungs has not progressed. 

It's remained stable. 

Dr. Jespersen examined x-rays from three weeks ago. I'd read the written report that accompanied those x-rays and it asserted there'd been no change in my condition since the last images were taken a year ago.

Dr. Jespersen agreed.

The doctor encouraged me to keep going to the Fitness Center, remarked that the transplant program must be pleased that I've lost weight, and determined that I didn't need any more pulmonary testing at this time. 

I will see Dr. Jespersen again in six months. 

He reminded me that if between now and then I have a kidney transplanted into my system, that it's possible I could experience pulmonary complications connected to my immune system being so heavily minimized. 

Should that happen, he instructed me to contact him right away. 

2. Overnight, I thought it might be fun, after this appointment, to go to Spokane. Instead, I went to the Breakfast Nook, enjoyed a substantial breakfast, fueled the Camry at Costco, and headed home. I was tired. I'd had an up and down night and wanted to return home to rest and nap. So I did.

3. Debbie and I let HelloFresh choose the two meals a week we order from them. I find it fun to open the box when it arrives on Monday and be surprised by what's inside.

So, that this week's box included one of my favorite meals was a welcome revelation.

I fixed that old favorite this evening: Sun-Dried Tomato Spaghetti with Fresh Parsley, Almonds, & Parmesan.

I didn't take much effort.

I roasted the almonds, boiled the spaghetti, and sautéed the chopped sun-dried tomatoes with garlic. I added water, chicken stock, grape tomatoes, and a little cream cheese, parmesan cheese, and butter to the pan of ingredients and cooked it all up. I went outside the recipe and added Italian seasoning and red pepper flakes to the sauce to enhance the flavor and give it what Debbie and I always enjoy: a little heat. 

In separate bowls, I dished out the spaghetti, topped it with the sauce, and garnished it with parsley, almonds, and parmesan cheese. 

It worked!