Dialysis from the sharp end of the needle

Week two, seven days of work

By Bill Peckham

My comment to Week One was wrong, the pay period is Sunday to Saturday, which means 36 hours for week one but those Sunday hours last week count towards this week's total of 60.5 (today's hours will count to next week). I can see down the road not wanting to work this many hours but right now I want them and I'm keeping up. I always think of overtime as going towards travel, the old formula was four hours of overtime to one day of travel. These days, I need to budget more for accommodations (I'm feeling my years) so now the formula should probably be five to one, thus I had 20 hours of OT so I have four days of travel banked.

My body has definately aged - !shock! Those first few shifts left me stiff and sore but it  is getting easier. I started off the year and through the first week of working dialyzing in the evenings without heparin. A long story short, I slipped and fell on New Year's Eve day (I was sober), landing on my backside, which left an immense bruise and required the change in dialysis modality: shorter, faster, heparinless. Dialyzing in the evening, after working all day, is a hard schedule to maintain, there isn't any margin for something to take longer than expected, and something always takes longer than expected.

For the last couple of treatments I have been back to overnight, extended runs while I sleep, which is much easier on the schedule. Without having to fit in dialysis right after work, I now can address my current scheduling challenge: making time in the work week for iron repletion at the clinic and my monthly doctor's appointment. If I could just teleport from place to place it would be much less of a problem.

Habilitated to dialysis

By Bill Peckham

My second or third shift was at the GES warehouse. I had no idea what the shift would be but it turned out to be working for T in the sign shop (it wasn't a graphics department yet). I probably worked 25% of my shifts in the sign shop my first year in the union. It was definitely my preferred shift.

I don't know what the state of the art was in 1995 sign making but we made signs mostly two ways - either cut vinyl or with an ink press Gutenberg would recognize. At first I just helped but over time I had many shifts making booth identification signs on that press. Making signs old school.

Each booth at a trade show gets a 7" x 44" cardboard booth ID sign with the company name, often a booth number and sometimes city, state. It's still true today, but whereas today the sign stock is autofed through a modified desktop printer, back in 1995 ID signs were hand crafted using blocks of wood or metal. The work was to arrange the wood blocks as the sign would look in a mirror - reading right to left and then pressing the cardboard stock down on the inked wood letters. In all it was a pretty elaborate process to make 300 booth ID signs. Hour after hour of repetitive, finger staining work and after an eight hour shift I couldn't read a newspaper ... but I liked it in a love hate sort of way.

I think in 1996 a wide format printer was added to the sign shop's tools and more and more we were adhering computer printed paper to a substrate (foam board or card board). I think in 1997 I made my first signs for Northwest Kidney Centers, probably 15 or 20 to cover all the NKC units, probably to announce a patient picnic. Making those first signs was my first volunteer activity for NKC but since then I have been an NKC volunteer in many different ways, but making signs has been an ongoing activity. The total number of signs I've produced for NKC would have to number closer to 2,000 than 1,000; both companies I've worked for - first GES and now Triumph - have been willing to donate the sign making equipment and materials, so that I could make signs on my own time after hours.

Thus, Working directly led to Volunteering. If I hadn't started making signs for NKC it is hard to imagine that I would have become so involved in the organization. Work equals Travel, but it is also true for me to say: Work allows Volunteering. The three activities together - work, travel, volunteering - add up to evidence that I am habilitated to dialysis. If rehabilitation is the restoration of skills, habilitation is the maintenance of maximum self-sufficiency and function in a normal or as near normal manner as possible. I'm habilitated.

Day one, at the base of a hill

By Bill Peckham

DSEN has taken a turn, hasn't it? It went by fast these last three years ... someday I'll have to tell you about it. But for me, for now, I have been given the opportunity to go back to work and I welcome the chance. 

My immediate goal is to work 330 hours by April 1. If I do that, I earn three months of health insurance (including dental) starting May 1; 330 paid hours in a three month period is just the first step but everything else depends on it. I work through the carpenter's union as a tradeshow specialist, something I've been doing for 16 years. The union's health insurance is very good, it reimburses for charges not covered by Medicare, for instance dialysis abroad.  

Work = Insurance, Insurance = Travel, thus Work = Travel ... I figured out that little equasion about 6 hours into my first union shift in January 1995. It was the Seattle Boat Show, which was going in at the old Kingdome, former home of the Seahawks and Mariners. A college friend worked for GES, a big national tradeshow company that was setting it up, and they needed bodies to fill out the install crew. The union had an open call.

This being the days before Facebook, I think K called me to get access to some of my lay about friends. Since my transplant had failed in 1990 I had been using dialysis and mostly not worked, but K and I had been to Burning Man the previous Labor Day Weekend so maybe she thought I would be willing to do it. It was an overnight shift carpeting the 100 Level of the Kingdome for the show opening the next day.

We had to kick out rolls of 9' wide carpet and tape them down. The 100 Level had to have been half a mile around; the crew I was on carpeted it, one roll of carpet at a time, all night. Some of the rolls were 100 footers and it took three guys mule kicking it in sync to get it to roll out, others were shorter and could be handled alone or with one other guy. Once the carpet was kicked out it had to be taped down on all four sides. There were rolls and rolls of 2" double stick tape. This went on through the night, we had a 30 minute lunch dinner food break about 2 in the morning, plus the 15 minute union break every two hours.

It was about as bad a first shift as it sounds, but it was also fun and exhilarating. To just work, to be working. The physicality of it, the camaraderie, the bitching. I was so physically tired, my muscles so sore but as physically tiring as it was, mentally it was energizing. It was like waking up. Maybe this experience is why FixDialysis with its focus on Re/habilitation speaks so strongly to me, I know it can be done and there was a time when I didn't think it was possible. But after that first shift I took another, and then another. I would dialyze incenter three days a week and take shifts that fit. By 2001 I had switched companies, jobs and dialysis modalities.  At work I spent a lot more time at a computer than I did on my feet and at home I dialyzed, first on the B Braun then on the Aksys PHD. These were good years. Years of work, travel and volunteering.

By the time I started DSEN over Christmas 2007 I had increased my commitment to volunteer activities at the cost of deemphasizing work, and for the next three years volunteering was a priority. These too were good years, I'll take the good and the bad. I feel like I made good use of my time away from work, immersed in CKD advocacy and the provision of dialysis, but now I need to get back on the clock. It is time for me to reemphasize work, regain health insurance and start visiting new countries. Work still equals Travel.

The tradeshow business follows a business cycle, the season starts about now and goes to the weeks before Thanksgiving with a slow period usually in the summer (August conventions? Not popular). Today was my first shift of the new year. I'm back on my feet, working in the graphics department as production lead, which should keep me busy if I can keep up. 

A lot of water has passed under the bridge since I last worked on my feet, week after week, month after month. For now DSEN will mostly be reporting from this journey to 330, however, I can't help but keep an eye on industry news and trends, in advocacy, reimbursement, politics and the provision of dialysis. But for now, certainly for the next three months, DSEN will be about me, work, and thoughts on what it means to be rehabilitated. I'll tell the tale of combining dialysis, volunteering and work, with the emphasis on work ... and if the plan comes together dialysis, volunteering, work and travel. (Spoiler alert: To me rehabilitation means being able to do all four).

I had 7 hours and forty five minutes clocked today; my feet are tired; my back hurts; I need a shower.