You’re in the Hat

Feb 14/15, JD writing:

At 6a.m. on Valentines Day the outside temperature in the backyard was -14º (F).  The previous night my hand-made valentine’s card was printed out and rolled into a long-lost blue vase, put on the table next to the bed for when Kate would wake.

 

Two weeks previously the Dialysis Center had given us again a graduated orange plastic 4-liter container that looked like a lost milk carton. Along with the container came 2 hats as they’re called, that using your imagination you could picture Napoleon’s soldiers wearing them.

We got tired of looking at the hats and the orange container in the entry hall so Sunday Valentine’s Day was the start of a 24 hour collection of Kate’s urine. Every 3 months the Center wants (at least they say) the collection...another chore that proves you the patient can obey rules and make a good transplant candidate...

One hat gets taped (“upside down”) to the bowl of the downstairs toilet, and the other to the toilet in the upstairs Blue Bathroom. Good thing there’s the Green Bathroom, for me, the non-patient. Every six hours or so I empty the hats’ contents into the orange 4-liter and re-tape them back down.

On Monday morning her total this time was about 1100 mL. Over the three years on dialysis she’s ranged from 900mL to 1400. The calculation for normal production is this: 1mL/kg/hr. → 24 hr * 56 kg = 1344mL, so she was about 20% below normal this time.

The Center analyses her urine for “waste” products... urea and nitrogen. On a scale where 15 would be normal, and 10 the minimum needed to avoid dialysis, Kate is about a 4, so 40% of the minimum needed to be “healthy” is done by what is probably the 2% kidney function remaining. Over her 3 years of dialysis her percentage hasn’t changed much.

As far as we can tell, Kate is the only patient in her Center who produces urine worth measuring. An indication, I suppose, of her relatively good health. 

Still, it is a messy chore. We’d like the Center to be more enthusiastic about their request for the 24 hour urine. But bringing the orange carton back--lid screwed on tight--starts a game of hot potato: Don’t put it on the waiting room counter, don’t put it on the nurses’ station counter, put it over there in the corner...

And finding out later that the chemistry results are just like they were 3 months ago is a little disappointing... Better? Worse? Why not wait for six months next time?

But heck, this time we weren’t going anywhere. With the temperature below zero all day what else was there to do but stay inside and collect urine?!