Friday, June 25, 2010

Steve Makes a Break for It!

In the hospital since March 2, 2010, Steve's got cabin fever! He's making good progress. We are hoping to get him home in July. But Steve apparently tried to escape!!

Here are the photos and comments of George Mead, Steve's very long-term friend (and the son of my junior high math teacher!). In the first photo, we see Steve with one of his Physical Therapists, Kelli.

As George says (all in fun), "Kelli does her best to keep Steve in her life, but Steve needs his freedom. He does his best to let Kelli down gently."

(Likely story!)

In the photo at left, George says, "Steve jacks up his courage with an unauthorized beverage. To the untrained eye he's just enjoying the passing scene at the Starbucks center at Providence Hospital. He's very close to an unguarded door."

Then, in the final photo below, George writes,

"CODE PURPLE! Steve is outside for the first time since March 2nd, 2010. His cover story is that he's a tourist who accidentally mistook the hospital for a museum.

His sister Carole lends an authentic touch as Steve mingles undetected in the outdoor plaza. It's worth noting that Seattle enjoyed its first warm day [above 75ยบ] since September 2009. It's also worth noting that Steve isn't fully in control of his middle right hand fingers."

Steve, we can't wait to get you home!!!

What a journey! Thanks, George, for the photos and text.
Take care. Linda Gromko, MD

Thursday, June 24, 2010

Join Jane McClure and me for Home Dialysis Central Webinar June 30!

Jane McClure and I, co-authors of "Arranging Your Life When Dialysis Comes Home: 'The Underwear Factor,'" are presenting a Webinar:

"Care for the Care Partner in Home Dialysis"

Wednesday, June 30 at 5:00 p.m. Pacific Daylight Time.

We'll examine:
  • the impact of ESRD on the Care Partner
  • the spectrum of what it involves to be a Care Partner
  • the advantages for the Care Partner
  • recognizing signs of Care Partner "burnout"
  • supporting the Care Partner to prevent and treat "burnout"

Essentially, we are devoting our entire Webinar to the Care Partner - that most critical, yet often under-recognized part of successful Home Dialysis!

Visit for more information.

By the way, this seminar applies to Care Partners in ALL circumstances!
Take cae. Linda Gromko, MD

Sunday, June 20, 2010

Critical Illness Myopathy Challenges the Caregiver's Reserve

After almost three weeks in the Inpatient Rehab Unit with aggressive Physical and Occupational Therapy, Steve has made progress, but it has been slow. His condition has been defined as "Critical Illness Myopathy/Polyneuropathy." Evidently, Critical Illness Myopathy/Polyneuropathy is a global and profound weakness of muscles and nerves which typically follows a prolonged ICU course and/or sepsis. The condition can lift over time. But it may take many months.

So, as we think ahead -- and as we have recently learned that none of the Skilled Nursing Homes that take Medicare will even accept Steve, we turn again to Home Care.

One of the Rehab staff asked me how it would be different to do Home Dialysis with Steve now, as opposed to before his lengthy hospitalization. The differences are obvious. Before, Steve could sit up by himself. He could walk. He could weigh himself, take his own blood pressure, and generally participate more in his care.

He's medically more stable now, with a vastly improved left ventricular ejection fraction of 45-50%. And, his brain looked normal on this week's head CT.

As long as the Kidney Center approves, we will resume Home Hemodialysis soon. This will mean five treatments a week - but no transportation to and from a Center. The transportation wouldn't be covered by Medicare anyway, and it would be enormously disruptive and uncomfortable for Steve.

We turn to Home Dialysis again, with the hope that it will buy us more time until this perplexing condition of Critical Illness Myopathy runs its course.

We are so grateful that he is alive, and mobility via wheelchair  would certainly work. We both just want him to live as well as he can.

So send good wishes for us in this new chapter. This is a road we haven't traveled before, and we welcome all the support we can find.

Take care. Linda Gromko, MD

Wednesday, June 9, 2010

Arranging Your Life When Everything Goes to Health!

When Jane McClure and I wrote "Arranging Your Life When Dialysis Comes Home: The Underwear Factor," it became clear that our concepts could be generalized to an audience beyond the Kidney Community. Many people deal with chronic medical conditions in one way or another. Whether that means healing a broken limb, or dealing with an elderly parent, chronic health care in the home touches all of us.

Dealing with a chronic medical condition changes the way we live. Yet, we find that people spend more time preparing for a new baby than they do for other life-changing medical circumstances.

As Jane and I worked on "Arranging Your Life When Dialysis Comes Home," we realized that if you can manage Kidney Dialysis at home, you can manage just about anything!

So, we are presenting a seminar entitled "Arranging Your Life When Everything Goes to Health!"

Our first seminar will be presented at the Bainbridge Island Public Library on Sunday, July 11th from 1 to 4 pm. There will be a $25 fee for this seminar, with scholarships available.

Later seminars will be presented in Seattle at the Queen Anne Square Building at 200 W. Mercer.

If you would like to attend the July 11th seminar on beautiful Bainbridge Island, please contact me by email at or by mail at 200 W. Mercer #104; Seattle, WA 98119 -- we'll send a brochure.

Do you know of others who might benefit from such a seminar: church groups, caregiver support groups, etc.? Please feel free to pass this on to anyone who might benefit.

Take care. Linda Gromko, MD