Saturday, November 27, 2010

How I Write a Blog

Photo: Blogger at work

A young friend who is a graduate student has asked me about the process of writing and posting a blog.
First: I need an idea. Sometimes ideas are handed to me, like “how I write a blog.” Thank you, Amelia.
Sometimes I am interested in something, and I do some research and write about that subject. Case in point: the recent series of columns on the pioneers who developed treatments for renal failure.
Those columns also tapped my personal experience. Personal experience is a rich source of material, and I've now lived long enough and done enough that I can tell stories until everyone in the room is asleep with their mouths open and drool running out.
Occasionally something will happen that catches my attention so vividly I write about it. Latest example: a few months ago President Obama was in town, and some poor guy in a private plane didn't know that the air space over Seattle was restricted during the President's visit. Two military jets scrambled from Portland and flew up here so fast that they caused a couple of sonic booms which (a) shook our whole house, and (b) scared the bewhatsis out of a lot of people in the Puget Sound, thereby causing the 911 system in Tacoma and other areas to crash from the call overload.
So, I get the idea and I start writing. My most used reference is my dictionary. That tells me if I'm using the exact word that conveys my meaning, and how it is spelled. Spell check can be helpful, but it will make suggestions like “collisions” when I really mean Colossians, a book of the Bible. Funny, but not helpful.
Online is my second go-to after the dictionary. I go to several different sites about any given subject because I've found they will say slightly different things and I'm looking for a consensus of information that will be as factual as I can make it.
The writing process is a combination of writing, tweaking what I've written, staring out the window without seeing anything, and looking things up.
I write a first draft that includes everything. Anne Lamott says, “Write a shitty first draft.” (Asterisks were supplied here in the printed version of this column in The Loop, in consideration of Loop readers' tender sensibilities) Anyway, Anne Lamott is right. I write a first draft, then I let that draft sit for an unspecified length of time, anywhere from long enough to eat breakfast to a couple of days. When I come back to it, the serious tweaking and cutting begin.
William F. Buckley said, “Be grateful for every word you cut.” I doubt if Bill and I agreed on much, but that is my number one rule as a writer.
So, I come back to the first draft with refreshed eyes, and cut, re-write, edit and proofread until I'm satisfied. That can take hours, or days.
Sometimes I'll write a whole piece, think about it, and throw it out. Oh well.
It is good to have a photo or illustration with a blog. I prefer to use a photo I have taken, or, if I'm lucky, a drawing my husband has done. Rick's cartoons always have humor, which can range from whimsical to perverse, and I have learned to trust his instincts for what a 'toon should be, even if I'm slightly horrified when he tells me what he's going to draw.
Now I'm going to go eat breakfast.
Okay, I'm back. When I think the piece is as succinct and clear as it is going to get, I post it. I go to my blog page, paste the copy in, upload images, and hit “Publish.” Then I read it and find the typos I couldn't see before. When I'm satisfied with the post, I send out a blog alert to an email list of people who might want to read it. Then I'm free for a while, until the need to write reasserts itself.
That's my process. The blog address is right here, if you're reading this. Thanks for asking.
Post Script: when this was published in The Loop, the caption of the photo said, "Bloger at work." I went back and checked my email from when I sent my column in, and I had typed "Blogger at work." So between my email and publication, the editor had dropped a "g" from the word "blogger." Now, if I had made the typo after writing about how I tried to catch all my typos, that would be ironic. If the editor of the paper, who is supposed to catch and correct mistakes, actually puts a mistake in, that's another kind of ironic, and completely out of my control. So it goes. Sigh.

Saturday, November 6, 2010

Kidney Transplants: Not a Cure

Rick Tuel: water worker, cartoonist, end stage renal disease patient, modern medical miracle. Photo by Mary

The first thing the Northwest Kidney Center tells you about having a kidney transplant is that it is not a cure; however, it is the most effective treatment for kidney failure we have at present.
The major obstacle to successful kidney transplants is the recipient's body's rejection of the new kidney as a foreign object. People who have kidney transplants must take anti-rejection drugs for the rest of their lives. That is why a transplant is not a cure.
When transplant surgery was new, it was only done from living donors, and between close matches such as identical twins. The development of anti-rejection protocols made it possible for kidneys to be taken from cadavers for transplantation, so now transplanted kidneys come from both living and deceased donors.
Kidneys from living donors tend to last longer than kidneys from deceased donors, but how long a kidney will last is an unknown. Kidneys from cadavers tend to last 15 to 20 years; kidneys from living donors tend to last longer, and there are people who have been going with a transplanted kidney for thirty and forty-plus years, but some kidneys fail immediately, or within a few years. You never know.
Sometimes living donors donate in a “chain.” Say your best friend Ralph needs a kidney, and you'd like to donate, but your blood and tissue don't match Ralph's. So you donate your kidney to someone who is your match, and a friend or relative of theirs donates a kidney to someone else who is their match, and so on, until some friend or relative of a kidney recipient is a match for Ralph, who finally gets a kidney.
Experience seems to indicate that the majority of kidney donors do fine with only one kidney, and both donors and recipients are required to go through rigorous testing and screening. It costs donors money to donate, by the way. That doesn't seem fair, but there it is.
Potential kidney recipients can be turned down for a variety of reasons. From what we heard at the Kidney Center, you have to be in the pink of health, except of course for your non-functioning kidneys. The committees that decide who will get a transplant do not want to “waste” a kidney when there are so many more people who need kidneys than there are kidneys to transplant. Many people who get on the waiting list for a kidney wait for years. Some don't live long enough to get a kidney.
The immune suppressant drugs recipients must take cause problems of their own: infections because the drugs suppress the immune system; sepsis; a form of post-transplant lymphoma (cancer); and side effects such as unwanted hair growth OR loss; obesity; acne; type 2 diabetes; etc.
A major problem with the immune suppressant drugs is that they are expensive. Not having adequate insurance to pay for immune suppressant drugs is a reason for being turned down for a kidney transplant in the United States. This will not seem important to you until you or someone you love needs a kidney.
My husband was diagnosed with end stage renal disease on October 5, 2009. In the last year he has had multiple surgeries and continual tweaking of drugs to keep him going, and he is now on peritoneal dialysis. Because he had cancer last year, he will not be considered for a kidney transplant until he has been cancer-free for two or more years.
It has been a hard year, friends, but we have been carried through it by you and other people as we adjusted to the new normal. Rick is starting to work again, gradually, just a little bit. If you see him out there spraying paint on the road to mark the location of an underground utility, give him a smile and a wave. He and everyone living with kidney disease is a modern medical miracle.