Smokey Mountain Breakdown

I really like my new kidney doctor at UT. His name is Dr. Suresh and he's handsome in the way some Indian men are.

He orders a 24 hour urine test to see if my lupus is eating my kidneys up. We've known something was going on for the past year. We just aren't sure what. I've been really lucky not to have nephritis and the type of SLE I have morphed out of a type of discoid that isn't associated with a high incidence of nephritis. This appears to be changing.

I've had this test before, but usually I'm in the hospital and all I have to really do is the peeing part. Not the collecting and pouring into the jug part.

"So, do I keep this in the refrigerator?" I ask.

"No." He says. "People will think you are odd if you do something like that. Urine isn't something you want to see someone's refrigerator."

Funny, funny man.

Not that I don't feel odd enough saving my urine over a 24 hour period. And I have two bathrooms so I have to move the urine saving paraphernalia from one to the other.

So, today I go into the lab at tiny little Baptist hospital in Newport to deliver my jug of urine. I also have to have about a quart of blood drawn. We get into an argument about the C3, C4 test.

Evidently the Mayo wants you to fast to do a C3, C4. I've never fasted for this.

"Just do it." I say.

The head tech has a book out. They evidently haven't seen a C3, C4 test before. I'm not surprised. I've had local medicos tell me the damn thing didn't exist.

"But the Mayo says...."

"Look, I've had this test done for the past 15 years. It's the primary indicator of how apeshit my lupus is going. The Mayo may say to fast, but the NIH, Emory, MUSC and UT say go for it. I need that test. Just do it."

I'm so damn tired. Bone, sick tired. I don't really need to be getting flack about something I know more about than the lab tech.

I get a wee bit snappish when I'm tired.

When I get into the phleeb, she looks nervous. I think the head tech has warned her that I'm "difficult". I'm not really. I hand her my jug of pee.

"Man, does that look like a lot of pee to you?. It looks like a lot of pee to me."

I'm trying to set her at ease with my quirky sense of humor. It's important that phleebs are relaxed and confident. That way you don't end up with a big bruise on you arm and I'm an easy draw so there really is no need for that.

She doesn't know if that is a lot of pee or not. She writes my name and when I started collecting the pee on the tag on the jug.

I show her my good vein. I've been using the same vein for 20 years. It's never failed me and even the most junior phleeb can hit it. She hits it without any trouble, but still is a bit nervous.

She drops one of the red tubes.

"I can hold the needle if you need to pick that up." I say.

She looks horrified but doesn't say anything.

"I have a lot of experience with hospitals. I was in one for six months. Anyplace you stay for six months becomes very familiar."

We talk a bit about my hospital experiences as she slips in the eight tubes to collect all the red stuff. I tell her about my living despite only having a 10 percent chance of doing so. I crack a few more inappropriate hospital jokes.

"And look at you...here you are!" She says.

I laugh. It's hard to laugh as tired as I am, but I feel good that I've at least brightened up this one phleeb's day a bit with my irreverence.

"But you never really get over feeling...you know...every time you go into a hospital...that maybe you won't be leaving there for some time. Since it happened once before. It's not really the sort of place you want to be familiar with."

I leave feeling that odd elation I always feel when I escape the hospital.