While on vacation here in Flagstaff, AZ, my grandmother passed away in Colorado. This was not too unexpected, but it happened suddenly. She's been ill for several years. I have decided to go to the memorial service on Sat the 8th and have already re-arranged my flights to fly up to Colorado Springs and then home to Tampa from there on the 9th. The only situation I have to solve now is getting at least 2 more treatments (in Colorado) arranged. I guess I'll call my home unit tomorrow and ask them what to do. I've never had something like this happen where I've ended up in an entirely different place without pre-arranged dialysis. I'll have to cross my fingers and hope I can get a treatment on Wed the 4th and Friday the 7th... I feel stressed... and sad.

My first treatment (yesterday) in Flagstaff went well. Boy was I ready for dialysis after 4.5 days without. The center here is alright, but I do miss Bay Breeze (my home center). Dialysis at home becomes somewhat like a twisted family reunion three times a week... but, when you travel its like walking into the wrong family reunion but still trying to fit in. LOL I feel good and our vacation is going good. Now snow, yet :( but I'm still hopeful!

We made it to Flagstaff, AZ. Happy Holidays, everyone! My first dialysis treatment here isn't until Tues at 1 PM. That will be the longest I've ever gone without a treatment (from Friday @ 6:30 AM to Tues at 1) so it makes me a little nervous. I feel OK so far and I don't feel fluid-overloaded. I've been careful so hopefully I won't have any complications. Its strange to know that no matter where I go, I'm still tethered to the machine for life. I'm OK with that, but it feels overwhelming at times.... stressful to think that no matter where I go or what I do my life still depends on dialysis. At least its pretty easy to travel and still get treatment. I'd hate to be stuck at home, not able to go anywhere.

I've been talking about it in my other journal... but I should mention it here, too... I'm going back to school (again) starting Jan 10th! Yay me! Now I REALLY need a laptop so I can work on homework while I sit in the chair... besides, I'm sick of watching television all the time... I've been doing it every treatment for a year and I'm sick of early-morning TV!!! I'm so excited about school. I can't stop thinking about it :) I finally figured out what I want to be when I grow up - a Social Worker. This means I will have to get not only a BS degree, but also a Master's. I think it will take me 3 years, so long as nothing major goes wrong.

I'm looking forward to my vacation! This will be the first time I've traveled and not gone to a DaVita unit. The unit I'm going to is either a Gambro or Fresenius unit. Apparently there's only one dialysis unit in all of Flagstaff, AZ. And, wouldn't you know it? Zack (our re-use tech here at my unit) used to work there... its a small world, huh? He gave me the scoop on who to say 'hello' to and who to avoid, LOL. My first treatment in Flagsaff will be after a 4 day break. I get dialysis here at home on Xmas Eve (Friday) and then won't have my first treatment there until the next Tues. Waiting that long for a treatment always makes me nervous, but I've always gotten through OK. I guess I just won't be drinking too much apple cider or hot chocolate with peppermint schnapps :)

The skin rash is really red and more irritated now. I asked the nurse if it looked too bad or infected and she said it didn't. Instead of sticking bandaids on we just used gauze and tape instead. I've also been using Neosporin to help keep it from drying out. I want to set up Constant Site / Buttonhole access to my fistula. I think this will give me a better opportunity to learn how to self-cannulate, even though I'm not left-handed. I'm also hoping this will help me make a case for doing short-daily home dialysis with one of the new home hemodialysis systems I've been researching. Today I watched a clinical video after my treatment that talked about the basics of "buttonholing". Our charge nurse Joan is going to get certified in establishing these types of accesses, and then sometime shortly after Christmas I get to be the first guinea pig at our unit to try it.

I'm getting this itchy rash on my arm from the banaids and tape used during and after my treatments. One spot has turned into eczema, which I've had on other patches on my skin off-and-on throughout my lifetime. I'm surprised its taken this long for me to start being sensitive to the tape... usually my skin breaks out from even the slightest artificial anything applied to it (including makeup, perfume and some lotions...) I'm watching the rash closely to make certain it doesn't get infected or turn into something else.

DaVita to Buy Gambro's U.S. Clinics for $3.1 Billion Dec. 7 (Bloomberg) -- DaVita Inc., the fourth-largest dialysis provider, agreed to buy Gambro AB's U.S. clinics for $3.1 billion in cash to become the kidney-treatment leader in the world's biggest health-care market. Gambro shares soared. DaVita, based in El Segundo, California, will double the number of people using its services to 96,000 patients at more than 1,200 sites in the U.S. The Gambro unit had about $1.8 billion in 2003 sales, the Swedish company said today. Gambro's operations will allow DaVita to overtake Fresenius Medical Care AG of Germany, whose 84,600 U.S. customers make it the largest provider of dialysis, which filters impurities from the blood. Stockholm-based Gambro will focus on devices for blood- and cell-based therapies, including dialysis. "It's certainly a good price and a good deal for both sides," said Ludger Mues, a medical-technology analyst at Sal. Oppenheim who has a "neutral" rating on Gambro. "DaVita believes it can make the business more profitable and Gambro can concentrate on its devices." Shares of Gambro rose 5.5 kronor, or 6.2 percent, to 95 kronor at the close of trading in Stockholm. DaVita shares climbed 90 cents, or 2.4 percent, to $37.72 at 4:15 p.m. in New York Stock Exchange composite trading. Gambro shares have risen 60 percent and DaVita's stock has gained 45 percent this year. DaVita plans to finance the acquisition through a new financing arrangement and by issuing notes, it said in a PR Newswire statement. J.P. Morgan Chase & Co., its financial adviser, has committed financing for the transaction, it said. McDermott Will & Emery LLP and Bingham McCutchen LLP were DaVita's legal counsel. Goldman Sachs Group Inc. advised Gambro. Industry Probes The U.S. company expects the acquisition to cut into its earnings in the first year, have no effect in the second quarter and add to earnings in the third year after the purchase. Earlier this year, Gambro, DaVita, Fresenius Medical and Renal Care Group Inc. got subpoenas from U.S. prosecutors in an industrywide probe of practices involved in testing kidney patients' hormone levels. Last week, Gambro said it reached a final settlement in a different U.S. investigation. Gambro, which began mass production of single-use artificial kidneys and dialysis machines in 1967, agreed to supply DaVita with renal products for at least 10 years and jointly develop dialysis products. "It clearly makes sense for Gambro," Mues said. "They are the preferred product partner for Davita for the next 10 years. This is Gambro's most profitable business and they get really a good price for the U.S. business." 43,200 Patients DaVita and Gambro expect to complete the transaction in the first half of 2005. The acquisition will add about 43,200 patients in 565 dialysis centers to DaVita's operations. After completion DaVita will have combined sales of about $4.4 billion. Gambro, today the world's No. 2 operator of dialysis centers, had about $1.9 billion in sales at its continuing operations in 2003 and will employ about 11,000 people. The sale will result in a pretax capital gain of $1.2 billion and net debt will become a cash surplus of about $2 billion. The Wallenberg family is Gambro's largest shareholder. "The question is what they're going to do with the money," said Anders Evander, chief investment officer at Alfred Berg in Stockholm, a unit of ABN Amro NV that manages the equivalent of about $12 billion. "They have to make acquisitions or hand it out to shareholders. It would be fun if they would grow and become big again. There's not one obvious solution to the excess cash." Settlements Earlier this month, Gambro reached a final agreement with the U.S. Justice Department after a probe into its billing practices. It set aside 2.7 billion kronor ($410 million) in July when it reached a tentative agreement with the U.S. Gambro staff will receive more training in billing and coding practices during the next five years as part of the settlement. Gambro will have three business units: Gambro Healthcare, which provides dialysis services outside the U.S.; Renal Products, which makes dialysis products; and BCT, which provides blood collection services. Shares of Gambro were suspended yesterday after the Wall Street Journal reported the companies were close to an agreement.2.7 Peter Grauer, chairman of Bloomberg LP, has been on the board of DaVita since 1994. I go to a DaVita dialysis unit but have a Gambro doctor. I just love DaVita :)

I wish we had more patients who would come to our get-togethers. It seems like mostly only board members show up. Tonight we had just two small tables of new people. Even some of the familiar faces I expected to see there didn't show.