Two days, two doctors.

I never know if it's better to give the good news or the bad news first. There are good arguments for both ways. In my writing I think I tend to write the good news first; to set the mood. Then, after the bad news is out there, I usually try to end on a good note, but it doesn't always happen. As we say here, I'll go with the flow (לזרום).

I saw the infectious disease (ID) doctor on Monday, and today (Tuesday) I saw the nephrologist.

The good news is that the ID doctor said I don't have an infectious disease to worry about. This is *Really Good News*. Turns out that the last culture that was taken- the one by catheter- was negative for any bacterial growth. That means that the klebsiella is not in the bladder, ie: not a bladder infection. The ID doctor said that as long as I am asymptomatic, we don't have to worry about it. The klebsiella will just be part of my system. I left there with no need for prescriptions, or follow-up appointments. Love that!!

Yeah,  you guessed it... the nephrologist visit was the one with the not-so-great-news-that-we-hoped-we-wouldn't-hear. First of all, I'll say that he was a really nice doctor, and I am very comfortable with him. That is good, because [unfortunately] I think I'll be seeing him semi-regularly.
I have what he calls "chronic kidney disease". Part of that is the nephrocalcinosis. There is also low kidney function regarding the breaking down of lipids, according to my blood tests.

One big thing is that the tests that he ordered weren't carried out as per his orders, unfortunately. He sent me a list of which tests to do, and I gave the list to my GP. She said that she ordered them. Today I found out that she didn't read every word of his list, and the doctor said some basic information is missing from the tests I did. Boohiss. I have to repeat some annoying tests, and look over my GP's shoulder to make sure she orders exactly what the doctor requested. So without that information he couldn't go much further with the diagnosis.

One thing that was clear was that the medicine that I take for my thigh pain is not good for my kidneys. That is what we were hoping not to hear. I already doubled up on that one (the "Art-50"), and it has been helping with the pain. Not 100%, but definitely helping. The doctor said that it is a bad one for someone who has kidney disease. He wrote on the paper for my GP "chronic high consumption of NSAIDs" (NSAID= non steroidal anti inflammatory drug). The NSAIDs he is referring to are not only the Art-50, but also the tons of Advil I take. That Advil covers my migraines, as well as for days with break-through pain. So, he suggested I see a proper neurologist for migraine medicine that isn't an NSAID, and also to go back to the pain clinic to see if there is a better (kidney-friendly) pain relief for my thigh joint.

I was really, really hoping that my meds would get the kidney O-K from this doctor. Thankfully, the Lyrica isn't on the kidney hit-list. Having the near disappearance of the neuropathy has been a huge difference in quality of life for me. I can keep that. But, the thigh joint pain is also a big deal. Without medicines, it is so sore that there is not a minute of any day that I am not aware of having pain, as well as reduced motion problems. I need a good solution for that. Now that I've gotten a taste of life with less pain, I am not willing to go back.

Fortuitously, I already have an appointment at the pain clinic with Dr. D (in Jerusalem) on Thursday. He's the one I saw 5 months ago who recommended the Lyrica and the Art-50. Before I saw the nephrologist today, I had been thinking that there may be a possibility I could cancel that appointment with the pain clinic. If the nephrologist had said that things are fine regarding my meds, there wouldn't be reason to go to Jerusalem on Thursday. But, I'm going.

The nephrologist recommended the procedure of nerve blocking for me. I told him that I also wanted that, but I am not a candidate for that.

So, I remember that Dr. D had other things that he could recommend if this regimen didn't work out. There were a few things "on the table" so to speak. One of them was medical cannabis (marijuana). It is now possible to use it without smoking it. I wonder if that is still on the table.... we'll see on Thursday.