Fistula

So I had fistula surgery a little over two weeks ago. To facilitate my ongoing apheresis therapy.

This is a pretty common thing for people who take dialysis, which apheresis resembles. They're filtering my blood for different reasons but it's still filtering the blood. In my case, it's high LP(a) which is strongly correlated with early onset heart disease, which I have. Heart attack at 32, a double bypass at 43, it's financially ruinous, physically unpleasant, and time consuming but while there's no guarantees, it's the best shot I can see to being a senior citizen some day.

So this fistula. The surgeon basically hooked an artery to a vein in my left arm. Gotta remember not to let them take my blood pressure on that side ever again. And there's a visible bulge where this rewiring of my circulatory system creates a big fat vein for the apheresis clinic to access both for input and output.

The up side is besides making it easier to access me and possibly even to run the treatment a little faster, I'll have one hand free to jack with Netflix and whatnot (what else are you going to do when immobile for a half day?) The downside is if you were to cull my phobias and squeamishness to come up with the perfect freak out, the only thing this surgery is missing is giant spiders.

I played guitar this evening for the first time since the surgery. I was officially cleared to do so a few days ago but I wasn't feeling up to it. I have all kinds of neuropathy symptoms from the surgery that call back my senior year of high school when I dealt with a lot of Thoracic Outlet Syndrome symptoms that were misdiagnosed at the time as tendinitis. I have chills, spasms, numbness, sweats, aches in my forearm and wrist. It wakes me up at night sometimes.

Physically I seemed able to play pretty well, but it felt so freaky and sometimes painful. But the worst, looking down at my upper arm above the elbow and seeing the fistula bulge. I almost fainted dead away in the middle of the living room with the guitar around my neck.

I'm sure I'll get used to it, but it's not instantaneous.

Lucky 13

I went to a casino. To gamble. For the first time in my life. But first....

I had fistula surgery last week to facilitate ongoing apheresis treatments. Basically after almost four years of fortnightly filtrations, my veins had developed sufficient scar tissue that it was getting impossible to get a treatment going. Jennifer was on vacation (she's got her spots and ways, she's been the main one to access me all this time), and the whole crew plus the IV nurse (who apparently floats the hospital just starting IVs and who appeared to have been at it for decades) tried for over two hours without success.

I've had better days. Anyway, so the fistula surgery. I tend to think of fistulas as something to repair, but in this case they went in on purpose and hacked one of the arteries in my left arm into one of the veins, which is supposed to create a big vein they can easily do both the take-out and put-in of my blood for the treatments. All the other patients who come on Tuesday mornings already have them, seemed surprised I'd been going so long with out one. I guess dialysis patients get them pretty commonly too, same reason except their treatments are even more frequent than mine.

So anyway, no bicycle. No guitar. Can't lift more than 10 lbs. My arm feels weird with chills and tingling and one night it swelled up pretty good and there's been spookly looking contusions and hopefuly it's healing the way it's supposed to but I went to a casino. It seemed like something to do on the way home from work.

I'm not a big gambler. I guy the occasional Powerball ticket even though I'm pretty sure winning that just ruins your life. A life ruined by windfall money doesn't sound that bad to me sometimes. I buy scratchers for my relatives at Christmas to remember my late step-brother who did the same, though I buy them without hope or expectation of winning anything. But my favorite memory of Todd was taking a smoke outside (we both smoked back then), and lecturing him about how stupid lottery tickets were and the odds of winning and so on and he just smoked in silence until I ran out of lecturing words and then asked, "So you want another one?"

I grew up with a play casino set in the board games closet, and I'd play roulette (it had a little plastic wheel with a BB sized ball), my Dad taught me and my brother stud and draw poker, but we were just playing for chips. And all of this play gambling came with heavy lectures about how the house always wins, it has to. Who do you think is paying the light bill on that casino? My first, and most important professional mentor in life, Rich Nadler, had a huge anti-gambling bias. He thought the lottery and casinos were in many ways worse than the illegal, mafia-run gambling they were meant to replace.

And while I'm not great with money, I'm relatively risk averse and I know the odds.

So I was watching the movie Casino the other night and it occurred to me, I've never once, in my life, place a bet at a casino. On my way home from work, I decided to stop in the Isle of Capri and take a look. I like Texas Hold'Em (though I've never been good at it; I've only ever played in charity tournaments and I'm usually the first one out of chips). According to their website they had some version of it.

Walking in, the first thing that struck me was the smell. You're allowed to smoke in there, at the slots, the table games, as far as I can tell everywhere. It smells like 1987 in the Isle of Capri. Actually down in the rows of slot machines where the smoking is really going on, it smells like my Mom's house when my aunt and late uncle used to come for a visit and all three of them would sit in the closed house smoking every waking moment of the day.

The vast rows of slow machines, there's a bar, the cashier. I can't believe how many slot machines, with lots of people many appear retired, just zombied out. I can get plenty addicted to games on my iPhone that I play for free, Pokemon Go, Candy Crush, Words with Friends, I don't see the appeal of the slot machines. Maybe if they had Galaga with money payouts for clearing levels I could get into that. But I headed over to the table games.

I watched their version of Texas Hold'Em for a while. I noticed there wasn't much folding going on. Unless I'm the blind or the small blind, I check my pocket cards and decide if it's even worth seeing the flop in Hold'Em. It often isn't, sure a pocket 2 of diamonds with a 4 of spades could, theoretically, become the connectors of a straight or the completion of a full house, but don't bet on it. Literally.

This 'ultimate' version of the game, you're playing against the house. You ante every hand, and the only real decision is whether to bet against the dealer. It ends up resembling Black Jack more than poker to my mind. Same thing with their Six Card Poker. Black Jack didn't hold much appeal for me either.

I watched the craps table for a long time. I don't fully comprehend the game, it's so complicated it takes three casino employees to run it. It's quite popular, there was constantly a full crowd playing the whole time I was there, but I just couldn't place a wager on a game where I can't understand why money is coming and going from different spots on the table.

Roulette was fun to watch. I understand roulette more or less. Well, I later learned I didn't entirely.

I watched a woman buy in, get a little stack of chips, and proceed to hit straight up on a number. 35:1 payoff, she suddenly had several stacks of chips twice as tall as her one, original buy in. I was thinking, "take the money and run." But she stayed and played through those chips until she was down to nothing. And I judged her for it, oh boy, did I.

So I never did get around to placing a bet on that visit. I watched, the people watching aspect was pretty entertaining. I saw other people get up significantly and stay playing until they were back down again, not just at the roulette wheel, at all the games. I had a beer and watched and eventually decided the smoke was getting to me and went home.

The next night I decided to go back and actually play. That whole know when to stop before you start thing they throw in to the gambling ads? I decided going in that $40 was all I'd put at risk. I put two twenties in my front shirt pocket and was like, that's it for the gambling part. I got a drink from the bar and watched for a while more before I finally sat down at the roulette table. I didn't want to buy in with the whole $40 a once, I figured I'd blow through the chips faster if I went that way. So I gave the guy $20 and got a cute little stack of blue chips.

It's a $5 minimum, $50 maximum bet, and I knew from watching that people spread their bets around. I started to do so, and the dealer was like, you can't do that! I didn't understand, but when I explained that this was my first go at this, scooped the chips back to me and explained the whole inside/outside thing. Outside bets like black or red, even/odd, etc., don't pay as well as inside bets (where you're placing on a specific number or straddling numbers). The minimum applies to a single spot on the outside, so you can bet $5 on black, for instance, but you can't spread the $5 to multiple outside bets. On the inside, as long as you put a total of $5 in play, you can split it up between single numbers or groups of up to six numbers, with correspondingly lower payouts as you get less and less specific in your bet.

So anyway, 13 is as close as I get to thinking a number is lucky. Both my daughters were born on the 13th. So was my wife. In hindsight, we got married on a 12th but should have done it the next day, on the 13th. So I put $5 on 13 and $5 on black. A guy came to the table and bought in with $100 and proceeded to spread about half of it over so many spots on the table that I told him he'd missed a spot. One of those spots was 00 and he ended up with more chips than he'd started with. And proceeded to litter the board with chips again. I tried 13 by itself, nothing. The money is going fast, mind you. I did 13 one more time and bought in with my other twenty.

The next spin I played 13 and odd again, and the guy who'd bought in for $100 and already hit an improbably high payout scattered bets all over the board again.

And it hit on 13.

A little voice in my head said, 'quit while you're ahead.' Pretty sure this situation is exactly where that expression comes from in fact. I decided to play one more spin, put $5 on 13 again. "Gonna see if lightning strikes the same place twice," I said. The little voice in my head said '33.' I almost put $5 on the 33 spot but chickened out.

And it hit on 33. And that's when I decided to listen to the voice in my head. As my brother pointed out later, the longer I stayed and played the more my results where going to revert to the average, and the place can only stay open if the average is in favor of the house. The $100 buy in guy left the table with considerably less than he'd bought in with to move to another game and I decided to cash out. I gave the dealer a $5 tip, not sure what the standard is on that, I had one more drink while I watched people gamble as I held the $190 worth of chips (which the dealer had exchanged from the cumbersome $1 chips to a $100, three $25s, etc.

I left with $190. I'd spent a little over $10 at the bar, tipped the dealer $5 and bought in with $40, so up what, $135 or so? Watching other people win and give the winnings back over and over, I just don't think that's for me. I got lucky. I basically had eight cracks at the wheel and managed to hit a 35:1 plus a 1:1 payoff on one turn. If I'd listened to the voice in my head about that 33, sure I'd be up another $175 but I don't think life works that way.

So rather than take my winnings back to a riverboat casino and turn them into riverboat casino profits, I decided to take my wife to a nice sushi dinner and ice cream.