Remember This Infographic About My Last Labs?
Remember the infographic I shared about my latest dialysis lab results? I was excited because my pre-dialysis BUN had fallen into the normal range for the first time since I started tracking it in October 2025.
On Mondays, either my nephrologist or a Physician Assistant from the nephrology practice stops by the dialysis clinic to check in on patients. I had a feeling the conversation I had with Clark was coming.
He reviewed my labs—not just the BUN, but the entire panel—and simply said:
"We're going to run them again."
As encouraging as the BUN result was, a few other values were out of whack. My phosphorus was very, very low, along with a couple of other numbers that deserved another look.
By the time Clark reviewed everything, I was already well into my dialysis treatment. That meant it was too late to draw a true pre-dialysis sample and then compare it with a post-dialysis sample.
So, we may repeat the labs on Wednesday to see whether last week's results were an anomaly or the beginning of a new trend.
I'm as curious as you are.
Stay tuned!
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Monthly Dialysis Labs: A Surprising Number I Haven't Seen Since 2025
Every month during dialysis, I have a full set of lab work done. The nice part? No extra needle stick. The blood is drawn directly through the dialysis tubing while I'm already connected.
The monthly labs help monitor many aspects of living with End Stage Renal Disease (ESRD), including:
Potassium – helps reduce the risk of dangerous heart rhythm problems.
Creatinine – shows how well my kidneys are filtering waste.
Phosphorus – high levels can pull calcium from the bones, while levels that are too low can affect oxygen delivery to muscles and lead to weakness.
Iron
Hemoglobin
Sodium
Chloride
Carbon Dioxide
Total Serum Protein
Albumin
Magnesium
Platelet Count
White Blood Cell Count
The number I paid the closest attention to this month was BUN (Blood Urea Nitrogen).
Here's the simple version. When we eat protein, our bodies break it down, producing ammonia, which is toxic. The liver converts that ammonia into urea. Urea travels through the bloodstream to the kidneys, where healthy kidneys filter it into urine.
With ESRD, that process doesn't work very well, so BUN levels can rise because waste isn't being removed efficiently.
During dialysis, my care team measures BUN before treatment and after treatment to see how effectively the dialysis removes that waste.
When I reviewed my results on Saturday, July 18, something caught my attention.
For the first time, when my monthly labs were tracked starting in October 2025, my pre-dialysis BUN was in the normal (green) range.
Even more interesting, my post-dialysis BUN wasn't dramatically lower. Normally, I'd expect to see a much bigger drop after treatment.
So now I'm left with a few questions:
Are my kidneys somehow recovering a little?
Was this simply an unusually good month?
Did my diet or hydration affect the result?
Or was it just one of those lab quirks that occasionally happens?
The answer is... I don't know.
One lab result doesn't establish a trend, especially with ESRD. But after months of watching these numbers, seeing that green result definitely made me stop and smile.
I'll be watching closely next month to see whether this was the beginning of a trend or simply a one-time surprise.
Either way, I'll keep sharing the journey.
Nextdoor, Pharma, and the Lowest-Hanging Fruit
I came across a pharmaceutical marketing benchmark survey that mentions Nextdoor as part of the media landscape.
One thing stood out to me: Nextdoor didn't even lead the study. It was simply referenced as another channel.
And, by the way, this is now Day #3 since I requested the complete insurance study from Jacob Chavis. Still no report. Still no acknowledgment. At this point, I'm not surprised.
Back to the survey.
My first reaction was that this feels like picking the lowest-hanging fruit.
A census tells us where populations are aging. Local demographic data shows where seniors live. It's hardly groundbreaking to conclude that neighborhoods with older residents will have greater demand for medications that improve quality of life.
Any competent regional pharmaceutical sales team already knows which physicians are prescribing what, which pharmacies are dispensing it, and where the opportunities exist. Compensation plans, quotas, bonuses, and territory strategies have relied on those metrics for years.
And if AI is truly the revolutionary force that Nextdoor leadership frequently promotes, why not simply overlay prescribing trends, demographic data, and ZIP code maps? The opportunities would become obvious without another marketing survey.
My larger concern is perception.
After watching the outstanding miniseries Dopesick, which explored the devastating impact of Purdue Pharma, OxyContin, and the Sackler family's pursuit of profit, I find it disappointing to see neighborhood platforms associated with pharmaceutical marketing studies without acknowledging the broader societal consequences that can accompany profit-driven healthcare initiatives.
Healthcare is essential. Medications save lives.
But when marketing becomes the primary focus without equal discussion of responsibility, history reminds us that communities can pay a heavy price.
In other news, NXDR is up today, but so is much of the broader market. I'm still watching to see whether the recent momentum holds or whether the bottom eventually falls out.
These are my personal opinions and observations and should not be interpreted as investment or medical advice.