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.
Another One Caught: Parking Like the Rules Don't Apply
I caught another one.
Today I was on my way to the local Harris Teeter to pick up additional lottery tickets for the pool I'm in (more about that over at NielFlamm.com/blog). Harris Teeter is only about a mile from my house, and to get there, I pass Rivertowne Public House—which, by the way, has a great Caesar salad and chicken nachos if you've never been.
As I approached Harris Teeter, just past the Pub House, I noticed a white BMW X3 with a South Carolina license plate WUP 290. The driver was inching his way into a parking space so slowly that he backed up traffic in both directions. It wasn't a particularly difficult parking job—it just seemed like everyone else had to wait while he perfected it.
I didn't have time to snap a photo on the way in because I was headed to buy those lottery tickets. But I secretly hoped the BMW would still be there when I came back out on my way to get a car wash.
It was.
One thing that crossed my mind: this happened before anyone at the nearby pub would reasonably have had a chance to enjoy a few adult beverages and make questionable decisions afterward. From what I observed, this appeared to be a sober driver making a deliberate choice to take as much time as needed, regardless of the line of cars waiting behind him.
That's one of the reasons I'm glad I have this blog. It gives me a place to document the little moments that make you shake your head.
One quick note before anyone points it out: yes, you'll notice a golf cart parked in a handicap space. It appears to be a legitimate designated spot, and I don’t have information on whether the owner has a disability. I'm not making any assumptions about that.
What I am commenting on is the behavior I personally witnessed. Taking your time is one thing. Holding up traffic in both directions because you're determined to execute the perfect parking maneuver is another. A little consideration for the people around you goes a long way.
As a BMW owner myself, I hate seeing behavior that reinforces the stereotype that BMW drivers are selfish or entitled. Most of us aren't. Unfortunately, it only takes a few memorable moments like this to give everyone else a bad reputation.
Let's all remember that parking lots work best when everyone shares them with a little patience, courtesy, and awareness.
Have you ever witnessed a parking lot moment that made you wonder what someone was thinking? Leave a comment and let me know.
My Billion-Dollar Career Is Delayed... Again 💸😂
Well...
I checked my personal Powerball and Mega Millions tickets.
The results were exactly what you'd expect.
I did not become an instant billionaire.
I'm still checking the lottery pool tickets, so there's a microscopic glimmer of hope. Somewhere between "highly unlikely" and "did I miss a number?"
The jackpots continue to climb:
🎟️ Powerball: $544 million (Monday)
🎟️ Mega Millions: $707 million (Tuesday)
That's a combined $1.251 billion waiting for someone.
I've already shared some of the practical things I'd do if I won. But after taking care of my family, helping my community, and making sure my friends were doing well, I'd have to spend a little on nonsense.
Here are three new ideas:
1. Hire a Professional Excuse Writer
Running late? Flat tire? Alien abduction? My personal excuse writer would have a believable explanation ready in under 30 seconds.
2. Open the World's First Museum of Lost TV Remotes
Every remote you've ever lost somehow ends up there. Admission is free, but finding the exit remote costs extra.
3. Start a Competitive Lawn Flamingo League
Teams would draft the finest pink plastic flamingos, complete with instant replay, referees, and commentators, treating every lawn decoration like the Super Bowl.
Completely ridiculous?
Absolutely.
That's part of the fun.
Now it's your turn...
If you won $1.251 billion, what's the first ridiculous thing you'd do?
Leave a comment on the blog. I can't wait to see your ideas—and who knows, maybe one of us will actually need them one day.
Join the discussion on NielFlamm.com.
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We Won the Lottery! (Sort Of...) 😂💸
Guess who didn't win the Mega Millions?
Me.
You.
And apparently everyone else.
The jackpot has now climbed to $707 million for Monday's drawing. Meanwhile, Powerball is $526 million tonight.
That puts a staggering $1.23 billion on the table. That's enough money to make a calculator ask for a coffee break.
I didn't win personally, but I did organize a lottery pool with 11 of my Tau Epsilon Phi fraternity brothers.
And...
We won $70!
After dividing it up, everyone would receive a whopping $6.36.
If the payout is less than $1 per person, that’s the “Niel Tax”; it barely counts. In this case, I declared the investment... less than inspiring.
Rather than pocketing our $6.36 each, the majority of the pool voted to let it ride. We rolled the winnings into 35 more Powerball tickets for tonight's drawing.
Clearly, we've chosen optimism over financial responsibility.
So naturally, I started brainstorming what we could have done with our newfound fortune.
Option 1: Relive Our College Days
Buy 28 bottles of Country Club Malt Liquor (about $2.50 each back in Harlem).
That's roughly 2½ bottles per brother.
I don't drink anymore so that someone can have my share. The other ten can spend the next morning comparing ibuprofen brands, arguing over whose knees hurt the most, and wondering why they thought drinking malt liquor in their 50s was a good idea. The hangover would probably last longer than our college careers. 🍻😂
Option 2: Invest in the Future
Head to Costco and buy three giant packs of Kirkland 2-Ply, 30-roll, 380-sheet toilet paper.
With all the news about a diarrheal parasite affecting more than 30 states, this may actually be the smartest investment on the list. Future us might look back and call this the greatest financial decision we ever made.
Option 3: Think of the Kids
Put the money toward our annual Winter Holiday Celebration, Christmanukwanza Party.
More cookies for the kids.
And let's be honest...
...a lot more cookies for the adults, too.
Instead, we bought 35 more chances to become instant billionaires.
Sure, we didn't become billionaires this week.
But for a few minutes, we got to dream about it together—and that's part of the fun.
Now excuse me while I check my tickets one more time... just in case I accidentally overlooked a billion dollars.