The human body was not created to live on extended kidney dialysis. While dialysis cleans a lot of toxic poisons out of the body, it also cleans out plenty of things necessary for human survival as well. Mike has been on kidney dialysis since Monday, April 15, 2013 when his kidneys shut down as a result of a major secondary infection in his body and a very strong IV antibiotic being administered, Vancomycin.
In the beginning the kidney team, headed by Dr. Jumpaport of University of Iowa Hospitals, was hopeful Mike’s kidneys would bounce back and recover with time enough to heal while he was undergoing dialysis, but their expectation was that it should happen in a time period of from a few weeks to possibly six months. That has not happened. Fortunately, Mike’s lab numbers through this extended period of dialysis have been outstanding, though. It was his dialysis team that approached him about the idea of a kidney transplant. Over a few weeks, Mike came to realize, the sooner he was on a transplant list the more options he had, and the longer he waited, he increased the risk he would never qualify for a transplant. Currently, there is a pretty decent chance he may as long as we proceed in a timely manner.
Dialysis, over long periods of time, can damage blood cells, and when that happens, a patient can need a blood transfusion. Mike has had 3 units of blood in the last 6 months. Dialysis can cause fluctuations in blood pressure, because what dialysis does is remove excess fluid accumulating in your body because the kidney is no longer removing it fast enough. There is some risk of your blood pressure dropping too low if too much fluid is removed, but this can be controlled by giving saline. There is also some risk of blood clots in the port through which dialysis is done. Should that happen it requires immediate attention.
MIke is in what is called end-stage renal disease (ESRD), and that definitely puts his long-term survival at risk. Key factors in that survival rate are: 1. Patient age and gender, 2. Cause of kidney failure, and 3. Method of treatment. Younger patients have a longer survival rate, but even older patients survive longer with a kidney transplant than without one.
Meanwhile, Mike is on a strict diabetic/renal diet. Either one is a challenge for the patient, and the two of them together make nutritional health even more challenging. Things Mike can’t have on a renal diet include: any citrus fruit of any kind, bananas, tomatoes or sauces with a tomato base, potatoes, salt, things high in potassium or phosphorus. The one thing he can liberally have is any kind of meat. He continually needs a high protein intake to rebuild blood cells.
Mike has some criteria he has to meet to be eligible for a projected kidney transplant. Mike’s diabetes has to be under control. It is. His heart has to be healthy and functioning at 100% capacity. Six months ago, in April, during his amputation crisis, Mike’s heart capacity dropped to under 50%. All current test, though, show nothing wrong with his heart. He needs to make a decision, should a kidney become available, would he take a kidney from a donor who has been kept alive on machines to keep their organs viable. As we continue working our way through the list of criteria Mike needs to meet, he has a colonoscopy and a prostrate exam in his immediate future.
Meanwhile, dialysis is physically exhausting and time consuming. Three days a week Mike leaves home at 11:00 A.M. and doesn’t get home from kidney dialysis until 4:00 P.M. in the afternoon. Despite the fact he is in a prone position during this treatment, he still usually comes home needing a nap.
A kidney transplant should hopefully improve the quality of his life by eliminating the need for dialysis 3 times a week. It’s risky and and there is no guarantee it will ever happen, but first, he has to meet the standard criteria, make the list, and then he would begin the on-call wait, packed and ready to leave on a moment’s notice, should a kidney donor match become available..