After falling ill and urinating blood at age 16, Tim Guimon was diagnosed with IgA nephropathy — a kidney disease that causes inflammation and interferes with the kidney’s ability to filter waste from blood. He also learned that he was born with one kidney smaller than the other, and that these conditions could cause issues throughout his life.
“At that time, though, I didn’t have any major symptoms,” Tim says. “My doctor said I was doing fine, but warned me that it would probably progress as I got older. So for about 10 years, I kind of neglected to think about my kidneys.”
But when he was 26 years old, Tim’s wife, Kerstin, noticed that his legs were unusually swollen. Though he initially didn’t think it was a big deal, Kerstin and his mom, Sandy, encouraged him to see a doctor to determine if the swelling was related to his kidneys.
I had become quite familiar with Mrs. M since her husband was placed on the liver transplant list at Rush. He had been in and out of the hospital multiple times for the many complications of liver disease we commonly see. He suffered all of them: life-threatening bleeding from the upper GI tract, ascites, muscle wasting, kidney failure and chronic encephalopathy, or state of delirium caused by the liver’s inability to clear toxins.
Not knowing his age (early 60s), I would have guessed he was 75 or 80. The few conversations he could have made little sense. Some were humorous, even to Mrs. M, who couldn’t help but smirk when he asked the nurse if his dialysis catheter was really a tracking device to prevent him from escaping.
She knew this was not her husband. She probably hadn’t seen the man she knew, the man she married, for six months or so, since before the cirrhosis took over. Yet she spent every day at his bedside. Even when he was well enough to leave the hospital (or more appropriately, not sick enough to stay), a nursing home was not acceptable. She was his 24-hour caregiver. His life outside of the hospital depended on her. It was the least she could do while she waited and prayed for that one phone call. Continue reading →
An organ transplant can only happen if there is an organ donor. When we encourage community members to consider becoming organ donors, we usually begin by describing how recipients benefit from transplantation. Mostly, we talk about the “big” things: a patient with cirrhosis from hepatitis C or liver failure from a Tylenol overdose who doesn’t die, a patient with kidney failure from hypertension who no longer needs dialysis (and statistically will live longer as a result), or a patient with end-stage heart failure who gets to see her children grow up because of a heart transplant. However, we often forget about the smaller but no less dramatic ways that organ transplants affect recipients’ lives.
During my transplant fellowship, I cared for a man in his mid-50s who had been a brittle diabetic since his teens. His diabetes eventually caused kidney failure, and he had to start dialysis. He was listed for and soon received a simultaneous kidney and pancreas transplant. Because of his multiple medical problems, he had a difficult post-transplant course. He had several readmissions to the hospital, mostly because of nausea and vomiting from the damage that diabetes had caused to his stomach and bowel. We all felt that he was a bit depressed that he had not recovered as quickly as we had hoped (and he had expected). Continue reading →