Kidney disease harms family members

• May 8, 2024

Kidney disease does not only affect the patient, since the people who are around resent the state of health of their relative. Care and moral support are the main physical and emotional wear and tear on both sides.

Continue reading the second part of this life story and learn how Eduardo and his family won and had a positive attitude towards his kidney disease.

The task of getting a kidney and the potential cost of the condition, although I had a major medical insurance, also overwhelmed me, especially when I ponder that maybe I could not see grow, along with Elisabeth, our children.

Soon many of these initial fears were dissipating. Shortly after the diagnosis of my transplant, I already had a list of five donors, while my insurer began to cover promptly and in accordance with the terms of the policy, the expenses I incurred in preparation for that medical procedure.

An antidote that I also found to combat the negative thoughts that invaded me was information. As Elisabeth and I learned more about the risks and implications of a kidney transplant, in conversations with Dr. Madero, in the medical literature and in the talks with those who had already faced one, at least I was reassured.

For these times, kidney transplants, while not as routine as removing a tooth, have achieved a high probability of success after more than half a century of application, especially for patients with cysts.

The cysts are like small transparent bags that grow in the nephrons - the small filtering units of the kidneys. These bags impede kidney function, which is to extract water and toxins that the body assimilates and generates.

In my case, I did not have to wait long to get a kidney. Elisabeth and I are compatible. We have the same type of blood and I, after several tests, did not show antibodies that could reject your kidney. Elisabeth's health condition was also good - a crucial element for the transplant.

Also, faced with the previous diagnosis of suffering from PKD, I had led, almost unconsciously, a moderate life and, in general terms, healthy. I swim two or three times a week when I can and I do not smoke.

In addition, the very favorable responses I had from family and friends to my request for a kidney helped me a lot.

The offers I received are considered as one of the most genuine expressions of love and friendship. David even wrote me to know that the tests of compatibility between Elisabeth and I was going well, that he was following the barrel: "As for me, I am more than ready to donate a redundant part of my body."

His expression could not be more eloquent. Most of us have two kidneys, but in order to live we really only need one - as shown by multiple medical-academic studies carried out with kidney donors and which have shown that the lifestyle or health of donors do not change after a nephrectomy.

I was very lucky to have several living donors. In Mexico, the organ recovery system for people with brain death is improving, but much remains to be done. Waiting times can be two, three or more years, at which time the patient's health can deteriorate.

My transplant could move forward without the mental torture of not knowing when that vital organ would arrive. Moreover, he progressed with the advantage that Dr. Madero could plan it with anticipation and methodology.

In those were Elisabeth, me and Dr. Madero, who is also head of the department of nephrology of the National Institute of Cardiology - Ignacio Chavez, one of the most prestigious public hospital institutions in Mexico, when in mid-April my kidneys began to bleed.

Renal bleeding in patients with PDK is usually due to the rupture of one or more cysts. They manifest through urine. One at first thinks he is urinating blood, which is not necessarily accurate. A few drops easily stain the urine. Either way, one feels as if life is being emptied by that reddish stream.

After the bleeding came the renal pains. First at the end of April, which forced me to hospitalize for three days, and then in early May. On this second occasion the pains were so severe that I felt as if someone was electrocuting me from my kidneys.

Dr. Madero, who specialized in nephrology at Tufts New England Medical Center, where she also collaborated with some of the best specialists in my disease, decided not to wait any longer: my kidneys, she told me, had to come out. "They are hurting you," he added.

By then, my physical condition had worsened. He was anemic and had a worse renal leak. I confess that when Dr. Madero announced her decision, I felt relief. I already wanted my kidneys out.

The bilateral nephrectomy had to be postponed 10 days because of my anemia. It was conducted by Dr. Fernando Cordera, oncologist surgeon at the ABC Hospital, on May 14. It lasted three hours. He had no problems.

The relief I felt after the surgery was immediate. The discomfort disappeared by not having in me those two bales that crushed my stomach and my intestines. The bleeding obviously also disappeared.

Without kidneys I had to use an artificial procedure to clean my blood that is known as dialysis. Since I entered the hospital in May, Dr. Madero asked me to put a catheter in the upper right part of my body.

The catheter is a tube that bifurcates in two at one end, like a "y". The tube is inserted at shoulder height and reaches the jugular vein inside the skin. After installation, the patient has two tubes hanging on top of his body, which allow him to connect, via plastic hoses, to a machine, or artificial kidney, so that it cleans the blood.

After bilateral nephrectomy, I had to dialyze three times a week. Each session lasted three hours. For me, some dialysis was quite annoying. When finished, he suffered from severe headaches and severe stomach discomforts.

In medical jargon this is known as "dialysis raw", since the procedure can dehydrate the patient by extracting too much water, causing discomfort similar to those suffered by those who drink excessively.

In spite of everything, dialysis allowed me to live without kidneys for two months, a somewhat strange situation. Although my bilateral nephrectomy was a success, I experienced many emotions prior to that surgery.

The uncertainty that I had about the procedure, combined with the renal pains, distressed me, especially at night. In addition, a certain impotence and despair seized me several times to see me in such poor health. He had lost 12 kilos in less than three weeks.

The wait for the transplant was two months. Elisabeth and I went to the ABC in mid-July. The surgeons Salvador Aburto and Eduardo Mancilla, who collaborated with Dr. Madero in Cardiology, were in charge of carrying it out.

Dr. Aburto does the extraction of the kidney with the laparoscopic technique. Thanks to her, Elisabeth only received three punctures in the abdomen and a small incision on the side of her navel, where her kidney came from.

She returned home three days after the operation, with the normal discomfort of any major surgery, but without a large incision.

A few hours after my transplant, I felt great. I was still half doped by anesthesia and the steroids that I had been given to help my body accept Elisabeth's kidney, when I already noticed an improvement. I was almost euphoric. I had great relief, especially because despite the compatibility that existed between Elisabeth and I, there was still a 15% chance of rejection.

I also felt a new scar on my abdomen, in addition to the one I had in the center of my trunk, where Dr. Cordera took out my two kidneys.

The transplanted kidney is placed in the abdominal cavity, right or left, above the groin. In this area the kidney fits well and is close to the aorta artery, which irrigates it, as in its original position. In this area it is also very close to the urinary tract to which it also connects.

The transplant wound is not small. The cut, in a circular shape, is almost a quarter of a circumference and goes from the lower abdominal part, in the center of the body, to almost the height of the navel, as if the body acquired a mean smile.

Elisabeth's kidney began to work on me perfectly from the beginning. After the operation, my creatinine level, a substance in the blood that removes the kidney and that allows to measure the capacity of renal filtration, was the same as a healthy person.

When I returned home four days later, the only restrictions I had were avoiding multiple visits and staying home as long as possible. If he went out, he had to do it with a covers to avoid contagion.

I also had the strict mandate not to forget to take my medications, mainly immunosuppressants, which allow me to accept the kidney. This task is for life, but insignificant compared to what I won.

One more element of care was to protect me from the sun's rays.Those who take immunosuppressants are more likely to get skin cancer because their defenses are low. To avoid that risk, I wear a hat today, on sunny days, plus every morning I protect my face, neck and hands with sunscreen.

The first month is the most critical period after a transplant. In my case it went smoothly. More than three months away, another crucial period, everything continued to work well. Today I'm still very good, and I've already recovered the weight I lost, not including the 4.3 kilos of my two kidneys removed.

Little by little I have been resuming my activities, but under a new approach. From now on I have decided to live with fewer worries and trying to enjoy to the fullest what I have.

The average life of a transplanted kidney is 10 to 12 years, but there are cases of a longer duration of up to 20 or 25 years. With a decade, I would be more than served, although obviously I do not lose hope that my "spare", lasts much longer.

The burden that Elisabeth and I have had that our children have inherited my condition (they have a 50% chance of doing so) is also decreasing. Apparently, a drug that stops the growth and appearance of cysts is only a few years to become a reality.

I hope that medical science will continue to advance so that it can change, as it did with me, the lives of millions.

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