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Dialysis Discussion => Dialysis: News Articles => Topic started by: okarol on December 24, 2008, 12:33:37 AM
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'He saved our family.'
Pioneer Press
Updated: 12/20/2008 07:57:46 PM CST
So they saved him. Twice.
You could call him lucky. Maybe blessed. Definitely loved. When Bill Ludtke needed a liver, his stepdaughter gave him hers. And when his kidneys went bad, his stepson was there to give up one of his.
By Bob Shaw bshaw@pioneerpress.com
Talk about marrying well.
Since Bill Ludtke tied the knot with wife Kathy, her children by a previous marriage have saved his life — twice.
A stepdaughter donated half of her liver six years ago. Then, on Dec. 2, his stepson gave him a kidney.
Just as remarkable as stepchildren wanting to donate organs was the fact that they could. The odds of someone finding living donors with compatible organs — among unrelated stepchildren — are astronomically low.
Last week in his Andover home, 70-year-old Ludtke felt like a walking miracle.
'If you knew Bill, you would have offered your kidney or liver, too,' said Kathy, tending to her husband in their town home slathered with Christmas decorations.
Ludtke looked a little tired, sitting on a sofa in his slippers. But he was healthy enough to be the butt of family jokes — as usual.
"A liver? A kidney? We are running out of parts around here!" Kathy said.
"I could use a brain," Ludtke said.
Kathy helped her 2-year-old grandson blow out a candle. She tipped her head back and smiled, basking in the candlelight and love.
"This is all my Christmas miracles wrapped up into one," she said
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quietly. "There are tons of miracles in this family."
EVERYONE VOLUNTEERED
For starters, it is miraculous that Ludtke is alive.
He had polio as a child. Ten years ago, he was a 60-year-old diabetic who had triple bypass surgery.
Only a year later, his abdomen began to swell. He began to feel itchy, and his energy was low.
"I was bleeding to death internally," he said.
Doctors said he would die without a liver transplant. But after two years on a list — waiting for a stranger with a matching liver to die — he gave up.
His only hope was finding a living donor. He began — quietly, awkwardly — to nose around for people willing to risk their lives to save his.
That was when a different kind of miracle paid off for Ludtke.
He had married Kathy Rosandich in 1986. His new family was troubled. Kathy's ex-husband, now dead, was a traveling salesman who served time in prison. Son Tony was taking illegal drugs.
Kathy had adopted Chad, then Nicole.
But Ludtke's strong, steady presence stitched the family together.
"He saved our family," Tony said. "If I could model myself after any man, I would model myself after Bill."
So when Ludtke needed a liver, everyone in his family volunteered.
By coincidence, Nicole's liver matched Ludtke's blood and tissue types.
"I would have been jealous if it had been anyone else," she said.
The operation worked. But a common side effect of a liver transplant is harm to the kidneys.
In 2007, Ludtke wasn't discharging fluids properly and gained 20 pounds of water. He faced a life dependent on dialysis machines, unless he could find a willing donor.
Once again, all family members were willing. But only Tony's kidneys matched.
SWAPPING SURVIVAL STORIES
On Dec. 1, the day before the surgery, father and stepson were prodded, poked and tested at University of Minnesota Medical Center, Fairview.
Ludtke, with a full gray beard, looked like an exhausted Santa Claus. Tony, 35, was on the other side of the generation gap, with a shaved head and tattoos on his muscular arms.
They sat side by side on a gurney, in their too-revealing gowns.
They didn't talk about danger. No one mentioned mortality. But somehow it seemed like a good time to review their lives.
"You want to know my claim to fame?" Ludtke said.
Tony laughed at a story he had heard many times — how Ludtke was a Golden Valley police officer in 1968 and stumbled across an intruder tying up a store clerk. Ludtke aimed his shotgun at the suspect, who turned out to be the Lone Ranger himself, the retired TV actor Clayton Moore.
Only then did the clerk announce Moore had been untying him.
"Afterwards, he gave me a silver bullet," Ludtke said.
Then it was Tony's turn. His moment of fame came from falling through the ice of a lake near Cambridge in 2004, remaining for 90 minutes and surviving unscathed. It made all the newspapers, he said.
The unspoken message: If we survived that, surely we can survive this.
"If you can be OK with one kidney, then why do we have two?" wondered Ludtke.
"So I can donate one to you," Tony said.
Ludtke didn't say thank you. He didn't have to.
PRE-OP LEVITY
The next morning, the family arrived about 7. It would be a long day.
The Fairview pre-operation room seemed like a toga party, with men in gowns, children running underfoot, laughter and teasing everywhere.
"Hey, I know how to do a kidney transplant. I watch 'ER' and 'CSI,' " said Kathy, laughing.
She pretended to guilt-trip son Chad for not contributing any organs. "He is saving his parts for me," she said.
A doctor had trouble finding a vein on Ludtke's arm.
"Do I get a medal for this?" Ludtke said, wincing after the third attempt. When the intravenous tube was finally in, Kathy cried "Touchdown!" and thrust her arms in the air like a referee.
But they knew this could be goodbye. Emotions were as close to the surface as the blood beneath Ludtke's skin, with joy and tears sometimes in the same breath.
Nicole laughed as she showed off the liver transplant scar she nicknamed her "flux capacitor," shaped like an upside-down Y.
Then she gazed at her dad.
"What I did was a selfish thing," she said, wiping away a tear. "I don't know what I would do without Pop."
Doctors came in at 9:05 a.m. It was time to go.
They wanted to work on Tony first, to open him up and make sure everything was OK.
"See you on the other side!" he called merrily, as he waved to Ludtke.
They came for Ludtke at 10:30 a.m.
Kathy said blithely, "This isn't as scary as last time."
Bill lay flat, tubes sticking out of his arms, looking very small on the big gurney.
"Um, I dunno," he said.
"Guess who loves you," said Kathy, hugging him.
The doctors rolled him away.
KIDNEY COMES OUT
If the kidney was a gift, it would be a difficult one to unwrap.
In the dark operating room, a steady beep-beep of a heart monitor mingled with faint Muzak. Nurses and surgeons looked like clones in blue scrubs and masks, huddling around the unconscious Tony. An air pump had puffed up Tony's gut like a basketball, giving them room to move inside him.
The doctors worked through air seals fitted into the skin — one for a TV camera and lights, two for various microcutters and one just big enough for a doctor's hand.
"This is the hand-assisted laparoscopic method," said the voice of Dr. Abhi Humar from inside one of the gowns.
They didn't look at Tony. Instead, they stared at a TV screen and the drama unfolding within him.
It was a production complete with lights, camera and instruments on wands, set against a backdrop of burgundy-red arteries, pink organs, cream-colored fat marbled with veins. The star was the kidney, but it wouldn't be visible for a while.
For hours, doctors gradually cut the organ free of connecting webbing. Over and over, the TV screen showed Humar's fingertip lifting a piece of tissue, then putting a heat wand under it.
Humar pressed a foot pedal, a faint beep sounded — and the TV screen would show a puff of smoke as another vein was burned and sealed. An exhaust system inside Tony kept the air clear.
Such a small amount of blood was leaking that only occasionally did Humar say "vacuum" — and a perforated wand appeared to slurp up a few red drops.
"We are getting pretty close," said Humar at 1:20 p.m. A nurse mopped his forehead.
Using alligator clippers on a rod, a surgeon pulled out several pieces of gauze. A nurse marked the number on a board. No one wanted to leave anything behind.
Humar snipped a tube on the kidney. On the TV screen, clear urine dribbled out of a protrusion that looked like a tiny phallus. "That tells us it's a boy," he joked.
At 1:45, he reached into the theater-in-red, and a giant hand appeared on the TV screen. It caressed the kidney, then lifted it out.
Off-camera, it didn't look miraculous, just a limp wad of flesh the size of a wallet. A doctor put it in a plastic pan and carried it away.
KIDNEY GOES IN
In the room next door, Ludtke had been prepped. A stainless-steel rack kept the carefully carved wound open like a giant mouth waiting to be fed.
Dr. Ty Dunn hefted the kidney, evaluating. "Looks just great — superduper," she said.
She began to seal off veins, as another doctor plucked thread from a tray and made tiny black stitches.
Some of the veins were as big around as the period at the end of this sentence. "But if they tear, they will bleed a lot," Dunn said.
A nurse rinsed the kidney in ice water.
"It's like putting it into hibernation," Dunn said.
At 2:25 p.m., she put the kidney in an unnatural place. Ludtke's two busted kidneys remained in his lower back — but the new one was put in front, into his lower right abdomen.
"There is a cupping in the hipbone where it goes. It has to be close to the bladder, and you have to give it protection," Dunn said. It isn't uncommon, she said, for a transplanted kidney to slip out of place.
Reconnecting a kidney, she said, is like putting a mini football in the bottom of an envelope — then trying to sew tiny threads beneath it.
"You can't see around it," she said. "You are working on something in a hole."
Hours passed. Stitching, clamping, cutting. A pump hissed, and drops of blood slowly crawled up the vacuum tube.
The doctors reconnected layer after layer of muscles, blood vessels, fat. Finally they sealed up the final layer — the skin.
CELEBRATION
On Monday, the family gathered in the Ludtkes' town home for a Christmas celebration.
Nicole picked up Tony's 2-year-old son, Jameson, and expertly flipped him upside down. "Again!" he shouted.
Ludtke and his son were moving slowly, but they could hardly stop smiling.
They marveled at the medical miracles.
"The whole thing was astonishing to me," Tony said. "It was as easy as getting your tires changed."
They raved about the doctors.
"It was everyone, really, right down to the nurses' aides," Ludtke said.
They raved about each other — delivered with the usual tongue-in-cheek humor.
"It's quite a marriage," wisecracked Nicole. "Mom has her faults, and Dad can't see them. Dad has his faults, and Mom points them out all the time."
They teased soft-hearted Ludtke for sometimes weeping over TV commercials and Christmas cards.
"Being emotional," he said, "is such a pain in the ass."
Nicole, who donated half her liver, explained, "He is more emotional because he has girl parts in him."
On the wall was a 6-foot-wide clock made by Kathy. It seemed to be ticking out extra time for Ludtke, extra time for all of them.
Ludtke surveyed the room, taking in everything he might have missed. Nicole was tickling his grandson. Tony was showing off his scar. Kathy was fussing with a centerpiece.
"The thrill of it all, other than surviving ..." He paused, choked with emotion.
"Bill, just spit it out," snapped Kathy.
"The thrill of it all is that my kids are related to me now."
Bob Shaw can be reached at 651-228-5433.
http://www.twincities.com/ci_11277885