Marvin Hoffenberg works out, at 86, to be fit for a kidney transplant

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Marvin Hoffenberg works out, at 86, to be fit for a kidney transplant
By LIZ FREEMAN
Posted July 31, 2012 at 4 a.m.

Much of Marvin Hoffenberg's life these days involves two routines — one that keeps him alive and the other which makes him feel more alive.

The 86-year-old moves gingerly, as do most people his age, but he puts aside his cane when he arrives at the fitness center at Kensington Country Club. A devoted friend, Mel Jacobs, just one year his junior, guides him through a workout at the North Naples center.

Later in the day, Hoffenberg is attached to a dialysis machine. Doctors were at a loss, more than three years ago, as to why his kidneys began to fail. It was discovered during triple bypass surgery in 2008.

"Cause unknown," he said matter-of-factly, perhaps reciting the doctor's report.

He doesn't like dialysis — nobody does — but he has no choice. Three days a week, three hours a session.

"If I think about it, I resent it, but I'm grateful because I would be dead," he said. "It's a blessing if you can sleep."

All the while, he's been waiting for a kidney transplant. The exercise, he knows, will make him stronger and his recovery better.

He was told, with luck, he would be on a waiting list for 14 months. That was more than two years ago. Lately, his patience is waning.

"The intensity of my desire to get one is going down," he said. "If I don't get it, I don't get it. I feel like this is my last year I could be considered because of my age."

It is practically miraculous he is doing so well on dialysis, said Dr. Leslie Spry, a nephrologist in Lincoln, Neb., and spokesman for the National Kidney Foundation. He has never met Hoffenberg, but statistically speaking, people who are 86 and on dialysis aren't faring well after three years.

"He would be in the 99th percentile," Spry said. "He would be extraordinary in my experience. He's one of those survivors. He's doing well. You like to see those folks."

Spry said the oldest person he ever transplanted was 82. The patient received the kidney from his 66-year-old daughter, a living donor.

"He went on to live eight or nine years," Spry said.

Between 17,000 and 18,000 kidney transplants are done each year, but there are 90,000 people on waiting lists, he said. Each transplant center sets its own criteria for whom they put on their kidney transplant list; there is no national standard.

Hoffenberg is listed with the University of Maryland Medical Center in Baltimore. That's where he grew up, and after he and his wife of 42 years, Lucia, researched where to go they chose UMMC.

Since he's been listed, the couple has faced numerous false alarms that a kidney was available. Recently they were told he's at the top of the list for "extended criteria donors." That's a list on which the kidneys are from older donors who may have their own medical conditions.

"The extended list is not blue ribbon, but it's going to get him off dialysis and that's what he wants," Spry said.

So far this year, the Hoffenbergs have had 17 alerts from the Maryland hospital that a kidney may be in hand for him.

"We went once last year, in September," his wife, 68, said. "We flew to Baltimore and when he got ready for the surgery, the surgeon came out and said the kidney was not good. It was devastating."

Since then, the couple has learned to temper their expectations. During a dinner party once at their home in Naples Bath and Tennis Club, they got an alert call from the hospital. They continued the evening with their guests, knowing how much false hopes can hurt.

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Hoffenberg worries at times his frailties are burdensome to his wife, who is 18 years younger.

"I make more and more demands," he said. "I appreciate it and she knows I appreciate it. She is the nicest person in the world you can find. Lucky me. Lucky me."

They met in Brazil, where Lucia is from, when Hoffenberg was a foreign service officer with the U.S. State Department in Rio.

"I wouldn't call it love but interest," he said when they met she walked into his office one day in the American Embassy. He was a widower with two young sons.

"I had three boyfriends," she said, describing him and his two sons, Bill and Edward. One year into dating, Hoffenberg was transferred to Brazilia, hundreds of miles away from Rio. The slow pace of their romance would change.

Hoffenberg recalls telling her, "I'll see you," he said. "But I couldn't last so we got married."

Their years in South America were good, especially in Brazil.

"I liked the people. I liked being there. I liked the food," he said. "We traveled, went to parties, danced and just loved each other. We have complete confidence and trust in each other."

After returning to the United States, he worked in the State Department, reviewing records for release under the Freedom of Information Act. His wife worked as a medical librarian for the National Institutes of Health.

They've been coming to Naples part time since 1987, and became full time residents in 2004.

Like clockwork at 9:15 a.m. on Mondays, Wednesdays and Fridays, Jacobs picks Hoffenberg up at his home. Jacobs also lives in Naples Bath and Tennis, but neither can recall how they met. Maybe it was through their wives, Hoffenberg said.

Fifteen minutes later, they arrive at the Kensington fitness center, which they joined about two years ago.

"They come through that door religiously," Marion Johnson, the center's director, said.

When they started coming together Hoffenberg couldn't do much, Johnson recalled. She put together an exercise plan for him and he takes part in his wife's water aerobics classes she teaches at the club on Tuesdays and Thursdays.

"He doesn't miss one of his sessions with Mike, (his) physical therapist. He doesn't miss one of his sessions with Mel," Johnson said. "It's only because he has the desire to keep himself at a place physically so when he gets to the transplant, he will recover faster and have physical stamina."

Hoffenberg can handle 50 pounds on the chest press, but he and Jacobs lose track of his repetitions. He does at least five nautilus machines, some free weights and rides an upright stationary bike for 20 minutes. Sessions with his physical therapist, Michael Betlach, focus on functional mobility with a lot of balance exercises for real-life needs.

"I don't think I've ever seen someone who does dialysis and who works out," Betlach said. "It's been a challenge, but he's progressed a lot. I wasn't sure. The first time I saw him, he was barely doing anything. Now he goes for 50 minutes. He might sit for a few seconds."

At 11:15 a.m., they call it a day.

"He needs to rest before dialysis," Jacobs said.

Hoffenberg accepts his limitations, and aging, but that wasn't always the case.

"I really denied it for a long time. Now I can accept it but only in the last few years. I just thought 'Fix it,' " he said. "Now I don't think it is all fix, fix fix anymore."


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