Walking 1,000 miles to give her sister the gift of a kidney

[okarol]

December 16, 2008

Walking 1,000 miles to give her sister the gift of a kidney

By JILL FREDEL
The News Journal

I promised my sister.

Those simple words kept looping through my mind as I lay in the MRI tube, listening to Sister Sledge sing "We Are Family" and wondering whether I would pass the tests to be a kidney donor for my older sister.

Two years earlier, as she lay similarly in a hospital bed in Washington, D.C., with failing kidneys, I told her if she needed a kidney transplant, I would give her one of mine.

At first, it seemed so simple.

A few months after tests confirmed that my sister Ellen's kidney function was severely limited, I called the transplant coordinator at Georgetown University Hospital in Washington to arrange for blood tests and other physical tests to see if I was eligible. The coordinator asked for my weight. She hesitated. She asked for my height.

"You need to lose 50 pounds" to get to an acceptable body mass index, she told me.

"I can't donate right now?" I asked in disbelief.

We made arrangements to get my blood tested, because there was a 50 percent chance that my sister and I wouldn't be compatible.

I passed that test, and, as Ellen continued dialysis three times a week, I made a commitment: I would lose the weight by walking more and eating less. I would walk each morning -- 2.6 miles around Glasgow Park -- and several nights a week on a treadmill.

To carve out the time, I decided to watch less TV and to get up earlier. Next, I needed a walking goal.

I calculated: 2.6 miles, times five mornings per week, times 48 weeks (I gave myself vacation, sick time and bad-weather days). On the calculator, 600 miles was very doable.

On the food front, I took my husband Brad's advice and didn't deny myself any one food or drink because it would just make me crave it more. I just ate less of everything and increased my daily servings of fruits and veggies.

I did simple things. I switched from cheeseburgers to hamburgers. I ordered my grande Starbucks mocha nonfat and no-whip. I drank more water. I switched from ice cream to frozen yogurt or sorbet. Instead of two or three slices of pepperoni pizza at Grotto's, I ate one slice and a salad.

The worries set in

Month after month, as I followed this change in my lifestyle, I worried that I wasn't losing weight fast enough, especially when my sister had the inevitable physical setbacks and hospitalizations. She was patient, encouraging, stoic. I thought I was letting her down.

I hated the weight-loss plateaus and wondered whether I really could lose all of this weight. On top of that, I felt the pressure of having another person depending on me.

I kept walking -- on snowy days when I fell on the ice, on rainy days when mine was the only car in the parking lot, on 90-degree days when the sweat dripped into my eyes, on windy days when I didn't think I could walk 100 feet.

I passed 600 miles and reset my goal for 1,000. The pounds came off. My husband told me how proud he was of me for not only losing the weight, but also for getting up every morning to go to the park when it would have been so easy to say it was too cold, too hot, too windy or too early.

I lost weight in my face. My butt got smaller. So did my stomach. My watch slid around my wrist. My rings slipped off. I dropped four clothing sizes.

This year, in September, I called the transplant coordinator: I had lost the 50 pounds. In less than a week, she scheduled me for meetings with a surgeon, a nephrologist -- a kidney specialist -- and a social worker, and set up blood and urine tests, a chest X-ray, an EKG and an MRI. My sister underwent testing, too.

The surgeon told me he would make three incisions -- small ones on my left side and above my belly button and a three-inch cut at my belly button through which my left kidney would be removed. The left one is taken because the right one is less likely to be injured in a car accident or other trauma.

He talked me through what to expect. I would be in the hospital for 24 to 36 hours. I would be driving within a week after that, and back to work one week later. My only restrictions post-surgery would be to avoid pain-relievers such as Advil, Motrin or Aleve, which can be difficult for the kidneys to process, and check with my doctor before using any herbal medicines, which also can be tough on kidneys.

He told me he would approve me for the donation.

They wanted the 'why'

From there, I met with the social worker. She wanted to be sure I was donating freely and that my sister or anyone else hadn't pressured me. I assured her I wanted to do this and that I had made a promise to Ellen to help.

The next day, I met the nephrologist. He said my life would change little after donating my 4- to 6-ounce kidney. My risk of kidney disease or failure would be no greater with one kidney than with two, but that my doctor would need to monitor my kidney function. He complimented my weight loss and said I would need to lose another 25 to 35 pounds so I wouldn't overtax my remaining kidney.

His final question was the same as everyone else's: Why did I want to do this?

The answer was so multi- layered that it was difficult to untangle one part from another. My sister needed this kidney to lead a life that's less painful, less complicated, less difficult. I can give it because I am healthy, and because I have two kidneys that work fine. I wanted to give it to her so someone else who needed a kidney transplant could use one from someone who has died. And, most importantly, she is my sister and I love her.

At this point, my eyes were filled with tears, and I knew the doctor saw this, but I refused to wipe them away because I didn't want him to think I was weak.

He said he needed to see the rest of my test results, but he didn't see any reason not to approve the surgery.

All of the members of the transplant review panel would convene in less than a week -- with the results of my tests and my sister's tests -- to make a final decision. As Tom Petty sings, the waiting is the hardest part.

My sister and I had decided if we were approved that we wanted to do the surgery the following week. We didn't want to wait any longer. Our husbands agreed.

On Oct. 1, the transplant coordinator called me at work. We had been approved.

The surgery was scheduled to start at 7:30 a.m. Oct. 7 at Georgetown University Hospital. I would go first and my sister a short time later.

Early that afternoon, I woke up in post-op, asking for my husband and about my sister.

"How's Ellen?" I croaked when my husband was allowed to see me.

"She's in ICU with a new kidney," Brad said.

There was one more thing I wanted to know.

"It's working," he said with a smile.

Two years after I had visited my sister in the very same hospital, I had only one thought: I had kept my promise.

Contact Jill Fredel at 324-2859 or jfredel@delawareonline.com.

http://www.delawareonline.com/article/20081216/LIFE/812160338