Living with dialysis

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Living with dialysis
Treatment helps Thibodaux man overcome failing kidneys
By ELLYN COUVILLION
Advocate staff writer
Published: May 1, 2011 - Page: 1D

On a recent Wednesday evening at a dialysis center in Denham Springs, Andrew Barron carefully and expertly inserted two needles into a vein of his arm.

He would spend the next eight hours receiving the life-saving, blood-cleansing process of dialysis.

“Healthy people are getting treatment 24 hours a day from their kidneys,” Barron, 43, explained.

For such dialysis patients as Barron, flexible plastic tubing attached to each needle helps his body receive the cleansing his kidneys can’t provide.

One tube carries the blood out of his body to be pumped through a filter called a dialyzer, which pulls harmful wastes and extra salt and fluid out of his blood. The other tube returns the cleansed blood to his body.

Twenty-five years ago, at age 18 and playing football on scholarship at the state university in Lafayette, Barron was diagnosed with kidney failure due to an autoimmune disease.

Today, still an active man who canoes, runs and bikes, Barron drives about 90 miles from his home in Thibodaux to a Fresenius Medical Care dialysis center in Denham Springs three times a week for overnight dialysis treatments.

Some patients prefer the nighttime treatments over daytime dialysis, to help free up their schedules.

At some point in those evenings, the lights in the large treatment room of the center on Veterans Boulevard will dim, and Barron and others there for nocturnal dialysis will make themselves comfortable in their reclining chairs next to the computerized dialysis machines.

They might watch a little TV on the individual screens over their chairs or look at their laptops, but, most of all, they’ll try to get some sleep, so they can get back to their regular lives the next day.

While a nurse is always on hand at the center to provide assessments and assistance, Barron has become quite expert in handling his dialysis.

He’s been on the treatment for 25 years, except for about three years following a kidney transplant that ultimately became unviable.

“The people that you find that are making it for 25 years are the ones who are really following the clinical plan” that’s been set up for them, said Julie Gable, program services director for the National Kidney Foundation of Louisiana in New Orleans.

The average survival rate for a person on dialysis is two to eight years, she said.

While Barron used an alternative process called peritoneal dialysis for a while, he’s mostly used what’s called hemodialysis, which moves a person’s blood through a special filter.

“To me, it’s very important to understand as much as I can about dialysis. I’m going to learn what I need to learn and do what I need to do, to get by,” said Barron, who holds a master’s degree in soil chemistry and soil mineralogy from LSU.

He works as a water quality screener for the Barataria-Terrebonne National Estuary Program based in Thibodaux.

Along with learning as much as he can about dialysis, Barron also stays fit and watches his diet, particularly his salt intake.

“It all comes down to how much sodium I consume,” he said.

If he keeps that low, it means he doesn’t get as thirsty and doesn’t drink as much liquid — meaning there will be less fluid to be drawn off  in dialysis.

Nocturnal dialysis became available in this area a few years ago and has been a boon for Barron, who recently enjoyed canoe trips for both work and pleasure that he had been able to dovetail with his dialysis schedule.

Healthy kidneys cleanse the blood of waste products and extra water that become urine.

The kidneys also release vital hormones that affect the production of red blood cells, regulate blood pressure and maintain calcium for bones, according to the National Kidney and Urologic Disease Information Clearinghouse.

When kidneys fail and their function drops below 10 percent to 15 percent, a person must have dialysis or a kidney transplant to survive.

Diabetes and high blood pressure are the two most common causes of kidney failure.

Others are autoimmune diseases, inherited and congenital kidney diseases and even a direct blow to the kidneys, according to the information clearinghouse.

In April 2010, there were 7,820 people in Louisiana receiving dialysis treatment for kidney failure, said Torie Kranze, chief executive officer of the National Kidney Foundation of Louisiana in New Orleans.
Federal health insurance programs pay for much of the cost of dialysis treatment.

Besides the physical demands, dialysis also requires a huge emotional adjustment for the person receiving the treatment and their families.

Before he was diagnosed with an autoimmune kidney disease in his teens, Barron had been nauseated for about a month and thought he had the flu. He went to the doctor, though, when his vision became blurred.

High blood pressure had caused Barron’s retinas to hemorrhage, and a search for the cause followed.

“The next day my blood analysis came back and showed that I had already experienced kidney failure. … I was completely confused and devastated,” Barron wrote in an email.

“I was still making urine or so I thought,” he wrote of his 18-year-old self.

But, he wrote, “My kidneys were not actually filtering my blood any more.”

His nausea and vomiting had been caused by excessively high levels of potassium — which would have been filtered out by healthy kidneys, he said.

Helen Stevens is the coordinator of a local dialysis support group, Taylor’s Kidney Support Group, named after the late Albert Taylor, the founder of the group.

Stevens has received dialysis since November 1994. Her diagnosis of kidney failure in the fall of that year took her completely by surprise.

An active woman who went for annual checkups, Stevens went to see her doctor in October 1994, when she was feeling too tired to go to her regular exercise classes, Stevens said.

The doctor told her the culprit was probably her sinuses, she said.

The next day, Stevens got a call from the doctor’s office, asking her to come in for an appointment.

She did — but first she went to the special school luncheon she had helped plan at St. Gerard Majella Catholic School, where she was then president of the parent-teacher association.

It was later that day, at her doctor’s office, that Stevens learned her kidneys had failed, probably due to undetected hypertension.

“I cried all the way home,” Stevens, 63, said.

“It was really life-changing, at first,” said Stevens, who is retired from a Winn-Dixie store.

Eventually, she said, “I just prayed and put it in God’s hands.”

“You have to go on with your life. You have to live,” Stevens said. “God is good. I love my life.”
For more information on Taylor’s Kidney Support Group, which meets quarterly, call Stevens at (225) 241-6479.

In February, Andrew Barron was honored as a “Quarter Century Patient” by Fresenius Medical Care, which is an international provider of kidney dialysis treatment, with more than 2,700 clinics worldwide.

At a ceremony at the Fresenius Medical Care center in Denham Springs, there was cake and a certificate for Barron.

Presenting the certificate was Shad Ireland, a national spokesman for Fresenius Medical Care North America.

Ireland,  38, who was diagnosed with kidney failure at 10, is a home dialysis patient who has completed more than 20 triathlons and biked across the United States.

“I made history as the first dialysis patient to do Iron Man,” Ireland said, referring to the prestigious triathlon event.

He regularly travels throughout the United States, recognizing those people who have reached their 25th year of dialysis and beyond.

“These strong, devoted people help show other patients that there is life after a kidney disease diagnosis, and they can still accomplish great things,” he said.

Kidney transplants — a dialysis alternative
The average wait for a kidney transplant in the U.S. is seven to 10 years, but the National Kidney Foundation hopes to reduce that timeframe with an initiative called “End the Wait.” During the next 10 years, the foundation plans to work with Congress to create legislation that will address barriers to donation. The initiative will seek to:

Improve outcomes of first transplants.
Increase deceased donation, through education of hospital personnel and potential donor families.
Increase the number of living donors by ensuring they are reimbursed for all expenses involved and have access to insurance coverage and state-of-the-art medical care.
Eliminate regional variations in access to transplantation and follow-up care.
Source: National Kidney Foundation of Louisiana and the  National Kidney Foundation

Kidney disease proves difficult to diagnose
Chronic kidney disease too often goes undetected until it’s very advanced, but tests can diagnose it early so it can be treated in the beginning stages with less chances of complications. Some stats about the disease:

- Risk factors for chronic kidney disease include having high blood pressure or diabetes, or having parents or siblings who have those conditions or who have kidney disease.
- One in nine adults suffers from chronic kidney disease and another 20 million are at risk.
- The National Kidney Foundation of Louisiana, with support from the Pennington Foundation, regularly offers free screenings through its Kidney Early Evaluation Program, for people at risk for chronic kidney disease
- For more information on future screenings, call (800) 462-3694 or visit the website, http://www.kidney.org.
Source: National Kidney Foundation of Louisiana

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