The Hemodialysis Marathon ManNelly Edmondson Gupta
October 16, 2007
At age 67, Ed Strudwick's nearly 36 years on hemodialysis may be a world record
No matter how ordinary his life looks from the outside, though, Ed Strudwick, 67, is not a typical senior. Three times each week since February 1972 he has undergone hemodialysis, a nearly 36-year time span that could possibly make him the longest-surviving dialysis patient in the world. Strudwick's nephrologist, Robert Rigolosi, MD, says he attributes his patient's longevity to several factors. “Ed is very compliant,” says Dr. Rigolosi, director of the hemo-dialysis department at HolyNameHospital in Teaneck, N.J. “He does exactly what we ask as far as following a diet and taking his medications are concerned. He arrives on time and stays for the entire length of his treatments. He's also got great family support and good medical care.”
While Strudwick's record-breaking dialysis survival is certainly cause for celebration, he, his family and his medical team have faced numerous challenges and setbacks over the years. On a recent morning, as blood flowed through tubes connected to a state-of-the-art dialysis machine and into his left thigh, Strudwick shared his experience with Renal & Urology News.
A medical odyssey
When Ed Strudwick was 31, he was diagnosed with pyelonephritis, which led to hospitalization and, ultimately, kidney failure. Doctors told him his options for survival were few. “At that time, access to dialysis was limited,” Dr. Rigolosi says.
Under the hospital staff's supervision, Gloria Strudwick learned how to dialyze her husband, something she continued to do for the next 25 years. This arrangement enabled Strudwick to keep working, fitting in his treatments around job and family commitments. “If I worked the afternoon shift, I'd dialyze in the morning; if I worked the midnight shift I'd dialyze in the afternoon. And if we had a family party to go to I'd just dialyze the next day. As long as I dialyzed three times a week, it was fine.”
In 1977, Strudwick underwent a cadaveric kidney transplant. Unfortunately, it was a disaster. “I never got out of the hospital,” he says, grimacing at the memory. “My body started rejecting it immediately and they had to take it out.”
After that, Strudwick decided dialysis was the way to go. “When Ed was younger, we encouraged him to go back on the transplant registry,” Dr. Rigolosi says. “But he had a bad experience and just didn't want to go through it again.”
Dialysis itself, however, was hardly a bed of roses. In 1988, in the days before erythropoietin-stimulating agents, Strudwick underwent numerous blood transfusions following an episode of internal bleeding. As a result, he contracted hepatitis B. Then, in 2000, Strudwick needed a heart-valve re-placement. Since then, he has added Coumadin (warfarin) to a medication regimen that also includes vitamins, antacids, phosphate binders, and anti-hypertensives. He has also had num-erous vascular access complications, including infections and clotting problems. Because he has been on dialysis for so long, he's also “running out of vascular access sites,” says Dr. Rigolosi. “He's had fistulas, grafts, and catheters in his neck.”
He has also lived through many of the problems encountered by dialysis patients in the past. For example, physicians used to give patients phosphate binders that contained aluminum; those who took them often developed aluminum toxicity-related encephalopathy that caused convulsions and disorientation. “Ed's been through that era,” Dr. Rigolosi says, “and he survived it.”
In fact, both men have been around long enough to see vast improvements in the dialysis field. “In 1969, it took almost an hour to set up one machine,” Dr. Rigolosi relates. “Today, the
technicians do it in 15-20 minutes. The monitoring is better; solutions are better; the dialyzer itself is better.”
“When I first started, they had a machine with a big plastic tank on the bottom that held 30 gallons of water;” adds Strudwick. “And I was on the machine for six hours at a time. Then the equipment got better and now I'm down to just three hours.”
Living with limits
About 10 years ago, when Strudwick stopped working, he began coming to the hospital for dialysis treatments to give Gloria a much-needed breather. Once the children were in school fulltime, she'd taken a job in the laundry department of a nearby nursing home. “She got the job to help pay for our daughter's braces,” Strudwick says. “And 25 years later, she's still there.”
Although dialyzing at the hospital is less convenient than doing it at home, coming regularly to Holy Name has made Strudwick feel closer to his health care providers. The doctors, nurses and technicians, he says, have become “almost like family.”
His fellow dialysis patients, however, are a different story. Although Strudwick used to attend Christmas parties with the other dialysis patients when his daughters were small, he doesn't go out of his way to socialize with them. “You'll come in and say, ‘What happened to so and so?' And someone will tell you, ‘Oh, he had a heart attack and passed away.' Luckily. I've been able to live through it.”
The price of survival has been learning to live within strict limits. Al-though he's allowed to drink a quart of fluid a day, Strudwick has trained himself to drink no more than a pint. “Last weekend, my wife and I took our two granddaughters to Lake George,” he says. “We left Friday and came back Sunday afternoon, and I don't think I gained even 2 kilos. Some patients come back from a weekend having gained between 10 and 15 kilos; they just can't stop drinking.”
He also knows what he can and cannot eat. “I haven't had a banana in over 35 years,” he says. “My wife has them in the house, but I know I'm not supposed to eat them so I don't touch them.”
When Strudwick wants to travel, he and his doctors must plan his trips carefully, making sure not only that there's a dialysis center near his destination, but that it accepts patients with hepatitis. “I envy people who can just pack up and take off. I cannot,” Strudwick says.
He has not let these limitations stop him, though. Two years ago, one of the hospital social workers helped Strudwick get an electric scooter, which he uses indoors and out. Back and leg problems had made it difficult for Strudwick to get around without a walker, but as soon as he got the scooter, he and Gloria added a deck and a ramp to their house to help Ed navigate. “I can go around the neighborhood to visit and shop,” he says. “And when we travel, we just put the scooter in my wife's van and go.”
It is Strudwick's tenacity of spirit, Dr. Rigolosi says, that has helped him overcome so many of the problems and challenges that dialysis patients face. “The fact that we can keep Ed alive and he can go about his daily activities and lead a normal family life with his wife, children and grandchildren—that's an accomplishment in itself,” he says.
Dr. Rigolosi notes, too, that Strudwick's example serves as an inspiration for others. “Ed's a role model. I frequently have new patients ask me, ‘How long can I live on dialysis?' And I say, ‘We have a patient here who's been on it for 36 years and he's doing okay. It takes a lot of endurance and will to survive,” he concludes, “and Ed's got them both.”
From the October 2007 Issue of Renal And Urology News
http://www.renalandurologynews.com/The-Hemodialysis-Marathon-Man/article/58020/
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