Young man stayed strong to the end

02/01/2008
Young man stayed strong to the end
By: Zachary McDonald, Leader staff writer

Editor's note: The Bellevue Leader was saddened to hear that Andrew Pawlak passed away in his sleep early Friday morning. Our prayers go out to the Pawlak family as they deal with this great tragedy.

Andrew Pawlak has gotten over his fear of needles. As he prepares to perform dialysis on himself with a NxStage machine, a new form of dialysis, he has the detached voice of a doctor lecturing a class of medical students.

"On dialysis, they pull the blood out and put it back in at the same time," he said, explaining why he has two fistulas - a vein and artery sewn together - in his arms. "If you do that to a regular vein, it'll explode. [The fistula] strengthens the walls so they can withstand the pressure of pulling blood out and putting it back in at the same time."

But Pawlak, 21, is not detached from the situation. The fistulas are frustrating to him because he can hear the blood rushing through his arm.

"I hear it all frickin' night," he said. "Drives me nuts."

Pawlak is anything but a complainer. When he was diagnosed with Wegener's Granulomatosis, a rare autoimmune disease, five years ago, he went on dialysis immediately. But when his kidneys regained the ability to function on their own the following year, he rejoined the football team at Bellevue East.

Pawlak used to have to go to Dialysis Clinic, Inc. at Twin Creek three times a week for four hours of dialysis each time. With the commute and prep work involved, he would spend close to six hours away from home each time. After getting home, he would go to sleep for a few hours and then go to work.

If the Pawlak family wanted to travel, they had to find dialysis clinics where they were going and set up appointments with nurses and doctors who were unfamiliar with Andrew's case. Whenever he went in for dialysis, he was one of several patients waiting for the attention of four or five nurses. Plus, there are relatively few people Andrew's age who are on dialysis.

Andrew's father, Art, was frustrated for his son.

"You're competing with 20 other people and what do they want to watch on TV and you have to listen to their gripes and complaints because some of them are older patients that are complaining about every ache in their body," Art said. "When you're 20 years old, you're like, 'OK, I don't really want to hear about that.'"

Andrew always asked the nurses to show him what they were doing and to teach him how to do the easy stuff so they wouldn't have to come into his room for every little thing. That independent spirit made him the perfect candidate for a NxStage System.

"He's young and wanted to do all the work at the time," said Milly Greenway, a nurse at Renal Advantage, Inc., where Andrew did his last in-center treatments. "The majority of the dialysis population is an older one. When we see the younger ones come through, we want them to have a life like any other 20-year-old would have."

A nurse suggested Andrew try home dialysis and as soon as he heard there were less dietary restrictions when dialysis was performed more often, he was sold.

"I used to have to watch potassium, phosphorous and sodium," he said. "Well, everything has sodium. Stuff that's high in potassium is low in phosphorous and stuff that's low in potassium is high in phosphorous. When I was following the old diet, my mom and I went shopping and it probably took us three hours because we were looking at the labels for everything."

"I followed the diet originally for a couple months. It was the blandest thing I'd ever had in my entire life. I was basically eating noodles and rice with butter. I read up on the Internet [about the NxStage System] and it said, 'Most people's diet changes,' and I said, 'OK, I'm doing that.'"

Now, Andrew performs dialysis on himself six times a week for two hours at a time. With shorter periods of dialysis, Andrew has plenty of energy to work at Fantasy's Cornhusker gas station on 15th Street, lift weights and hang out with his friends. Plus, now he can travel whenever he wants. He just brings the machine with him and asks NxStage to ship supplies to where he will be.

When he began training to do home dialysis last June, the nurses told him it normally takes three to four weeks, but Andrew wanted to go see his brother in Texas sooner than that.

"I was like, 'No, I think I'll be out of here in about two weeks tops.' After two weeks, they said I looked comfortable with it."

While home dialysis is easier, and Andrew has more energy now than he has in the past three years, his plans for the future are on hold until he gets a kidney transplant. He has been on the waiting list since last April. His immediate and extended family have all been tested for compatibility, but no one was a match except his mother until doctors discovered that she had breast cancer, something Art sees as nothing short of a miracle.

"Did it knock him out of getting a kidney? Yeah. Did it save my wife's life? Yeah, because we'd have never known."

"With him, we're just taking it one day at a time. Some days are good, some days aren't."

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PHOTO: Andrew Pawlak prepares to perform dialysis on himself using a NxStage home dialysis machine. With the NxStage, Pawlak does dialysis for shorter periods of time, giving him more energy.