By: Archie Graham
The Only Five Time Transplant Recipient
In 1960, I contracted glomerulonephritis from strep throat. I was four years old. That was the beginning of my End Stage Renal Disease (ESRD). For the next fifty-three years I experienced many successes and pitfalls relating to renal failure. However, this is about some of the social, technological, and emotional changes I experienced during those early days of renal failure.
Let me fast forward ahead six years. I was ten years old. I had lost kidney function in both kidneys and was receiving peritoneal dialysis. At this time, peritoneal dialysis was quite painful and definitely traumatic for anyone, especially a ten year old child. The process involved having a small incision made right below the navel. A physician would stand on a stepping platform beside the bed and place a sterile plastic tube with a sterile metal rod within the plastic tube over the incision and push it through the small incision, into the peritoneal cavity. Lidocaine was placed at the incision site to numb the pain. After the plastic tube had been inserted, the metal rod was removed; and, the isotonic solution was allowed to go into the peritoneal cavity to begin the diffusion process of dialysis. The entire dialysis was endured for approximately twenty-four hours. Three days would go by before the process was repeated.
During this time I was enduring peritoneal dialysis, which was about six months, my parents and I were told about hemodialysis. We visited a dialysis center at the hospital where I was receiving the peritoneal dialysis. It was frightening and fascinating to see the patients on dialysis and the blood going out of one tube in their arm, into the machine, and returning to their arm through another tube. I remember thinking, “This definitely doesn’t seem as bad as peritoneal dialysis.” A discussion among my physician, my parents, and myself, followed the visit. The one thing that stands out from that discussion is that the doctor said that I would have to be evaluated, completely. I was not sure what he meant at that time; but, I soon found out.
One week after the hemodialysis visit and discussion, I had the pleasure of meeting a psychiatrist, psychological, and a special phlebotomist. Seven large tubes of blood were taken first. After the phlebotomist left with the tubes of blood, the psychiatrist and psychologist began asking me numerous questions, As I answered, they wrote on their paper pads. I was somewhat confused. My parents had always been there when the doctors were around. Why weren’t they there now? I wasn’t afraid! I just wondered! Two days after that inquisition, three doctors and a nurse came into my room. They said they were there to perform a “complete physical.” Again, I was not scared, just wondered what was going on. At the end this “complete physical,” one of the doctors said, “Young man, are you alright? Are you scared?” “No,” I said calmly, as I looked him in the eye. “I would like to know why all of the questions and what is all this for?” “It’s about you, young man. I can say that I am not half as brave as you are,” as he shook my hand. All of the doctors and the nurse walked out of my room.
The next morning, I was awakened early by the nurse. Apparently my parents were waiting downstairs for me. I thought I was going home. I soon found out I was going to another hospital. I was going to meet “The Panel,” as it was called. I realized later that “The Panel” was a group of medical professionals, including the State Supervisor of the State Department of Rehabilitation. These were the people who made the decision about who would and would not receive hemodialysis. In the 1960’s, there was a shortage of dialysis machines. Hemodialysis was not available to everyone. Having health insurance was not a determining factor when it came to the final decision of The Panel. Each case was decided individually. Fortunately, I was chosen to begin the in-home dialysis training program, which was a pilot program. A total of five young people were chosen for the program. I was the youngest; and, the one least likely to succeed.
In spite of the odds being against me, I am fortunate and blessed to be here today. Hemodialysis has definitely improved since the sixties. It has progressed from eight hours a day, three times a week to approximately three and one-half hours a day, three times a week. The machines have decreased in size and the per-treatment cost has actually decreased. It continues to get better with time as the technology improves. There is even a surgically-implantable kidney on the horizon, a far cry from The Panel-driven dialysis days from which I began.