A Kidney Story

When it comes to our physical well-being, it seems that getting rid of this symptom or numbing that pain is enough to set us on the path to a healthier life. Wonder drugs and revolutionary treatments have allowed us to be reckless with our health. Until we get a rude wake-up call.

 
A few years ago, my brother went to see a dietitian for his weight problem. Let’s call the dietitian Dr. X. He was a nice man, my brother said over the phone during one of our late-night conversations. Dr. X prescribed my brother – who was about 90 kg and 164 cm tall – some “special” meds. “Special” because they weren’t sold over the counter and, he assured my brother, those pills would work magic.

Within a week, my brother found himself grateful for Dr. X’s drugs. He recommended them to friends and family, and marveled at how fast and easy it was to lose weight. My mother was pleased he had lost weight, yet mostly she was concerned. She told me it was too fast, too easy.

About three or four months later my brother had his routine medical check-up test. One particular reading showed his creatinine level at three times the normal range. No one in the family suspected anything. No one knew what creatinine was. So he went back to see the dietitian.

Dr. X pored over the report, nodded every once in a while and said everything was OK. He told my brother to continue his medication. The next blood test my brother took a few months later showed his creatinine – indicating proper renal function – at 10 times above normal. This time the dietitian’s reaction was very different.

“He was unusually quiet,” my brother told me of the last visit he paid Dr. X. “His face turned paler and paler with every second. Then he gave me a referral – some kidney specialist in town.”

The following day, my brother made an appointment with the kidney specialist. He wasn’t too concerned because he thought it was just one of those things that another set of drugs could fix in no time.

“Why did you wait so long to see me?” asked the kidney specialist.

“I didn’t know I had to see you until Dr. X referred me to you,” said my brother, inside the specialist’s office-slash-examination room. “Why, what’s wrong?”

“Dr. X should have told you to come here much earlier,” said the kidney specialist; his voice – according to my brother – had that weight of regret, of something terrible that could not be undone. Something fatal.

The facts were these: his kidneys were shrinking, functioning at a maximum of 10 percent capacity and for the previous few months his body had slowly deteriorated in anticipation of a kidney failure, all the while retaining too much water and with escalating blood pressure.

He would have to either go on dialysis for the rest of his life or get an immediate transplant.

“Look, it’s much too expensive for me to get a transplant and I really don’t want to go on dialysis,” said my brother, near tears. “I don’t want to get any treatment. It’s going to be fine.”

At my mother’s insistence, my brother took a red-eye out of Jakarta to get a second opinion in Singapore.

Again, the prognosis was poor. He was given two weeks to prepare himself for transplant surgery, which turned out to be 14 days of misdirected anger, frustration and despair.

Now, were the diet pills to blame?

“It could be a number of things,” said a nurse friend of mine, who worked as an emergency medical technician in Boston when I asked for advice. “But the doctor who treated your brother should have told him the first time he saw something was amiss.”

On the eve of my brother’s surgery, it didn’t matter anymore whose fault it was. It only mattered that he came out of the surgery room OK. My mother and sister-in-law waited by his bedside after he went through the six-hour operation. Groggy and in pain, he smiled when he finally opened his eyes.

I had my ear pressed against the phone for the better part of the longest night in my life. No one had gotten any sleep, save for my brother who was somewhat high on morphine. My aunt, who was the kidney donor, said to me, “It’s OK. Everybody’s OK now.”

But that’s an exaggeration. Anyone who has ever undergone a kidney transplant, or who is related to a kidney transplant patient, knows the end of a successful operation is far from the end of the patient’s struggle for health. It usually never is.

The specialist who treated my brother warned him that the biggest, most difficult, challenge he would have to face for the rest of his life was to kick his old eating habits and adopt a new, healthier lifestyle – no more late-night partying; no more quick trips to food courts at the mall (where he loved to tuck into high-protein, high-fat favorites); no cigarettes; and, most importantly, no alcohol.

If the surgery had taken six hours, it took my brother three years and about half a dozen red-eye flights to Singapore to realize the truth of what the specialist told him. For three years, he carried on with life as if he was the devil-may-care teenager back in high school, despite our warnings.

That was until the day he came down with terrible diarrhea that confined him to a hospital bed for a week. My mother and aunt begged him to change, his wife cried for days on end. I held myself aloof from the situation, fearing the worst but believing my responsibility for his health stopped when he refused to make a difference. That was when he sent me a text message:

“I’m sorry,” he wrote, “I promise to try harder this time. Now I’ve learned my lesson.”

And so he had. A long, difficult and painful lesson that continues to this day.

+ Maggie Tiojakin

Back to The top page