If he'd had a choice between contracting the Human Immunodeficiency Virus (HIV) or developing kidney failure, Marcellus Miller, an eight-year dialysis patient said having the HIV virus would be a much more attractive option. This may sound alarming, but the 38-year-old believes that life with HIV is much better because he believes it at least offers a quality of life that kidney failure does not.
Miller said many people do not fully understand to what extent being on dialysis indefinitely means and that it more or less ends your life.
"No matter what you do or how healthy you may try to be, being on dialysis will take its toll and your life is definitely in limbo. On the other hand [with] HIV/AIDS, although there is a stigma attached to it and it has its downfalls, it doesn't stop life if you take care of yourself. You at least have a greater chance of living a normal and unhindered life as long as you stay on the recommended medication and remain healthy. On dialysis you are not so lucky. You can do everything to the moon and back and you can still just die due to complications or with no warning at all."
Knowing that his heart could fail, or that he could go from feeling great to awful in a split second is a scary prospect that he has to live with daily.
It took him a long time to come to terms with the many lifestyle changes he had to endure due to having kidney failure and being forced to use a hemodialysis machine to have his blood cleaned.
Developing kidney failure was not a surprise to Miller. Because he was diagnosed with type 1 diabetes at the age of seven, he grew up knowing that he would probably have to face issues like an enlarged heart, blindness or kidney failure one day.
"My doctors actually were surprised at how long it took to happen since I was about 30-years-old when my kidneys just gave out. So I knew it would come and I would just have to make changes but how much it would affect my life never really hit me until it happened."
When it happened though, he was still not mentally prepared. Adjusting to dialysis and his new life was hard for him. He described it as traumatizing. The young man who had always been on the go, continued his world travels for a year after his diagnosis as he attempted to continue with his normal.
"At first, I missed out on a lot of dialysis sessions. I still traveled as usual and would attempt to do dialysis in another country when I could. I don't think I paid attention to my diet as well as I should've at first either. It was such a big adjustment for me. It took me getting tired of feeling deathly sick, and spending so much money to do dialysis in another country for me to just say that I had enough. I knew I had to slow down and fully grasp what was happening to me after a while."
He started to take care of his health and tried to do what he knew was best. He watched his diet, and committed himself to his four-hour long three-days per week dialysis treatments at the Princess Margaret Hospital.
No joking matter
Kidney failure is nothing to joke about and why people should pay attention to their health, said nephrologist Dr. Ronald Knowles. He said most kidney failure can be prevented, or at least put off until much later in life, but that many people do not take it seriously until it is too late in most cases.
"Most people are under the misconception that kidneys only do one thing - filter toxins from the blood, but this is not so. Kidneys actually are essential for three main things in the body. They remove toxins that accumulate in the blood. They regulate the body's water content which is important because without it you can bloat excessively, [and] they also work to control blood pressure and certain mineral levels within the body like sodium, potassium and calcium. Without these organs (kidneys) a person is prone to further health problems and death."
Most people attribute kidney damage and failure to not drinking enough water on a daily basis. Although the lack of fluid intake is a contributing factor, the leading causes of kidney failure are uncontrolled high blood pressure and diabetes, according to the doctor. And these two chronic conditions are responsible for at least 80 percent of the kidney damage and failure in Bahamians.
"Diabetes and hypertension are two conditions popular in our country and this wouldn't be so bad if people did what they had to do to regulate them, but they don't for the most part. This is why we have so many people who are suffering from kidney failure."
The medical professional urged people to remain vigilant about their health.
"If you are monitoring your blood pressure, it should be less than 135/85. A controlled blood sugar level is less than seven percent when a [hemoglobin A1c] test is done. A regular urine analysis is not enough anymore because it's not the most accurate in determining blood sugar levels. I think it is important to do things the best way you can so you know what just what is going on in your body."
Eat your fruits and vegetables
To ensure one's kidneys are in the best health, eating fruits and vegetables regularly is key. Cutting back on salts and eliminating fast foods as much as possible is also important. Also, keeping up with exercising, drinking adequate water daily and doing an annual physical is a good addition to your health regimen.
Even if you do all of that, there are still some people who will develop kidney damage and eventually failure, said the doctor. In those cases, he said it's usually an inherited defect or due to other health related problems that overtax the kidneys and shut them down. No matter how someone developed kidney failure, Dr. Knowles said there are ways to deal with the problem and that someone with kidney failure does not have to feel like their life is over and that they have to give up everything.
Treatment options
There are three main options for people with kidney failure - a kidney transplant, hemodialysis and peritoneal dialysis.
The best treatment is always a kidney transplant, said Dr. Knowles, but transplants are usually hard to get if a patient does not have a relative who is compatible and willing to give a kidney.
Hemodialysis, the form of treatment most people are familiar with is a good option to use until a transplant can be performed. Hemodialysis requires patients to visit a clinic three times a week for four hours each time in order to cleanse the blood of toxins by using a dialysis machine. The third option, peritoneal dialysis, is a good way to go for patients requiring more freedom and not minding a more hands-on experience with their dialysis treatments. It is a personal dialysis procedure in which the patient undergoes a minor surgery to insert a catheter or permanent tube in the stomach. This allows fluids to be introduced into the stomach and then toxins like urea and excess glucose from the body diffuse across the peritoneum - a layer in abdomen - to be drained out later. The process usually needs to happen three or more times a day. The doctor said this option is good for people with busy lives who don't have the time to visit a medical facility three times a week. It does have a downside because people with the catheter are likely to get infections at least once a year because of it.
"While there are ways to deal with this problem (kidney failure), people do have a higher likelihood to live shortened lives. This is due to other health related problems that arise due to their kidney disease and failure. Most people with kidney failure tend to die from heart disease later on and it happens so quickly it is unexpected," said the nephrologist.
"But if one is healthy and their own ailment is kidney problems, they have a possibility of living 20-plus years after commencing treatment and staying healthy. The reason other people can die a week or months into treatment is usually due to other ongoing problems like poorly regulated diabetes, hypertension, pre-existing heart conditions or other chronic ailments. Having kidney disease and doing dialysis only adds to the strain on the body and this can eventually lead to early death in the long run. Even so, I encourage all persons to just stay positive and be as healthy as possible. Kidney disease is only one of the many problems that exist due to poor health, so this is not the only problem to look out for," said the doctor.
Not an easy road
Miller said dealing with his kidney failure and dialysis has not been easy and that he misses many of the things he used to do, but that he's happy he is doing better and that he's actually now doing what is right.
"Having something like kidney failure really makes you see things in a new light. You realize what is most important from what isn't. I have definitely grown closer to God and just learned to laugh at life and myself a lot more. It's not an easy road but it is one that you have to make the best of," he said.
He encouraged people who have to undergo dialysis to find support in family members and in other people who are going through the same thing.
"If there was one lesson I have learned in doing dialysis is that you have to keep positive and do all that you can to keep busy. You can't think about yourself anymore and sometimes the only way to get through life at this point is to laugh and just enjoy the small things. I have grown a great sense of humor and a sense of giving that I never had before. To me it's important to just keep on going no matter what."
After eight years of dialysis treatments and sporadic visits to the hospital's emergency room, a ray of hope is being shed on Miller's life. A kidney match has been found for him and he's scheduled for a 2015 transplant. He said it's the best thing he could imagine happening to him and that he was looking forward to living a better quality life in years to come.
Click here to read more at The Nassau Guardian
