Kidney Dialysis: A Way of Life for Sandy Mikesell ; Through Organ Donation You Can Give the Gift of Life ; Medical Briefs

              SHREVEPORT JOURNAL Tuesday PM SHREVEPORT-BOSSIER CITY, LA.. MARCH 9, 1982 Your Health
Kidney dialysis: A way of
life for Sandy Mikesell
By NANCY MORRIS
Neighborhoods North Reporter
Eleven years ago, when Sandy Mikesell was
four months pregnant with her third child,
Charley, she began to retain fluids and have
high blood pressure. Her doctor told her that
she had the symptoms of toxemia of pregnan-cy,
which, he said was unusual since those
symptoms usually show up during the first
pregnancy and then only in the last months.
The doctor treated Sandy — she went to his
office every day during her pregnancy — but
he was not able to do much in the way of tests
until after the baby was delivered.
After the baby was safely delivered,
Sandy's doctor sent her to be tested and, Sandy
said, "It turned out that I had the functioning
of one kidney between both of my kidneys,
which meant they were both damaged."
To Sandy, there seemed to be no "rhyme or
reason" as to why she had this kind of kidney
damage. She had never been sick — never had
any kidney infections that she knew of — and
she didn't understand why, all of a sudden, she
had these problems.
Sandy knew it was serious because she had
worked in a dialysis unit in a local hospital,
and had even dialyzed her mother (ironical-ly,
Sandy's mother was born with a "horse-shoe"
kidney and had to be dialyzed the last
Sandy waits for
kidney transplant
By NANCY MORRIS
j Neighborhoods North Reporter
She has no kidneys. And she has to go to LSU
Medical Center and undergo dialysis three
times a week — at five hours a sitting. She has
a husband, and she and her husband have three
sons. And she worries more about the effect of
her problems on her husband and sons than
she worries about herself.
She is a candidate for a kidney transplant,
but she is a "high risk" candidate — she's
already had one transplant and she rejected it.
But she isn't afraid. She isn't afraid to die —
she faces death every time she undergoes
dialysis. Or faces another blood transfusion.
Or faces another surgery. And she isn't afraid
to live — she faces life every day she wakes
up and is still breathing.
She isn't bitter. In fact, she is probably
happier than most people walking around.
Because, she says, she has "experienced love."
She talks about the times when she has
"actually felt people's prayers wrapped
around me." And she talks about the cards,
letters and flowers that people have sent to
her throughout her numerous hospitalizations.
She smiles when she speaks of the man
whose children attended school with her sons.
He walked into her hospital room one day and
offered her one of his kidneys.
And tears come to her eyes when she speaks
of the little kindergarten child who ran up to
her car one day while she was waiting in the
school parking lot for her children. The child,
whom she had never met nor even seen
before, came to her car window and asked,
"can I hug your neck?" She answered in the
affirmative, and then the child said, "I have
said prayers for you every day since I knew
you were sick."
She says that "Shreveport is a city of love,"
and goes on to tell about how, during the snow
and ice last winter, the Caddo Parish Sheriff's
Department sent a squad car out to her house
and brought her to LSU to be dialyzed.
And she comforts all the people who care
about her. All the people who love her and are
scared for her. When she rejected her kidney
transplant, a lot of the people in her world —
including her children — asked why. And she
would tell them that "it just wasn't the right
time. God didn't want to heal me for some
reason. Whether God heals me by giving me a
kidney or whether he'll take me home one of
these days, it will still be fine with me."
She talks about the team of kidney special-ists
at LSU Med Center — about how caring
they are. How very much the team cares
about the patients. And how much the patients
care about the team.
Most of all, she talks about hope. And she
says that even if she doesn't live, she hopes her
problems will help in the research that is
being done to help others live.
But though she talks about all these things,
what she mostly does is wait. She waits for her
appointments for dialysis. And she waits for
her blood transfusions. She waits for more
research to be done on kidney diseases. And
she waits for more people to realize that many
lives could be saved with the donation of
kidneys.
Most of all. she waits for the phone to ring.
And for the voice on the other end of the
receiver to say, "we've found a perfect match
— come quickly."
five years of her life. But her mother's disease
was totally unrelated to Sandy's, which is not
hereditary).
So Sandy asked the doctors why. And they
told her that she had probably had a low-grade
kidney infection since she was a little girl but,
because she was an otherwise healthy, robust
child, it never showed up. The doctors told
Sandy that although little boys often were
taught to take showers, little girls almost
always were taught to take tub baths.
"Apparently," said Sandy, "from the time I
was a little girl, I sat in tub water — dirty
water — and I got a kidney infection. The
doctors said that this was a common occur-rence,
and often, these kidney infections are
'A-symptomatic' and show no signs of being
there. In |my case, I had had this kidney
infection for years and it just simmered —
like a fire that looks as if it has gone out, but a
breeze can come through and throw sparks or
even re-ignite the fire.
"It never showed up until I started my
menstrual periods, and then I'd get blisters
around my mouth and run a low grade fever
for a day or two. We know now it was because
of the kidney infection, but at the time I never
worried about it because it always went away.
I never really knew anything was wrong until
my last pregnancy, when the whole thing blew
up."
Sandy wasn't really sick after the baby was
born, so even though she was aware of her
kidney damage, she went home and resumed a
normal life. It wasn't until two years later
that she began to have health problems again,
only this time they came in the form of double
vision.
"I thought it was eyestrain from reading too
much, but I went to the doctor to check it out
and make sure," continued Sandy. "The doctor
referred me to a specialist who checked, me
out for a brain tumor.When those tests came
back negative, the doctor said I had a 'false
brain tumor' and he started treating me for
that.
"Six months later, I went into the special-ist's
office one day and he asked me to sign a
statement releasing him of any responsibility
'when' I lost my eyesight. He scared me to
death, so I went home, called my family
doctor and said 'I don't care where you send
me — just send me someplace so I can talk to
another specialist."
The family doetor sent Sandy to Dallas, and
there Sandy went through tests which de-termined
that her double vision was due to her
kidney problems. At that time, doctors told
Sandy that within three months she would be
on a machine (dialysis) and they put her on a
low protein diet and medication.
The Dallas doctors also put a shunt in
Sandy's spine which relieved her double vi-sion.
"They told me that it was like a teapot
getting too much steam — when fluid built up
in my body, it had to come out. The shunt
relieved all the pressure that had built up
from my kidneys not doing the job.
"The shunt works as, a 'release valve',
Sandy added. "When the pressure builds up in
my system, the shunt releases all the excess
fluid into my abdomen." Sandy still has the
shunt and has had no more problems with
double vision.
Although Sandy did not go on dialysis at
that time, she was prepared for the procedure.
"They have to use a '15' gauge (very large)
needle," she said, "and to do this they either
have to join your vein and your artery togeth-er
and make an AB fistula, or they have to do
something else. In my case, my veins were too
small to be joined to an artery, so they had to
put a cow vein in my arm (Sandy's cow vein
lasted for five years and then it died. She
recently got a new artificial vein).
"I lasted another year and a half on the
protein diet and the medication — even
though they (doctors) had only given me three
months — and then they told me I had to go on
dialysis. They didn't pull any punches — the
doctors came into my room at the hospital and
said, 'We're not going to tell you that you're
going to live happily ever after — you're
either going to have to go home and make out
your will, or you're going to have to go on the
machine.' It was just cut and dried.
"When this happens, you do a lot of soul
searching, a lot of thinking and you just have
to accept the facts the best you can. They (the
doctors) were very blunt, very open, and they
answered all my questions. They had me meet
with psychologists, social workers. Not only
did I have to meet with them, but my husband,
Joe, had to meet with them, also. My illness is
a family illness and it affects the whole
family."
Sandy said that the decision to go on dialysis
was not an easy one. "I was ready to meet
God," she said, "and I knew my day would
come. And I couldn't make up my mind — I
didn't know if I wanted to live the rest of my
life on a machine (Sandy was 31 years old
when she went on dialysis). Your whole life -•
your time schedule has to revolve around
Please see DIALYSIS, Page 5-B
Journal Photo by Louis DeLuca
Sandy Mikesell has no kidneys and spends three days a week on a kidney
dialysis machine at LSU Medical Center. Before using the facilities at LSI), she
was dialyzed at home with the help of her husband and sons. Sandy, pictured
with her husband E. J. Mikesell (left) and sons, Bill, (right) and (standing)
Charley (left) and Trevor, is waiting for a kidney to be donated so that she can
undergo a transplant operation.
Through organ donation you
can give the gift of life
By NANCY MORRIS
Neighborhoods North Reporter
Sandy Mikesell may be short on kidneys,
but nobody could ever say that she is short on
hope. Because, although Sandy is now con-sidered
a "high risk" kidney transplant can-didate,
she says that she plans on "raising my
kids and helping take care of my grandkids."
Sandy is a "high risk" patient because of her
first transplant rejection and because of other
medical problems which include low
hemoglobin. Ordinarily, kidneys regulate the
electrolytes which stimulate the bone marrow
where hemoglobin is produced. Since Sandy
has no kidneys and the stimulation is done by
artificial means, her hemoglobin is very low.
Because of her low hemoglobin, Sandy
receives what she calls "periodic blood trans-fusions."
These transfusions come about once
a month when Sandy is given two pints of
blood.
But the side effects of the much-needed
transfusions put Sandy in the "high risk"
group: with each transfusion she receives, she
also receives more antibodies which are in the
new blood. And each time Sandy receives a
transfusion, her chances lessen for ever re-ceiving
a healthy kidney which will perfectly
match her own tissue. Because with each
transfusion, Sandy's antibodies change.
But, there is some good news. Because
Sandy's case presents such a difficult prob-lem,
she is on what is called by Ms. Louise
Jacobbi, coordinator of the Louisiana Organ
Procurement Program, a "high priority" list.
"Because it will be so difficult to match
Sandy's tissue," said Ms. Jacobbi, "a sample
of her serum, as well as serum samples of all
high risk patients, is sent once a month to all
of the (donor) labs in the Southeast. If any of
those labs should happen to get a kidney that
almost perfectly matches Sandy's tissue, that
kidney will immediately be sent to Shreveport
and a transplant will be done."
Ms. Jacobbi did say that although it would
be much more difficult to match Sandy with
an appropriate donor, there have been "many
second transplants which were successful."
Ms. Jacobbi, a medical technologist, is a
member of a "team" working in the area of
kidney transplants at LSU Medical Center. "I
came here with Dr. McDonald (John C.
McDonald, chairman of the department of
surgery and director of transplant surgery at
the medical center) and Dr. Rohr (Michael
Rohr, associate director of surgery and trans-plant
surgeon at the medical center) from
Tulane University Medical School in June of
1977 when the department was opened.
"Also on the team are dietitians, technolog-ists,
social workers, nurses and dialysis doc-tors.
All of these people have special training
in kidney problems."
The success (non-rejection) rate of kidney
transplants is now at about 70 percent, using
"cadaver donors," according to Dr. Rohr,
"and it's close to 95 percent when the donor is
from a well-matched sibling, relative or
donor."
Rohr, who has been doing the actual trans-plants
at the medical school since October of
1977 said, "We take kidneys from cadavers
which have sustained brain death, and we
match them with the most suitable recipient.
We are members of the Southeastern Organ
Procurement Foundation which consists of 39
transplant centers in the South.
"If one of the other centers has a kidney
which will match with the tissue of one of our
recipients, they send it to us. We do the same
with them," continued Rohr. "Kidneys can be
stored a maximum of 60 hours if they are
preserved in precisely controlled cool tem-peratures,
so there is time to get them to other
transplant centers if necessary."
According to Mrs. Jacobbi, there are cur-rently
82 people on the list at LSU — all
waiting for kidneys lo be donated. "But that
waiting list," she said, "includes people from
all over Louisiana and East Texas." The wait
can be anywhere from one day to five years,
but Mrs. Jacobbi said the average is probably
"two to three years."
The reason the list is so long, and that the
wait is sometimes so long is twofold. There is,
of course, the problem of finding donors —
people who are willing to donate their kidneys
in the event they have sudden brain death.
"This," said Ms. Jacobbi, "is basically a
problem of public education. A lot of people
don't think about doing it (donating organs), or
if they do think about it, they don't tell anyone.
I do a lot of public service lectures, just
informing people of our needs.
"There are several ways to donate (after
death)," said Ms. Jacobbi, "There is a uniform
donor card which can be signed, or people can
inform the driver's license bureau when they
renew their license and the state will put the
donor information on the back of the license.
Probably the best way to do it, though, is to
allow these intentions to be known among
family and friends. Some people are uncom-fortable
about signing anything — it seems so
final — but they have no objection to telling
those closest to them."
The second reason that the list is so long has
to do with matching donor kidneys with the
appropriate recipient. "An 0 blood type can
donate to several other blood types; others
have to correspond."
But the situation is far from hopeless, and
the LSU team is doing everything within its
power to get the information out about Sandy
and people like her.
This month, National Kidney Month, there
will be donor drives held, billboards put up
and the Z Clubs in Shreveport will have donor
booths in shopping areas.
And because of the information that is being
put out to people who Sandy says are "good
and want to help, but just don't know how," it
just may be that Sandy's dream of raising her
kids and someday taking care of her grand-kids
will become a reality.
When Louise Jacobbi gives a lecture or
speech, she always ends them the same way
— "Only you can give that imaginative and
original gift — the gift of life. Be an organ
donor."
Medical Briefs
Aphasia Conference
An Aphasia Conference will begin at
noon Thursday at LSU Medical Center, and
will continue through Friday. Purpose of,
the conference is to share information of
new developments within the field with
physicians, nurses, physical therapists, oc-cupational
therapists and speech
pathologists who are concerned with pa-tient
management.
Speakers will be Donnell Johns, Ph.D.,
associate professor of surgery and director
of clinical research, division of plastic
surgery, and professor of neurology and
otolaryngology at Parkland Hospital, Dal-las,
Texas; Larry Warren, Ph.D., chief of
speech, Harry Truman Veterans Adminis-tration
Hospital and assistant professor of
speech pathology audiology, University of
Missouri Medical School, Columbus, Mo.; •
and Alton Ochsner, M.D., cardiovascular
surgeon and associate professor of
surgery, Tulane Medical School, New Or-leans.
Registration fees are $20, and $10 for
students. Contact Dr. Mary Pannbacker,
director, Mollie E. Webb Speech and Hear-ing
Center, LSU Medical Center, 3735 Blair
Drive, Shreveport, La. 71101 for further
information.
Kidney Foundation
The Shreveport Chapter of the Kidney
Foundation of Louisiana will meet Sunday,
3 p.m., at Schumpert Medical Center
auditorium. The main topic at the meeting •
will be the chapter's upcoming Country
Music Festival, to be held April 3-4.
Kidney patients, their families and
friends, individuals in the medical com-munity
and the general public are invited
to attend.
Nurses Meeting
The Shreveport Black Nurses' Associa-tion
will meet Saturday, 4:30 p.m., at the
Allendale YWCA, 700 Pierre Ave. All
members are encouraged to attend. For [
further information, contact Dorothy
Hines, 865-2897, after 5 p.m.
-
Health Professions Program
An allied health professions program for ]
Caddo Parish high school juniors and sen-iors
will be held Wednesday and Thursday,
9 to 11 a.m., in the Schumpert Medical
Center auditorium. Schumpert is sponsor-ing
the program to make local college- .
bound students more aware of the numer-ous
career choices available to the hospital
industry.
Professions represented in the program
will include biomedical engineering,
cardiology, nurse anesthetists, dietitians,
laboratory, nuclear medicine, nursing,
pharmacy, physical therapy, radiology and
respiratory therapy. Representatives from
those fields will speak to the students about
job duties, salary, required training and
length of education. Participants will be
given the opportunity to browse through
booths, ask hospital personnel questions,
take professional literature and look at
equipment used in the various medical
fields.
Barrett to Speak
Alice Barrett, head nurse , of the
Shreveport Regional Dialysis Center will
speak to the Ark-La-Tex Chapter, of the
American Association of Nephrology
Nurses and Technicians (AANNT) Thurs-day,
7 p.m., at a meeting to be held in the
doctors' dining room of Schumpert Medi-cal
Center. Her topic will be hepatitis.
All nurses interested in nephrology are
invited to attend. For further information,
contact Loyce Ward, program chairman,
at 227-4542, or Kathy Brooks, secretary, at
797-0999.
Easter Seal Event
A Las Vegas Night, to be held Friday, 7
p.m., at the Ramada Inn, 5116 Monkhouse
Drive, will be the first in a series of local
events to raise funds for the Easter Seal
program, which benefits handicapped per-sons.
The Easter Seal Society and Ramada
Inn, Inc. are co-sponsors for the events.
Persons attending Las Vegas Night will
be able to purchase 500 chips for $7, and
later in the evening may buy 100 chips for
$1. At the end of the evening, participants
will be able to bid on prizes donated by
local merchants and valued at $50 and
above. Raffle tickets for a three-day, two-night
trip for two to Las Vegas, airfare and
hotel accommodations at the Tropicana,
also will be sold.
All proceeds will go to the Easter Seal
program.
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