Healthy Living explores kidney diseases
If you’re diabetic or hypertensive and struggling to keep up with your regimen; then pay attention. In the following segment, Healthy Living goes directly to a diabetic who suffered chronic kidney disease and is a kidney transplant survivor. There are many persons from all walks of life that do not know they are diabetic and can be developing kidney disease. Find out more about the long term effects of these common conditions and how to prevent damage to the kidney.
Andrea Cox, Kidney Transplant Patient
“I was diagnosed with type 1 diabetes at the age of eight and from that day I’ve been on insulin—insulin dependent.”
Marleni Cuellar, Reporting
Fifty year old, Andrea Cox, is one of the thirteen point one percent of Belize’s population is living with diabetes. For most people who are diagnosed, the lifestyle changes required are very difficult to maintain. In Andrea’s case, a diagnosis at eight was challenging but it is one she’s learned to adapt to.
Andrea Cox
Andrea Cox
“As a child it became very challenging—it’s a life-changing experience. Your diet has to change right away, your habits and activities and of course your family becomes very overprotective of you. And of course you’re at school, so you see what everybody else can do so it has been very challenging. But I have been on insulin since then. There were period when it was all well, but it something that you have to check your glucose everyday; more than once a day and take the appropriate amount of insulin especially if you are insulin dependent. I used to do that. And in those days, you didn’t have those little glucose testers. You had to test using Bunsen burner and light the fire and everything—you had to test it through your urine. But now it is easier. You have the glucose monitors and you check it two three times for the day and you take your medication as needed—the doctors will give you an idea of what you are to take. And it is just a constant checking of these things. And I thought I was checking it enough and was doing—but you do have times when you go off your schedule and the sugar levels go up a bit. And whenever the sugar levels vary too much that’s when it’s attacking all the organs.”
In her thirties, her first diabetes-related complication was with her eyes. This required laser surgery to re attach her retina and restore her vision. As serious a complication as vision loss is, her major complication occurred a few years later.
Andrea Cox
“I started feeling very tired and when I would stand too long, I would have this cold feeling going through me [and] weakness. I did different blood testing and the doctors mentioned to me right away that the kidney was showing signs of decreasing in function. And o would ask questions and they would explain—it might take a while—but they put me on medication to slow down the progress; the decrease in function. But they told me to get ready to go on hemo-dialysis at some point.”
Chronic Kidney Disease is when the kidneys begin to lose its function. It is common for diabetics to develop this disease, especially those who don’t manage their glucose levels properly. Internist, Dr Pedro Arriaga explains why.
Pedro Arriaga
Dr. Pedro Arriaga, Head of Internal Medicine, K.H.M.H.
“The kidney is a complex organ. It has significant functions: it has hormonal functions; it helps us to produce red blood cells; it is an organ that help to filtrate the blood from venoms and poisons and water that we don’t need and it is an organ that helps us to manage different forms of substances that we call electrolytes. In general, when we talk about permanent damage to the kidneys, the two conditions that there are more of are diabetes around the world and hypertension. Sugars in general is toxic. If you have high levels of sugar for a long time that will create substances that will cause toxicity to the kidneys and the kidneys will start failing.”
The problem is, according to Arriaga, is that when the kidney function begin to lessen the symptoms are few.
Dr. Pedro Arriaga
“Most of the patients that have kidney problems, they have no symptoms. When the patient start having swelling and low blood count because the anemia is affecting, because lack of production of hormones from the kidney; when the patient start having problems to breathe, it is because the patient have a disease or if it is very well established disease and we can do very little except dialysis or kidney transplant.”
At the time of Andrea’s there were no dialysis treatment offered in Belize. With the assistance of her family, she immediately sought information about kidney transplant. They found a hospital in Tampa, Florida and luckily, her older brother Mark immediately volunteered to donate his kidney.
Andrea Cox
“Going through that period, you know your body deceased in function; different things happen. I started swelling, retaining all my fluids so they had to put me on medications for that. Then also too we were discussing with nephrologists in the states also along with seeing the doctors here; at that time it was the late Miguel Rosado who would advice me on steps to take. Both him and the doctors in the states would mention to me about different cases; would do transplants. So you started getting involved with these places, started finding out the information, there were forms you had to fill out. The difference right away was if you have a family member that can give you a kidney, it would be quicker than going on a list cause you’d have to wait. August this year will make ten years which I’m grateful for and thankful to everyone who took part in helping me to get that done; especially my brother, my family, my medical teams and the good lord.”
The most cost effective transplant surgery is done in Guatemala where, including all medical tests, donor and transplant surgeries and post-op care, the estimated price is a hundred and fifty thousand Belize dollars. The cost doubles if done in the United States. However, the surgery is not the end-all for Andrea’s health problems. She must take medication everyday for the rest of her life so that her body does not reject the kidney; and, as every other diabetic; she must maintain control of her diabetes. But she is one of the lucky ones: She is one of five Belizeans who’ve had successful kidney transplants. In the case of others, their bodies reject the kidney and return to dialysis treatment and some cannot afford the daily medication that is needed post-transplant to be able to survive. It is a reality that is frustrating to survivors like Andrea and medical professionals.
Dr. Pedro Arriaga
“Dialysis is a possibility, but I think one of the problem we have is the financial cost is tremendous—not only for the patient, but for the public system point of view too. We have tremendous amount of patients, they come in and they have the condition and they need help for that. But I think it is extremely expensive to support this patient from a financial point of view. In the country, we have a hemo-dialysis unit at K.H.M.H. and Loma Luz, but they have a limited amount of patients that they are seeing right now. Ethical dilemma—who will get the dialysis and who is not going to get dialysis—because a lot of patients they need dialysis you know. Again, you know they have a limited amount of post and seats for patients and the amount of people it will be able to handle is not enough for the amount of people that have kidney disease in the country. So we have a tremendous amount of people that are not getting the therapy that they need.”
Andrea Cox
“It gets me desperate. I have always been involved with kidney association of Belize and I have met and dealt with many patients and it makes me angry and then I realize anger won’t help the situation. So we try to find solutions, but you realize the desperation of these people and their families when they are in this situation. And thank the lord, we now have a dialysis unit—one that’s private and the one at the hospital which is limited at this point still because you can’t just walk in and go for dialysis. But I pray that there is a day where you can walk in and get dialysis done at a reasonable price.”
Andrea works along with the Kidney Association of Belize to spread awareness about chronic kidney disease and its prevention. She speaks to other diabetics about the importance of keeping to their regimen. Her hope is that one day a Kidney Center can be developed in Belize offering full services. In the meantime; the aim is prevention.
Dr. Pedro Arriaga
“I have a feeling we could do more for a patient. If Belize, as a country, we get together—the physicians and family members and patients to tackle the disease—I think we should be able to do more than what we do if we work together. The better control, the less complications; the worse control, the worse complications. So if you have diabetes and hypertension, those are diseases that definitely have been affecting our population tremendously from a kidney point of view. The best thing is try to be on time with the appointment with the physician, be sure the sugar and blood pressure in under control, get the right type of tests, try to control your weight diet and exercise; that is extremely important.”
