World Kidney Day: 'I need my brother's kidney to save my life'
On World Kidney Day, Laura Gahan tells how, at 23, she needs her brother's healthy kidney to save her life
It took Laura Gahan a long time to find a job in retail she enjoyed, so she was heartbroken when she had to give it up. "I remember a woman, who used to come into the shop, asked me why I was leaving and I told her I was sick," she recalls. "She looked at me and said 'Get away with you, there's nothing wrong with you!' Her faced dropped when I told her I was on dialysis."
It says something about the 23-year-old from Ballyfermot's strength of character that she's able to laugh at the memory. She says she's used to it. From birth she's been on medication, and since last year, when her kidneys started to fail, she's been on life-saving dialysis, sometimes for 12 hours a day. This month she hopes to find out if she's a match for a donor kidney, kindly offered to her by her 26-year-old brother.
"Looking at me you wouldn't have a clue," she says. "I might look a bit sick some days but I can scrub up well. Inside I feel like I've a really bad hangover all the time. That's the best way I can describe what kidney disease feels like. I forget what it feels like to wake up feeling on top of the world."
Kidneys are the unsung organs of public health campaigns. We know how to care for our hearts (exercise and eating well) and lungs (cut out cigarettes), but watching for the warning signs in kidney damage is not common knowledge.
"Kidneys are absolutely not getting the publicity they deserve," says Dr Declan de Freitas, consultant nephrologist (a medical doctor specialising in kidney care) and transplant physician at Beaumont Hospital.
"Kidney disease is common but often silent and not picked up until the kidneys are close to failing. Early recognition and management by a nephrologist can slow the progression of kidney disease, meaning that some people will never need dialysis or a kidney transplant."
Today marks World Kidney Day, an initiative established to try and boost the public's understanding of these vital organs and the many people dealing with issues associated with them.
It is estimated that around 500,000 people in Ireland, 12pc of the population, has chronic kidney disease. This is when the kidneys haven't been working well, preventing them from carrying out their job of cleaning the blood, balancing salt and mineral levels in the body and helping control blood pressure.
Older people are more prone to the disease as kidney function is lost with age, but the illness is also associated with those who have high blood pressure and diabetes, explains Laura's nephrologist at Tallaght hospital, Dr Peter Lavin.
"Then there are more unusual causes which can be genetic, as in the case with Laura or when the person's own immune system attacks the kidneys."
Laura was born with Nail Patella Syndrome, a rare disease affecting just one in 50,000 people. When she was born, she had to have several operations to straighten her feet and she can't fully extend her arms. Crucially, Nail Patella Syndrome also produces too much protein in the kidneys meaning that, throughout her life, Laura has had to take medication and attend regular hospital appointments to monitor blood and blood pressure.
Last February she was attending a regular appointment when medics became concerned.
"I remember it was Friday 13," laughs Laura wryly. "They said my blood pressure was very high and asked if I was feeling okay. I'd actually been getting headaches for the last few weeks, but I just brushed them off. I knew I'd been tired but it had been busy in work with Christmas and I kept thinking I'd be grand. But the doctor told me headaches were dangerous."
At 10 o'clock that night she got a call. "It was the hospital saying to come in straight away," she says. "They said my blood tests showed I was going into kidney failure, my kidneys were only working at 20pc."
A week in hospital followed, then home dialysis began in June 2015. "It was a nightmare," she says. "Twelve hours every day and I felt so sick after being on the machine."
Laura had to move home, give up work and, unfortunately, her relationship ended. Since December she switched to a new haemodialysis treatment at Tallaght hospital, which helps her separate treatment from her home life and she's happier with that. But it's still just a temporary solution; she needs a donor.
And there may be a glimmer of hope on that front. Recently her family were tested to see if they might be compatible donors. A cousin came up as a 60pc match and an aunt at 40pc. Her mum wasn't compatible and "devastated" about the result. Then the tests revealed her older brother Glen was a 100pc match.
"He didn't think twice about offering to donate," says Laura. "His attitude is 'the sooner the better'."
It's a remarkable attitude for a young man. But as Laura points out, she comes from a "caring" family. Her parents are both carers and Glen is a carer for the blind Irish adventurer, Mark Pollock, who was also left paralysed after falling from a second floor window in 2010. She has another brother who is also a carer, but has yet to be tested to see if he's a donor match.
Genetic testing still has to be done to make sure Glen doesn't carry the same gene as Laura, but the family will find out next Tuesday whether surgery can go ahead. Laura has mixed emotions about the results.
"I don't want to have to take my brother's kidney but I do want a transplant," she explain. "I feel anxious about it. All surgery comes with risks and I worry it's worth it. What if my body rejects the kidney?"
She gets through those worries and the shattering tiredness by staying focused on the future and that's her advice to anyone going through something similar.
"You have to keep thinking of the future, not what's happened or what's happening now," she explains. "I want to go to Bali and the Philippines. Maybe it'll take two or three years, but I like to say I'm going there one day."
She also feels her experience has hammered home the importance of family. "At first I was heartbroken having to move home and losing my job. I was used to cooking for myself and having my independence. But you really learn what's important in your life. If anything happens, it's your family who are the ones that will drop everything for you. The support of my family has been amazing, no one else will give you that."
There are things she misses, like long walks and being able to "have a potter round town" with her close mates. And she doesn't drink - but even on the few times she would have had alcohol in the past, she wasn't a big drinker, so doesn't miss it.
"There's more to life than drinking. I think a lot of people realise that later in life, I've just got there a little bit faster."
She adds: "I believe everything happens for a reason and this has happened to me for a reason, even though right now I don't know what that reason is.
"But I do know that this is just a bad chapter in my life and I'll get to write a better one."
Kidney disease: the facts
Last year alone 4,329 Irish citizens had kidney failure and were receiving either life-saving dialysis (2,314) or had a functioning kidney transplant (2,015).
There are currently 459 people waiting for a kidney transplant with an average wait of three years for someone who has died and donated a kidney. If someone has a friend or relative that's a match for a 'living donor kidney', this wait drops to around three months.
People with one working kidney can lead normal, healthy lives with many unaware they have only one functioning kidney. Causes of loss of kidney function can include a lack of blood flow to the kidneys, damage directly to the kidneys and their drainage being blocked. Certain drugs like anti-inflammatories can damage the kidneys. But the most common causes are diabetes (types one and two) as well as high blood pressure.
Symptoms of kidney disease can include swollen ankles, an increased need to urinate (particularly at night), weight loss, muscle cramps, blood in the urine or frothy urine.
"Kidney disease is often silent until the kidneys are close to failing and can only be picked up by blood and urine tests," warns Dr de Freitas.
"It's important for anyone with diabetes, high blood pressure or taking anti-inflammatory medications to see their GP every six months to get their kidney function checked out."
Kidney disease can often be treated with lifestyle changes and medication to control blood pressure and lower blood cholesterol levels. Kidney failure usually necessitates dialysis, where a machine artificially replaces some functions of the kidney, or a transplant.
Take care of your kidneys by staying hydrated (urine should be clear), eating a balanced diet that is low in salt-heavy and fatty foods, watch your blood pressure, exercise at least 30 minutes a day, don't smoke, and only drink alcohol in moderation.