At four o’clock in the morning, the phone rang at the Coghlans’ home. “Bring your daughter to the hospital right away,” a lab technician instructed Kim. Other than having some blood tests done to try to figure out why Candice’s flu symptoms weren’t clearing up, the day before had been a regular day for the Kitchener family. So when Candice’s mother and father roused her for a sudden drive to Grand River Hospital, Candice realized something more serious must be going on.
In fact, that phone call signaled the start of a life-changing journey for the U of G student who was just 21 at the time.
“As a teenager, I occasionally got itchy rashes and upset stomachs, but for the most part, I was healthy and energetic,” says Candice. “Over the years, my symptoms were attributed to allergies and food sensitivities and they were manageable. But by July of 2008, I was also suffering from loss of appetite, muscle cramps, psoriasis and night terrors. My mom insisted that more blood work be done. That’s how I found out I had kidney failure, or ESRD.”
The kidneys of people with ESRD (end stage renal disease) cannot adequately remove waste molecules or maintain the proper levels of certain kidney-regulated chemicals in the bloodstream. Candice’s blood tests had revealed a creatinine level many times higher than the normal range for her height and weight. A chemical waste produced from muscle metabolism, normally most creatinine is filtered out of the blood by the kidneys and expelled from the body in the urine on a daily basis. That makes high creatinine levels in the blood an important clue in the diagnosis of kidney trouble.
Dialysis, the process of cleaning the body’s natural wastes from the blood with the aid of a machine, in effect does the work for compromised kidneys. Other than replacing diseased kidneys through organ transplantation, dialysis is the only treatment. Candice needed dialysis as soon as possible. Within 36 hours of hearing the news about her kidneys, she had surgery for a hemodialysis catheter insertion and underwent dialysis for the first time.
While hooked up to a machine that was allowing her to feel better than she had in the past few years, Candice reflected upon what at first appeared to be her remarkably sudden onset of kidney disease.
“I realized that since starting university, I’d been struggling with my major in English and theatre studies,” she says. “I felt exhausted; I couldn’t concentrate and my grades dropped dramatically. I’d been putting it all down to an increased difficulty level compared with high school, and felt a bit discouraged even working towards my undergraduate degree part-time. So, in 2006, I decided to do some volunteer work overseas, which was fun and fulfilling. And yet, even while enjoying my experience in Kenya, I continually suffered from bouts of illness. Without knowing the real cause, I just couldn’t do anything about it.”
She returned to university and was half way through her third year in 2008 when her underlying medical condition became a crisis and she was forced to take time off again.
As an in-patient over the subsequent three weeks, Candice was doing everything she could to recover and return to her normal lifestyle. She began a renal-friendly diet program, including vitamins and dialyzed for four hours three times a week. There were ups and downs in what would turn out to be 14 months of regular dialysis treatments.
“Hemodialysis gave me back my healthy energy levels in the short-term, but the day after treatment, I’d feel tired again. So I tried to learn as much as I could about the kidneys and about dialysis from renal dietitians and my nephrologists. Then I opted to try at-home peritoneal dialysis. A different catheter was inserted into my abdomen this time. Then I had peritoneal dialysis every night while I slept and it worked really well for me.”
Peritoneal dialysis is based on the same process as hemodialysis, but the thin membrane (peritoneum) that lines the abdominal cavity does the filtering instead of an external machine. The abdominal cavity is filled with a solution (dialysate) and toxins in the blood are absorbed by osmosis into the solution, which is drained and replaced periodically.
Since starting peritoneal dialysis, Candice has enjoyed a cruise with her family, a trip to British Columbia with her boyfriend and she has returned to university. But her return to an active lifestyle is not only thanks to successful dialysis treatments.
Kidney transplantation was recommended from the get-go. With the support of Candice’s renal team, the Coghlans headed to Hamilton-based nephrologist Dr. Darin Treleaven. Candice’s mother Kim was the first person in the family to be tested for organ compatibility and, as luck would have it, was a match. Kim was then put through several levels of testing to ensure she was healthy enough for organ donation.
On Sept. 9, 2009, Candice and Kim both underwent surgery. Within months both had fully recovered.
“That may have been the most stressful day in the lives of my family members and close friends so far, but now we have our lives back,” says Candice. “And mom and I share this special bond. Because my mom gave up an organ, her recovery took longer than mine, but the human body adjusts and can be completely healthy with one kidney. It’s amazing.
“I have probably 10 times the energy I used to have; all my so-called allergies have disappeared; I can indulge in as much chocolate and chili as I want; I play baseball better than ever; I’m living on my own without the assistance of any machines and my creatinine levels are normal.”
She visits her nephrologists twice a year, has monthly blood tests and takes anti-rejection medications five times a day.
“I’ll always be grateful to the excellent doctors and nurses at Grand River Hospital and St. Joseph’s Healthcare Hamilton. If it were not for their expertise and for my kidney transplant, I might not have come this far.”
Candice is the fund development officer for the Kidney Foundation of Canada’s Western Chapter, which encompasses a large area from Kitchener-Waterloo to Owen Sound. Being involved with an organization that helps people who find themselves in the very circumstances she survived means a lot to her.
“I want to give back to the community that supported me through my struggle with kidney failure,” she says. “Organizing events to raise awareness about kidney disease and organ donation, and funds for research requires energy, passion and creativity; I am happy to be well enough to tackle this role. Advances in science and technology mean that today there are dialysis patients and organ transplant recipients who’ve survived more than 20 years.
“Even though we know that organ donations save lives, the need still outpaces supply. I really wish more people were aware that you can’t simply sign an organ donor card anymore. You have to register your consent to donate organs or tissue online at www.beadonor.ca or by mailing in a paper registration form to record your decision in the Ministry of Health and Long-Term Care database. It’s the only guaranteed way to make the decision to donate official. ”
March is National Kidney Month. Candice will graduate in August.