23 Feb

kim_g

Patient Spotlight: Kim Graham

What’s the most surprising news you ever received?

For Kim Graham, that answer is easy: kidney disease.

At 34-years-old, Kim was totally unprepared for a kidney disease diagnosis. As a single mother raising a two-year-old son, her mind was reeling with questions and concerns when her doctor said her kidneys were failing.  She numbly agreed when her doctor urged her to tour a dialysis facility and learn more about her treatment options. Nervously, she toured the facility. She left the dialysis center thinking surely she wasn’t as sick as the people she’d just seen. And, if she needed dialysis, she’d do it for a little while until she got better, right? Wrong.

 After learning more about in-center hemodialysis and peritoneal dialysis (PD), Kim opted for dialysis in the comfort of her home. The DCI home training department spent several weeks educating Kim on how to perform PD.

“For eight years I dialyzed at home. I did not see myself as sick,” Kim shared.

Kim continued to work full time and raise her son. While PD was working for her family, she was placed on the transplant list in hopes of being able to get back to a life without dialysis. Then, to her surprise, she received a call. She had a match! Unfortunately,  two years later, after constant tests and antirejection hopes, she lost the transplant. Kim was told she must resume dialysis.

At this stage in her life, Kim was not eager to return to dialysis at home. She found that dialysis was everywhere in her home. She was tired of looking at the supplies.  Now that her son was older and in school, she opted to give in-center hemodialysis a try.

“I decided that dialysis had to work for me, I didn’t work for dialysis,” said Kim. “Just like a new job, I had to train myself on every aspect of dialysis in order for it to work for me,” she said.

Kim took her dialysis education seriously. She learned how to interpret her labs. She began to monitor her medications. She met with the clinic dietitian and took the nutritional feedback to heart. She even encouraged her family members to change their eating habits, too.

As the seasons of her life changed, she often reflected on how dialysis was fitting into her life. Was it working for her? Kim wasn’t afraid to speak up if things needed to change.

“I tell other patients to talk to their doctors and nurses,” she said. “If your current treatment isn’t working for you or your schedule, explore your options. Don’t give in and feel like you’re stuck.”

A few years later, when her son graduated from high school, she realized she had more flexibility in her schedule again. She began considering yet a new method of dialysis: home hemodialysis.  Home hemodialysis requires a care partner to be available during the treatment. Kim, her mother, and son trained to perform this new treatment. Kim’s son became her primary caregiver. He enjoyed learning about dialysis and was inspired to enter into nursing school. As her son’s schedule changed, Kim didn’t want to burden him or her mother with being a full-time care partner.

“I asked my doctor what to do now. Life kept changing, and I needed another option. She suggested a new program, nocturnal dialysis, where I could come in to the center and dialyze while I sleep. This would leave my days free and sounded like the perfect fit for me,” she said.

The nocturnal program in Tucson, Arizona, allows patients to enter the dialysis center at 8:30pm. Patients bring their blanket and pillow. They can watch television or settle in and sleep for the night. The nursing staff manages the patient’s treatments through the evening. Treatments usually end around 4:30 in the morning. The nocturnal dialysis program is meeting a need in the community that can be seen in its growth from four to twelve patients.

“I think nocturnal dialysis illustrates the beauty of renal replacement therapy – in that we have a potpourri of modalities to fit people’s lifestyle.  Our patients do not need to be ‘married’ to one treatment option.  We can switch to accommodate their lifestyle at that point.  The most important thing to remember is to educate our patients such that they are aware these opportunities exist,” said Amy Sussman, MD. 

 “Nocturnal dialysis has allowed primary income earners to continue their jobs, and for my sicker patients who cannot tolerate high blood flows and ultrafiltration rates, a much gentler modality to suit their lifestyle. I have also been able to send high school children to school without dialysis interrupting their education. It has been an essential modality for many patients who lead active or busy lifestyles,” said Amy Sussman, MD, and the founder of the nocturnal program that Kim attends.

At 56 years old with 22 years of dialysis behind her, Kim continues to find a way to make dialysis fit for every season of her life.

 “I’ve tried it all,” she said. “And I always find a way to make dialysis work for me.”

Whether Kim is travelling or hosting a book club in town, she has the freedom to choose what she wants to do each day. Tragically, Kim’s son was killed in a car accident before his 24th birthday. While the news was devastating to Kim, she remembers her son’s desire to become a nurse and help others. And in her time of sorrow, Kim has found a purpose that is bringing light back into her world.

“I want to start volunteering with children on dialysis,” she shared. “I think helping them and their parents to understand kidney failure and what they will face will be extremely rewarding.”