Founder and Kidney Recipient
In 2011, Doug Lehman learned his one remaining kidney was failing and he would need life-sustaining treatment until a kidney became available for transplant.
That November, Doug started on dialysis, a lifesaving but time-consuming and exhausting therapy, and started the process of obtaining a transplant. While Doug’s journey to a transplant lasted only three months, he and many other transplant recipients will tell you theirs was the longest, most exhausting time of their lives.
Throughout the three months Doug was on dialysis, he was working with the University of Nebraska Medical Center-Omaha toward the ultimate goal of receiving a kidney transplant. For the first two months, Doug was on hemodialysis, a treatment that required him to go to a clinic and be hooked up to a machine for four hours a day three times a week. Then he switched to peritoneal dialysis, a therapy that was a little less time consuming and gave him a little more freedom to do other things.
Doug put a lot of his newfound time into the transplant process. He realized almost immediately the effort needed on his part to make this a reality. The paperwork from the transplant center to even be considered was daunting. Then add to that trips to Omaha for transplant workups, appointments with the dentist, hunting down medical records for transplant, and the list goes on. Not to mention that, for him and many other patients, most of the driving, gas and hotel expenses are financially the patient’s responsibility.
In February 2012, Doug got the CALL, the one that all patients on the waiting list dream of: there had been a match and a kidney was waiting for him.
While Doug was recovering from the major surgery, he started to realize how hard this process was. For those with little to no knowledge of how to move forward or those without the means to do so, a transplant would seem impossible. Doug decided he had received this kidney as a gift and he needed to pay it forward.
In March 2012, just a month after his transplant, Doug decided to start Doug’s Donors, a nonprofit organization to preserve and improve life through education and awareness of organ donation.
Jim Langhorst received a new kidney as a transplant recipient on Sept. 12, 2013. His journey to that day began on Jan. 18, 2011, when he had a hemorrhagic stroke as a complication of his diabetes. After surgery and more than two weeks in a coma at Mercy Medical Center in Sioux City, his kidneys failed and he went on kidney dialysis.
Awakening from his coma, he spent two more weeks at Mercy before transferring to Madonna Rehab hospital in Lincoln, Neb. As he improved, he transitioned to outpatient dialysis and worked hard for eight weeks in physical, occupation and speech therapy at Madonna. On April 15, 2011, he was discharged from the hospital for ongoing home care and therapy.
He continued outpatient kidney dialysis over the next 2 ½ years. In September 2012, he completed his three-day kidney transplant evaluation at the University of Nebraska Medical Center in Omaha, and was placed on the kidney transplant waiting list. Over the next year, his focus was on keeping himself in good condition physically, spiritually and emotionally to be ready to receive the call that there was a possible kidney match for him. Jim’s kidney match was successful, and for Jim and his family, every day is a gift.
In September of 2005, at age 44, I was working for Schwan’s as a route manager. My work days were long and it was usually after 11 p.m. when I got home, feeling both tired and hungry. On this particular evening I didn’t feel like cooking, so before I went to bed I had a peanut butter and jelly sandwich. While it may sound pretty bland and harmless it turned out to be anything but. To say it didn’t sit well would be putting it mildly. It wasn’t long after I ate it that something in the sandwich triggered a gall bladder attack. Despite experiencing significant discomfort, I managed to find my way to the Emergency Room in a Fairmont, Minnesota hospital.
On arrival they took X-rays and decided I needed care they could not provide, so they wheeled me into an ambulance and sent me to the Mayo Clinic in Rochester, Minn. The highway the ambulance used to get me to Rochester was not in good condition, so the 120 mile ride that took about two hours was rough and uncomfortable. Finally, though, at 5 a.m. the next day I was admitted to Mayo’s St. Mary’s hospital.
The Mayo doctors wasted no time. After performing tests to determine the severity of my condition, and to locate the gall stones, they did an ERCP (Endoscopic retrograde cholangiopancreatography). ERCP is an X-ray exam of the bile ducts that is aided by a video endoscope. It allows the physician to view the inside of the stomach and duodenum, and inject dyes that can be seen on X-rays. The lighted probe that goes down your throat has a tiny claw at the end that allows them to open the passageway and let any gall stones pass.
It all seemed to go well, but there was a complication. The surgeons didn’t know until later that my intestine was punctured during the procedure. And that’s where my long journey began. Instead of a normal recovery from a routine surgery, my condition worsened. I spiked a fever and kept getting sicker – so sick that my kidneys shut down. That’s when they had to take drastic measures to save my life. What started as a simple gall stone attack had now turned into a life threatening situation. I can only thank God I was at Mayo, where they are well equipped to handle such an emergency. It was going to be 207 days before I was released from the hospital. That simple peanut butter and jelly sandwich changed my life and almost ended it.
To keep me comfortable yet treat me effectively and remove the infection, physicians put me in a drug-induced coma, which lasted 21 days, into October. While I was comatose, they opened my abdominal cavity and washed out handfuls of dead, blackened fat. This procedure, which had to be done seven times in a month, helps to ensure removal of the infection. As part of my recovery the Mayo doctors placed me in a special bed that would rock me gently back and forth so that no fluids would settle in my body, but even with that extraordinary step my hands and head swelled to almost twice their normal size.
When I finally awakened I had more than 12 tubes coming out of my stomach. They were not only for drainage, but also for feeding and other healing purposes. In the middle of my stomach was a very large 9-inch diameter hernia. For three months I was unable to drink anything or eat for six months.
Studies indicate that being immobilized for long periods has a very negative effect. It is estimated that a person can lose 10 percent to 20 percent of his/her muscle strength per week in bed, so upon awakening from the coma I found that the combination of immobilization and the surgery left me so weak that walking was almost impossible. Because of all the drainage and feeding tubes, I was forced to lie on my back for the first two months. Three times a week, they would wheel me down to the dialysis unit to undergo the cleansing process. They hoped my kidneys would be able to bounce back from the trauma, but as time went on, and despite the best efforts of the Mayo team, the likelihood of this happening decreased. We still had a long way to go before I would walk out of the hospital and return to anything that even remotely resembled a normal life.
Probably the scariest time for me was in early March of 2006. I had a blood clot pass through my lungs and I could not catch my breath. Not being able to breathe is very frightening, I was gasping for air while the medical team worked feverishly to get it under control. It took a couple of hours, but finally they were able to transfer me to an Intensive Care Unit (ICU). At the same time I had a skin graft done for the hernia that developed during the two weeks following the initial surgery.
I was in the hospital for 207 days or 7 months when I was finally discharged on April 23, 2006. Weak and unable to care for myself, I went to Yale, South Dakota to live with my parents and try to recover. They estimate that for every day you are in the hospital, it takes three days to recover.
I had a long road ahead. My kidneys were still not functioning properly and never would. I started dialysis in Huron, S.D., and made three trips a week to the dialysis unit there on Tuesdays, Thursdays and Saturdays.
Dialysis is a procedure of cleaning the blood and removing excess fluids since the kidney cannot produce urine. Once connected to the machine it takes about four and a half hours for the cleansing process to be completed. The procedure leaves you drained of energy, so for all practical purposes it results in a lost day.
If you are on dialysis your liquid intake is very limited and almost impossible to follow. It is recommended that you consume less than 50 ounces between treatments. I had great difficulty with that limitation so they would have to remove 10 to 12 pounds of fluid with each treatment. That’s a problem because too much liquid represents a danger to the heart.
I was also limited in what I could eat since the kidney works at balancing potassium and phosphorous in the body. Too much potassium could cause a heart attack; therefore, it was recommended that I not eat potatoes, tomato products or any dairy products.
From May of 2006 to October of 2007, I went to Avera McKennan hospital in Sioux Falls, S.D. 10 times because the vein in my arm kept narrowing and the blood could not return to it, causing extreme swelling. With the exception of being admitted to the hospital just once, all of the trips involved outpatient surgery to correct the swelling. Finally, they put in a stent, which solved the problem.
In March of 2007 I saw Dr. Fred Harris in Sioux Falls. He did a masterful job of fixing the hernia in my stomach. Although the surgery was a success, infection kept me in the hospital for two weeks. I also had a new dialysis catheter put in, a fistula (the Medline Encyclopedia defines fistula as an abnormal connection between an organ, vessel, or intestine and another structure). The fistula was combining a vein and an artery in my arm to allow the dialysis needle to enter and function properly. Without the fistula the vein would collapse.
During this time it was a matter of recovery and being evaluated for a kidney transplant so I could be placed on the national transplant list. I had decided to have the transplant done in Sioux Falls, where I lived, only because it was close. While I was excited about getting on the list I was not optimistic about getting an organ. The fact is I really had little hope of getting a kidney because my O blood type is quite common and kidneys of that type are in greatest demand. The doctors told me it would be at least a five-year wait. When I asked what the average life span is for someone on dialysis, I was told five years. So, I just resigned myself to thinking that dialysis would be a part of my life until I die.
Then in 2008, a miracle happened. A friend of the family came forward in January and offered to donate a kidney. A kidney from a live person is so much better than one from a deceased patient because it lasts much longer.
My donor, Joey Bich (pronounced Bish), wanted to have it done at Mayo in Rochester, so that’s where I went for my evaluation in June. Finally, I knew beyond a doubt that the transplant would be a reality; it was really going to happen. Dialysis was going to end and I had a shot at a normal life again. And…I was very happy with the decision to go to Mayo because of their experience. They average a transplant every day. Joey and I were approved and the transplant date of July 25, 2008, was set.
Remnants of that black cloud that followed me around for months after the PB and J sandwich still appeared, though. It seems as though, when it comes to medical issues, complications are a fact of life for me. While the transplant was successful, it was not without a hitch. What is normally a two-hour surgical procedure that some surgeons are now calling “Routine surgery,” was an 11 hour ordeal for me because there was so much scar tissue on the right side of my abdomen. As a result they had to put the kidney on the left side. My doctor told me in confidence later that he was about ready to give up; obviously he didn’t, but it still wasn’t over. A day later they had to open me up again because there was a leak in one of my bowels. They fixed it, but my recovery was delayed by about a month. I left the hospital on August 11 and had to stay in a motel until September 10 for checkups. Then I was free to go home.
Good news… Since being discharged for the final time, my future has been wide open and bright. Now I can drink as much as I want and eat what I like without fear or worry. I can travel for longer than a day and am free now to live like a normal human again, just as I did before that fateful PB and J sandwich. It’s all because someone was brave, kind and generous enough to give up one of his kidneys. Thank you, Joey…thank you.