Her kidney transplant lasted a surprising 42 years but now she needs another
For 42 years, someone else's kidney has kept Deby Nash off dialysis and given her independence and the freedom to live a life of adventure.
Having far exceeded its expected lifespan, that kidney is starting to fail, and Nash hopes life as she knows it isn't over.
Nash underwent a successful kidney transplant on March 1, 1981, in Montreal. At the time, she was told the kidney would last five to 10 years. According to the Kidney Foundation of Canada, only about half of transplanted kidneys are still working after 10 years.
So after 42 years, the 70-year-old Fredericton resident is not shocked her transplanted kidney is tiring, but she still hopes to qualify for another transplant so she can keep her energy and independence.
"I'm now at the stage I'm just working to be at peace with all of it," Nash said. "Half of me is moving towards dialysis. The other half has fingers, toes and everything crossed that my name will be on the transplant list because that's the pot of gold at the end of the rainbow for this patient. I don't know what's gonna happen, so I prefer to stay with hope until I get a definitive answer."
She relied on dialysis before, and hoped to avoid it going forward.
Nash was first diagnosed with kidney failure while completing a master's degree at Concordia University in Montreal. She felt really tired, and assumed she was low on iron.
She went to a clinic where she received one blood test, then another, then was asked to go to the hospital across the street immediately. She was a 24-year-old working university student, and said she was completely shocked to be diagnosed with glomerulonephritis, which is inflammation of the kidney's tiny filters.
"They walked me across the street into the hospital and within about a half an hour, I was in the intensive care unit and somebody was sticking a tube in my stomach," said Nash.
"It was later explained to me that it was peritoneal dialysis. It started like immediately from then, the dialysis, and I was on dialysis for three years until I got my first transplant."
Nash first received a kidney transplant from her sister, as a living donor, in 1979 in Montreal. That transplant only lasted about a year and a half before she was forced back on dialysis because that kidney also succumbed to the same disease.
Months later, on March 1, 1981, Nash received a second kidney transplant from a deceased donor.
That transplant set Nash free. She had finished her degree at Concordia while on dialysis, and after her transplant, she moved to Ottawa to work as a lecturer at Carleton University.
Nash wasn't done travelling yet, though. She said she then moved to the Bahamas, where she lived for almost 20 years teaching English and writing for news publications.
"I've had a wonderful, creative, colourful life with my transplant," said Nash. "It's very difficult for me to imagine having to adjust to dialysis. It feels like I'm going backwards, to tell you the truth."
Nash said she moved back to New Brunswick, where she grew up, approximately 10 years ago, following her father's death, in order to look after her mother, who has since passed away.
In 2015, Nash's medical team discovered a cancerous tumour in her kidney. Still determined to survive, she underwent surgery in Halifax to remove the tumour, which was successful despite challenging odds.
Early last year, her monthly blood tests, which she's had to complete since she received the transplant, showed her creatinine levels were rising. Nash said this is a sign that her transplanted kidney is starting to fail.
Nash said she has been left in "limboland" on whether she qualifies for another kidney transplant. She says she's not giving up yet, though.
Once she realized kidney failure was again imminent, she immediately took steps to find out whether she was eligible for another transplant from the Multi-Organ Transplant Program of Atlantic Canada, which is located in Halifax at the Queen Elizabeth II Health Sciences Centre.
Nash's medical team advised her the process of completing all the required testing and vaccinations typically takes about a year, but she said she had them completed in six months. Since then, she said she has been forced to wait and worry.
"I don't even have words to describe how I am feeling now because I literally am feeling my body deteriorating," said Nash.
According to a spokesperson for Nova Scotia Health, the health-screening tests and procedures leading up to a potential recipient being placed on the transplant list in Atlantic Canada does follow standardized criteria, but the process often looks different for individuals depending on what led to the organ failure.
Nash said the testing is extensive, and the team evaluating someone for the transplant wait list can request additional tests. She gave the example of her nephrology team requesting a report from her dermatologist on her skin health because the steroids and other medications a transplant recipient has to take after the transplant to prevent rejection can cause skin issues, and they inquired about cancer risk.
"They test all parts of your body for transplant," said Nash. "They do not want to waste a human kidney and that part, I respect."
March is kidney health month
March is kidney health month in Canada, and according to the Canadian Institute for Health Information, the number of patients in Canada with end-stage kidney disease continues to rise.
Their numbers show a 24 per cent increase in patients receiving either dialysis or a preemptive kidney transplant (done before dialysis was required) between 2012 and 2021 across Canada, though their data excludes Quebec.
The Kidney Transplant Program in Atlantic Canada performs approximately 80-100 kidney transplants yearly. According to the Multi-Organ Transplant Program of Atlantic Canada's statistics, there were 191 people in Atlantic Canada waiting for a kidney transplant at the end of 2022, and four people waiting for a kidney and pancreas transplant.
Last year, 74 kidney transplants were completed — 24 of which were New Brunswick patients.
According to the Kidney Foundation of Canada, damaged kidneys don't heal.
Nash finds little comfort in being familiar with the symptoms that are coming for her as her transplanted kidney continues to fail. She has already begun to plan for doing dialysis at home in the coming months.
"Those that are aware of my journey, they just say, 'Where do you get the strength from?' I would like to say it's the chutzpah that comes from my Jewish mother. I don't even know how to answer that. I surprise myself because most people at this stage would have given up and it's so much easier to give up.
"I'm a fighter, so I'm gonna keep a positive thought, keep asking the questions, keep trying to keep take care of myself."