by NATHANIEL NELSON
Three times a week, Andy Kuklinski gets ready for a day at Winona Health. He preps his arm, says goodbye to his son, Yusef, and heads out to the hospital for an afternoon of needles and machines pumping his blood in and out of his system. Kuklinski suffers from kidney failure and, for the last three years, has been undergoing dialysis treatment while he waits for a new kidney.
“There’s a lot to say about it,” Kuklinski said. “Being on dialysis pretty much consumes your whole life.”
Wearing a shirt with an hourglass on the front, Kuklinski pointed out what was written on the back: “Single father of 13-year-old son seeking living kidney donor blood-type 0+,” along with his phone number and email address. He explained that the shirt was modeled after one he saw on TV, where a man wearing a similar shirt to a live show eventually received an organ from the notice.
Just last month, Kuklinski was still waiting for a donor to come along and offer him a kidney, but three weeks ago, he received the best news he could get: he had made it onto the kidney transplant list.
“I’ve been waiting for this for three years,” he explained, adding that he was one step closer to going back to living his life with his son.
Dialysis, or more precisely hemodialysis, is a treatment for kidney failure which involves constant attention for the rest of a patient’s life. A hemodialysis machine takes on the role of what is essentially an artificial kidney, taking the patient’s blood out of the body through a filter and back into their veins. It cleans out the toxins and chemicals that would usually be removed by a kidney –– but at only a fraction of the level.
“They’re getting just enough kidney function to survive,” explained Natalie Kuhn, a registered nurse at Winona Health. “It’s a big deal for them.”
Kuhn has worked in the kidney care center for roughly four years, alongside nurse practitioner Mary Vang, caring for patients with kidney failure and those undergoing dialysis. According to Vang, one-in-three Americans are at risk of having some form of kidney disease as a result of diabetes, high blood pressure, being overweight or their family history; however, only 20 percent of those are aware of the risk.
Kidney disease comes in five stages, Kuhn explained. The first two are the most common, and those with stage one or two can go throughout their entire life without having any complications. Dialysis comes in stage five, when the kidney has ceased to function and the toxins begin to pile up in the bloodstream.
“When someone’s kidney fails, they have three options. Hemodialysis, peritoneal dialysis, or a kidney transplant,” Vang said.
“If they don’t choose one of those options, they choose death,” Kuhn said.
Kuklinski explained that he was diagnosed with diabetes in 2012 and, after emergency dialysis in 2016, has been undergoing dialysis treatment for the last three years. Every other day, he spends more than half his day prepping for and going through dialysis treatment, and often rests afterward due to the immense fluid loss from the process.
“When I go in for a four-hour treatment, I lose anywhere between five and 12 pounds,” he explained.
Dialysis comes with a harsh set of guidelines, from dietary and liquid restrictions to a long-term care plan, but there’s also the matter of getting on the list for a transplant. For years, Kuklinski was ineligible for the list –– he weighed more than 300 pounds and was considered unhealthy, which kept him from being added to the list. Kuklinski explained that over time, he worked hard to lose weight and get fit, losing more than 100 pounds and –– in the process –– improving his health immensely.
“I was on three high blood pressure medications. Now I’m on one,” Kuklinski said. “Now all I do is ride bikes, paddle canoes, hike these trails and chase my 13-year-old son around.”
His son, Yusuf, has been a huge factor in his recovery, Kuklinski explained. Yusuf attends Cotter Schools in town, and is an avid baseball, golf, and football player. Kuklinski wanted to not only get healthy for his sake, but for his son’s sake, getting back to being a father that is always there.
“My son has watched me go through every piece of it, and he probably understands it more than most adults I know,” Kuklinski explained.
Distance is a difficult problem for many dialysis patients, Kuklinski explained, but it’s more than just the day-to-day. Vacations are particularly tricky, as dialysis patients have to plan months in advance to make sure there are dialysis services available where they are visiting and that they can continue their treatment regularly.
“It’s like you’re hauling around a ball and chain,” Kuklinski explained.
That is how he initially came upon the Winona Health Dialysis Unit. For the first two years of dialysis, Kuklinski received treatment at a center in Tennessee, which was understaffed, inconsistent and unreliable. However, several times a year, he would travel to Winona to visit his family and undergo treatment at Winona Health.
“I can’t explained the difference of care I got at Winona Health compared to the center I had been at,” Kuklinski explained, adding that he moved 820 miles across the country in order to receive treatments at Winona and to be close to Mayo Clinic.
Winona Health’s Dialysis Unit was formed in 1973 as a result of one family’s needs for local services. James Stewart, the eldest of four siblings in the Stewart family, had been going to Rochester, Minn., for dialysis treatments three times a week, but the drive became impractical, so he approached a Winona Health administrator by the name of Earl Hagberg to create a center in Winona.
After the unit was formed, Stewart continued local dialysis treatment for 22 years until he passed away in 1995, and all three of his siblings received dialysis care in Winona until each of them received kidney transplants.
Many patients are on dialysis for a long period of time, Vang said. From the time they make it on the transplant list, it often takes three to seven years for an organ to become available. Sometimes, patients continue on dialysis for 20 years or more. It’s a difficult process, too, particularly in those first few years.
“Being here every other day for that amount of time wears on people, They feel that a portion of their life is taken from them,” Vang explained.
“It’s a grieving process, when you go on dialysis. It’s a major life transition,” Kuhn added.
The staff at Winona Health do their best to keep patients’ spirits up, however.
“We’re their cheerleading team,” Kuhn said. “It’s exciting when they get the call and then tell us, ‘I’m not coming in today, I’m getting a new kidney!’ We’re like a family, in a way.”
The transplant list is only for deceased organ donors, but that’s not the only way kidney-failure patients can receive a new organ. Kidneys are one of the few organs that can be donated while someone is still alive, and donating a kidney comes at no cost for donors.
“I’m a living donor myself,” Vang said. “But people can be afraid of donating.”
Despite the stress that comes with waiting for a transplant, Kuklinski said he is enjoying living as he is. The news of getting on the transplant list has raised his hopes once again.
“I’m very optimistic,” Kuklinski said. “When I first went on dialysis, for the first year or two, I was preparing for what will happen for my son after I die. Now, I’m preparing to keep on living.”
Those interested in learning about becoming a living donor may visit www.mayoclinic.org/livingdonor, or contact the Winona Health dialysis manager at 507-453-3770.
Winona Health has recently established a special fund to support the operation of the Winona Health Kidney Care Team and Hemodialysis Department in providing this life-sustaining treatment in the community. For more information, please contact Winona Health Foundation, 855 Mankato Avenue, Winona, Minn., 55987, or call 507-457-4394.