March is Kidney MonthChronic Kidney Disease… a personal storyRita Smith knew last December that she was ill, but she had no idea what was wrong.“I kept going to the doctor and to the hospital. I wasn’t in pain but I just kept vomiting,” she said. “I couldn’t keep anything down.”She said for a while she was surviving only on ginger ale.This is commonly used in Bermuda as a means of getting some nourishment (the sugar in the soda provides energy) in the bodies of those afflicted with bad cases of vomiting and/or diarrhoea. Ms Smith said she was unable to keep even ginger ale in her system.After a slew of tests she said doctors still could not pinpoint the problem but believed something was wrong with her kidneys.“I kept bringing up the ginger ale because my kidneys were not functioning properly,” she said.But all the kidney tests she had in Bermuda failed to indicate exactly what was wrong.Ms Smith said she was eventually admitted to King Edward VII Memorial Hospita and put on dialysis.“My doctor said it was possible I had developed a blockage in one of the arteries serving my kidneys. To test for this she sent me to Johns Hopkins,” said Ms Smith.Ms Smith’s granddaughter took her to the Baltimore hospital on Christmas Day. Her son, who lives in Atlanta, met them there.“The doctors at Johns Hopkins ran a barrage of tests, many I’m sure I had already had but they had to do them again,” she said. The tests indicated that one of the arteries supplying her kidneys was blocked.She said cholesterol build-up was what blocked her artery. She had had problems with cholesterol before and underwent quadruple bypass surgery in 2009, to correct damage to her heart.Ms Smith also had high blood pressure, a condition that made treating the blockage in her renal (kidney) artery more risky.She said doctors at Johns Hopkins originally thought her operation would be fairly routine. A closer look with a camera revealed that the blockage was more extensive than they first thought, and that surgery posed significant risks.“They said the procedure would have to be more drastic than they had believed at first and explained that it could kill me,” said Ms Smith. “They said there was a possibility that I would lose my toes. I thought: ‘That’s okay, I can live without my toes, and if I die, that’s okay too because it means that God has called me into his hands.”Ms Smith decided to go ahead with the surgery, called renal artery stenosis.Doctors put a stent, a small coil, in her artery to hold it open. They then blew on the area, causing the blockage to dislodge and allowing blood to flow freely through the kidneys.The blockage was not removed from her body, however. The doctors explained that the procedure usually results in it moving to the toes.The surgery was a success.Ms Smith felt better almost immediately. “I had no soreness in the area where they had made a small incision and felt much better almost right away,” she said. “I could eat and drink again.”She had the surgery on December 29 and by the first week of January was back in Bermuda. She was released to KEMH as a precaution and after five days was able to go home.She remained on dialysis, having the treatment three times a week.“That was to start with,” she said. “They took it down to twice a week, then once a week for three hours. Now I’m down to once a week for two hours.”She is anxious to be off dialysis as the treatment makes her feel sick however doctors have not set a date when she is likely to be finished.“I am giving myself a month. I want to be off dialysis by summertime. I love to swim and go bowling,” she said. “ I’ve already cancelled a bowling trip overseas that was slated for June.”How her life has changedEvery day is a battle over what food Ms Smith can and cannot eat since the surgery.“This is the biggest way the surgery has changed my life,” she said.One of her kidneys does not work at all, and the other is deemed not to be functioning at its optimum level.“My diet is very strict now. I cannot have anything with potassium in it. This means no tomatoes, no bananas, no avocadoes, no potatoes unless I soak them the night before I need them,” she said.“I just don’t use them at all.”One of the functions of the kidneys is to regulate the concentration of ions in the blood including sodium, chlorine, potassium, calcium and phosphorus. For this reason Ms Smith’s diet needs to have as little of these ions as possible. This helps ensure her functioning kidney is not overworked.But keeping these nutrients out of her diet is a Herculean task. “It’s more than just reading labels,” she said. “You have to know what nutrients are in every food.”Ms Smith said she loves fresh fruit and vegetables but now has to educate herself on the nutrient make-up of each item, as fresh produce does not come with such labelling.“I can’t have phosphorus. I didn’t know what foods have phosphorus, so it’s a lot I have to learn,” she said.She does have a dietician helping her, which is some benefit, she said.Stressing that she’s thankful to be alive and well, she lamented that she can no longer eat the traditional Bermuda Sunday breakfast codfish and potatoes.“The fish may be too salty, I can’t have banana, avocado, tomatoes, potatoes what’s left would not be breakfast,” she said.She also has to be sure to include a lot of fluids in her diet. “I drink a lot of water now which has been an adjustment because I really don’t like water,” she said.And she has to walk.“My son from Atlanta stayed and looked after me here. He left two weeks ago, but he still calls checking up on me and insisting that I go walking every day,” she said. “And I can’t think of a more boring exercise than walking. I don’t like it at all.”Ms Smith said she loves bowling and swimming, activities she has been unable to do because of the method used in her dialysis treatment. She was fitted with a catheter on her chest. This enabled her to have dialysis without being stuck by a needle. The disadvantage was that she could not get the area wet.“I can’t take a shower, and I certainly can’t swim. Swimming would kill me,” she said.l Only a few hours after the interview with Body & Soul, Ms Smith’s doctor told her she no longer needs dialysis.“It’s very happy news for me,” she said.