My name is Joseph Chatmon. I'm fifty years old. I have been a mechanic at the city bus garage here in Memphis for twenty-four years, brakes and transmissions mostly, and a deacon at my church for eleven. I've been married to Marilyn for twenty-eight years, and we have two grown children, William and Jennifer.

Three mornings a week, Monday, Wednesday and Friday, I'm at the dialysis center at 5:30 a.m. I sit in a recliner for about four hours while a machine does the work my kidneys can't do anymore. Then I drive to the garage and fix buses until the afternoon. I've been doing that since 1997.

I'm on the waiting list for a kidney transplant. And this month, September of 1999, I found out my younger brother, Mark, is a good match to give me one of his. We're praying for this winter.

I made this page for two reasons. The second one is to help people who are on dialysis or about to start, and their families. The first one is in the box below, and I'm putting it first on purpose.

Kidney Failure · Dialysis & My Fistula · The 5:30 Crew · Fluid & the Kidney Diet · The List & My Brother · Help

Kidney Failure, Plain

I'm a mechanic, so here's how I understand it. Your kidneys are the oil filter and the radiator both. They clean the waste out of your blood, take off the extra water, and keep the salts and minerals in balance. They also help keep your blood pressure right, help your body make red blood cells and help keep your bones strong. You have two, and you can get along fine on one. When both quit, the waste and water build up in your body, and without treatment you can't live.

The two leading causes of kidney failure in this country are diabetes and high blood pressure. African Americans are at much higher risk of kidney failure than white Americans, and diabetes and high blood pressure are a big part of why.

Kidney disease is quiet early on. By the time I felt it, my ankles swelling up like balloons, tired all the time, short of breath on the stairs at the garage, itching, no appetite, my kidneys were mostly gone. Don't wait to feel it. Ask your doctor about a urine test and a blood test that check how your kidneys are working, especially if you have diabetes, high blood pressure, or kidney trouble in your family.

Dialysis and My Fistula

Hemodialysis, which is what I do, means my blood runs out of my body through tubing, through a filter that works like an artificial kidney, and back into me, over and over, for about four hours. The filter takes out the waste and the extra water. It doesn't do everything a real kidney does, and it does it three days a week instead of every minute, but it keeps me alive and working. There's another kind called peritoneal dialysis that some folks do at home, using the lining of the belly as the filter. Ask your doctor which is right for you.

The fistula. To get that much blood in and out three times a week, you need a good strong blood vessel. So before I started, a surgeon connected an artery to a vein in my left forearm. That's a fistula. Over a couple of months the vein got bigger and stronger, and now that's where the two needles go in at every treatment. If you put your fingers on it you can feel it buzz, like a little motor running. The nurses call that the "thrill." I check it every morning and every night. If the buzz ever stops, you call your dialysis unit right away.

Take care of your fistula like it's your lifeline, because it is. No blood pressure cuffs and no blood draws on that arm, ever. Tell every nurse at every doctor's office. No tight watches or sleeves. Don't sleep on it. I'm a mechanic, so I'm careful how I lift and I keep that arm out of harm's way under a bus. It's the most important thing I own, and I've got a nice set of Snap-on wrenches.

The 5:30 Crew

When you sit in the same chair at the same hour three days a week for two and a half years, the people in the other chairs become family. Here's mine, the 5:30 Monday-Wednesday-Friday shift. They all said I could, as long as I spelled their names right and said nice things. I am obliged to report that I'm the handsomest one.

And our nurse Michelle, who can put a needle in a fistula so gentle you don't know she's done it, and who calls everybody "Baby," including Mr. Phillip, who is eighty-one.

Getting used to dialysis: the first few weeks I was wiped out after every treatment, and some days I still am. Cramps sometimes, and sometimes I'm dizzy getting up. Tell your nurses everything. They can often fix it by adjusting your treatment. And if you can, keep doing what you love. My job is part of what keeps me well. Not everybody can work on dialysis, and there's no shame in that. I just thank God I can.

Fluid and the Kidney Diet

This is the hard part, harder than the needles. When your kidneys don't work, everything you eat and drink stays in you until the next treatment. So you have to watch it. Here's what I've learned. Your dietitian sets your limits, not this page. Ours is Marisa, and she is a saint with a calculator.

Fluid. I have a daily limit on fluids, and it isn't much. And "fluid" means anything that's liquid at room temperature: water, coffee, soup, ice cream, Jell-O, ice. Tricks that help me:

• A small cup. I drink out of a little juice glass. It fools your eyes.
• Ice chips instead of water. Count them as fluid, but they last longer.
• Sugar-free hard candy or a cold slice of lemon for a dry mouth.
• Cut the salt. Salt makes you thirsty, and thirsty makes you drink. Less salt is the biggest help of all.

Potassium. Too much or too little potassium in your blood can be dangerous for your heart, and your kidneys used to keep it right. Now you have to. Here's a general list. Your dietitian will tell you how much of what, and it's different for everybody.

Portion size matters as much as the food. A big plate of something "low" can add up to a lot. Ask your dietitian.

Phosphorus. Too much hurts your bones and makes you itch something terrible. It's high in milk and cheese, dark colas, nuts and dried beans. I take binder pills with every meal that soak some of it up. Don't skip them.

Salt. As little as you can stand, and then a little less. Watch canned soup, lunch meat, chips, fast food, and anything that comes in a box. I'm a Memphis man and it grieves me to tell you that a plate of dry-rub ribs is a salt lick. I have one a year, on my birthday, a small one, and I plan the rest of the week around it.

Protein. This one surprised me. On hemodialysis, many of us need plenty of good protein, because some is lost in the treatment. Eggs, chicken, fish. Your dietitian will tell you how much.

The List, and My Brother

The waiting list. A transplant isn't a cure, but for a lot of people it's the best treatment there is, and it would get me out of that chair. I've been on the national waiting list since 1998. The list is kept by UNOS, the United Network for Organ Sharing, and when a kidney from a deceased donor becomes available, it goes to the person who is the best match by their system. You can wait years. You have to keep your phone on and stay as healthy as you can, so you're ready when the call comes. Ask about getting evaluated at a transplant center early. Don't wait for somebody to bring it up.

Living donors. A kidney can also come from a living person. A healthy person can live a normal life with one kidney. Often it's a family member, but not always. Kidneys from living donors often work very well, and you don't have to wait for the list. The donor goes through a lot of testing first, for blood type and tissue match and to make sure they're healthy enough to give, and their health always comes first. Some hospitals now do a newer donor operation through a few small cuts instead of one big one, so donors heal faster. Ask your transplant center about it.

Mark. My little brother is forty-four. He drives a truck for a grocery chain and has never been sick a day in his life except the time he ate a whole sweet potato pie on a dare in 1971. I never asked him. You don't ask a man for his kidney. Last winter, at our mother's table after church, he put down his fork and said, "I'm getting tested. Don't argue with me." I argued. He got tested.

The testing took most of this year: blood work, and more blood work, and X-rays, and appointments at the transplant center, and a long talk with people whose only job was to look out for him, not me. I was glad of that. In September they told us he's a good match and healthy enough to give. If everything keeps going right, we're hoping for surgery this winter.

I don't have the words for what my brother is doing. I'm a deacon and I talk for a living on Sundays, and I don't have them. I'll just say I've been praying for a kidney for two years, and the Lord sent it in a man I used to hold upside down by his ankles when he was six. Marilyn says I should write that I'm scared for him. I am. Mark says to tell everybody he's going to want a new truck. He is not getting a new truck.

Organ donation. If you want to help, talk to your family about being an organ donor, and sign the back of your driver's license. Tell your family, because they'll be the ones asked. One donor can help a lot of people. There are about a dozen of them in the chairs around me three times a week.

Help

Your doctor. Get your blood pressure checked. Ask about your kidneys. Yes, I'm saying it again.

The National Kidney Foundation. Good, plain information about kidney disease, dialysis, diet and transplant, for patients and families, and local offices that can point you to help near you.

UNOS, the United Network for Organ Sharing. They keep the national transplant waiting list and have information about transplants and donation.

The social worker at your dialysis unit. Every unit has one. Mine helped us with insurance and Medicare, which covers most people with kidney failure no matter their age, and with time off work. Go see them.

Your dietitian and your nurses. They know more than any web page. Including this one.

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I'm a mechanic and a deacon, not a doctor or a dietitian. Ask yours about everything on this page.
Last updated Wednesday, September 22, 1999