After long wait for 4th kidney transplant, life is ‘wonderful’
Normally people wait for Santa to come to them.
In Mike Gerald’s case, he drove thousands of miles during a three-year search for the elusive elf.
He found him wearing scrubs in a Washington, D.C., teaching hospital.
Dr. Matt Cooper and Dr. Alex Gilbert, who play St. Nick in this Christmas story, allowed Gerald to finally receive a new kidney in October.
“I feel wonderful,” said Gerald, 65, of New Baltimore. “Everything is real good.”
But it was no ordinary operation. Each kidney transplant becomes more perilous, and this was Gerald’s fourth, a rare occurrence. No hospital would touch him. He had contacted dozens of medical facilities.
The University of Michigan Hospital, he said, waited until he arrived for the surgery before telling him it wouldn’t be done for murky reasons.
Citing patient privacy laws, the hospital said it couldn't discuss the specifics of Gerald's case but did elaborate on the challenges of transplants.
“The road to transplant is different for each patient," said Shantell Kirkendoll, a hospital spokeswoman. "We work with patients and their families to keep them informed of our comprehensive evaluation process."
Enter the Medstar Georgetown Transplant Institute in Washington, which pronounced the delicate procedure a success.
Gerald and his wife, Leanne, will be returning home in several weeks. They have to settle for celebrating Christmas in a sterile hotel room in Arlington, Virginia, but that didn’t remove any luster from the holiday.
“He’s doing great,” said Leanne. “It’s a night-and-day difference.”
Gerald, a retired millwright who is the father of three grown children, has a favorite expression: "Whaddya think about that?" It’s a question he asked a lot while recounting his medical odyssey.
A rare genetic disorder ran in his family, killing a cousin at 22. Glomerulonephritis hampers the kidneys’ ability to filter blood.
Gerald, who was 17 when he learned he had the ailment, had kidney transplants in 1980 and ’81, but they didn’t take, leaving him on dialysis for a decade. The procedure removes wastes and excess fluid from the blood.
He received his third transplant from U-M in 1991, which was a big success. It lasted 27 years, nearly twice the average lifespan of a cadaver kidney.
In 2015, Gerald began to get easily tired. His complexion turned gray. A blood test confirmed his suspicions: the kidney was wearing out.
He returned to UM to prepare to receive a new kidney.
Each transplant becomes more difficult to perform, said Cooper, the Georgetown surgeon. The arteries harden. High blood pressure damages the heart.
“It gets harder each time,” the surgeon said. “Our immune system gets sensitized.”
It also becomes harder to find a donor, he said. Patients built up antibodies that would reject a donated organ. Their blood becomes incompatible with 99 percent of donors.
Gerald luckily found a match when the fiancée of Leanne’s niece volunteered to give his kidney.
The offer also meant he wouldn’t have to go on a waiting list, which could take five to seven years.
After eight months of working with UM, Gerald arrived at the hospital in 2016 to receive the transplant the next morning. An admissions clerk gave him his room number.
But a hospital administrator pulled him and Leanne into a room to tell them the operation wouldn’t be done, the couple said. This was one week after they met the surgeon, who said there were no problems.
What changed since the surgical consult, the couple asked. Nothing, said the administrator, it’s just that doctors were worried about Gerald’s heart being too weak, according to the couple.
But Gerald had undergone tests that showed his heart was fine, he said. He believes the hospital was worried its transplant success rate would be hurt if the operation wasn’t a success.
The hospital said the success rate doesn't influence decisions on whether to perform a procedure.
"Michigan Medicine (which oversees the hospital) cares for high-risk patients all the time and evaluates cases based on the best outcome for the patient," Kirkendoll said.
The Geralds were crushed.
“It was the most confusing, horrifying, devastating thing,” Leanne said.
No giving up
UM wouldn’t be the last hospital to dampen the Geralds’ spirits.
Leanne took all the medical records and mailed them to medical facilities across the country. The couple visited a half-dozen of them, some several times.
One hospital told them to not bother visiting. Another strung them along for a year before ultimately rejecting them.
The couple wouldn’t give up.
“If you let it get to you, you just lie down and die,” Gerald said.
Two Metro Detroit hospitals turned them down but, unlike the other places, gave a reason. They said their surgeons weren’t experienced enough to perform such a delicate operation.
The Geralds appreciated the candor.
Meanwhile, Gerald’s kidney grew worse. He began to receive dialysis at home in 2017, tying him to a bed five hours a day, five days a week.
He learned about the Georgetown institute from his longtime doctor, who had received a brochure about it.
The couple met Cooper, who said there were no guarantees, but he believed the chances of the transplant being successful were better than 50 percent. Yes, he told them, they could do it.
After all the waiting and all the rejection, Leanne began bawling.
“Don’t say it if it isn’t true,” she told the surgeon.
Cooper assured her he meant what he said.
In most transplants, doctors remove the donor’s organ before operating on the recipient.
In Gerald’s case, they first worked on him. That’s because, being his fourth transplant, they wanted to ensure they could find a spot for the new kidney.
If Gerald couldn’t receive the kidney, the donor had given his permission for it to be given to another person.
During his recovery, Gerald will remain in the Washington area for three months. That allows the doctors to monitor how well his body is accepting the new kidney and to adjust his medication.
Twice-a-week blood tests at the institute are down to once-a-week.
Gerald said he feels great. Despite being cut open, he has taken medicine for pain just one time, he said.
After feeling so bad for so long, his renewed vigor trumps any discomfort from the surgery.
“Whaddya think about that?” he asked.
Gerald recently had a hankering for a Coney dog, which he hadn’t had since starting dialysis a year ago.
He ventured into the high-priced confines of Washington and plunked down $12 for a hot dog. It was terrible.
As for his saintly doctors, Gerald has taken to calling one of them “the mayor.” That’s because the doctor, Gilbert, looks like Detroit Mayor Mike Duggan.
But, given that today is Christmas, we all know Gilbert’s real name.