Video: Living with End-Stage Renal (Kidney) Disease

by Curlan Campbell, NOW Grenada

  • Dr Germain Bristol-Stanisclaus diagnosed with ESRD in 2012
  • Persons with ESRD are required to have a minimum of 3 haemodialysis treatments per week
  • The Grenada National Patients Kidney Foundation currently assists a small number of patients who cannot afford treatment

At the prime of her professional career in the medical field, Dr Germain Bristol-Stanisclaus continues to struggle with End-Stage Renal Disease (ESRD), a devastating diagnosis which poses a constant daily challenge.

In 2012 while undergoing her clinical rotations in the UK, Dr Bristol-Stanisclaus, who is Assistant to the Medical Director of Grenada General Hospital, was diagnosed with ESRD.

Prior to being diagnosed, she was clueless about her condition and even after being diagnosed is still unable to determine the cause of her condition. A situation of this nature where the cause cannot be determined is termed idiopathic. ESRD is the last stage (stage 5) of Chronic Kidney Disease (CKD). This means the kidneys are only functioning at 10-15% of their normal capacity.

Her medical condition could not come at a worse time, as the country faces tremendous challenges with regard to dialysis treatments available, which can cost upwards of EC$9,000 per month.

Persons with ESRD are required to have a minimum of 3 haemodialysis treatments per week, but due to the high cost, she, along with many other patients cannot afford to maintain optimum treatment.

“In a situation where dialysis is not available, then I would have symptoms like vomiting, diarrhoea, fatigue; and if it gets really bad where I don’t get dialysis for an extended period, I have had situations where I had seizures. I had arrhythmia when my potassium built up too high, I had blackouts where I ended up in the ICU (Intensive Care Unit) on 3 occasions.”

When receiving treatment, patients undergo an average of 4 hours a session, 3 times a week, at an outpatient clinic at St Augustine Medical Services (SAMS). Another alternative treatment for dialysis patients is peritoneal dialysis which can be a lot cheaper and convenient, however, Dr Bristol-Stanisclaus said that type of treatment is largely dependent on a number of factors that must be taken into consideration.

“For patients who have serious heart problems, haemodialysis may not be the best treatment for them because it puts a lot of pressure on your heart, whereas who have polycystic kidney disease with a very large cyst or patients who might be pregnant, or patients who are large in terms of size may not be able to accommodate the peritoneal dialysis.”

At the helm of the Peritoneal Dialysis programme in Grenada, Dr Bristol-Stanisclaus has regular interaction with kidney disease patients and has observed that a lot more people are being diagnosed with kidney disease rather than ESRD. She is advocating for the cost of dialysis treatment to be subsidised and made available at the General Hospital so that ordinary Grenadians can afford treatment.

“If we can get more in terms of subsidising the cost, making treatment more available it will be a lot better for the Grenadian public… Mr Forrester is already established in the haemodialysis department, so it is just a matter of maintaining the services. For the government, I am not going to say that they should have their own dialysis, per se, but at least we should have dialysis available at the General Hospital so patients who are hospitalised don’t have to get dropped up in an ambulance to St Augustine to get treatment.”

The Grenada National Patients Kidney Foundation is currently only able to assist a small number of patients who cannot afford treatment.

When asked how she found the strength to work despite her condition, Dr Bristol-Stanisclaus said understanding her condition through education has helped her maintain her physical and mental wellbeing. “I think education is going to play an important role and once people get to know that this is what is happening then they will understand better because sometimes you hear [people] wanting to give you advice about what herbs to take, but there is a difference between kidney problems and end-stage renal failure.”

She added, “If you have kidney problems you may have to drink more water to flush the kidneys and help you regain kidney function, as opposed to when the kidneys are no longer working, you drink too much water you can swell up and then you can’t breathe. There are some people with kidney disease who continue to pass good volume of urine and there are others who don’t, so then you would need to balance the number of foods you can take in based on how much urine you produce.”

At present, the Haemodialysis Unit at SAMS has 3 dialysis machines which serve more than 18 patients. Efforts are being made to have more machines on the island with a new facility being built in St George to accommodate patients.

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