January 5, 2011 is a memorable day for husband and wife, Scott and Jo McCalman, “Kurandah”, Gunnedah.
Both had been prepped for surgery at Royal Prince Alfred hospital and were wheeled into adjacent operating theatres. After their anesthetics, one team of surgeons opened Scott’s back while the other team did the same to Jo.
What happened next enabled Scott to remain alive without daily kidney dialysis and to keep on farming.
Months before the operation and after exhaustive psychological testing, Scott and Jo were approved suitable donor and recipient of one of Jo’s kidneys to Scott.
This is a more unusual situation with organ donations as the majority come from recently deceased bodies, not a living donor.
Since the age of 28, Scott had been experiencing random bouts of ‘feeling crook’ with a metallic taste in his mouth, low-grade headaches, blood in his urine and occasional extreme back pain. He applied to get his B-Double truck licence which also included a blood-test and, on the returned application form, written in red ink was “needs follow-up” but this went unheeded by Scott’s General Practitioner (GP) in his then home-town of Warren. Even then his creatanine levels were above the normal count of 100.
(Creatinine is an important indicator of renal health because it is an easily measured byproduct of muscle metabolism that is excreted unchanged by the kidneys. If the filtration in the kidney is deficient, creatinine blood levels rise indicating kidney malfunction.)
“I used to get really tired and I thought I was being lazy”, Mr McCalman said. “After dinner I’d always help Jo with the dishes as it’s a good time to catch up on the day’s activities but I used to fall asleep in the chair”.
Over the next few years he had appointments with other GP’s with diagnoses including ‘soldier’s syndrome’ from walking so many kilometres around the irrigation, potential prostrate problems and bladder infections.
As the symptoms became worse and new ones manifested including more severe headaches for which a brain tumour was suspected, and ‘restless legs syndrome’ at night, ‘feeling crook’ incapacitated him more often.
Even after visiting two different specialist urologists no-one was any closer to diagnosing the symptoms until one fateful day in Sydney when it was suggested he see a renal specialist.
“We went straight from one surgery to the next and my blood results had arrived before me. When the renal specialist saw me she said in very plain language, you have Stage V renal failure”.
“When I asked how many stages there are she answered there are no more. It is a wonder you are walking, much less alive. Your blood creatinine levels are over 1000 and you are dangerously ill”.
“I hadn’t been expecting this information and a range of emotions hit me hard”.
This was in August 2009 when Mr McCalman was diagnosed with IgA nephropathy, an auto-immune disease that affects mostly active young men with no random pattern, links or genetic history.
“The prognosis is quite poor as treatment is to keep you alive unless you can have a kidney transplant”.
Mr McCalman commenced drug therapy to lower his blood pressure which reduced the frequency and severity of the headaches. He also took a kidney stimulant to boost function and started dialysis.
At the same time, Jo McCalman and Scott’s sister Kylie both commenced testing to see if either would be a suitable donor. In the end, Jo’s kidney was the preferred choice and, on the 5th January, 2011, the transplant took place.
The Royal Price Alfred (RPA) Hospital houses Australia’s Transplant Institute on the 9th floor, a place Mr McCalman spent three months visiting once the transplant was completed. The first kidney transplant in Australia was done in 1976 by trial and error. Back then, there were 10 dialysis machines in Sydney, the same as the number of patients waiting for a kidney transplant.
By 2006, more than 2000 kidneys had been transplanted at RPA. The waiting list for kidney transplantations sits around 400 indicating the success of the procedure.
“The moment I woke from the anaesthetic, I felt as though I had a new battery, it was such a contrast to how I’d been feeling for years”, Mr Mccalman explained. “Apparently my body was so poisoned, my veins were like jelly. The surgical teams are outstanding and, without them, I’d be dead”.
Being an organ recipient means being on immuno-suppressant drugs for life, and in Mr McCalman’s case, he had only one bout of rejection – day five after the transplant.
“Some recipients are crook for months and they do get depressed. While I was living next to RPA for three months for daily post-op check ups and treatment, I’d visit Rooms One and Two where patients with new organs are under observation”.
“I’d say, look at me, I am alive and well and you can be too”.
“I finally went home almost five months after the transplant. It was totally necessary for me to be in Sydney that long however it is very difficult to run a rural-based business hundreds of kilometres away”.
Mr McCalman’s story is similar to the stock men and women participating in the fund raising Herd Of Hope ride across the Sydney Harbour Bridge towards the end of May, 2017. All the riders are organ recipients from rural areas across Australia who also had to spend months away from home while receiving their life-saving treatments.
Event organiser, Megan McLoughlin, a pancreas and kidney recipient said “the money raised for the event will go towards areas recently identified by the University of South Australia in a research thesis to include establishing regional transplant care nurses, and providing therapy for families and recipients at the three months, post-transplant stage in their home towns”.
Keep an eye out for Scott and Jo McCalman as participants and supporters of the Herds of Hope.
There is anecdotal evidence that recipients sometimes acquire a characteristic of the donor. In Scott’s case he revealed that when he walks past a women’s shoe shop, he does feel a tremor where Jo’s kidney is located.