Coping with renal failure …no longer out of the ordinary man’s reach

Feb 24, 2013 News

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By Sharmain Grainger

Although the symptoms were clear, it was only months later that he was convinced that he had a condition that required urgent medical attention. Having suffered various distressing spells over the years which took a dreadful turn last year, 53-year-old Paul Grovesnor was eventually convinced by medical practitioners that he was a victim of renal failure.
Renal failure, also known as kidney failure or renal insufficiency, is a medical condition in which the kidneys fail to adequately filter waste products from the blood.
Ahead of being diagnosed with the condition, the Sophia, Georgetown resident had on numerous occasions visited several medical institutions, both public and private, and it was at this point that he had in fact learned that he was a diabetic. Little did he know that his condition was becoming worse with each passing day; something that he opted to pay little attention to.
“I was feeling ill on an off for about four years straight but I wasn’t really taking it serious,” Grovesnor admitted during a recent interview with this publication.
The contractor by profession was however forced to seriously confront his condition after he became severely unwell while engaged in a job at the RUSAL company in Kwakwani, Region 10.
He explained that “I just get sick; I start swelling up and I couldn’t sleep at nights; I was getting short breath and all kind of things start happening to me.”
Grovesnor recalled that his extreme ailment came on at a time when there was unrest in Linden, thus he was unable to travel to the city to gain needful medical attention. As a result he was forced to spend six devastating weeks in Kwakwani “just sitting and hoping that I get a chance to come down to see a doctor.”

As soon as the way was cleared for him to travel, Grovesnor said that he headed to the Georgetown Public Hospital Corporation (GPHC) where his condition warranted that he be immediately admitted. He was required to have a catheter implanted in the upper left section of his chest in order to allow for the proper filtering of his blood.
According to scholarly medical papers published by the American Diabetes Association, diabetes can damage the kidneys and cause them to fail. Moreover failing kidneys lose their ability to filter out waste products, resulting in kidney disease.
When our bodies digest the protein we eat, the process creates waste products. In the kidneys, millions of tiny blood vessels (capillaries) with even tinier holes in them act as filters. As blood flows through the blood vessels, small molecules such as waste products squeeze through the holes. These waste products become part of the urine and useful substances, such as protein and red blood cells, are too big to pass through the holes in the filter and stay in the blood.
Diabetes therefore can damage this system causing high levels of blood sugar and make the kidneys filter too much blood. All this extra work is said to be hard on the filters and after a few years, they start to leak and useful protein is lost in the urine. Having small amounts of protein in the urine is called microalbuminuria and larger amounts of protein in the urine is called macroalbuminuria.
Medical experts have been able to deduce that when kidney disease is diagnosed early, (during microalbuminuria), several treatments may keep kidney disease from getting worse. When kidney disease is caught later (during macroalbuminuria), end-stage renal disease usually follows.
In the past there was little to no hope for patients after being diagnosed with renal failure in Guyana, but today there is greater scope for high-quality treatment even for those who can be considered the less fortunate.  This advent has been realised through the renal care service offered by the Annandale, East Coast Demerara, Doobay Renal Centre which opened its doors in September of 2011.
In fact it was this very facility that Grovesnor was referred after he was discharged from the public hospital. “They (GPHC officials) link me with this clinic to continue dialysis,” he related even as he disclosed that the service offered there is very satisfying. He is required to be dialysed three times per week, a process that currently cost $9,000 per session, an amount which is reportedly the lowest offered in Guyana.
However, according to Founder of the not for profit Renal Centre, Dr Budhendranauth Doobay, his objective is to see that the cost of dialysis be lowered even further. He claims that the facility was created with a view of ensuring that quality service was made available to individuals from any stratum of the society.
According to the vascular surgeon, the Renal Centre idea matured after a conversation with the now Chief Executive Officer of the facility, Mr Vic Oudit, who informed that so costly had been renal failure treatment that some persons were forced to mortgage their homes and even cattle to make requisite payment, hence the need to introduce affordable yet quality health care in this regard.
However, the service offered at the Renal Centre has defied expectations whereby patients are afforded a procedure called Arteriovenous (AV) fistula, which is recognised as the gold standard hemodialysis access. Although very costly, the procedure is done free of cost, effectively doing away with the catheter which can become infected and allowing for a safer, neater and cleaner method of dialysis. Grovesnor along with a few other patients were just last week offered this procedure by Dr Doobay himself.
Added to the regular treatment for his condition, Grovesnor, like other renal patients, is expected to adhere to strict diet if he is to maintain a healthy condition. This, according to him, is no easy task, but one that he intends to fully embrace in order to further improve his health and hopefully by extension help to extend his lifespan.
“I’m trying to stay away from certain foods and I am trying the hardest to stay away from red meat and I do a little bit of exercise too,” said the husband and father of three as he considered his journey since joining the Doobay Renal Centre some five months ago.
According to Dr Doobay, one of the key areas of helping to prevent conditions that can ultimately lead to renal failure is in fact that of diet. It is for this reason, he said, that the Renal Centre has as part of its programme sensitisation sessions which keeps patients as well as their family members the importance of eating the right types of foods. He however noted that it is evident that refraining from certain foods is a major challenge to many. “They should not eat salt, but they are still eating the salt, people are still eating too much carbohydrates and they have to control their sugars…people are still doing the things we tell them not to do. We can only teach them and advise them, it is up to them to adhere,” Dr Doobay asserted.
He added too that although the Doobay Renal Centre has been able to help address the renal failure challenge in Guyana, there is still evidence to suggest that “we are under-dialysed in this country. We should have 100 patients on dialysis since there is one patient per 1,000…so if there are 700,000 people we should have 700 people on dialysis.”
At the moment there are just about 40 patients on dialysis at the East Coast Renal Centre, several of whom were receiving treatment at other facilities before learning of the reduced treatment available.
“We should have 100 patients on dialysis. What about the people in Pomeroon, Bartica, Essequibo and Skeldon?” questioned Dr Doobay.
Nevertheless he is very confident that the facility has been and will continue to be able to make an immense impact as it relates to helping to bolster health care in Guyana so that patients the likes of Paul Grovesnor can gain needful affordable treatment.

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