dbachman@observer-reporter.com
CARMICHAELS - For the past two years, Craig Church has spent as many as 18 hours a week at Fresenius Medical Care-Greene County Dialysis.
Of course, he would prefer to spend his time elsewhere, but he's OK with the routine. Dialysis is keeping him alive, and he's come too far to give up now.
The 56-year-old Waynesburg resident has been an insulin-dependent diabetic since he was 12. He has survived double pneumonia, pleurisy, a kidney-pancreas transplant and a debilitating stroke.
Yet, he rarely gets frustrated or depressed.
"That's one thing I don't do very much. I tend to be determined," he said.
And the folks at Fresenius have made dialysis - the process of artificially cleansing the blood of wastes and fluid for those with kidney failure - much easier to handle.
The clinic moved in January from a small office on Route 21 in Carmichaels to a nearby industrial park with 12 individual dialysis stations, each of which is equipped with a flat-screen monitor and headphones so patients can watch television, hook up to the Internet or listen to satellite radio.
Church, an architect and registered engineer, also reads the newspaper and sketches building plans to help pass the 41/2 hours he typically spends on the dialysis machine three times a week.
"Dialysis isn't for everyone," said Beth Cook, the charge nurse at Fresenius who has worked with dialysis patients for 14 years, the majority as a patient care technician.
"Dialysis takes a lot out of a patient," she said. "It's really working your body."
According to the End Stage Renal Disease Network's 2006 annual report, 13,750 Pennsylvanians were undergoing dialysis, with 5,033 new cases reported. At Fresenius in Carmichaels, 28 patients are dialyzed six days a week.
That's why it's so important, Cook said, to make patients as comfortable as possible and to provide them with educational tips and programs, which can be viewed on their monitors.
"For proactive patients, it's quite a tool," Cook said. "Fresenius uses ultracare, which is unique in dialysis. It's really cutting-edge technology."
The two main types of dialysis are peritoneal and hemodialysis. Peritoneal dialysis can be done in the home by the patient and involves a glucose-based solution that's infused through a catheter implanted into the abdominal cavity. The fluid remains for about two hours and is then drained out.
Hemodialysis involves a machine that removes the blood from the body, runs it through a dialyzer - designed to mimic the kidneys - and then returns it to the body. This procedure must be performed at a hospital or dialysis center.
HD relies on a fistula or vein in the arm to remove and restore the blood. Cook said veins are preferred but in most cases, patients decide what is the best option for them.
In some instances, however, a catheter must be implanted in the neck or chest. Church is dialyzed through the chest, and, unlike most patients, he had no choice.
Church had previously tried PD, but he ran into complications because of scar tissue. Then he went to HD and tried being dialyzed through the arm. That, too, failed.
"I had three fistulas put in in the late 1990s," Church said. "The left arm became infected, and the right never worked well. It wasn't as successful as they wanted it to be."
Hence, the tube in his chest.
Church began experiencing serious kidney problems in the early 1990s when he developed pneumonia while working on a job site in West Virginia.
"It's the first time in my life I had pneumonia," he said.
His doctor suggested he take off work for a week. But Church continued to work long hours, and his body rebelled. He developed double pneumonia and pleurisy. It was at that point he was told his kidneys were starting to fail.
By 1997, his kidneys were functioning at 10 percent their normal level, so he began dialysis at Allegheny General Hospital. For 16 months, he made the thrice-weekly trek to Pittsburgh.
In February 1999, he underwent a kidney-pancreas transplant, and for six years he remained dialysis-free until his kidney stopped functioning. Church partially blames the failure on the 30-hour delay in the kidney's arrival during a snowstorm. The pancreas arrived immediately, and it still functions.
He's been on dialysis ever since, and the intensity of the treatment has forced him to resign from board positions he held with architectural and engineering societies in Pittsburgh.
However, he continues to work, albeit on a limited basis, from a home office he built in his attic.
"I turn down work all the time. I just can't do it. I mean, this is fun," he joked.
A year after his transplant, Church's blood pressure became extremely erratic, dipping and peaking on a regular basis. Eventually, he suffered a stroke that robbed him of his speech and his ability to walk. In addition, he couldn't sit up without vomiting.
"They didn't expect me to live," Church said. "They called in the family. I was given 31/2 weeks."
But he pulled through and underwent one month of rehabilitation at Harmarville.
"They said I'd be in a nursing home for the rest of my life. I fooled them, too," he said.
He then did outpatient rehabilitation at HealthSouth in Washington, and within a year, he was good to go.
"I lost a little bit of control on my right side, but nothing much that I notice," Church said.
He credits his mother, who is deceased, his wife, Nancy, and his children, Heather, Jennifer and Kelby, with helping him live an active life with diabetes and dialysis.
"My mom was an excellent caregiver," he said. "My mother was probably the best single determining factor in my life.
"When my blood sugar was real high, she made me feel secure, knowing she was always there for me. My wife reminds me in a lot of ways of Mother."
Church, who also has three grandchildren, is now undergoing a transplant evaluation through Ohio Valley Hospital. His younger brother, who resides in Ohio, said he would donate a kidney.
Despite his previous experience, Church said he hopes he's approved for the transplant.
"It would be a lot better than this," he said, noting that on the rare occasions he travels, he also must make arrangements in advance to be dialyzed at a local clinic.
"If I don't get on a transplant list, it's OK. I'm lucky to be alive," he said.