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Liberated After Living with Diabetes for 30 Years

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Michael found compassion and hope in the Temple Kidney Transplant Program

Diagnosed with diabetes nearly 30 years ago, Michael suspected his type I diabetes was slowly killing him. When his nephrologist advised him that he was going to need a kidney transplant, and to contact the Temple Kidney Transplant Program, he realized his worst fear was becoming a reality.

But in Sunil S. Karhadkar, MD, FACS, one of the program’s surgeons, Michael found compassion and hope.

“Going in, I was very concerned that my health insurance wouldn’t provide enough coverage for a transplant,” Michael says. “Dr. Karhadkar told me not to worry about that and to focus on my health. I knew right then that I was in the right place.”

Dr. Karhadkar recommended that Michael undergo a simultaneous kidney-pancreas (SKP) transplant to address both the kidney disease and the diabetes. Type 1 diabetes occurs because the pancreas does not produce enough insulin, which controls a person’s blood sugar levels. Years of erratic blood sugar levels can negatively affect the kidneys, and like in Michael’s case, cause chronic kidney damage. The combined transplant has become more prevalent in recent years because research shows that addressing the root cause of both problems – the pancreas – type 1 diabetes can be eliminated in the recipient, preventing complications from the disease and improving the recipient’s quality of life.

Extreme Highs and Lows

In early 2017, Michael began undergoing the extensive testing that was required to be added to the SKP transplant waiting list. A year later, that moment finally arrived. It was progress, but it was far from the finish line. According to the National Kidney Foundation, the average wait for an SKP is about three years. Meanwhile, Michael’s condition continued to deteriorate.

“I always tried to be proactive with my health. My specialist told me to get on the waiting list before I needed dialysis, which I thought was good advice,” he says. “Dialysis, to me, was a scary prospect. I equated it with the final stage of life.”

As his kidney function level declined past the point when dialysis is usually recommended, Michael continued to resist dialysis. He still felt okay, he told his nephrologist. When his kidneys were functioning at 7% capacity — well within the parameters of kidney failure — his blood sugar began to swing erratically.

“My kidneys were shutting down, which was pushing my diabetes into hyper-overdrive,” Michael says. “When I finally started dialysis, all of that only intensified.”

To try to cope with the extreme highs and lows, he was taking 60 units of insulin one day and 30 the next. For reference, a shift in only two to three units of insulin is a fairly dramatic change for most people with diabetes, and the change can cause a whole host of side effects. 

After a year on the waiting list, Michael also moved back in with his parents so that he could focus solely on preparing for his transplant. He was going to the gym four or five days a week. After three-and-a-half years on the waiting list, Michael was struggling with depression. The loss of independence, coupled with not knowing when, or if, he was going to get his transplant, was wearing on him.

Following surgery, Michael says, “When I woke up the next morning, I felt great. Right away, I wanted to get out of bed and move. So, I did."

The Day Everything Changed

On November 14, 2021, Michael got the call he had been waiting for — his time on the transplant list had finally come to an end. Michael was moved into an operating room at Temple University Hospital, where Dr. Karhadkar and Antonio Di Carlo, MD, CM, FACS, FRCSC, Surgical Director of Abdominal Organ Transplantation at Temple University Hospital, performed his SKP transplantation. Kelvin Kwan N. Lau, MD, Associate Professor of Surgery at Lewis Katz School of Medicine at Temple University, was also involved in Michael’s care before and after his surgery.

“When I woke up the next morning, I felt great. Right away, I wanted to get out of bed and move. So, I did,” Michael says. “When my parents arrived a couple of hours later, I was sitting in a chair watching TV. I’d walked there myself. No one could believe it.”

Dr. Karhadkar told him the quality of the kidney and pancreas he received was helping his cause, as was all the hard work he’d put in at the gym. Michael’s new pancreas started working right away when typically, it takes a few days. And his body was healing faster than expected because he was in great shape. He was moved out of the intensive care unit the next day and was allowed to go home a week later. 

“From day one, Dr. Karhadkar made me believe I could do this,” Michael says. “As great as he was throughout the last few years, my Temple experience isn’t defined by only him. Just walking through the hallways at the hospital, everyone I encountered was kind and supportive. And the host of nurses and doctors who participated in my treatment all went above and beyond.”

Two months removed from his transplantation, Michael said his life is great — and weird.

“I had diabetes for 30 years, and I’d developed all these little habits to help me cope. I’ve sort of had to reprogram myself,” he says. “There were just so many challenges with my health. I finally feel like a regular person. I can live life on my terms for the first time, really. And I’m so grateful for that.”

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