Undeterred by the pandemic

Merlyn Paul, 32, from India, tells how she received her second kidney transplant while the COVID-19 pandemic was ongoing. With her kidney condition worsening at the beginning of the pandemic, she shares her experience as a kidney patient and the challenges she faced during this difficult time.

It was early January 2020 – I woke up with some tiredness and lethargy from my travel to my parent’s place in Kerala for Christmas and New Year. My mother, who is my first kidney donor, had requested everyone to celebrate it together. It was the 11th year of my kidney transplant. Even though we were all celebrating as a family, things were not going well at our house. My biopsy revealed a reoccurrence of IgA Nephropathy with about 40 percent of the kidney function left. Adjusting to being now in CKD stage 3, I got the news that COVID-19 was beginning to spread across the globe. 

Back in Mumbai, where I worked and lived, I got a feeling that things would not be easy if the virus spread further, considering the large population and limited health facilities.

In March 2020, a complete lockdown was declared to curtail the massive spread. Managing CKD stage 3, and slowly progressing to CKD 4 stage was not easy in lockdown; my blood pressure began to increase with the stress and fear of the unknown and my future.  

As I remained at home and did little exercise, I began to gain weight, and the decline in my mental health added to it, compounding the issue further. I could not travel to Kerala from Mumbai as there was a ban on all kinds of transport. I was lucky to get my medicines through some vendors. During the brief period when the lockdown was lifted, as my health declined, I rushed to Kerala. Arriving home, I took care of the household affairs and began to feel extremely tired. My creatinine level reached 5 mg in the kidney function test, and after consultation with doctors, I was placed on dialysis when it reached 7 mg.

As the pandemic was gaining its strength in India with thousands of people dying every day, I began my journey to the hospital for dialysis three times a week. Roads were deserted, and it was hard to get private or public transport. As my father had poor night vision, he couldn’t drive me in the evening or at night. We hired a private vehicle driver who lived nearby after obtaining the necessary permits from the police and hospital. He took me and my family through deserted roads three times a week for dialysis. As dialysis patients began to be infected with Covid, part of the dialysis center had to be frequently quarantined. All dialysis patients had to be extremely careful at that time. Increasingly frequent visits to the hospital made me worry about contracting Covid.

One year went by, adjusting to this new lifestyle. I got used to the masks. It feels strange to look back and realize that I have never seen some of my dialysis technicians without masks, and I would be unable to recognize their faces now.

After a year on dialysis, we decided to do a second transplant. Planning a transplant in November 2021 was still risky, as the Covid wave was hitting Kerala again. Our doctor warned us that if any of our family members caught covid, my transplant surgery would be delayed by at least three months. Everyone in my family, including my extended family, was very careful about this. My older sister, who is only two years older than me, came forward to donate her kidney to me. I was overwhelmed at the time as I witnessed how many sacrifices my family was making. After a few initial blood tests, my sister and I stayed in the hospital for two weeks in complete quarantine for the pre-transplant workup. The day before the transplant, the doctor admitted my mother and brother-in-law, after covid tests, as the caretakers post-transplant. No one else was allowed. Even my father was not permitted for many days. After my transplant, I remained in the hospital for ten days, and since Covid was still around, I had to spend all ten days in the ICU. My stay in the ICU was very restrictive as I could not go outside at all, and my family members could only see me from a distance, wearing a mask and gown. With the support and guidance of my excellent doctor and his staff, my transplanted kidney was doing well. I was discharged from the hospital after ten days.

In the subsequent days, we had to follow up with the hospital many times, and in between, I contracted Covid during my third-month post-transplant. I wept all day thinking about the consequences of my transplant. I had to take fever medication while being in quarantine for two weeks and closely monitoring my oxygen levels. Gradually, I became healthy again.

For my family and me, Covid was a very challenging time. We went through many highs and lows together, from losing my kidney function after 11 years of my first transplant to undergoing dialysis for one whole year and then getting a second transplant. It was an arduous journey. Enduring all this during Covid times was unimaginable, but still made possible with the love, help, and support of my beloved family.