A patient credits a Saugus kidney care center for helping to preserve his quality of life after COVID-19 and cancer
Life dealt Dario Volante a dangerous double whammy two years ago that forced him to retire from his career as an optician to address some serious health issues. First, he came down with COVID-19. Soon after, he learned that his remaining kidney was being ravaged by cancer. He had lost his other kidney to cancer back in 2013, so the prospects of losing another one left his life in limbo.
“Believe it or not, the COVID is how they found the cancer,” Volante, 58, said in a recent interview at Fresenius Kidney Care on Route 1 in Saugus, where he has been a patient.
“My kidney was failing a little bit too fast. They originally thought it was the COVID ruining the kidney, but it turned out it was the cancer. Had I not had COVID, I’d probably have had to wait til the kidney showed other signs of cancer,” he said. “The COVID was a scary thing – because I did not know what to expect… If I had gone on dialysis after kidney failure, they probably wouldn’t have caught the cancer as quickly until it spread.”
The doctors who discovered the kidney cancer removed the organ quickly, leaving Volante with a grim, life-altering prospect that he would have to go on dialysis until he could receive a kidney donation.
“Once I got over the shock about the cancer, things worked out great,” Volante said.
“It was not that difficult to make it work. About the kidney donation … My wife tried. She couldn’t do it. I had a couple of friends who offered, but they couldn’t help. But my sister was the perfect match,” he said
On average, dialysis patients have to wait seven years for a kidney transplant. With Sandra Volante, 56, of Wilmington, being willing and able to donate one of her kidneys to her brother, the retired optician from Lynnfield only had to spend 11 months on dialysis.
Going home for dialysis
Volante had his kidney removed in September of 2020. He received the new kidney from his sister last August and considers it a life-altering gift that may have extended his life another 20 to 25 years. The traditional life expectancy without a kidney transfer is five to 10 years.
But Volante made a crucial decision about a year before his kidney transplant which enabled him to undergo the operation a lot sooner and end his dialysis much earlier, according to his registered nurse at Fresenius Kidney Care. “It possibly would have been years for the transplant because he wasn’t in such a healthy state,” Giavanna Cardarella said of her patient.
“They wouldn’t want to do the transplant as soon as they did,” she said.
Cardarella, a registered nurse from Wakefield, has worked at the center for two years. She’s been in the dialysis field for 12 years – seven as an RN.
These days, Cardarella is a huge advocate of home dialysis – an option that she says is simply better for the patient for many reasons, particularly during these perilous times of COVID-19.
Fresenius Kidney Care – like many of its locations throughout Massachusetts and the nation – is home to a transitional care unit (TCU) which enables dialysis patients to treat themselves in the comfort of their own homes. Fresenius’ TCU at 124 Broadway (Route 1 North) is just one of more than 100 TCUs the company has across the country.
“It’s something that’s being pushed by the company and is better for the patients,” Cardarella said. “With this transitional care unit dynamic, you get to learn your options. You’re less likely to have an infection. You’re a more compliant patient.”
“With home patients, they’re never in the hospital. They’re more healthy. They’re happier and they are more active in their care,” she said.
There are currently 100 patients being treated by Fresenius Kidney Care in Saugus. Of those, 23 patients (23 percent) are involved in home dialysis while the other 77 patients receive their treatment an average of three times a week at the Route 1 clinic, where there are 27 stations.
Cardarella acknowledges that patients may find the option of managing their own dialysis at home “initially is very intimidating.”
“I’ve had people who are reluctant to do this,” Cardarella said.
“Having kidney failure is already a life-changing event. But with DCU, you have the opportunity to see things differently. As long as you are educated and have the right nurse, you can do it. Most of my patients who do it at home also work,” she said.
Meanwhile, most of the people who do their dialysis at the center can’t hold full-time jobs. The dialysis clinics are usually open from 5 a.m. to 10 at night. And scheduling the three-to-four weekly visits usually dictates the rest of a patient’s life, according to Cardarella.
“There are other options, and your life doesn’t have to revolve around dialysis at a center,” Cardarella said.
“At the center, your life revolves around dialysis. And you wind up having a poor quality of life,” she said.
“But at home, the house revolves around your life. You don’t have to plan your life around dialysis. You can do it at 3 in the morning or any other time of the day that fits your schedule. And you end up having a better quality of life,” she said. “And another positive during these times: There’s less exposure to COVID when you are getting treated at home. I think the more people who know about home dialysis, the more people who are going to want to try it.”
“It saved my lifestyle”
It’s been about five months since Volante received his kidney transplant – ending nearly a year’s worth of dialysis at his home.
But he agrees that his life would have been a lot different had he decided to receive the dialysis treatments at Fresenius Kidney Care. “I would never have the transplant this fast if I had decided to do my treatments at the center,” Volante said.
“Looking back, I’m so glad when I said ‘yes’ to the doctor. It saved my lifestyle. It really did,” he said.
“The home health kept me in really good shape. There’s a lot of positives to having home hemo: You feel better; it’s a more flexible life. I would do a Monday-Wednesday-Friday schedule, then Saturday or Sunday, depending upon what was going on in my life that week. And the doctor who was treating me was able to adjust my time. You don’t have that option when you’re going to the center,” he said.
Volante credits a conversation he had with his wife, Constance Leccese, with influencing his decision to have his treatments at home rather than in the clinic. “My wife asked me: ‘If you want to live 10 years, do you want to live miserably or the best way possible?’” Volante recalled.
“That’s what I did. I felt I was the luckiest person in the world because I didn’t lose my lifestyle. Even though this trauma – COVID and cancer – was a temporary setback; I was able to lead my life in a more normal way,” he said.
“Why would you want to leave the center – beat up and exhausted – if you didn’t have to? I chose to be at home because I wanted to give myself the best quality of life that I could and keep my body in the best shape possible,” he said.
Meanwhile, he has learned to live with a few inconveniences that go with being a kidney transplant patient. He goes for blood work weekly. He also knows that he will be on anti-rejection pills for the rest of his life. But when he adds up all the benefits derived from picking home treatment over dialysis at the clinic, Volante counts his blessings.
It was more convenient doing his treatments at home. He felt better and less fatigued. It just became a function of his daily life – four days a week. And he could spend time watching a movie while undergoing his dialysis.
“The future looks bright. I retired because of kidney failure,” Volante said.
“Either I will stay retired or go back to work. I feel I have options now that I didn’t have before. What’s great about home hemo – it gave me options to do things – home hemo has given me a new lease on life,” he said.
Cardarella said she’s noticed a huge difference, which explains how the home dialysis “added years to your life and made a difference in your lifestyle”
“Who’s smiling and happy when you feel like crap?”