Kadi, age 33

Kadi and her daughter Bella

Most people don't know quite when their FMD became symptomatic, but I know exactly when it happened. In March of 2003 I was closing in on the due date for my daughter's birth and going to weekly check-ups. At 36-weeks my blood pressure was its usual 120/80. A week later it was 140/90. A week after that, it was 180/110. My doctor induced labor and told me my blood pressure would return to normal as soon as my daughter was born. Weeks afterward it was still high. Because I was 28, in good shape, and busy with a baby, I didn't pay much attention. A year later I started taking a low dose of blood pressure medicine.

While I was on a diuretic, I showed up to an annual exam to find my blood pressure was 180/102. For another year, my doctor switched prescriptions and increased my dosages until I was taking four blood pressure drugs every day and spacing them out on a schedule to maximize their effectiveness.

In the summer of 2006 I came home from a vacation with a wicked, days-long headache. On the Monday I returned to work, I used a co-worker's blood pressure cuff and had a reading of 180/117. I went to my doctor the same afternoon and she agreed I should see a cardiologist.

After three years of trying to manage my blood pressure with a variety of doctors, the cardiologist was the first person to listen to my belly. He heard bruits and sent me for a CT-scan of my abdomen. Within the week I had a diagnosis, a vascular surgeon, and a lot of uncertainty.

My vascular surgeon scheduled an arteriogram and told me he would likely do an angioplasty at the same time. If the damage was worse than suspected, he warned me, I could need a bypass. But the afternoon before my arteriogram, he called to say he had looked at my CT-scans and thought my renal arteries were too damaged for angioplasty. When we came out of the arteriogram, my vascular surgeon told me for the first time that an auto-transplant was also a possibility. My left renal artery was more like a string of marbles than a string of beads, and the lesions were into the arterial branches near my kidney. The right renal artery, he said, had more moderate damage and might not need any treatment.

I'm lucky to live near Duke University's hospital and am a short drive from the surgeon who literally wrote the book on renovascular hypertension. He agreed that my left renal artery had no healthy tissue where a bypass could be attached and that an auto-transplant was the way to go. We set up an angioplasty for the healthier right side so it would be in good shape for the bigger surgery.

The first angioplasty was disastrous. Part of the way into the procedure, the doctor said he didn't think the healthier artery could have an angioplasty either, and he abandoned it.

Nine weeks after my FMD diagnosis, I had the autotransplant at Duke, a kidney transplant in which I was both the donor and the recipient. My kidney was removed from my body and chilled, and the renal artery was cut off. The kidney was put under a microscope and the smaller lesions were repaired. A vein was taken out of my leg, and my kidney was re-attached as a transplant near my hip with the vein serving as my new renal artery. The whole surgery took about seven hours and cost $80,000 (I've never been so grateful for good insurance!).

I had some complications in the days after the surgery, but so far my left kidney is holding up brilliantly. Amazingly to me, I was back at work seven weeks later.

Three months after the transplant, I returned for another shot at an angioplasty. The second time was much better, and my right renal artery was stretched to 4 millimeters. Everything is working now, and unless the creek rises, I won't need another arteriogram until 2008.

I wish I could say the experience had inspired me to run marathons and climb mountains. Instead, it's made me realize that I'm not even a little bit interested in doing those things. I'd much rather read books and watch movies, so I'm doing lots of that. I figure that if I had to spend all that time in hospitals, I deserve to make up for it by spending an equivalent amount of time lying on the couch eating ice cream.

My friends and family kept a blog of my experience at poshkidney.blogspot.com
*FMDSA webmaster highly recommends visiting Kadi's blog!