Taking a holiday on dialysis

New perspectives

I remember the occasion well. It was a bright spring morning when I climbed Cul Beag from the north and descended via the rocky cioch to the bealach under Stac Pollaidh, a route I was researching for Wild Walks. The sun was hot and I drank deeply from a spring of ice cold water before joining my family for fried sausages and eggs cooked on a bonfire at Garvie Bay. But intense pains were wracking my abdomen and making me sick. Just cramps from drinking too much cold water we thought, but 24 hours later they were worse than ever and the local doctor diagnosed gall bladder inflamation. When I started passing blood we headed straight home and reported to York District Hospital for an ultra sound scan. The consultant broke the news to me gently: You have had a kidney haemorrhage as a result of polycystic kidneys, which is an untreatable inherited disease with a 50% chance of both inheriting it from your parents and of passing it on to your children.

Richard and Lucy Gilbert on the summit of Creag Meaghaidh in May '99

After weeks of tests I was told that my remaining kidney function would probably last five years but then dialysis would be necessary to keep me alive. Within a year my two brothers had been diagnosed with the same disease and scans on my four children showed that three of them had also inherited it. So much for chance.

But that was all 18 years ago and a combination of drugs, diet and fitness training meant that I did not require dialysis until January 1999. Of course, I thoroughly expected that my active life would be at an end and, watching my fellow dialysis patients being helped from the ambulances to the renal unit three times a week, I was resigned to being a semi-invalid for the rest of my life. After all dialysis provides only five per cent of normal kidney function and it is time-consuming and exhausting.

While I still had some energy left I retired from teaching and we hectically crammed in many unfulfilled ambitions: a cruise from Ushuaia to the Antarctic Continent; cultural weekends in European cities; The Great Outdoors Challenge (a two-week backpack across Scotland) and umpteen breaks in the Highlands.

The lowest ebb was 1998, the year before dialysis, with poisoned blood, nausea and lack of appetite and energy. I remember the humiliation of staggering around a four-mile walk with my friends and having to be helped up the steps to the pub at the end. Yet, one year on from the start of dialysis, I can look back with amazement. Only two days after my first dialysis fresh snow fell on the North York Moors and Trisha and I went out into the biting wind under a blue sky for an hours walk and, at once, I realized that I was a different man. My head had cleared, I felt 10 years younger and I returned home with an appetite and started making plans for the future.

The first thing was to build up my strength and wasted muscles, thus regular walks became the pattern. With the Yorkshire Dales within easy reach I explored the hidden nooks and crannies of Wensleydale and Swaledale and it was a red letter day when I made my first post dialysis ascent of Whernside. Looking further afield it is sometimes possible to obtain holiday dialysis at other hospitals, thus I bombarded Raigmore Hospital, Inverness with letters, faxes and phone calls but their renal unit was fully booked for local kidney patients and they could not accommodate me. However, in May, they persuaded one of their patients, from Fort William, to take a holiday in York and with Yorks co-operation we swapped machines for a week.

Although a week in the North West meant only four non-dialysis days I wasted no time and managed ascents of Cul Mor, Schiehallion and Creag Meagaidh. Never have I enjoyed the mountains more, I savoured every step, every bud bursting on the birch trees and every tumbling burn. This was borrowed time, I realized, and I had no right to be able to return to my old haunts but I was so thankful for small mercies. Later, in September, I managed another swap with an Inverness patient and was able to complete the full traverse of An Teallach and the ascent of Conival. I lay in the sun eating my sandwiches beside the cairn on Conival, happy as a sandboy, drinking in the unsurpassed views of the rugged hills and coastline of the incomparable North West.

The kidney patients lifeline is a book listing all the dialysis units in Europe. It didnt take long for York to arrange for me to have two separate weeks (spring and autumn) holiday in Mallorca with dialysis in Palma. This meant more wonderful days walking in the limestone mountains overlooking the north coast, the terraces of fruit trees and the blue Mediterranean, easy walking, yes, but hugely enjoyable and another unexpected bonus for which I felt very privileged.

Back home I was now strong enough to climb both Whernside and Ingleborough in a day and, in early November, encouraged by a good weather forecast I attempted the Three Peaks Circuit. Leaving Ribblehead in darkness and drizzle at 6.30am I finished the circuit, also in darkness, at 5.30pm. It had been a wet day with the fells saturated and the evil bogs on the long descent from Penyghent knee-deep in ooze. The accomplishment of this much loved circuit, which I have done each year for the past 30 years or so, was a great boost for morale because one of the results of illness is a feeling of anger, inadequacy, pity and a loss of self-esteem. With the Three Peaks under my belt I felt I was returning to my old self.

And what of the future? I realize I am enjoying a honeymoon period but there might be a possibility of a transplant although, as is well-known, there is a chronic shortage of donor organs. If there are any High readers who cannot imagine life without mountains and who have been dealt a lousy hand, take heart, there may be compensations.

Richard Gilbert

This article first appeared in High Magazine in April 2000. It is reproduced here by kind permission of Richard Gilbert and High Magazine.