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Memoir

“Six years ago, a kidney transplant saved my life. Now, I need another one”

In 2019, after City TV journalist Cristina Howorun was faced with kidney failure, her cousin donated one of her own. The transplant gave Cristina the best years of her life—until her new kidney began failing too

By Cristina Howorun| Photography by Robert Boisvert
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Cristina Howorun, a CityTV journalist, leans against a brick wall and stares into the distance

My father was 50 when he died of complications from kidney disease in 2003, after spending years on dialysis and getting a transplant in the ’90s. The condition is genetic, so I had a nephrologist—a kidney specialist—before I was a year old, got regular blood work and ate a kidney-friendly diet: no cream, limited nuts, and low protein and sodium. Every specialist I saw thought I would be spared by the silent yet deadly disease that lingered in my genes.

In 2018, I was in my mid-30s, healthy and fit, working as a journalist for City TV. But, by March of that year, I was struggling. I was exhausted. I had insomnia, which I chalked up to work-related stress. I was bone-chillingly cold all the time, but it was winter in Toronto, so that wasn’t unusual. I was also itchy—so itchy I’d scratch until I bled—but I attributed it to dry skin from plane travel. The exhaustion, though, was debilitating. I started driving to work downtown from my home in the west end because I couldn’t summon the energy to walk the two blocks to the subway. Related: A complete stranger saved my life. Fifteen years later, another one saved my son

On a whim, I took a blood pressure test at a grocery store. A stroke-level reading of 190 compelled me to see my doctor. Still, I wasn’t too worried, and neither was she. My doctor prescribed blood pressure medication and gave me a requisition for blood work, just to be safe.

A week later, at a media conference, I became too tired to stand through a series of political speeches. I sat on the floor in my skirt suit and heels. I could hear my phone buzzing in my purse, and by the time the conference ended, I had several missed calls and voicemails from my doctor. As I was listening to them, she called again. I needed to go to the ER right away. I was in kidney failure.

I didn’t believe it. How does a healthy person go from not having kidney disease to being in the end stages so quickly? I went to the ER thinking it was a big misunderstanding. Blood tests confirmed it wasn’t. I had eight per cent kidney function.

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I called my partner, then my sister. I cried in the examination room while doctors told me they wanted to start dialysis immediately. I remembered my father’s illness—how I barely saw him for four years while he underwent dialysis in hospital, how he had no energy, how everything just seemed to stop. I wasn’t ready to stop.

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I was admitted to hospital so doctors could try to stabilize me. My nephrologist prescribed medications to try to stave off dialysis since I was young and otherwise healthy and I already had a potential donor. My mother wanted to give me her kidney, but doctors wouldn’t evaluate her until she lost weight. She changed her diet and got on the treadmill, working out as if my life depended on it—because it did.

In September, I started peritoneal dialysis. Doctors surgically inserted tubes into my abdomen, and I had to hook up to a machine in my bedroom for 10 to 11 hours every night. It pumped solutions into my stomach to soak up some of the toxins that healthy kidneys naturally filter out. The idea was that I could sleep through this process, but when the solutions drained back out, I’d often wake up with paralyzing stomach cramps. Moving around too much sounded the machine’s alarm. That year, my Fitbit pegged my average sleep at just over three hours a night.

I’d go to work, come home and almost immediately need to hook up to the machine. I cut down to three work days a week to fit my treatment in—but I was getting worse. The dialysis wasn’t filtering out enough. My kidney function had dropped to four per cent.

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In a blow that was tough for my mom, she was ruled out as a potential donor due to her age and health. Previously, at a family wedding, my cousin Christine had offered to donate her kidney if my mother wasn’t a match. My sister called her, and she raced to the plate. Fifteen years older than me and a mother of five, she epitomizes maternalism. When I was young, I coveted her sculpted cheekbones and eyelashes that seemed to go on forever, and now she was prepared to give me a much more important part of herself. I was floored.

Related: When the billionaire sports magnate Eugene Melnyk was diagnosed with liver failure, he crowdsourced a new organ and kick-started a trend

She began the testing process to see if we were a match. The head-to-toe work-ups take months; doctors look at everything from lung capacity to heart health. I was hopeful but not expectant. She could be ruled out or change her mind: there were risks associated with the surgery, and it meant several weeks of downtime, which isn’t easy for a mother.

Then, five months later, it happened. I got an email with upcoming appointments, and at the bottom, without any fanfare, were the words that changed my life: “Your kidney transplant surgery has been scheduled for Thursday, June 13, 2019.”

I called Christine, crying in gratitude. Then I panicked. The surgery was only a week away. I was scared and overwhelmed, and I started catastrophizing. What if it didn’t work? What if Christine died? What if she gave me her kidney and then I got hit by a car? I wanted to postpone, but Christine talked me off the ledge.

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I spent the eve of the surgery in the hospital alone. I thought the staff might roll my gurney by Christine’s so I could wish her good luck and take a photo of us touching hands, like the one Selena Gomez posted of her and her friend before Gomez’s transplant. But it didn’t happen that way. By the time they started prepping me for surgery, Christine was already in the operating room.

Twelve hours later, I woke up to cheers. The Raptors had just clinched the NBA championship. My hospital room faced University Avenue, where thousands of people were revelling in the win. I was just cheering for Christine. The surgeons told me that her kidney had started working as soon as they’d inserted it, like it had always been a part of me. They later told Christine that, without her incredible gift, I likely wouldn’t have survived the summer.

"Six years ago, a kidney transplant saved my life. Now, I need another one"
Cristina and Christine in the hospital after the surgery

Christine was out of the hospital in three days, and I was out a few days after that. On my second day home, I woke up clear-headed, with a burst of energy. I was able to conquer small feats, like climbing stairs, and it dawned on me that this was how healthy people felt everyday.

That day, I committed to maximizing the rest of my life. Doctors advised against travel for a year, so I started looking at places I’d want to visit in June of 2020—Italy, Spain, and Turks and Caicos were on my list. I had a few months before I’d be back at work, so I started researching documentary subjects for City TV. I felt like the world was mine to conquer.

Back at work, I produced, wrote and hosted several primetime documentaries. Covid hit—my vacation would have to wait—but I was engaged. I went public with my story, became an ambassador for the Kidney Foundation and spoke about organ donation. I spent the summer on the shores of Lake Huron, working on a documentary about the death of an Indigenous protester at the hands of the OPP. For another project, I staked out sex trafficking hotspots in London, and for another I found a former gun smuggler who showed our crew how he smuggled firearms across the border. I visited prisons across the country, talking to inmates about how they raise their children while incarcerated. I joined the board of directors for a group that fights intimate partner violence and sex trafficking. I was embracing every day and felt healthier than I had in a long time.

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The next spring, I was in Delaware on a shoot when my doctor called. My numbers had dropped by a lot. My kidney function, which had peaked at 40 per cent, was now down to the mid-20s. When I got home, I went for tests. My body wasn’t rejecting Christine’s kidney, and doctors couldn’t find anything in the biopsy. I went in for blood work regularly but carried on, nervous but confident that if I continued to follow my extensive regimen of medications and maybe slowed down a little, things would get better.

Christine was thriving with her lone kidney, but mine was scarred and rapidly losing function. My physician shared my file with doctors at UHN, and my nephrologist at Sunnybrook had her whole team of residents combing for clues. The best answer anybody could give me was that, when I’d contracted Covid in the summer of 2022, it had lived in my new kidney. I was back at eight per cent functionality. None of it made sense. I’d followed my doctor’s advice. I’d taken my pills when I was supposed to. I’d had my blood work done and gone to clinics and followed a kidney-friendly diet. I’d treated Christine’s gift of life as the treasure it was and is—and still, I was in trouble.

Related: “As a teenager, I lost my leg to bone cancer. Now, I’m captain of Canada’s sledge hockey team”

I would have to start hemodialysis, a more invasive form of dialysis where blood is pumped out of your body into a massive machine and filtered before returning through a separate tube. For that, I had to get a tube inserted into my chest, near my heart.

In-centre dialysis—three times a week at a hospital—didn’t work for me. I wanted to continue working, so I would need to figure out how to do the treatment at home. But hemodialysis is complex. Only about five per cent of patients do it themselves. Setting up the machine takes 40 minutes every time, and conditions need to be sterile. But if I wanted a chance at continuing the life I had built, I had to do it at home.

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For several weeks I showed up for training at the hospital. Nurses demonstrated how to set up the machine with its myriad tubes and gadgets, then I’d sit in a recliner and get my blood cleaned while going through transcripts, setting up interviews and writing scripts. Meanwhile, few people knew my health was failing. I knew I hadn’t squandered my cousin’s gift, yet I still felt immense guilt. I kept busy so I wouldn’t have time to let reality sink in.

On the fifth anniversary of the transplant, I drove to Christine’s cottage near Bancroft for a surprise visit. I had to tell her what was happening. I tried to protect myself with an orchid planter I brought as a gift; my little Havanese, Molly; and a warm beer in my bag for liquid courage—but these were weak defences. It was the hardest conversation of my life.

Christine consoled me while I ugly-cried and told her the truth: that her gift, which had given me the best five years of my life, was broken, and I couldn’t fix it. It was devastating news, but Christine was loving and supportive. I couldn’t even stay the night because I had to get home for dialysis.

Going public with my status was much harder this time. It’s a stark reminder that transplants aren’t cures and often don’t last forever—most recipients will need more than one. In the past, I’d been able to shine a light on the disease and document my experiences in an effort to help others. This time, I was asking for help: I needed another kidney, from an O donor.

I’ve been amazed by the response. People have reached out to say they’re submitting forms to get tested. But the process is slow, and recipients are kept in the dark until a match is confirmed. The average wait time for an O kidney is seven years. I likely don’t have that much time.

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I’m adjusting to my new reality. I’ve started nocturnal dialysis: six hours of treatment overnight. If my blood pressure crashes, there could be dire consequences. I experienced my first seizure, and I’ve passed out and vomited while hooked up to the machine. The ambulance came once when I had a suspected embolism as a result of an air bubble getting into my tube. But I’m getting better at gauging my vitals, and I’m fortunate to have a partner who understands dialysis and my limitations. Weekends away take a lot of planning, and nights out require back-scheduling treatment. And frankly, the big tube hanging out of my chest isn’t the most attractive feature. But my partner is still here and is shouldering the load I’m too tired to carry these days.

I’m still working and trying to highlight injustice. Life is still beautiful—it’s just much more complicated and exhausting. But I’m not done. I’m not ready to hang up my microphone just yet. It’s one of the many lifelines keeping me going.

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