Northpinellas: Take-charge lawyer must yield time to a machine

The tubes snaked to a machine looming over Armstrong's chair, full of electronic readouts monitoring his blood pressure and vital signs, quietly cleansing his blood, a pint at a time.

The machine is doing what Armstrong can't. Last month, his diseased kidneys were removed in an unusual and painful surgery. Since then, his life has been scheduled around his dialysis routine.

Tuesdays, Thursdays and Saturdays, Armstrong spends four hours and 15 minutes hooked to a dialysis machine at Gambro Health Care Patient Services off Curlew Road.

Dialysis is what Armstrong feared most as his kidneys began to fail. What he hoped to avoid. It's not that it's painful. It's not even spending hours watching your own blood.

Armstrong, a 44-year-old Clearwater lawyer best known as a power broker in local politics, said it's just difficult mentally. He's used to taking charge of his clients, advising politicians and being physically fit. Armstrong was a star pitcher in college and has remained an avid athlete.

"There's such a loss of control," he sighed. "You can't go anywhere. You're just chained to the machine."

Still, Armstrong knows he is extraordinarily lucky. Most of the others in this room face months, if not years, of dialysis, with little hope of any change. One patient there has been on dialysis for 27 years.

For now, Armstrong is one of about 217,000 Americans who receive regular dialysis treatments, according to the U.S. Food and Drug Administration. Treating them costs more than $11-billion a year.

Widespread use of dialysis began in the 1960s. The National Kidney Foundation says some people can live full lives on dialysis. Others face side effects, such as low blood pressure and other cardiac problems.

But Armstrong's dependence on a dialysis machine will be brief. He gets a kidney transplant on Thursday.

"I look around, and my situation is short-term," he said. "That makes me so grateful... so deeply grateful."

* * *

Armstrong has polycystic kidney disease. Over decades, more and more cysts formed in his kidneys, disrupting the delicate filters that cleanse toxins and distorting his kidneys until each organ, once the size of a fist, was bigger than a football. By the end, doctors said his kidneys weighed more than 30 pounds.

Armstrong knew he would need a transplant. But he had no family members who could donate -- his wife is too small, his father too old. Most people in such circumstances must wait months, if not years, for a stranger's kidney to become available.

There were nearly 14,000 kidney transplants in the U.S. in 2000, and one-year survival rates are greater than 96 percent. But more than 52,000 Americans are waiting for a kidney. Last year, more than 2,000 people died waiting.

But when word about Armstrong's illness got out, his friends began offering up kidneys. Half a dozen people volunteered to undergo surgery and give up a major organ. Eventually, one of those friends matched Armstrong's blood type and other factors. That man, who does not want to be identified, has said he just wants to help Armstrong and his wife, Tara, and their daughter Lexa, who turned 4 last week.

When most people get a transplant, their own kidneys remain inside their body. But surgeons told Armstrong that his were so big they would have to be removed. The procedure is so rare that even Lifelink Transplant Institute, one of the nation's busiest transplant centers, does it only about once a year.

On April 15, surgeons cut Armstrong's abdomen from his breastbone to 4 inches below his navel. Over four hours, they removed his kidneys.

The operation went well, and Armstrong moved out of intensive care earlier than expected. His biggest problem: the morphine doctors prescribed to ease his pain made him delusional. He laughed last week as he talked about watching The Weakest Link in the hospital, convinced that he was a contestant.

And Armstrong never likes to lose.

"I was shouting answers," he said. "I got to the end, and they wouldn't give me the prize I had won."

* * *

Cheryl Veilleux, director of the Gambro center, stopped by Armstrong's dialysis machine to check his vital signs. Everything looked good, she reported.

Dialysis isn't painful, but it's exhausting. Armstrong naps during most sessions, as do many of the other patients, scattered around the airy room in their own pink recliners, a machine humming away next to each one.

The amount of fluids, potassium and other minerals that patients have can also affect dialysis. Armstrong is limited to six cups of fluids per day.

"I can go through that in an hour with a Big Gulp, no problem," he said.

But patients who follow the rules are rewarded. A display in the lobby places patients' names on boats ("for smooth sailing") and race cars ("on the track") if tests show they've followed the rule. Armstrong, always a competitor, pointed out that he's already made both lists.

The consequences of not following the rules are more serious. Patients can have cramps and blood pressure problems during dialysis. Long term, Veilleux said, those patients also are more likely to develop cardiac problems.

"What normally takes two to three days, you're doing in a few hours" of dialysis, Veilleux said. "The heart is working really hard to pump everything through."

Age is also a factor in how well patients respond.

"If you're 65 or 70, it'll kill you a lot quicker," she told Armstrong.

"That's uplifting," he told her, the sarcasm dripping.

Veilleux was reassuring.

"You've got a lot of room to maneuver," she said.

Armstrong brought newspapers, a briefcase and a lunch -- packed by his wife in Lexa's lunch box -- with him Thursday. Sometimes he makes phone calls. Other times, he just sleeps.

Lexa's been in to visit a few times. Tara Armstrong sneaked her into the hospital while her husband was recovering, as well.

"She's been very intrigued," Armstrong said. "We're trying to be very objective, very open with her."

On days he's not in dialysis, Armstrong goes in to his office. He realized how much better it makes him feel when Lexa offered up the following bedtime prayer: "God, please let Dad feel good so he can go to work tomorrow."

On Thursday, Armstrong heads back to Tampa for surgery, a much simpler operation than the first. His donor has told him that he's not nervous. Armstrong admits that he is.

It's not the surgery that scares him so much, but the prospect that the transplant could fail. His donor is an excellent match, and doctors have told him the chances that his body will reject the kidney are less than 1 percent.

He watched his blood running through the tubes and said he tries not to think too much about what he sees.

"If you get caught up in it, that would be detrimental," he said. "I try to just say, 'Oh yeah, there's my blood.' "

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