Friends for life

Be positive was the mantra that led Dr. Gurunath Kilara, a radiation Oncologist, through difficult times in life. Quite coincidentally, his blood group was also B Positive. So was that of Dr. Ramesh Bilimagga, whom Kilara had met at Post Graduate Institute of Medical Education and Research, Chandigarh, in 1977. Bilimagga, also a radiation oncologist and Kilara have remained friends and professional colleagues since then.

But above all that now there is an inseparable link between the doctors. Two years ago, in December 2010, Kilara underwent a kidney transplant at M.S, Ramaiah Memorial Hospital, and Bangalore. And Bilimagga turned from a friend to a lifesaver when he became Kilara’s unrelated altruistic kidney donor.

“We have a family history of hereditary polycystic kidney disease (PKD) that was inherited from my mother’s side. My mother’s elder sister had lost a son to PKD and her other son had to undergo a kidney transplant, “says Kilara. “My elder brother, who is a food scientist in the US, was also diagnosed with PKD and underwent a Kidney transplant eight years ago. My younger sister has also been diagnosed with PKD”.

Kilara had got screened for PKD in 1984, but was not diagnosed with the condition then. “That was mainly because the ultrasound scanning procedure was new in India. The Radiologist might have somehow missed the diagnosis,” he says.

It was in 1990, when Kilara was diagnosed with hypertension at age 39, that he underwent another round of abdominal scanning, which revealed that he had, indeed, in-herited adult PKD and his hypertension was secondary to it. : As I was diagnosed with KPD within a fortnight of my mother’s demise, I was totally devastated,” he recalls. Kilara was advised an appropriate anti-hypertensive treatment and was leading a near-normal healthy life. But, 2002 turned out to be yet another testing period for him.

“I was at a dinner party, when one of my friend a neurologist, who was also diagnosed with PKD, said, ‘Guru, for my sake, kindly get an MR-angiogram of the brain (which reveals any pathology in the blood vessels of the Brain) done tomorrow itself”, recalls Kilara. “Just the diagnosis of PKD in me prompted him to advice me to undergo a higher investigation.” Kilara, though taken aback, laughed off his friend’s advice. “But he held my hand and pleaded with me, ‘Please listen to y advice!” recalls Kilara.

As he had professional commitments, he got the angiogram done two days later. “The MR-Angiogram revealed a 0.9cm left middle cerebral artery aneurysm (a bulb-like enlargement of a portion of a vital artery), which was like a ticking time bomb!” he says. “That pulsating aeurysm could have burst anytime and the situation then would have been anytime and the situation then would have been quite alarming. I had to undergo an emergency brain surgery called ‘open-triple clipping if the aneurysm’ which, in fact, was like defusing a time bomb!”

Dr. A.S. Hegde, the neurosurgeon at Manipal Hospital, Bangalore, who successfully conducted the surgery, advised a month’s rest and medication. After the period of convalescence, kilara bounced back and resumed his profession.

Nearly eight years later, Kilara decided to undergo a kidney transplant. “In September 2010, I Made ups my mind to get a transplant done, because I felt that PKD has started reducing my stamina. My quality of life was deteriorating slowly, with stress intolerance and fatigue,” explains Kilara. “Going for dialysis sessions and then waiting for a kidney would have further reduced my energy levels and professional life-span. As I was already 59, I decided to have the transplant done at the pre-end stage renal phase, so that the chances of success would be fairly high.”

Since his siblings also had PKD and his father was too old, Kilara needed an unrelated donor. When he confided his dilemma to Bilimagga, his colleague and friend of three decades, he readily volunteered to donate a kidney to Kilara. Another female colleague of Kilara also came forward to donate her kidney. Says Bilimagga, a founder member of the Bangalore Institute of Oncology: “When I Volunteered, I was not even sure whether our blood groups and tissues would be compatible. It was a spontaneous decision.”

“In India, unrelated kidney transplants are not permitted unless the donor genuinely proves his/her altruistic gesture. Living organ donors should also be metabolically fit, says Bilimagga, who first obtained the consent of his wife, Dr. Sudha (who is also a cancer specialist) before visiting his only son and daughter-in-law in the US to tell them about his decision. “My other relatives came to know o the donation only six months ago,” he says.

Through Bilimagga had already signed up for eye donation long ago, the official procedure for altruistic kidney donation was different. “Police verification about my address proof and profession was carried out. In the local city civil court, my wife and I had to give an affidavit stating that it was a voluntary, emotional donation, not involving financial transaction and not due to coercion, “he explains. “We had to fill up a detailed application form to be submitted to the authorization committee that approves ethical, altruistic and unrelated kidney donation. We were then independently interviewed by the members of the committee, which consisted of six eminent persons including a retired judge and the chairman of the Karnataka Medical Council.”

Bilimagga and his wife also had to submit their bank statements. In a month, he was officially and legally permitted to donate his kidney to Kilara. “Pre-transplant, besides blood typing and tissue matching, I had to undergo a CT-angiogram of the kidneys, to detect any abnormal vasculature that could pose a challenge to the surgeon. No such abnormality was found in my case,” says Bilimagga, who is neither hypertensive nor diabetic.

After the kidney donation surgery, he had to stay in the hospital for five days and later was advised to take ten days of rest at home. “Except for a very minimum rise in my blood keratinize level n the initial postoperative period and weight loss of about two and a half kilos; I did not feel a negative effect. I was given pain-relieving medication and was allowed oral intake of food from the second day of the surgery,” says Bilimagga, who recently completed a high-altitude Manasaraovar yatra, where he had to walk 40km.

Kilara has now established The Kilara Foundation, along with his sister and brother-in-law, to help the underprivileged get access to treatment for kidney disease, cancer and malnutrition. “Ramesh has told me that I should never say that I owe his something and that our occasional arguments as radiation oncologist should continue as before,” says Kilara.

He emerged a new person from the experience, he says, and has accepted his condition without blaming heredity. Though there are imposed disciplines like a low-salt diet, decreased fluid intake and a compromise on infection-fighting capacity due to medication, Kilara is full of life. Without bothering to dissect life’s puzzles, he happily attends his ghazal classes, three evenings in a week. The one song which Kilara should definitely be humming is Tere Jaisa Yaar Kahaan, Kahan Aisa Yaarana (Where does a friend and friendship like this exist)!

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