Transplant: One woman's story of hope

JENNI Corrales has been fighting chronic illness since she was diagnosed with type 1 diabetes at just two years old. Today the Wollongong mother of two is living an injection-free life, without insulin, after undergoing a kidney and pancreas transplant four years ago. She has battled many health hurdles to get to this point, some of them unexpected, and says the transplant surgery brought some surprises of its own.

Here she talks about the lifestyle shock of no longer having diabetes, her expectations, and the transplant and her life afterwards. This is her story:

As a small child, Jenni’s diabetes was reasonably manageable. But once she reached her teenage years, this changed.

'As I grew into my teenage and young adult years, my diabetes became much more unstable. I was very non-compliant with my management, and that was probably the main contributor to the kidney degeneration I had later in life,' Jenni said.

Another factor that took a toll on her health was her pregnancy with twins in 1993… her son Benjamin and daughter Jessica.

'My first reaction when I found out I was expecting twins was one of utter joy… I still feel that way,' Jenni said.

However, once her endocrinologist was told she was expecting twins and that her blood pressure was up, Jenni was immediately ushered into Prince of Wales Hospital, where she stayed for a month before returning home.

Keeping a tight control on her blood glucose levels (BGLs), fighting off a bout of pneumonia and keeping one eye on her kidney health, Jenni managed a successful pregnancy, after spending the last three months of her pregnancy in the Royal Women’s Hospital.

'I was on an enormous amount of insulin while I was pregnant. I ended up with toxaemia. My kidneys didn’t fare too well.'

'Then my kidneys got a lot worse in 1997 and they put me on the waiting list for a kidney and pancreas transplant.'

'I found it harder to pick the signs of a hypo. I was really lucky that my renal specialist put me on the list for a transplant early on... I didn’t end up at the stage where I needed to be on dialysis.'

After two and a half years on the waiting list, Jenni found herself at the top.

'I’d had six months before the operation where I was really, really sick. My diabetes was badly out of control, I’d feel really nauseous all the time and really faint sometimes.'

For the transplant, she spent seven days in Westmead Hospital and then eight weeks returning as an outpatient for regular check-ups and treatment.

'They told me that it would probably take me to a year to recover from the operation.'
Jenni had visions of coming out of the transplant operation as 'a healthy superwoman, with boundless energy and no more health problems.'

'The reality was a lot different, because of the immuno-suppression drugs I was catching a lot of infections for the first two years. I’d get a simple infection and end up in hospital for a fortnight, being rehydrated and treated. I also had a lot of vomiting and diahorrea.'

After the transplant, it took Jenni a few months to recognise that her body’s day-to-day signals were in fact ordinary reactions that a person without diabetes would normally feel.
'That was really weird. It was Summer and I remember I’d feel tired, and then I’d start feeling thirsty… and my immediate reaction was to go and check my BGLs. It took me a while to get used to, ‘oh, there’s nothing wrong, I’m just tired and thirsty!'
'I healed really well from the operation… I didn’t have any rejection, I haven’t had any insulin since.'

But what Jenni didn’t expect was the depression she experienced after the operation.
'For me, the second anniversary of the operation was really hard, I was having flashbacks to the time of the transplant.'
Jenni later discovered that people who have kidney problems, chronic illness or transplants are all at higher risk of developing depression.

'It doesn’t happen to everybody, but it’s quite common,' she said.

'Some immuno-suppression drugs can also cause depression. None of that was explained to me. I also didn’t have any counselling before or after the operation.'
'I have now been hospitalised four times because of the depression. I thought I was losing my mind.'

Jenni would now like to see counselling units set up in the kidney transplant units of hospitals to help people through what can be an emotionally challenging time. 'People would say to me, ‘Isn’t that great, you don’t have to take your insulin any more, and I knew I should feel grateful… but I wasn’t feeling grateful.'

She has begun work as a Consumer Advocate with the Mental Health Services on this idea, speaking to some groups about her experiences.

'People should accept that it takes a long time to heal,' she says. 'They shouldn’t expect too much of themselves while they recover. I think people have to be aware that it will take a lot of healing both physically, and even more so emotionally.'