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This story is part of William Osler Health System’s (Osler) Doctors Making a Difference campaign featuring Osler doctors who are going beyond to improve our community’s health.
Sometimes life can feel like a roller coaster, with its share of highs and lows. That was certainly the case for Andrea Turner, who kicked off 2023 with the joyful birth of her son in March, then landed in hospital with a ruptured cyst on her ovaries in July, and ended the year in surgery to insert a catheter for dialysis.
A long-time diabetic, 34-year old Andrea began experiencing low kidney function a few years ago and was referred by her diabetes specialist to Dr. Davinder Wadehra, Medical Director of Osler’s Renal Program and Head of Nephrology.
“At that time, my kidneys were functioning at about 18 per cent, so I saw Dr. Wadehra on a regular basis for bloodwork and monitoring,” said Andrea. She readily welcomed Dr. Wadehra’s people-centred approach to care. “He is the calmest doctor I’ve ever had. He took the time to get to know me and explained things in a way I could easily understand.”
When Andrea discovered she was pregnant, Dr. Wadehra co-managed her in collaboration with the Maternal Renal Program at Sunnybrook Health Sciences Centre, as a similar program wasn’t yet available at Osler. Following her pregnancy, Andrea resumed seeing Dr. Wadehra. With her kidney function declining, Dr. Wadehra started talking to her about the possibility of dialysis in her future. “He wanted me to be prepared for it when it happened.”
That day came in late 2023, when Dr. Wadehra informed Andrea that her kidney function had declined unexpectedly quite a bit more and the time had come to start dialysis. Andrea was referred on an urgent basis to Osler surgeon Dr. Stewart Lo, who expedited her peritoneal dialysis catheter insertion, an essential step when starting dialysis. Dialysis is a life-sustaining, repetitive procedure that enables patients to maintain kidney function while they await a kidney transplant.
“We provide different options for patients and their families so that they can choose the type of dialysis that best fits their lifestyle,” said Dr. Wadehra. “While our number one goal is to delay the need for or avoid dialysis altogether, if a patient has to go on dialysis, we can either do it in the hospital, or the patient can be supported to do dialysis at home.”
Given that Andrea lives in a smaller community north of Orangeville, she elected to go on home dialysis, giving her greater flexibility as a new mom, and preventing the need for frequent hospital visits. Andrea spent two weeks of intensive training on the home dialysis machine in Brampton Civic Hospital’s kidney clinic. “The nurses there were amazing. They gave me as much time as I needed to soak in all the information and let me learn at my own pace. That really helped me feel at ease.”
Andrea’s home dialysis machine is about the size of a printer. Thanks to this sophisticated technology, her dedicated renal nurse can monitor and support her remotely. If the nurse needs Andrea to update anything on the machine, she simply calls her, and Andrea knows that her nurse is only a phone call away if she has any questions.
Dr. Wadehra is incredibly proud of Osler’s multi-disciplinary renal team. He and Josie Barbita, Director, Renal Program, provide strong leadership to a team of world-class nephrologists, renal nurses, renal navigators, social workers, dieticians, and pharmacists who collectively take a holistic approach to the care of each patient.
“All too often I see patients who are devastated by the diagnosis of kidney disease, but we have so many better options available to support them today than we had a few years ago, including the more recent approval of new medications which can help prevent or slow the progression of kidney disease, and that’s exciting.”
Recognized provincially for its expertise in home dialysis, Osler’s renal program also supports patients with in-hospital dialysis at its three hospital sites – Brampton Civic Hospital, Etobicoke General Hospital and Peel Memorial Centre for Integrated Health and Wellness.
In addition to dialysis, in 2023, Osler’s renal program successfully facilitated 61 kidney transplants, with a quarter of them coming from living donors who generously donated their organs to help a recipient get a kidney transplant faster. Thanks to the partnership between Osler’s renal and palliative care teams, older patients who prefer to avoid dialysis to preserve their quality of life are supported through a specialty renal conservative care clinic that focuses on planned holistic person-centred care for people with end-stage kidney disease.
Fueled by his passion for making a difference in patients’ lives, Dr. Wadehra is excited about the comprehensive care provided by Osler’s renal program. “We are currently working on establishing a specialized glomerulonephritis (GN) program which will address complex kinds of kidney disease and make us one of only a few centres in the province that have the ability to manage these patients. Our GN specialists will also be able to treat pregnant women with kidney disease in this clinic.”
As for Andrea, while she’s only been on home dialysis for a couple of months, she is already noticing a positive difference. “After feeling exhausted almost every day for a year, I feel rejuvenated and energized, which has made a huge difference in my quality of life.”
Read about more Osler doctors making a difference.
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