Sunday 6 January 2013

Beating odds to be longest-surviving dialysis patient here

Strict routine cited as factor in his survival for 33 years
By Janice Tai, The Straits Times, 5 Jan 2013

IF LIFE is a big gamble, Mr Richard Tay has the odds stacked heavily against him.

After spending his first month of life behind bars, because his mother was breast-feeding him while serving her prison sentence, he went on to be warded in hospital until he was six, because of a blockage in his bladder.

When he got out, he was teased continually by his classmates for being smelly, as he could not control his bladder.

These obstacles made him even more determined to make good; he studied so hard for his diploma despite ill health that he collapsed after his final paper and slipped into a coma for three days.

But when he received his hard-earned diploma, doctors told the then 19-year-old that his bladder problem, which caused urine to flow back into his kidneys, had resulted in kidney failure. He would spend a significant part of the next 33 years hooked up to a machine to sustain his life.

Despite such overwhelming circumstances, the 51-year-old is Singapore's longest-surviving dialysis patient - and one of the longest surviving in the world.

Mr Tay is the only patient in the National Kidney Foundation's 44-year history to cross the 30-year mark. The average lifespan of kidney patients after going on dialysis is about 12 years - although one patient in London was known to have passed 39 years.

"I guess I am lucky. I am not scared of death, but I want to see how far I can go," said Mr Tay, a sales director at a medical equipment company.

Those who know him well, however, would argue that luck has had little to do with his battle for life. His highly regimented life has probably been more of a factor in his longevity.

For over three decades, three times a week, for four hours each time, he would turn up without fail for the dialysis sessions.

This self-discipline was extended to his diet. Knowing that any excess fluid intake is likely to put pressure on his heart and lungs, he stuck faithfully to the recommended two cups of water each day by measuring it out in the water bottle that he takes to work.

Mr Tay, who is single, does not mind the routine as it gives him some semblance of control, a hedge against the many vagaries of life that he has been witness to.

"I like to be in control. I want to make full use of my time and achieve something," he said emphatically.

The methodical and pragmatic man seems to have it all planned out. He was 19 when he asked his doctor how much longer he would live. Ten to 20 years, was the reply.

Without wasting tears, he hunkered down and told himself that he would set up and run a successful company in that span of time.

He started a medical equipment firm in 1983, and in two years he increased its annual turnover from $50,000 to $300,000.

When 10 years came and went, he asked the doctor once again how much longer he had. He was told "another five more years".

Undeterred by the ticking clock, he decided to use that time to expand the firm, by then known as Equip Medical, regionally.

The company has since grown to accommodate 50 staff, and is doing well in its regional operations in Thailand, Malaysia and Myanmar.

"Now, I no longer ask that of my doctor. They can't tell me what will happen next as no dialysis patient has lived this long," he said quietly.

He is not eligible for a kidney transplant because of his bladder condition.

One of the hardest things he has to deal with, he said, is sending off friends he had gotten to know at the dialysis centres over the years. He considers them as family.

"One by one, I will be at their funerals thinking, is my turn next?"

He credits an unremitting work ethic and caregiving duties for his mum for keeping him grasping on to life.

The workaholic, who used to pull 12-hour workdays despite a punishing dialysis regime, often pores over sales and budget reports while undergoing dialysis.

"Once you are gainfully employed, it gives you motivation to go on. I don't indulge in self-pity because once you lose the mental battle, you go fast."

His race against time takes on an added urgency as he is caring for his bedridden 95-year-old mother, who has dementia.

"When the medical social worker told her not to waste her money and let me die, since she has 11 other children, she told her, 'How do you know this child will not turn out to be the best?'" recalled Mr Tay, as his eyes glazed over.

"I can't go before her. She has fought for me and I will fight on to live for her now."


SELF-DISCIPLINE

I like to be in control. I want to make full use of my time and achieve something.
- Mr Richard Tay, on being strict with his health-care regimen

UNCHARTED TERRITORY

They can't tell me what will happen next as no dialysis patient has lived this long.
- Mr Tay, who is not eligible for a kidney transplant because of his bladder condition, on why he no longer asks doctors how much time he has left

MOTHER'S FAITH

When the medical social worker told her not to waste her money and let me die, since she has 11 other children, she told her, 'How do you know this child will not turn out to be the best?'
- Mr Tay, on his mother

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