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Publication Date: Friday, August 10, 2001

"No man is an island. I've come along because so many people have coaxed me along." @dropname:Ron Hasegawa

Living well on dialysis

By Diana Reynolds Roome

Thirty years of partnership are usually cause for celebration, and Ron Hasegawa's anniversary party on Aug. 22 is no exception.

The occasion is an unusual one. For three decades, since he was 19 years old, Hasegawa has returned several times each week to El Camino Hospital to put himself on a dialysis machine, essentially an artificial kidney. The commitment has kept him alive and active, despite kidney disease so severe that twice during his childhood he was not expected to survive. That was before the development of sophisticated technology that can efficiently cleanse the blood of excess fluids and toxins -- a job most peoples' kidneys perform without their even thinking about it.

Hasegawa is now the second longest surviving patient on dialysis in the Bay Area, and one of only a handful in the United States to live so long. He has not only survived but thrived, a fact that amazes and inspires those who know him.

"Ron has been a shining example of how dialysis can prolong peoples' lives in a very productive and positive way," says Dr. George Ting, medical director of the El Camino Dialysis Services Center. "This [anniversary] reflects his tremendous personal strength and tenacity, to overcome the unimaginable hardships that happen with so many decades on dialysis."

When kidneys don't function, wastes stay in the body and cause a number of problems, including high blood pressure and sometimes heart disease. Patients on dialysis have to be vigilant about many aspects of their lives, ranging from dietary restrictions to avoidance of infection, for which they have higher than normal risk.

While many patients with renal failure develop other problems too, Hasegawa has remained in good health, carrying on his job as a realtor at Midtown Realty in Palo Alto, walking three times a week, working on his garden, going to the theatre and actively participating in the life of Menlo Park Presbyterian Church.

While some patients need to be "pushed, coddled and cajoled" to follow health guidelines, says Ting, Hasegawa "is very diligent about taking care of himself. He understands the details and takes full responsibility for his own well-being."

One reason for his involvement is that despite the rigors of his treatment, and despite years of early schooling missed (his parents educated him at home through the third grade), Hasegawa earned an undergraduate degree in human biology from Stanford University. His route to the degree took him first to the University of California in San Diego, where he also planned to become a pre-med. However, after only one academic quarter, at age 19, his deteriorating health forced him to return home to Los Altos.

At that time, El Camino was one of the only hospitals in the country to offer dialysis (starting the year before, in 1970). Hasegawa learned to put himself on to the dialysis machine, and by reading, asking questions, and talking to nurses, he gradually came to understand the complex workings of the human kidney.

"Back then, there were six dialysis machines on the fourth floor of El Camino and [the dialyzing process] took eight hours," Hasegawa said, laughing when he recalled that in 1968, students collected Pillsbury coupons to help buy dialysis machines. (A few years later, Congress passed a Medicare provision to cover dialysis.)

He also described how dialysis worked before the invention of the Scribner shunt, a device permanently implanted to accept the needles for circulating blood into the machine and back into the body. "Nurses had to search for veins all over your body," he said. "There were fewer safety measures -- for example, no air detector to make sure there weren't air bubbles in the blood."

Today, Hasegawa is one of the rare patients who manages his own blood access, which means that he inserts his own catheter needles into the blood vessels at the beginning of each dialysis session, using a "buttonhole" technique learned from the renal technicians. This is one of several difficult and critical jobs he has taken on himself in his treatment.

When he first arrived at El Camino, Hasegawa had already been in and out of other hospitals 22 times, sometimes staying for as long as nine weeks. He had twice nearly died, and tells the story of the day his desperate mother even called the undertaker who refused to accept the job, insisting that the boy would pull through.

Hasegawa not only survived a childhood full of medical crises, but afterward underwent two unsuccessful attempts to transplant a new kidney -- both experiences painful, risky and traumatic. In spite of it all, he remains optimistic.

Marilyn Mayfield, MS, a renal dietician who has worked at the El Camino Dialysis Center for 29 years, remembers Hasegawa as one of her first patients. "Ron is a presence," she says. "He has always been really warm and outgoing, with a great sense of humor."

Above all, he always has time for other patients in dialysis. If they become hospitalized, he goes to visit them. If they have problems, he talks to them. He treats the staff by bringing in homemade lasagna or cheesecake.

"It's necessary to have a little tomfoolery once in a while," says Hasegawa, who occasionally plans a small party with fellow patients when they are in a smaller treatment room.

His humor cheers everyone, although keeping a sense of humor is not always easy. One of his self-appointed tasks is to attend memorial services of many who don't survive. Some of them have become personal friends, and such losses are hard to bear. Of the seven or eight renal failure patients who attended his 25-year celebration at El Camino, none have survived to attend the upcoming party.

"I wish all of them had lived so long," says Hasegawa. "There was a lot of camaraderie, and you lose a lot of good friends."

In addition to his outreach work with other dialysis patients, he took care of his parents until the end of their lives. His father, a first-generation immigrant from Japan, lived to be 92 under his son's watchful eye.

Hasegawa attributes his own remarkable survival to "good friends who pray for me, and a lot of good doctors," as well as his parents, his church, the staff at the Dialysis Center, and his good fortune in not having more medical problems (such as diabetes) to cope with. "No man is an island," he said. "I've come along because so many people have coaxed me along."

Medical technology has also progressed tremendously since the days when there simply weren't enough machines for everyone who needed them. He remembers with horror the room where acceptance committees would tell patients whether or not they had been chosen for treatment. Often the decision was based on age. A man of 22, for example, would be allocated a machine before a 55-year-old father of three.

Today, age is not a factor in selecting recipients for kidney transplant, an operation which, if successful, can get a person off the dialysis machine forever. Hasegawa, who turns 50 this year, is considering whether a third try might be lucky for him. Though surgical techniques and drugs have improved enormously since his last transplant surgery (on his birthday in 1983), there are still many factors to consider.

That decision still lies in the future. For now, it's time simply to revel in the extraordinary achievement of the past 30 years.

"Ron is very positive. I don't think you could accomplish what he has without that positive attitude," says Ting. "Being his physician for over 25 years has really been quite an honor." El Camino Dialysis Services welcome all whose lives have been touched by Ron Hasegawa to attend his 30-year celebration on Wednesday, Aug. 22, at 3 p.m. in the foyer of the Oak Pavilion at El Camino Hospital.