Don Paulus

Don Paulus bowed his head to receive a bronze medal for his efforts in the 200-meter run at the 2004 U.S. Transplant Games in Minneapolis. His throat tightened as he looked at the woman giving him the medal. Three years earlier, she had given Don a gift that made this moment possible: one of her kidneys.

The magnitude of her gift was not lost on the thousands of people gathered in the stands around them. The assembled crowd of transplant recipients, organ donors and family members cheered wildly as the announcer introduced the woman placing the medal around Don's neck as his wife and donor, Nancy Paulus.

"For me, that was the most moving part of the Transplant Games," says Don. "It was a reminder of how far we had come and what we had been through together."

Don Paulus spent six months training for the Transplant Games. But his journey to Minneapolis had begun more than four years earlier, when persistent headaches led to a series of medical appointments, diagnostic tests and finally, the life-changing news that he would need a kidney transplant.

For Don and other transplant recipients, the Transplant Games are more than just athletic events. They are an opportunity to showcase bodies restored to health, to rejoice in second chances, and to celebrate life.

Don's story

In May 2000, Don began experiencing splitting headaches. He wrote them off to increased stress in his position as a program manager for the Natural Resources Conservation Service. At the same time, he noticed his endurance was slipping.

"I thought that was a sign I needed to get in shape," says Don, who had been active in high school and college athletics.

But when he developed a headache he just couldn't shake, Don and Nancy went to the emergency room. An appointment with his primary physician followed the next day, and soon after the Pauluses learned the true cause of Don's symptoms: kidney failure brought on by familial nephropathy, a genetic disease affecting the structure of the kidneys. Though he'd lived a symptom-free life for 45 years, the diagnosis was not entirely shocking.

"My grandfather and mother passed away from kidney failure, and one of my uncles lives by means of a kidney transplant," says Don. "My family history made me somewhat prepared for the diagnosis."

Don's nephrologist estimated he had about a year before he'd need to go on dialysis; after that, he would need a kidney transplant. Rather than mourn the loss of life as he knew it, Don viewed his situation with an athlete's mentality.

"Sports have been an important part of my life and have given me a strong will to succeed," he says. "Rather than thinking about my kidney failure as an end to certain things in my life, I chose to view it as a series of challenges that I could overcome."

Among the first of those challenges was telling the people in his life that his life would be changing. As Don began sharing the difficult news with his family and friends, several people — including his brother--in- law and a friend he hadn't seen in 20 years — came forward to say they wanted to be tested to see if they could possibly donate a kidney to Don.

Nancy decided to be the first to go through the testing process. Though she was willing to do whatever she could to help save her husband's life, Nancy was worried. She'd heard donating a kidney was painful, and that recovery was long and difficult. Kassie Kasakewitsch told a different story.

Kasakewitsch, a patient service liaison at Mayo Clinic Hospital in Phoenix, is used to calming nerves. As a member of the front desk staff on unit 5E, Kasakewitsch is the first person to greet many patients as they arrive for appointments. She works hard to make all patients more comfortable, but is especially good at easing the nerves of organ donors.

That's because she was an organ donor herself.

"I always tell donor patients about my own experience," says Kasakewitsch, who donated one of her kidneys to her stepson on Oct. 5, 2000. "I tell them if I could grow another kidney and donate again, I would."

Kasakewitsch's words made a world of difference to Nancy.

"Kassie told us that she was out of the hospital two days after surgery and back to work in two weeks," says Nancy. "She said the discomfort she'd experienced was minimal. Kassie was the first person we met when we got to Mayo, and the perfect person for us to talk to at that moment in time."

Adyr Moss, M.D.

After going through rigorous physical and psychological evaluation, Nancy was cleared to donate.

"It was such a relief to know I would be getting off dialysis," says Don of the procedure that removes the waste products and extra fluid that accumulate when kidneys stop working. While dialysis is a lifesaving process for people who have kidney failure, it's also draining and time-consuming. Over time, people on dialysis also are subject to serious health problems including anemia, high blood pressure, nerve damage and infection.

"Living-donor kidney transplant has a number of advantages, one of which is that surgery can be scheduled at a time that is convenient for the patient," says Adyr Moss, M.D., a transplant surgeon at Mayo Clinic Hospital. "You have time to ensure the patient and donor are healthy. Deceased-donor transplantation doesn't offer those benefits. Most recipients wait three to five years for a compatible deceased-donor kidney to become available, and during that time their health deteriorates. Each year, thousands of people on dialysis die while waiting for a deceased-donor kidney."

Kidneys from living donors also have the advantage of being better accepted by their recipients, both initially and over time. More than half of living-donor kidneys transplanted today will still be functioning in 25 years; half of the kidneys transplanted from deceased donors will fail within 10 years.

"We at Mayo are very strong proponents of living donation," says Dr. Moss. "Unfortunately, not all patients are lucky enough to have someone who is willing to be that selfless and give a part of their body to them."

Nancy's gift was given on a very appropriate date. Don's transplant took place on Sept. 21, 2001, his 46th birthday.

Back on his feet

"The transplant gave me my life back," says Don, who was released from the hospital four days after his surgery. "Physically, I'm back to doing things I did in high school and college. And I've gained a greater appreciation for my family and friends."

Nancy was released from the hospital two days after surgery, but wouldn't have minded staying a few extra nights. "Mayo feels more like a five-star hotel than a hospital," she says. "Everyone treated us so well."

After leaving the hospital, Don didn't take any pain medication. Nancy took only one pain pill.

"I wish more people knew how easy it is to donate," she says. "I wouldn't have had any reservations if I had known what an easy process it would be."

After more than a year of deteriorating physical ability, Don was eager to get back in shape after his transplant. He went for a walk the first day he was home and the next day — unbeknownst to his physicians — he went for a "slow jog." When a friend at work asked if he was going to participate in the U. S. Transplant Games, Don had no idea what he was talking about. Don did some Internet research and discovered the games were Olympic-style events open to transplant recipients.

"I saw the times and thought 'I could do that,'" says Don. Though he'd never liked track and field, he decided to register for the 200-meter dash. And the long jump. Also basketball and team golf.

In July 2004, Don and Nancy, along with their children, Alyssa and Jared, arrived in Minneapolis for the U. S. Transplant Games. Don's father, two uncles and aunts were also there to support him. By the end of the games, they'd had plenty to cheer about: Don won a silver medal in the long jump, a silver in team golf and that bronze in the 200-meter run.

The Transplant Games are a great reminder that transplant recipients can and should lead active lives.

"We encourage transplant recipients to live normal lives," says Dr. Moss. "We tell them to exercise, work, have a full social life. There shouldn't be limitations after transplant; it would defeat the whole point of transplant medicine. Our goal is to return patients to the lifestyles they enjoyed before their kidneys began to fail."

Don has embraced that philosophy. He's returned to a level of physical activity he hadn't known for many years. And in the process, discovered a new love: track and field. He'll represent Team USA at the World Transplant Games in Canada in July 2005, competing in the 200-meter dash and long jump. (No golf or basketball this time around.)

Don will also be the unofficial representative of another team: his Mayo Clinic transplant team.

Raymond Heilman, M.D.

"Teamwork is an essential part of transplant medicine," says Raymond Heilman, M.D., a nephrologist and medical director of the Kidney Transplant Program at Mayo Clinic Hospital. "At Mayo, that's something we're very good at. We know how to draw the right players together to meet the specific needs of each patient."

And while he won't be getting any medals for his efforts, Dr. Heilman looks forward to attending his own "awards ceremony" each fall: Mayo Clinic Arizona's transplant reunion. The event, held yearly at the Arizona Transplant House, is an opportunity for kidney, liver and pancreas transplant recipients, their families, and program staff members to celebrate the gift of life. Don Paulus was a featured speaker at the 2004 reunion, showing off his medals and sharing his experiences at the Transplant Games.

"The reunion lets us see the impact transplant has not just on the recipients, but on their families and friends," says Dr. Heilman. "We get to see them not as patients, but as vibrant members of their families and communities. It's incredibly rewarding."

Even better when you get to see them go for the gold.