Living Fully After Kidney Transplant
Juan Ramos is thriving a decade after his transplant
Juan Ramos is thriving a decade after his transplant
In 2009, Juan Ramos was a college student at UC Riverside, “doing normal college things,” he says, when his world turned upside down. The Los Angeles native and competitive soccer player noticed he was gaining weight and had a cough that wouldn’t go away. His legs were swelling, and he had developed a rash on his neck and chest. At his mother’s insistence, he went for a physical. When he got the call with his test results, he was shocked.
“My guess was that I had diabetes,” he recalls. “Instead, I learned that I was prediabetic and had high blood pressure, but the real shock was when I found out that I was in kidney failure and immediately needed to see a nephrologist. I was only 21.”
Following the news, Juan asked his nephrologist if he did something that contributed to his kidney failure at such a young age. The answer surprised him. “The doctor told me, ‘You’ve probably been sick since you were 14,’” he says. “On one hand, I felt better that there wasn’t something I did to cause it, but on the other, I wanted something to pinpoint why I got sick.”
Juan learned he had a condition called focal segmental glomerulosclerosis (FSGS), a disease that causes scar tissue to develop on the small parts of the kidney that filter waste from the blood.
“There are a number of causes of kidney failure, and this is just one of the many,” explains Christopher Marsh, MD, program director at Scripps Center for Organ and Cell Transplantation and a transplant surgeon at Scripps Clinic. “It’s asymptomatic and slowly progresses, and it’s difficult to treat once you have it. Usually, by the time you find out you have it, you’re being referred for a transplant.”
Juan joined the national transplant waitlist for a kidney and began peritoneal dialysis to help remove waste products from his blood. He had dialysis seven days a week for the next five years.
Finding hope at Scripps
Finding hope at Scripps
“Over the past 10 years, Juan has been so committed to his treatment that he’s been willing to drive down from Riverside to receive care at Scripps. I can’t emphasize enough the role his compliance and commitment have played in his success.”
James Rice, MDDuring an appointment with his doctor in Riverside, a Scripps transplant physician happened to be visiting. Juan proactively seized the opportunity for a consultation.
“When I met Dr. Rice, we clicked immediately,” Juan says.
James Rice, MD, is a transplant nephrologist at Scripps Clinic. When he and Juan met that day, it changed the course of Juan’s treatment dramatically.
“Over the past 10 years, Juan has been so committed to his treatment that he’s been willing to drive down from Riverside to receive care at Scripps,” Dr. Rice says. “I can’t emphasize enough the role his compliance and commitment have played in his success.”
Once at Scripps, Juan became more optimistic about his likelihood of getting a kidney. At first, he had a living donor who offered to donate. That, unfortunately, fell through, so Juan chose to wait for a kidney that would have the best longevity.
On Dec. 12, 2015, Juan was notified that his transplant team had found a kidney. “They asked, ‘Are you ready?’” he recalls. "I'd never been more ready for anything — or more grateful. That one call changed my life.”
Juan and his family drove to San Diego for his kidney transplant. The surgery went as expected and set Juan on a course to recovery. “Juan was a good candidate for transplant,” says Dr. Marsh. “His surgery went well and so has his recovery. This is exactly what we want — for someone to do so well for 10 years and beyond.”
Ten years strong
Ten years strong
“Kidney failure is not the end. You’ve been given a new lease on life — make it count. As recipients, we have a significant role in caring for our transplants. Beyond that, focus on living life fully. Take that trip, pursue that goal and achieve what you thought was impossible when you were ill. A transplant could last five, 10 or even 25 years. Make every day meaningful.”
Juan RamosTen years later, Juan and his new kidney are thriving. He has remained in regular contact with his Scripps team and has learned how to keep his new kidney healthy by being vigilant with his medications and careful with his diet (transplant recipients must adhere to a low-sodium, low-potassium, high-fiber diet).
“There’s been a lot of communication over the years between Dr. Rice and his team in San Diego and my team in Riverside,” Juan says. “My doctors have become a big team, and they have allowed me to express how I feel and what I want the whole time.”
Liliana Uribe-Bruce, MD, an endocrinologist at Scripps Clinic Anderson Medical Pavilion in La Jolla, has also joined Juan’s Scripps care team to help manage his glucose levels as insulin resistance and post-transplant diabetes mellitus are side effects of his anti-rejection medications. Dr. Uribe-Bruce monitors Juan’s blood sugar levels remotely and works in tandem with Dr. Rice to protect his kidney.
“One of the unwanted side effects of some immunosuppressive medications is poor glucose control, which can damage the kidney he received,” says Dr. Uribe-Bruce. “He needs the transplant, but he needs those medications for the survival of the transplant, so we need to manage any side effects quickly.”
Though Juan will require insulin injections and other medications for the rest of his life, his outlook remains positive.
“One of Juan’s best qualities is his attitude in how he confronts challenges,” says Dr. Uribe-Bruce. “He’s the type of patient who’s a pleasure to work with because he asks how he can work to improve. That’s very important for everything that we do. He’s working, he’s successful, he’s happy — it’s a beautiful thing to see.”
Both Dr. Uribe-Bruce and Dr. Rice are optimistic about the prognosis for Juan’s new kidney.
“The lifespan of a deceased donor kidney is 10 to 12 years,” Dr. Rice says. “But Juan is doing unusually well. His kidney levels are at the level of a person with two kidneys. If he stays on this path, it’s hard to say when he’ll need another transplant.”
Advocating for others
Advocating for others
For Juan, envisioning the future means also looking at where he’s been and how far he’s come. A college student at the beginning of his journey, Juan admits that his journey hasn’t always been easy, but he’s put in a lot of effort to take care of himself through the years and follow the recommendations of his care team.
As he progressed with his dialysis, he was asked to be a patient advocate for others going through a similar experience.
“That really helped widen my perspective,” he says. “Speaking with others and seeing what they were going through made me feel like I wasn’t alone.”
Active and healthy a decade after transplant
Active and healthy a decade after transplant
As the years went on, Juan continued to work in health care, speaking at conferences and helping others whenever he could. He had a few downs and many ups, including marrying his best friend, Daisy, five years ago. He’s playing soccer again and continuing to progress in his career.
Through it all, he has a positive message to others who may be facing the same situation.
“Kidney failure is not the end,” he says. “You’ve been given a new lease on life — make it count. As recipients, we have a significant role in caring for our transplants. Beyond that, focus on living life fully. Take that trip, pursue that goal and achieve what you thought was impossible when you were ill. A transplant could last five, 10 or even 25 years. Make every day meaningful.”
Juan credits his job, his family, his wife, his friends and his medical team for his success. And he credits his own diligence and commitment to his medication regimen and doctor visits for the longevity of his healthy kidney.
He’s grateful that he met Dr. Rice on that fateful day and for the “incredible work” the Scripps team has done to help him get this far. He’s also appreciative that the team will continue to be there to support him well into the future.
“I really see this 10-year mark as a new beginning,” he says. “A transplant may not be a cure, I made it 10 years, and now I have to work to get to 20. You have to put in work every day. But believe me, it’s worth it.”
This content appeared in San Diego Health, a publication in partnership between Scripps and San Diego Magazine that celebrates the healthy spirit of San Diego.