Spotlight on: A scientist’s mind on dialysis

Kidney disease affects people from all walks of life. 52-year-old Polish professor Rajmund Michalski has a unique story to tell about personal struggles and triumph.   Academia was an obvious career path for Rajmund Michalski, who lives with his wife and daughter in Zabrze, a city in Southern Poland where he works as associate professor at the Institute of Environmental Engineering at the Polish Academy of Science. After obtaining his master’s degree, Michalski went on to successfully complete his PhD in chemistry in 1994 and his post­doctoral studies to become a professor in 2007. Through his contributions as an author and researcher, and as a member of numerous science associations and scien­tific journal editorial boards, he has estab­lished a strong foothold in his field. To say that Michalski likes to be busy and stay busy would be an understatement – despite his diagnosis of chronic kidney disease.

Unexpected news

Until 1992, when he was nearing 30, Michalski had barely given his kidneys a second thought. That all changed when during a routine medical exam he learnt he had high levels of protein in his urine. Follow-up tests at the local hospital ensued and after under­going a kidney biopsy, he received his diag­nosis: glomerulonephritis, or inflammation of the kidneys.

Initially, Michalski was able to continue living as usual without immediate need for dialysis, though his doctor told him this would change with time as his kidney function decreased. Eight years after first hearing his diagnosis, he noticed he was feeling more and more tired. Although he was seeing his nephrologist every three months, he could tell his condition was getting worse and at the end of 2011, his doctor shared with him that it was time to start dialysis. After reviewing options with his nephrologist, Michalski chose peritoneal dialysis (PD) for treatment, in great part because he felt it would give him more flexibility to continue pursuing the career he had worked so hard to establish.

In January 2012, he had surgery to insert the catheter that allowed the dialysis solution to flow in and out of his abdomen and he learnt how to perform the treatment at home. From the start, Michalski was open to transplantation, though he knew it came with both pluses and minuses. To keep his options open, his doctor placed his name on the list for a donor. On 26 January 2013, two years into PD treatment, and just a few days shy of his 50th birthday, he received a phone call that there might be a matching donor kidney. Michalski went directly to the hospital in Bydgoszcz where the surgery was successfully performed.

But the kidney was not only his birthday present; he also received the call on Polish Transplant Day, which is celebrated each year on 26 January to commemorate the anniversary of the first successful Polish kidney transplant in 1966.

A new research project helped to move forward

Because of his background in chemistry, Michalski understood his condition on a bio­chemical level. Before starting dialysis, it was important to him to know his precise medical outcomes at each doctor’s visit. But knowing and understanding so much about what was going on with his body has its pros and cons: every time he sat down face-to-face with his nephrologist he was stressed about what he might hear. Michalski dealt with this by keep­ing records documenting his physical condi­tion. Doing so gave him the feeling of being in better control of his health and it had a positive effect on his emotions.

Even now, after transplantation, he contin­ues to closely monitor and analyse his health stats. Recently he even submit­ted a scientific article about his experience to a journal for review and is eagerly awaiting a response about its publication.

When Michalski first learnt about his disease at age 29, with a one-year-old child at home to care for, he felt his world come crashing down around him. His instinct was to try to forget about the disease’s progression so he buried himself in his work. Continuing his usual lifestyle, including work and travel, also helped him ignore and understate the reality of his condition. But the fact is he knew from the beginning he would start dialysis sooner or later. Still, when he finally started PD, he struggled to accept the catheter and fluid exchanges four times a day. As time passed and the exchanges became routine, Michalski realised that living with dialysis is bearable and simply another part of his life. He openly admits that facing kidney disease and under­going dialysis has made him more patient and humble, two highly admirable traits.

Paying it forward

Though Michalski is not currently on dialysis, he continues to reach out to and support other dialysis patients. He is a proud member of Poland’s National Association of Dialysed Patients, which publishes a quarterly patient magazine and Michalski wrote a series of articles about coping with his disease, living well with dialy­sis and finally transplantation. Always think­ing of how his experience can help others faced with a similar diagnosis or situation, Michalski’s words are personal, motivating and provide emotional support to kidney patients. At various times of the year he can also be found at nephrology conferences where he represents the patient’s point of view of living with dialysis.

Committed to maintaining an active lifestyle, Michalski cooperates with the Polish Trans­plant Sport Association. In 2014 he helped with the organisation of the European Trans­plant & Dialysis Sports Championships in Krakow where he was a volunteer. In retrospect, dealing with the diagnosis of renal failure and dialysis breathed new vital­ity into Michalski’s life, giving him new research to conduct, new causes to support and new people whose lives he could affect in a positive way. He lives by the saying “When life gives you lemons, make lemonade.”

Successfully uniting dialysis with work

Michalski has always been a career man, passionate and devoted to science and research. His tenures include Dean of the Faculty of Social Sciences and Technology at the Silesian School of Management in Katowice as well as time spent in Japan. While on dialysis he held various positions at the Polish Academy of Science - Institute of Environmental Engineering, including Deputy Research Director.

During his time on PD, Michalski’s goal was to stay active. There were times he worried that lack of energy and creativity would affect his scientific career but his persistence paid off. He continued his work, including organ­ising conferences and travelling throughout Poland and the rest of Europe. Even today when he tells his story he emphasises the crucial role the medical staff at the Fresenius Medical Care centre in Zabrze played in his ability to live a normal life. They were always there for him, supporting him emotionally and showing empathy, for which he remains eternally grateful.