noth­ing says ‘i love you’ like a kid­ney

When hus­band’s or­gans failed, wife gave one of hers

Austin American-Statesman - - FRONT PAGE - By Mary Ann roser

Austin po­lit­i­cal power cou­ple Gay and Alan Er­win lay side by side on gur­neys in San An­to­nio’s Uni­ver­sity Hos­pi­tal sur­rounded by their three grown sons, along with Alan’s brother and sis­ter. The cou­ple stretched out their arms from un­der the sheets to hold hands and wait to be op­er­ated on.

If the Er­wins were ner­vous, they didn’t show it. They laughed heartily when some­one pointed out that Alan’s shower cap-like hat had be­come askew and was now tilted jaun­tily, beret-style. Then Gay was wheeled into surgery first, and the tears that fol­lowed at­tested to the bond be­tween the cou­ple, who met in a chem­istry class at the Uni­ver­sity of Texas and have been mar­ried for more than 42 years.

“They couldn’t lean over and kiss each other (good­bye), but they both looked into each other’s eyes and told each other, ‘I love you,’” son Josh, 36, re­called.

On April 29, Dr. Glenn Halff, di­rec­tor of the Trans­plant Cen­ter at the Uni­ver­sity of Texas Health Sci­ence Cen­ter at San An­to­nio and Uni­ver­sity Hos­pi­tal,

made a 3-inch in­ci­sion be­low Gay’s navel and two half-inch cuts on her lower left ab­domen, one for a tiny cam­era, the other for sur­gi­cal in­stru­ments. Halff then re­moved Gay’s left kid­ney from the largest in­ci­sion, rinsed the or­gan and put it in a tray as the sur­gi­cal di­rec­tor of the kid­ney trans­plant pro­gram, Dr. Gre­gory Abra­hamian, waited across the hall to put it into Alan’s right side.

Within a few hours, Alan, who had been on dial­y­sis to keep him alive with two non­work­ing kid­neys, joined a group of Amer­i­cans whose lives are for­ever changed by a spouse’s rare gift.

Last year, 799 U.S. hus­bands and wives do­nated kid­neys to their spouses, ac­cord­ing to United Net­work for Or­gan Shar­ing, which co­or­di­nates trans­plants na­tion­ally. Kid­neys from spouses were the fourth-biggest donor cat­e­gory — af­ter sib­lings, chil­dren and par­ents — among liv­ing donors and rep­re­sented 4.7 per­cent of all kid­ney do­na­tions in 2009. At Uni­ver­sity Hos­pi­tal, Halff says more spouses are do­nat­ing kid­neys, and he ex­pects that to con­tinue grow­ing.

“I knew all along I was go­ing to do this,” Gay said, tear­ing up dur­ing a re­cent in­ter­view at the cou­ple’s home in Rolling­wood. She knew she and Alan shared the same blood type, A-pos­i­tive, key to do­nat­ing an or­gan. But she didn’t know their com­pat­i­bil­ity on tis­sue type and other blood fac­tors.

She also didn’t im­me­di­ately tell Alan she wanted to give him one of her kid­neys be­cause she knew what he would say.

“No, you’re not,” he replied.

“Yes, I am,” in­sisted Gay, who is known as tough and de­ter­mined.

Kid­ney fail­ure

Alan Er­win, 65, said he had not felt good in decades and blamed it on Agent Orange ex­po­sure in Viet­nam. He was in the U.S. Navy and was an ad­viser to the Viet­namese navy. He made fre­quent trips on swift boats that were in­ad­ver­tently caught in the spray of the dioxin-con­tain­ing her­bi­cide from U.S. planes tar­get­ing the en­emy’s jun­gle hide­outs. Alan said he be­lieves he de­vel­oped skin can­cer and neu­ropa­thy — the loss of feel­ing — in his feet from the ex­po­sure and, ul­ti­mately, kid­ney fail­ure.

His doc­tor, Ti­mothy Hines, did not re­turn phone calls seek­ing com­ment.

The govern­ment was slow to rec­og­nize dam­age to Viet­nam vet­er­ans from Agent Orange and to­day lists a host of ail­ments re­lated to it — neu­ropa­thy is on the list, but kid­ney fail­ure isn’t.

Alan’s kid­neys failed — the first one sev­eral decades ago, he thinks; the other, more re­cently — and he felt bad most of the time. But he was afraid of some­thing hap­pen­ing to his en­er­getic wife if she gave him a kid­ney. Al­though stud­ies say most donors do well and live nor­mal life spans, com­pli­ca­tions, from bleed­ing to in­fec­tion, can oc­cur. In rare cases, donors have died. Alan told Gay he would wait for a de­ceased per­son’s kid­ney, even though the Trans­plant Cen­ter said that might mean five or six years — an un­rea­son­able wait for some­one in his 60s, Halff said.

Alan had be­gun dial­y­sis in Novem­ber af­ter his sec­ond kid­ney failed. Three days a week he rose at 3 a.m. for a 5 a.m. treat­ment that lasted about five hours. Then he would head to work at his pub­lic re­la­tions and lob­by­ing firm, Er­win & As­so­ci­ates, and come home wrung out. He won­dered how he would man­age with his clients when the Leg­is­la­ture came back in ses­sion in 2011.

Gay, vice pres­i­dent of the govern­ment re­la­tions con­sult­ing firm Strate­gic Part­ner­ships Inc. in Austin, was wor­ried, too, be­cause she knew how de­mand­ing his job was.

She had worked as chief ad­min­is­tra­tor of the Texas at­tor­ney gen­eral’s of­fice and had over­seen the op­er­a­tions and man­age­ment of then-U.S. Sen. Lloyd Bentsen’s Texas of­fice.

Alan, a for­mer Texas Pub­lic Util­ity Com­mis­sion mem­ber who had also worked on statewide po­lit­i­cal cam­paigns, wasn’t plan­ning to slow down. Alan’s friend Nick Voi­nis, who worked with him on Lt. Gov. David De­whurst’s 2002 cam­paign, no­ticed over their lunches with Alan that his skin was gray­ish. He could see the fa­tigue in Alan’s eyes and the toll kid­ney dis­ease was tak­ing.

“He never re­ally com­plained about it, but I could see how hard it was on him,” said Voi­nis, se­nior as­so­ci­ate ath­let­ics di­rec­tor at UT.

Gay was anx­ious to help her hus­band feel bet­ter.

“Gay is re­mark­able. She didn’t even blink when this came up,” said Mary Scott Nabers, a long­time friend and pres­i­dent and CEO of the com­pany where Gay now works.

But Nabers and some of Gay’s col­leagues tried to brace her for the pos­si­bil­ity that she and Alan would not be a match.

“She just brushed us off,” Nabers said. “Al is the love of her life.”

At the end of Jan­uary, the cou­ple went to the Trans­plant Cen­ter to start a bat­tery of tests for com­pat­i­bil­ity.

“Eigh­teen vials of blood apiece,” Alan re­calls. Within 24 hours, they got the word: They were a match. Not only did they match well enough to be con­sid­ered for the trans­plant, but they also matched bet­ter than most donors who are not blood relatives. Doc­tors tested their tis­sue com­pat­i­bil­ity on six anti­gens, or sub­stances that could cause the re­cip­i­ent to be more likely to re­ject the kid­ney; they matched on four, said Carmen Nolan, a Trans­plant Cen­ter nurse who was Gay’s ad­vo­cate dur­ing the do­na­tion process.

The doc­tors will do the surgery on peo­ple who don’t match on any of the six fac­tors, but gen­er­ally speak­ing, the more fac­tors the donor and re­cip­i­ent match on, the bet­ter the or­gan is ac­cepted, Nolan said.

Other fac­tors were in the Er­wins’ fa­vor, Nolan said. Gay was in ex­cel­lent shape. “She eats right, and she ex­er­cises … and it shows,” Nolan said. “All of her test­ing came back beau­ti­ful. I re­ally ad­mire her.”

Even so, she ad­vised Gay that she could back out at any time, even the day of surgery.

Gay was stead­fast.

Feel­ing bet­ter

On the day of surg­eries, the Er­wins’ sons leaned on the cou­ple’s rec­tor at Good Shep­herd Epis­co­pal Church, who ap­peared in the wait­ing room at 5 a.m. with break­fast for the fam­ily. “These were peo­ple deal­ing with real life with a great amount of grace they had learned from Gay and Al,” the Rev. Mor­gan Allen said.

The surg­eries went smoothly, Halff said.

The first thing each one did upon awakening was ask about the other, said Josh Er­win, their mid­dle son and the first as­sis­tant district at­tor­ney in Cald­well County. Told that Alan looked great and his new or­gan was func­tion­ing per­fectly, Gay “got a big smile on her face and said, ‘That’s my kid­ney,’” Josh Er­win said. “She’s real proud of it.”

Alan al­most in­stantly felt bet­ter. He had color in his cheeks for the first time in a long time. Gay was wheeled in to see her hus­band in the in­ten­sive care unit, at­tached to a mor­phine pump. She cried, and so did ev­ery­one else in the room, Josh said.

Gay got out of the hos­pi­tal on the third day but was sur­prised by the amount of pain she felt, much of it from car­bon diox­ide gas used to ex­pand her ab­domen. It caused “re­ferred pain” to her shoul­der and other body parts. Alan was out on the fifth day, but he had to be read­mit­ted three days later with fluid in his lungs, Gay said. It was a med­i­ca­tion prob­lem, and Alan spent five more days in the hos­pi­tal while ad­just­ments were made.

Gay and Alan were out of work nearly a month, and Gay said it took a long time to re­gain her en­ergy — but she would do it again in a heart­beat. She has be­come a fierce ad­vo­cate of or­gan do­na­tion and hopes their story in­spires oth­ers.

“What Gay did for Al just proves what I’ve al­ways known, that her kind­ness and gen­eros­ity know no bounds,” De­whurst, their friend, said in an e-mail. “That’s why I was not at all sur­prised that when she and Al faced this sit­u­a­tion, she was the one to give her hus­band the gift of life.”

“They are the per­fect match,” Voi­nis said, “in more ways than one.”

Jay Jan­ner Amer­i­cAn-StAteS­mAn

Gay and Alan Er­win, mar­ried for 42 years, are a rare match. Their com­pat­i­bil­ity made her a donor can­di­date.

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