Virus stalking dialysis patients
Treatment rates staggeringly high in Memphis
“I’ve worked here for eight years, and the disease burden here is heavy.”
Joy Barringer
Operations manager for Satellite Health Systems in Memphis
Darry Campbell left Elaine, Arkansas, behind years ago.
In that rural town, racist whites murdered hundreds of Black sharecroppers in 1919 because they tried to start a union. It now has just more than 600 residents, more than half of whom are Black and poor.
Campbell, who grew up there, ultimately wound up in Southaven, Mississippi, with a manager’s job at a fast-food restaurant, four children, and a marriage to a registered nurse.
But one day in 2014, the residue of poverty and inequality from his upbringing came barreling up
through his stomach and throat.
“I thought I had indigestion,” said Campbell, now 50. “I was working as a manager at Wendy’s, and I had a big inspection coming up, so I took some medication and drank a soda.
“It came right on up out of me.”
Campbell said he thought something was wrong with the soda, so he tried drinking another one. He threw that one up, too.
With prodding from his wife, he went to an emergency room, where the doctors referred him
to the hospital — and where he wound up in intensive care.
As it turned out, Campbell’s problem wasn’t his stomach.
It was his kidneys.
Campbell had hypertension that doctors had failed to diagnose for most of his life — something that happens to Black men like him frequently.
According to data from the Centers for Disease Control and Prevention, Black men who come from poor backgrounds are often diagnosed with high blood pressure later in life, or after a serious medical event.
Now, Campbell learned, it had destroyed the organs that cleanse waste from his body.
“I was experiencing fluid overload. That’s why I couldn’t drink anymore,” he said. It also made Campbell vulnerable to COVID-19, which he contracted in July.
“When I got up that morning to do my treatment, I felt funny. I had chills,” he said. “So, I went upstairs, I asked my son to set the (air conditioner) temperature higher, but it wasn’t that low to begin with. “I was out of breath when I went downstairs, and I kept falling asleep at treatment, which was unusual because I made it a practice to be well-rested for them. I took what I thought was going to be a short nap, but I woke up two hours later.” For nearly a month, Campbell needed a respirator to breathe. But he beat it.
Still, his dilemma represents that of a staggeringly large proportion of Black people who live in Memphis and the Mid-south — people who now have to worry about COVID-19 on top of managing their kidney dialysis.
While Memphis and Shelby County, of which Southaven is a suburb, make up 13% of Tennessee’s population, it accounts for nearly a quarter of its dialysis patients, according to information from the American Kidney Fund.
Also, a June study in the Clinical Journal of the American Society of Nephrology found dialysis patients who contract COVID-19 have a 14% chance of dying from the disease, compared with 4% for non-dialysis patients.
And Campbell is one of the thousands of people in Memphis and in the Mid-south for whom COVID-19 has ripped the scab off the scars of racial disparities.
It’s an area where the market for dialysis centers is booming largely because of the prevalence of chronic kidney disease — which, as of 2016, some 3,774 Shelby County residents are struggling with, according to data from the Kidney Fund. Of those 3,774, 3116 — more than 80% — were Black.
“I’ve worked here for eight years, and the disease burden here is heavy,” said Joy Barringer, operations manager for Satellite Health Systems in Memphis, which operates five kidney dialysis centers in the area.
“It’s heavy because of all the other co-morbidities that lead you into dialysis, like hypertension and diabetes.”
The disease is the end result of the poverty that fuels hypertension and diabetes in the Mid-south — conditions that account for 3 out of 4 new cases of kidney failure, according to the Kidney Fund. Barringer said the centers’ patients range in age from 18 to 90.
“I had a patient who came to me when she was in the 12th grade,” she said. “I say I went to graduation with her, but I wasn’t there, but looking at the pictures I felt I was. I felt like I went to the prom with her, looking at the pictures . ...
“So, we’ve reached these milestones with our patients because many of them come to us so young. We had one patient who had been with us for 20 years, and she finally got a transplant.
“We celebrated like it was our family member.” Barringer said Satellite cares for 345 patients each week in its centers. Eighty patients — Campbell is among them — do dialysis at home.
While Barringer said workers had been wearing face shields and masks at its centers before the pandemic, the difference is that patients have to wear them now. “The world looks different to us now, but I’m proud to say we haven’t had any patient-to-patient transfers of COVID, or employee transfers of COVID,” she said. That’s a triumph in and of itself — because in the Mid-south, the specter of kidney disease, the possibility of relying on dialysis and the vulnerability to COVID-19 stalk many people here.
According to data from the Methodist Le Bonheur Healthcare 2019 Community Needs Assessment, 36% of people in Shelby County struggle with hypertension, while 33% of people in Desoto County, Mississippi — where Campbell lives — do.
Diabetes affects 12% of people in Shelby County and 11% of people in Desoto County.
More than half of those who suffer from chronic kidney disease suffer from high blood pressure, and much of that problem is driven by socio-economic factors. Like how, in Shelby County, only 20 grocery stores exist for every 100,000 people, compared to 73 fast-food restaurants. And all are precursors to chronic kidney disease — and vulnerability to COVID-19.
Also, like Campbell, many of them “crash” into dialysis, meaning that when they have an episode in which they find out their kidneys are failing, they often have to go straight into dialysis, said Alice Andors, spokesperson for
the Kidney Fund.
Andors said that happens because many times, kidney disease has no symptoms until the person is far along.
Like Campbell, Mary Cole, 67, crashed into dialysis.
She comes to Satellite Health System’s dialysis center in Whitehaven three times a week.
Her blood reddens the tubes connected to the mechanical kidney that has, for the last four years, taken on the chore of keeping her alive after her real kidneys quit on her.
It was a bout of pneumonia that caused Cole’s kidneys to fail when she was 62. That and the high blood pressure that had weakened them years earlier. “I lost my oldest sister, and that kind of stressed me out,” said Cole, who was left to raise her sister’s three children along with her four children.
“After that I got high blood pressure … I got my first gray hairs then.”
Her children, and her sister’s children, turned out fine. But Cole, who grew up in Kosciusko, Mississippi, before moving to Memphis with her sisters in 1973, never shook her high blood pressure. “I got pneumonia, and one day, I just collapsed,” Cole said.
“The doctor told me that the pneumonia had damaged my kidneys. … The next thing I knew I was headed to dialysis. “Dialysis, in and of itself, is challenging. And now I have to worry about COVID-19.” One of the biggest challenges in dealing with the pandemic, Cole said, is not just trying to maintain her health and keeping up with masking and social distancing requirements to avoid COVID-19, but in helping her four grandchildren understand it all.
So, Cole turned it into a lesson.
“I’m big on education, so when I told them they couldn’t see Grandmother, I told the oldest one to look up the yellow fever in Memphis that wiped out the city. … I had them look up the Ebola in Africa and how people were falling dead in the street. …
“The oldest one (16) was able to help the youngest ones to understand.”
Nonetheless, it saddens Cole that one chronic ailment — hypertension — led to another one, kidney disease, and combined, they can make her susceptible to a deadly pandemic.
“Having friends, and having grandchildren, and them not being able to come see me because of this, it makes it kind of hard,” she said.
“But I can’t take any chances.”
“But,” Cole said, as she looked around the room at her fellow dialysis patients, “I have neighbors in here that I chit-chat with.”
You can reach Commercial Appeal columnist Tonyaa Weathersbee at 901568-3281, tonyaa.weathersbee@commercialappeal.com or follow her on Twitter @tonyaajw.