Ashley Giessler is like most 20-somethings. She works a couple of jobs to pay the rent at her Vancouver apartment, she enjoys weekends at the coast and she has plans to someday become an ultrasound technician.

But unlike others her age, Giessler has a unique hurdle to jump — she needs a kidney transplant.

The 24-year-old was diagnosed with Lupus — a chronic, autoimmune disease that can affect any part of the body — when she was 11 years old. When she was 19, it affected her kidneys. For the past five years, she’s been surviving on routine dialysis treatments.

“You have good cells and you have bad cells,” explained Giessler, a Kelso High School graduate. “In a normal person’s body, your good cells know to attack the bacteria and the bad cells — the enemy, basically. In my body my cells are confused so they end up attacking themselves.”

Lupus most commonly manifests as joint pain, fatigue and headaches, among other symptoms.

Except for her initial diagnosis and flare-ups every few years, Giessler’s Lupus remained relatively quiet until she was 14. That was the first time it began affecting her kidneys. She endured almost two years of chemotherapy to help preserve kidney function.

When she was 19, her kidneys came under fire once again and chemotherapy proved ineffective. She began dialysis treatments Christmas Day, one day after emergency surgery to implant a catheter.

“After surgery I literally had two tubes hanging out of my chest. One was blue and one was red,” Giessler explained. “I used to call them my crayons because it used to look like a little pack of crayons in my shirt. That’s what they have to do when you first start dialysis because they can use it right away.”

Because dialysis isn’t a permanent solution, Giessler has been working to raise $8,000 for a kidney transplant. Her insurance covers the cost of the surgery, but her doctors require her to raise money to pay for medications and other post-operation necessities. They won’t add her to the transplant list until she does.

“They’re basically setting me up for success,” Giessler explained. “I don’t have savings. I’m single. I support myself. I don’t get financial help from anybody. I have my own car that I make car payments on. I have rent.”

The money will help pay for essentials — her rent, her electric bill and the medications necessary to keep her healthy after the transplant. She has to take two months off from her part-time job at American Eagle and will be recovering at her apartment.

“I’m going to have medications that I’m going to have to pay for, and (the doctors) don’t want me to not take my medication because I can’t pay for it,” she said. “My kidney is going to be relying on those medications.”

To raise money for the transplant, Giessler held a benefit last week in Vancouver that raised almost $3,000. A second benefit at Red Leaf Coffee in Kelso last week raised $1,200. She also set up a GoFundMe account.

The cost of the surgery itself will be paid for by Giessler’s insurance, which includes Medicare. Patients on dialysis qualify for Medicare because they are considered “disabled,” Giessler said. She also is covered by her father’s insurance until the end of this year. Because the surgery is so expensive, her doctors won’t consider her for the procedure unless she has 100 percent coverage, she said. She’s hoping to schedule the transplant before the end of the year.

The next step is to begin testing possible donors, which could take several months, Giessler said. Among the possible donors is her sister, who shares her blood type. Giessler’s insurance will cover the cost of her transplant as well as the medical expenses of the donor.

“I do have a couple of people (interested in donating),” Ashley said. “I mean, they say they’re interested, but I’ve been hearing that for the last five years so until I see someone on the table ready to get cut open I can’t really believe anyone except my sister.”

Until she receives a transplant, Giessler is dependent on dialysis.

When her kidneys ultimately failed five years ago, she visited a clinic three times a week for hemodialysis. Now, Giessler prefers peritoneal dialysis — an at-home option that requires her to be hooked up to a machine for nine hours each night.

The dialysis machine automatically pulls fluid out of her stomach before pumping in new fluid through a tube in her abdomen.

“It’s collecting the crap out of my blood basically, and then when I drain it, it drains all the stuff out of me,” she said. “It’s a really simple process, and it’s really easy. It doesn’t hurt.”

Though she said her at-home regimen is a better option than weekly clinic visits, she still struggles with the feeling of being “stuck.”

“I really want to go to school, and I was going to school while working and dealing with dialysis, and it’s just it’s way too much,” she said. “I can’t quit working and I can’t quit dialysis. Something had to give, and unfortunately it was school.”

Giessler stressed that her dialysis isn’t a “cure.” That freedom won’t come until she receives a transplant.

“Without (dialysis) I wouldn’t be able to live. It’s like my life support. Either the hemodialysis or the (peritoneal dialysis) — I have to be doing something, and so it doesn’t necessarily increase my quantity or quality of life,” she said. “It just keeps me going until a transplant.”

Giessler said that for most transplant patients, there’s less than a 2 percent chance the new kidney will be rejected. However, she’s unsure how those chances differ for Lupus patients.

“I don’t think there’s a percentage in a situation like mine,” she said.

“I just have to be optimistic and hopeful that everything is going to work out perfect.”

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A higher intake by postmenopausal women of the natural antioxidant lycopene, found in foods like tomatoes, watermelon and papaya, may lower the risk of renal cell carcinoma, a type of kidney cancer.

A team led by Cathryn Bock, Ph.D., M.P.H., associate professor of Oncology at Wayne State University's School of Medicine, made the conclusion after analyzing data from 96,196 women nationwide and in Detroit who enrolled in the Women's Health Initiative from 1993 to 1998 and were followed through July 2013 by participating initiative sites, including Wayne State University.

"We were surprised to observe a protective effect of lycopene, as several previous studies in other populations did not detect a similar relationship," Bock said.

The results are explained in "Antioxidant micronutrients and the risk of renal cell carcinoma in the Women's Health Initiative cohort," featured in the Feb. 15 issue of Cancer.

The investigators analyzed the risks for kidney cancer associated with intake of lycopene and other micronutrients that have antioxidant properties, including lutein and vitamins C and E. During follow-up, 240 women were diagnosed with kidney cancer. Compared with women who reported a lower intake of lycopene, those who ingested more had a 39 percent lower risk. No other micronutrient was significantly associated with the same risk.

The 63,920 estimated new cases of kidney and renal pelvis cancer in 2014 made up 3.8 percent of all new cancer cases, according to the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. In 2011, there were an estimated 358,603 people living with the cancer in the United States.

It is the eighth-leading cancer among women and is commonly diagnosed at a more advance stage.

"Kidney cancer is a relatively rare cancer, and so focusing only on reducing risk of this disease would be short-sighted," Bock said. "Rather, a diet focused on one's own personal risk factors, such as family history, would be more beneficial."

A low-salt diet is recommended for women with a risk of hypertension, a major risk factor for kidney cancer. There are other steps women can take now for their health, including eating more foods and fruits with naturally-occurring lycopene.

"Lycopene from food sources has also been associated with decreased risk of breast and prostate cancers, and a diet high in vegetables and fruits are generally well-accepted for promoting good health," she said.

Good sources of lycopene include tomatoes and tomato-based products, watermelon, pink grapefruit, guava and papaya. Dr. Bock suggests consulting a doctor before taking a lycopene supplement.

The team is now examining whether there is a relationship between antioxidant nutrient intake and kidney cancer risk in a National Cancer Institute-funded case-control study primarily conducted with participants from the metropolitan Detroit area.

"This study included a broader population, including both men and women, and with greater representation of African-Americans, and therefore may help describe the associations in populations beyond post-menopausal women who are primarily of European descent," Dr. Bock said.

Wayne State University - Office of the Vice President for Research

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