Our Patients

Born into Resilience 
by Bellamy Leong

 

In the heart of Bukit Batok, where familial bonds are woven into the fabric of everyday life, Ms Salina and her mother, Mdm Sara, warmly welcomed me into their home. With a genuine smile and a petite frame, Ms Salina greeted me, saying, "Hi Bellamy, it’s great to see you!" This warm introduction sets the tone for an extraordinary narrative—a story of resilience and courage in the face of having to grapple with kidney disease since birth.

At the age of 39, Ms Salina's journey unfolds amidst the caring presence of her 68-year-old mother and two older sisters. One happily married, and the other residing in Australia for the past five years, their family dynamics tell a story of steadfast support, marking a journey defined by courage, familial love, and an unyielding spirit.

Pictured: Mdm Sara holding Ms Salina, who appears looking swollen at Alexandra Hospital.

Kidney disease crept into Ms Salina’s life in 1985 when she was just 1 year and 10 months old. At that time, her mother, Mdm Sara, sensed something amiss as Ms Salina appeared swollen and unusually heavy for a baby, weighing around 18kg. In the eyes of the public, it might be tempting to brush off such symptoms as mere chubbiness in a baby. However, the reality was different. Aside from her swollen appearance, Ms Salina also faced difficulties passing urine. Based on these symptoms, the doctor at Alexandra Hospital broke the news to Mdm Sara that her baby daughter, Ms Salina, was unfortunately diagnosed with kidney disease.

For Mdm Sara, the news hit her hard, leaving her shocked and speechless. She was taken aback by the harsh reality of how her baby daughter could contract kidney disease at such a young age, especially considering that kidney disease is typically diagnosed in individuals at a more senior age. Mdm Sara was advised to go to NUH’s General Ambulatory Paediatrics and Adolescent Medicine Department, where Ms Salina, at the tender age of 3, started to undergo peritoneal dialysis, a procedure involving a tube to introduce and remove dialysis solution from the abdominal cavity.

As Ms Salina entered primary school, she began to question what was wrong with her and if there was a cure for her condition. Being so young, she couldn’t fully comprehend her situation. School days often ended with her returning home straight for portable dialysis. At the age of 6, this routine involved dialysing four times a day, with a 500ml solution bag each time.

Pictured: Ms Salina posing for a photo at a Christmas party.

Complications arose as Ms Salina grew older. Infections and blockages in her stomach led to difficulties inserting the tube, causing her stomach to bloat too. The ineffectiveness of peritoneal dialysis became apparent when for instance, a litre of dialysis solution went in, but only 600 or 700ml came out, leaving residual liquid in her stomach. The doctor determined that peritoneal dialysis was no longer suitable for her, prompting a transition to haemodialysis at the age of 8.

Navigating the delicate balance between education and haemodialysis, Ms Salina faced challenges during her academic journey. From Jubilee Primary School near West Coast to Yusof Ishak Secondary School, her dialysis routine often meant missing out on lessons. However, Salina's classmates were not just understanding; they became her pillars of support. Whether it was carrying her bag, fetching food during recess, or even receiving free meals from the caring canteen staff, the camaraderie extended from primary to secondary school. Teachers, too, played their part, encouraging Salina to take breaks when needed.

When it came to tertiary education at the Institute of Technical Education (ITE), Salina initially delved into chemical processing at ITE College West. Enthusiastic about the course and its proximity to her home, Ms Salina charted her academic path. However, concerns about chemical exposure impacting her health prompted teachers to suggest a change. Switching gears to the Infocomm course at ITE College Central, Salina's educational journey reflected not just adaptability, but a community committed to both her well-being and academic pursuits.

Amidst her journey in her teens and young adult phase, Ms. Salina also experienced periods of hope and normalcy, highlighted by two kidney transplant episodes. At the tender age of 11, Ms Salina received her first transplant, a transformative moment that granted her a decade of respite, carrying her through the challenges of adolescence until she was 21. During this time, she believed her kidneys were in good health, allowing her to have thoughts of being able to pursue her education further at the Higher Nitec level.

However, the illusion of permanence shattered when signs of kidney failure emerged. The frequency of urination diminished, blood test results painted a grim picture, and creatinine levels steadily rose, casting a shadow on her educational aspirations. At 23, she underwent a second transplant, a beacon of hope that unfortunately dimmed after just over a year. By the age of 24/25, Salina found herself back on dialysis, a journey she continues to navigate.

Opening up about these experiences brought Ms Salina to tears. The disappointment and emotional toll were profound, as she had hoped the new transplants would last forever. Despite these challenging moments, she chose to bear the weight of her emotions privately, reminding herself of the strength she had exhibited throughout her pre-transplant days.

Pictured: Ms Salina with Mdm Sara at KDF’s patient outing to National Orchid Gardens.

Throughout this rollercoaster of emotional moments, Ms Salina found solace in the unwavering support of her mother. Grateful for this familial pillar, she acknowledged the care and support displayed by her mum, even during her bouts of illness where she had extended hospital stays of 2 months due to peritoneal dialysis (PD) infections. In these moments, the resilience and support from her mum always staying by her side, played a crucial role in Salina's journey of perseverance.

Ms Salina’s dialysis journey as an adult was not an easy one too. She faced needling challenges during her time at KDF Ghim Moh, and she sought resolution through consultation with a vascular doctor at NUH. It wasn't until the end of September 2022 that she transitioned back to Ghim Moh, underscoring the intricate nature of her dialysis journey.

In contrast to others who often have their needling done on the upper arms, Ms Salina's dialysis journey involved most of her body parts. Her needling initially involved both of her limbs. However, as complications arose, dialysis shifted to her thighs, a painful process marked by the removal of grafts and exposure of certain areas. Gauze insertions, requiring careful removal during dialysis sessions, added to the discomfort. Currently, complications resulting in blockages throughout her body, as noted by her mother's remark "Semua Sudah Blocked," indicating everything is blocked in Malay, have led Salina to undergo dialysis at the side of her body.

Acknowledging her limited pain tolerance, Salina expressed gratitude for the assistance provided by Professor Jackie Ho from NUH in her earlier days of dialysing at the thigh area. Her expertise in managing the dressing for the thigh area alleviated some of the challenges she faced. The dedicated nurses at KDF also grappled with the intricacies of Ms Salina’s needling area, a task Ms Salina recognised as particularly demanding, further deepening her appreciation for their commitment and care. Reflecting on her early days, Salina recounts the hesitancy of nurses from other dialysis centres when she was just 8 years old. Fearful of her small veins, they were initially apprehensive, highlighting the dialysis challenges she faced from a very young age.

Ms Salina's access to care is sustained through subsidies. Her family, reliant on her mother's income of around $800 per month, receives additional support from MUIS (Majlis Ugama Islam Singapura), contributing approximately $300. The combination of KDF's 100% subsidised dialysis and 95% coverage of hospital fees, renders the financial aspect of dialysis more manageable, providing a crucial lifeline for Salina and her family amid the complexities of her journey in dealing with kidney disease.

In terms of looking at the things that bring her joy in her daily life now, it is rather ironic to Ms Salina that she finds happiness on dialysis days. She treasures the interactions with the nurses and fellow patients, often affectionately referred to as "makcik," describing it as a delightful experience, exclaiming, "So fun la, to talk with these people." Engaging in the lively banter and shared experiences creates a sense of camaraderie, making the dialysis sessions more than just a medical routine.

Intriguingly, Ms Salina also enjoys the element of gossip during these moments, finding amusement in the stories shared by others. Each staff member and nurse, with their unique approach to patient care, adds a touch of individuality to the experience. Ms Salina appreciates their ability to understand patients, deftly handle procedures like needle removal, and engage in conversations that alleviate the potential monotony of the dialysis process.

  

Pictured: Different types of snacks and cookies home-baked by Ms Salina that she sells during Hari Raya.

Beyond her dialysis routine, Ms Salina finds solace and fulfilment in her passion for baking. This pastime takes a festive turn yearly, especially during Hari Raya where she takes in orders from patients and nurses at KDF. For this year’s Deepavali, one of the nurses at KDF also placed an order from her to support her home-based business. Ms Salina's baking repertoire includes a variety of flavours such as chocolate chips, cornflakes, and pineapple tarts. Her learning process involves online exploration, with YouTube being a significant source of inspiration. Running her home-based baking business for two years, Salina has developed a preference for baking over cooking, finding the intricate world of pastries and confections both fascinating and enjoyable.

Pictured: Ms Salina, posing with her mum and her 2 elder sisters in for a 2-day holiday in St Giles, Johor Bahru this year.

On the other hand, Ms Salina's mother, Mdm Sara is also a home-based seller, specialising in preparing and selling nasi goreng and mee goreng. Her day kicks off early at 2:30 am, diligently preparing the dishes until around 6 am where she heads to a shop located opposite Bukit Gombak MRT station. After her morning business routine, she would visit the market, return home for some rest, and then wake up around 10 am to prepare lunch for Ms Salina and herself. The home-based nature of her business provides Mdm Sara with flexibility and it allows her to stay active despite her age.

As Ms Salina approaches the milestone of turning 40 next year, she expressed an interest in venturing into the world of baking cakes. Recognising the uniqueness of cakes that demand a keen eye for details and elaborate decorations, she acknowledges the effort required in this culinary pursuit. To embark on this new journey, Ms Salina plans to start with the basics, opting for the simplicity of sponge cakes before delving into more intricate and challenging creations. With a target in mind, she aspires to showcase her baking skills before the next Hari Raya.

In reflecting on her journey with kidney disease, Ms Salina wants to share a motivational message for fellow patients: "I've come to realize that, regardless of whatever sickness you face, it should be seen as a small test—a challenge that you can overcome. Dwelling on it or continuously crying about it won't make the sickness disappear. While adopting this mindset might be easier said than done, I genuinely believe it is crucial to navigate life's challenges.”

Ms Salina's journey, marked by resilience and a spirited determination, serves as an inspiring testament to the strength of the human spirit in the face of chronic illness. Her unwavering courage, supported by the love of her family and the community around her, paints a vivid picture of triumph over adversity. As we delve into Salina's narrative, it becomes apparent that support in various forms, including donations in kind, can play a pivotal role in enhancing the quality of life for individuals grappling with chronic conditions. Whether it's through medical resources, financial assistance, or emotional support, every contribution can make a significant impact. By extending a helping hand, we can collectively contribute to creating a more supportive and compassionate environment for kidney patients like Ms Salina, to fight against the demands of kidney disease.