Transplant recipient paying it forward

The dictionary says that an experienced and trusted advisor is a mentor and accordingly, resident Bob Silvera, 63, is just that for individuals contemplating a kidney transplant.

A recipient himself, his road has been a medical odyssey.

“It started 25 years ago with a heart issue,” he said recently. “It was a blocked artery. I did not eat well or exercise and was overweight.”

A middle school principal in Belleville in June 1999, he did not feel well one Friday. The headache went away, but on Monday a Verona medicenter sent him to the hospital.

“I was diagnosed with diabetes, blocked arteries and high blood pressure,” he said. “My wife was pregnant, we had another child of five and were supposed to go to California. I wanted to go, but I trust hospitals.”

His blood glucose was 400-500. Normal is 70-120. His heart was checked.

“They go into the groin for this,” he said. “They give you a dye and you watch a screen and I saw that it was blocked. Just enough to put in stents. They wouldn’t let me go home and started rehab at Mountainside Hospital.”

Silvera said Phase I of the program was his hospital stay. Phase II was bike and treadmill exercise, hooked-up to meters checking heart rate and blood pressure.

“I did it before school,” he said. “Insurance covered 38-45 weeks. Phase III and IV were not mandatory or covered. Phase III was $88 a month, but worth it. There was free valet parking. Phase IV was the same, but no monitoring.”

He started insulin in January of 2000 and was getting healthy and even ran a half-marathon. But, he said, life catches up and he gained a little weight. He stopped seeing an endocrinologist, but his cardiologist told him to see one. Silvera did and was informed his kidneys were failing.

“In 2016 I was told to consider dialysis over the next one to one-and-a-half years,” he said. “At this time, I got my dream job as an elementary school principal.”

But Silvera’s kidneys began to fail quickly and he began dialysis Nov. 2017. His legs were swelling and seeping fluid. The pain was wicked and he could not sleep.

“There are two types of dialysis,” he said. “There’s peritoneal dialysis which is done at home or hemodialysis which is done at a clinic. In peritoneal dialysis, a catheter goes into the lining of your stomach. It’s attached to a bag of fluid called dialysate.”

Silvera said this fluid is pumped in. When it drains out, there should be more than went in. He did this four times a day, sometimes in his school office where he would talk about it to students and parents.

“The parents knew I was sick, but I wanted them to know I was present and would still be there,” he said.

After 10 days, he was able to sleep again. He called his nurse and cried because the treatment was working.

In 2018, he had triple-bypass surgery and the peritoneal catheter insertion became infected. Another catheter was inserted into his heart. It was supposed to be temporary, but the other side of his stomach was unsatisfactory for a catheter. He was now doing hemodialysis in a clinic three times a week. The blood would come out, be cleaned and returned to the heart.

“You have to be so careful,” he said. “It’s based on your weight. It’s so bad for your heart, your body.”

Silvera felt fine when the pandemic began, but was immuno-compromised and decided to retire in November of 2020. He began to experience exhaustion and nausea, symptoms of dialysis fatigue syndrome and was hospitalized.

“I didn’t know what it was,” he said. “My red blood cell count went down.”

In February of 2021, he learned a heart bypass was blocked. He had another bypass that spring. Nurses would come to him to see how dialysis worked.

“When you go on dialysis, you can get on a list for a kidney transplant,” he continued. “You have to wait. I waited five years and 10 days.”

On Dec. 3, 2022, he learned a kidney was available and burst into tears. He also learned the donor was a 22-year-old New England woman shot by her boyfriend.

“They don’t take out your old kidneys,” he said. “My new kidney is placed in the front, on the right side of my groin.”

He takes 30 pills a day and says the medical part of his life has taken over, but that is OK because before he would get so sick.

He was contacted by Quality Insights, a health care service, and asked to be a mentor to potential kidney recipients at the Fresenius Dialysis Center, in Belleville. Silvera signed on for two reasons. He wanted to demystify dialysis.

“Our mission is to discuss with people home dialysis and being on a transplant list,” he said. “You have a better success rate at home than in a center. People can hear it from a doctor, but it’s better hearing it from someone sitting across from them. And this is my way of giving back to that woman who died. Now I have a life.”

  Glen Ridge, kidney transplant