Chapter 9 (continued): What I learn about uremia

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Before I move on to Emmett’s funeral record, I thought I’d share what exactly I learned about the listed cause of Emmett’s death. I don’t want to leave the impression I just ‘Googled’ uremia and took the first hit and ran with it — no.

I didn’t become an expert on the illness, but I spent a least a week digging into the topic, particularly how it was treated in the early 1900s, interviewed kidney specialists, visited the library at the National Institutes of Health (which is only a bike ride away from my office — and ANYONE can go there to do research, by the way!) to check sources, and so forth — if Emmett died of this disease, what did that mean, exactly? What was it like in 1918?

Uremia (chronic kidney failure). At the time Emmett died, it was five years before there was any dialysis done on human beings — and the first actual example of dialysis on humans took place in Germany, by the way, in the mid-1920s. Interestingly, doctors were monitoring blood pressure in patients, but not was linking kidney failure to the more common underlying causes that we know today (diabetes or hypertension), either of which Emmett could have had at the time.

And again, Emmett could have had an accident that caused physical damage to a kidney — he played sports, and you know there was very little protective equipment provided back then (such as we have today). So, there’s that.

I went back to Donna the Nephrologist to ask about what might have been happening with Emmett if there was chronic kidney failure.

Donna said the symptoms would have crept up on Emmett gradually.  “So, what likely happened was he started feeling generally unwell. Uremia manifests itself quietly, much like colon cancer, where the individual goes for years without any symptoms. The first major symptom is massive headache that lasts for days and/or weeks, unrelentingly.”

The other symptoms of uremia are vomiting, loss of appetite/energy, sleeplessness/restless leg syndrome (“his legs might have twitched, while he was awake or asleep,”) a terrible itching, and a metallic taste in the mouth, then paranoia and psychosis, all of which can coalesce fairly rapidly, she said.

“The thing is, when these symptoms happen at this level, the disease is in the fourth stage (the fifth stage is considered terminal).”

I showed Donna this article, (which I shared in yesterday’s post):

Rheumatism. Really? Source: Ocala Banner, Dec 22, 1914.

The article from 1914 showing he had uremic poisoning and it was so critical his family had to come up from Pensacola for him.

“Right after this, I know that Emmett left Washington for about 10-12 weeks, and was given a general excuse from his duties in Congress. Honestly, I don’t think he was ever the same after that,” I told Donna.

She agreed. “The prognosis for uremia was not good. Kidneys had a way of ‘adjusting’ to the damage done, but ultimately, uremia can kill.”

“So, he died of the same disease in 1918. We can see that the same symptoms probably came back and when they did, doctors advised him that that generally indicated the end was near, right?” I asked.

“Right,” Donna said.

The answer, then, lies in what caused the uremia in the first place, I said. “Let’s say the original cause was an injury, which led to the initial kidney failure….”

“…he could have had another accident, which again impacted the kidney,” Donna replied. “So, you’ll need to find out what that initial cause was, if perhaps it was something he could have avoided, you see.”

===

Another mystery to track down! Emmett’s story is definitely intriguing.

More to come.

 

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