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A promise, a gift,  a trek to recovery

When Julie Engle reached the top of Mount Monadnock on the afternoon of Oct. 13, she cried.

Engle cried because reaching the summit of that mountain marked the completion of a pact that began more than two years ago when she was in the transplant ward of Beth Israel Deaconess Medical Center in Boston. She was one of eight to make the trip up the Dublin Trail that Saturday.

But for Engle — who has lived in Peterborough for almost eight years since her husband, John, became the pastor at Trinity Evangelical Church in Peterborough — only one person in that group was responsible for her climbing the mountain and that was Nancy Kemmis of Jaffrey. That’s because Kemmis is the one she made the pact with in 2010. Kemmis is also the one who donated Engle one of her kidneys.

“You don’t realize how sick you were until you feel better,” said Engle.

When Engle was 13, a strep infection caused irreparable damage to her kidneys. After a short time of recovery, Engle returned to school and her normal activities. She went through high school and the nursing program at Fairfield University in Connecticut and never saw any effects of the damage until her mid-20s. As the head nurse at Mary Hitchcock Hospital in Hanover, Engle’s blood pressure began to go up. Thinking it was stress related, there was never any thought it would lead to kidney failure.

Engle went on to get married and raise three children, two girls and a boy, without any real problems. But that all changed in December 2007.

“That’s when the nephrologist said I was heading toward dialysis and a transplant,” said Engle.

She was fatigued and short of breath, and her kidneys were beginning to fail. So the next step was to prepare for dialysis. It would be three days a week at 3 1/2 hours a time, but a necessary step to keep her feeling at her best until a kidney became available for transplant.

And then her daughter, Rebecca, stepped forward. They share the same O blood type and Rebecca had gone through the yearlong process and passed all the tests that study a person’s physical and psychological well-being and most importantly, their blood.

“She was a good match,” said Engle. “It wasn’t a perfect match because nobody’s a perfect match unless you’re a twin.”

In August 2008, Rebecca donated one of her kidneys to her mom. The next day, Engle’s body rejected it.

“I don’t think I even totally woke up from the anesthesia from the day before when they were taking me back in for surgery,” said Engle.

She was back to square one. It was dialysis again for Engle, and periods of time when she just didn’t feel right. The following March, Engle’s lungs filled up with fluid and she had to be med-flighted to Catholic Medical Center in Manchester. Her condition was worsening.

“That showed people I really needed a kidney,” said Engle.

The climb

It was a hike that would typically take about three hours round trip, but on that October day it took the group 10. Nobody seemed to care. It was something more than two years in the making and Engle was bound and determined to reach the top.

In the days following the transplant, Engle walked into Kemmis’ hospital room and that is when the plan was devised. Kemmis is an avid hiker, making her way up Mount Monadnock almost every week for the previous six years. Engle thought it would only be right to allow Kemmis’ kidney to return to the summit.

“This kidney inside of me was inside [Kemmis] and it went up every week, and it needed to go back up,” said Engle.

About three months following surgery, Kemmis returned to her weekly climb. For Engle, though, it was a long road before she could even think about going home, let alone hike a mountain. She and John had climbed mountains when they were dating, but that was many years ago and well before all the complications.

In the spring, Engle began preparing for the climb. She climbed Pack Monadnock three times, Mount Watatic once and was walking three days a week.

“She had a long way to go before she could go up that mountain,” said Kemmis. “It was just a huge, huge thing for her to do. We got to the top and it was such a delight.”

The original date for the trip was Sept. 29, but bad weather postponed it another two weeks. On that Saturday morning, Engle did not know who was going to show up at Trinity for the climb. It had been posted on the church bulletin for anyone interested to meet at 8:30 a.m. To her surprise, five others joined her, Kemmis and John.

The hike began around 9:15 a.m. and it wasn’t easy. The group stopped about a quarter of the way from the top for lunch and that was after Kemmis would have already been back down the mountain. But Engle, despite the difficulties of the climb and everyone saying they could turn around, was not going to stop until she made it to the top.

“I said, ‘No. I have to go all the way,’” said Engle.

And at about 2:30 p.m., Engle reached the summit of Mount Monadnock. She and the rest of the group only spent about 45 minutes there, but is was more about the journey she had taken to get there. She even left a wooden angel in a crevice of rock to signify her accomplishment.

“I cried because I look back and remember I was in bed so weak, and two years later here I am on top of the mountain,” said Engle.

The church

Trinity was not Kemmis’ regular church, but she had been going through some tough times and she needed a change. She was welcomed at Trinity and it just felt right for her to attend services.

One Sunday, there was an announcement that Engle had gone into kidney failure and needed dialysis. Right around that time, Kemmis had given blood and after a conversation with John, she realized her blood matched Engle’s.

“My first thought was, ‘I could give a kidney,’” said Kemmis.

A little time later, while listening to NPR, Kemmis heard a program about organ donation and really began thinking about it. Then another Sunday, she went back to John and told him she would be willing to go through the steps to donate a kidney. But she didn’t hear much about it after that. Later, she learned that many people had offered without a lot of follow through.

“I realized how hard it was for the position John and Julie were in,” said Kemmis. “How do you ask for someone to give up a part of their body? I can’t imagine being in that position to ask someone for that.”

So one day, Kemmis wrote Engle a letter.

“I told her I’m going to give someone a kidney and you might as well have first whack at it,” said Kemmis.

Both women are very religious. And both believe it was their faith that brought them together. Kemmis was reading through the Bible and came across a scripture on John the Baptist. In essence, it read that those with two of something should share with neighbors who have none. That was when she made her decision. If it was possible, Kemmis would donate a kidney.

“You just put your faith into action,” said Kemmis. “I had two kidneys and my neighbor had none.”

So the two met one morning for breakfast at Nonie’s. Engle discussed what would be involved and how the first transplanted kidney had been rejected.

“I said, ‘Lets just start the process and see what happens,’” said Kemmis.

The surgery

After the breakfast meeting, Kemmis made a call to the transplant floor at Beth Israel. And thus the year of testing began. With each test passed, Engle got closer to a new life. But throughout the year, Engle didn’t want to be updated because she didn’t want to be disappointed if it didn’t work out.

“There are a myriad of things that have to work,” said Kemmis. “Each test was like a little hurdle. They’re looking over every aspect of your health.”

And when Kemmis got the news that she was a viable donor, the surgery was scheduled for July 2010.

Engle’s nephrologist, Martha Pavlakis, had created a medical plan to ensure Engle’s body would not reject the new kidney. She received new plasma and treatment for one antibody that could have posed a problem after the surgery.

For Kemmis, this was something all new. She had never had surgery before. The only time she had spent the night in the hospital was after giving birth.

The surgery, performed by Dr. Seth Karp, lasted about seven hours and there were little issues during it.

Kemmis, who didn’t have insurance at the time, and Engle, who was on disability from her job at Crotched Mountain Rehabilitation Center, didn’t have to pay a dime for the surgery, hospital stay or anything leading up to it. Medicare took care of the bills, as it does for all kidney transplants.

“I couldn’t afford a transplant, if Medicare didn’t pay for it,” said Engle.

Following surgery, Kemmis was in the hospital for just a couple of days, but for Engle it would get worse before it got better.

The recovery

Kemmis was told it would be three to six weeks for recovery. She was a little sore and couldn’t go back to work for a while, but really there were no issues. Within three weeks, she out walking around her neighborhood.

Most kidney recipients are in the hospital for about five days. Engle spent eight weeks, including six days in the intensive care unit, and another two weeks in a rehab facility.

“There were times, I just wanted to jump out of a window because I was in so much pain,” she said “There were many complications.”

A few days after surgery, Engle’s new kidney shut down and it didn’t resume normal functions for about six weeks. During that time, Kemmis visited Engle. Engle went through another surgery while at Beth Israel and a third in May 2011.

“It was my faith in God that got me through everything,” said Engle. “It wasn’t an easy road.”

Once the kidney began working, Engle could finally begin her long journey to recovery. For a year and a half, Engle concentrated on getting healthy and eventually got back to feeling normal.

“She was so sick. She was knocking on death’s door,” said Kemmis.

Today

About four years ago, Kemmis held her first grandchild. At that time, she thought about Engle and whether or not she would live long enough to see her firstborn grandchild.

Now, Engle has two on the way and because of Kemmis’ gift she will get to hold them. There are no real signs that the two women are just a little more than two years removed from major surgery. Kemmis has two small incisions and one less kidney. Engle now has three kidneys and a new lease on life.

“It’s so hard to express to someone how grateful you are,” said Engle. “There’s no way you can thank a person enough for giving you life.”

Engle is now doing a home study for her registered nurse reentry program after five years out of work, while Kemmis still hikes Monadnock just about every week. She has no residual effects, she said.

“If it’s the right thing to do, then you should do it. It’s a few weeks out of your life and some pain, but it’s a big deal for Julie to feel she can live her life again,” said Kemmis.

Kemmis does not think she did anything special. She did what she thought was right. Kemmis has since gone back to her own church and doesn’t make it to Trinity all too often. But she believes she was sent there for a reason and that was to help someone in need.

But for Engle, it means everything because, if not for the generosity of Kemmis, she might not be here today.

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