Meet NKF’s longest-surviving patient

Richard Tay refuses to let tragedy, hardship and incredible odds beat him down. (Yahoo! Photo)

Under our new "Inspiring People" monthly column, we highlight the incredible journey of one person who has overcome tremendous odds to achieve personal success. This column celebrates the triumph of the human spirit and we hope it will inspire you to reach for your dreams too. For our first story, meet the National Kidney Foundation's longest-surviving patient, Richard Tay, 49, who has been undergoing dialysis treatment for 30 years with no hope of a transplant.

Tay's life has been marked by trial after trial from birth to adulthood.

Born with spina bifida, a birth defect involving the incomplete development of the spinal cord or its covering, Tay developed a stricture, or narrowing, along his urethra when he was just a few months old.

At just 10 months, he suffered from urine retention and was hospitalised as doctors tried to drain the urine from his bladder. After spending the first six years of his life in the hospital, he was finally discharged to attend school.

After an operation in the 60s left him unable to control when he would urinate, Tay would take with him extra pants for the embarrassing moments when he would wet himself at school.

His early experience in school was "traumatic." His peers shunned him because of the "urine smell" and he was slow in catching up with the other students who had the benefit of attending kindergarten. "I didn't know A-B-C or 1-2-3," he recalled.

But with the support of his teachers, he buckled down to study and topped the class in Primary Two. That helped him make friends too, when classmates approached him for help with schoolwork.

While school got better, his medical condition worsened. At 15, his face started swelling from water retention. A general practitioner said his kidneys were not working well and sent him to Singapore General Hospital, where he was put on antibiotics.

By the time Tay was in his third year in polytechnic, his doctor delivered the news that would change his life: His kidneys had failed.  At the age of 19, Tay would need dialysis kidney treatment for the rest of his life.

Unlike many others, a kidney transplant is not an option because his narrowed urethra means that urine will still flow backwards and infect a new kidney.

The young man, however, refused to accept that dialysis treatment was the only way out.

He left the hospital and started preparing for his final examination, which was in nine days. After his last paper, Tay fell unconscious for a few days because of the toxic build-up in his body.

His mother, the sole caregiver after his father passed away when he was 12, was frantic. She put him on a process of adding fluid into the abdominal cavity that would help absorb waste products and toxins.

During Continuous Ambulatory Peritoneal Dialysis, the fluid is drained out and replaced with fresh fluids. This daily procedure is performed by the patient, four or five times each day.

For the next five years, Tay underwent this dialysis every four-hours at home. In between, he tutored students. "It was quite tiring, but I had no choice," he said. "I couldn't sit idling at home. We were not well off."

To make matters worse, he couldn't find a job and faced bitter rejection by employers because of his illness. He was so angry he tore up his diploma certificate.

In 1983, Tay took his brother's suggestion and set up a company, Equip Medical, which as the name suggests, sold medical equipment.

Making the best of a bad situation, he started off by selling dialysis products.

Now, the company -- with a logo in the shape of two kidneys —- has 50 staff, with branches in Thailand, Malaysia, and possibly soon in Vietnam. They have also branched out to sell mother and baby products. The company is doing well with an annual turnover of about $10 million.

'I need to be independent'

In 1985, Tay started on hemodialysis, wherein the blood is circulated continuously through a machine that filters and removes waste and fluid.

At that time, another person had to be present to help with the procedure, a responsibility that Tay wouldn't accept. "This is going to be long-term and I cannot it impose on somebody," he said. "I had to do it myself."

His doctor relented and Tay became NKF's first patient to go through hemodialysis by himself, paving the way for others.

Tay also declined financial support from his 11 siblings, believing it would be an unfair burden on them. He pays more than $700 a month for dialysis and NKF subsidises more than $1,000.

"Even though I am on dialysis, I always tell myself I have to, and need to, be independent," he said. "Nobody's going to help you for life."

While he understands the mental anguish (he went through stages of denial), Tay urged patients on dialysis to think positive and not "indulge in self-pity."

"What keeps me going is my work commitments, and I try to live as normal as possible," he said. His thrice weekly, five-hour dialysis sessions at the NKF's Clementi branch is now part of his daily routine.

Over the weekends, Tay works for half a day to make up for the time he spends in dialysis. He also swims, takes walks, plays mahjong or bowls.

Even though he is self-reliant, he emphasises the importance of family support. Tay, who is single, lives with his bed-ridden mother, who's in her 90s. "Now, I have to take care of her," he said.

But what of the future?

In Singapore, the average survival for a patient on dialysis is seven years; 60 to 80 percent have hypertension and nearly 50 percent have diabetes. Given those odds, Tay, who does not have any secondary condition, has crossed a significant milestone.

"For Richard to have beaten the odds, it must have been because he received good quality dialysis," said Prof A. Vathsala, who leads the nephrology division at the National University Hospital. "He (must also have been) a very good patient who lived a regimented life controlling his fluid, salt and phosphate intake."

But much of Tay's success is also attributed to his personality -- and his indomitable spirit to keep fighting despite the odds.

"In life there are ups and downs," he said. "If everything goes smoothly, that is not life."