Around the World with Nephrology

The following sections are included:

• Foreword

• Contents

My parents were children of farmers and devout Catholics. My father, Józef Twardowski, was born in Damienice, Bochnia County, Cikowice Parish, on February 1, 1900. His primary education started in Damienice. At that time, grade lasted one year; grade 2, one year; and grade 3, two years. Because he was an exceptional student, his teacher urged his parents to send him for further education to a better school in Bochnia. His mother and father agreed and he continued his primary education in a school there (Szkoła im. Kazimierza Brodzińskiego). He then attended high school in Bochnia, graduating in 1920. Shortly after his graduation, a war broke out between Poland and the newly established Soviet Union, and he volunteered in the Polish Army's cavalry division…

Medical school in Poland started immediately after high school graduation and lasted six years. Five years were devoted to lectures and study and the sixth to final exams and internships in internal medicine, surgery, pediatrics, and gynecology/obstetrics. At the time of my entrance into medical school, I was told that students with mostly “A” grades — and no “C” grades — would receive the so-called “Red Diploma,” or Diploma with Distinction, corresponding to summa cum laude (with highest praise) or cum eximia laude (with special praise). This kind of diploma was supposed to guarantee employment as a teaching assistant in any department of the Medical Academy. I thought that I would be able to achieve that if I studied hard enough…

My professional life began to be impacted by forces beyond my control. Firstly, I was told that I would be drafted for two years to serve in military medicine, the prospect of which did not thrill me, as it was to be very basic service for mostly healthy soldiers. As my medical studies would be interrupted for two years, I considered it to be a waste of my time. Przemek was dealing with the same problem. Around the same time, Doc. Hanicki told Przemek and me that the Ministry of Mining had decided to buy an artificial kidney, as they were disappointed with the treatment of miners with crush syndrome…

On September 1, 1976, I headed to Columbia, Mo., through New York and St. Louis. It was my first flight to another continent and I was a little apprehensive. I spoke and understood English, but with a mostly British accent, and I had difficulties understanding American speakers, especially over the phone. I stayed one night in St. Louis and took a Greyhound bus to Columbia in the morning. Dr. Nolph's secretary, Ms. Midge Kellerhaus, gave me a ride to Dr. Nolph's office…

After returning to Bytom, I contacted Prof. Wojtczak and the Rector of the Medical Academy in Lublin. My wife and I visited Lublin to see the apartment that was provided for us by the Medical Academy, and within a few days we moved in. There were a few setbacks related to our relocation to Lublin. During the move, I tried to lift a large table, suffered a prolapsed disc (L3/L4) and started experiencing pain with increased abdominal pressure, especially when coughing and with any movement associated with leaning forward. Another problem was that we had no friends in shops and kiosks in Lublin, and we had to wait in line for food, particularly meat, because of the supply problems in the communist system. I remember standing in line for about four hours to buy some ground meat. Toilet paper was not available in shops at all. I later heard that a chronic shortage of toilet paper is characteristic of any communist system, and nobody knows why. Our sons had to change schools, but they adjusted pretty quickly. Halina found employment as a senior assistant in the Department of Psychiatry. Gradually, we were able to function in Lublin, but it took us several months…

I came back to Columbia, Mo., in August 1981 and settled in, once again, at the Tiger Motor Hotel. During my absence, the outpatient hemodialysis center had been moved from TD4 to a new building on Walnut Street, which was part of Dialysis Clinic Inc., headquartered in Nashville, Tennessee, the clinic was cooperating with the University of Missouri Hospital. In addition to the hemodialysis center there was also an outpatient peritoneal dialysis center and a clinical laboratory. I began multiple projects in the laboratory located in the Veterans Administration Hospital and in the outpatient peritoneal dialysis unit of Dialysis Clinic Inc. It was a short walk to the laboratory in the VA Hospital, but the clinic on Walnut Street was about three miles from the Tiger Motor Hotel and even further from the University Hospital. I could not afford to buy a car, so I bought a bicycle instead. Cycling came with its own problems, however.

The following sections are included:

• Fellows

• Laboratory Visitors

• Nurses and Technicians

The following sections are included:

• Insulin Binding to Peritoneal Dialysis Bags

• Serositis in Renal Failure

• Polymers as Osmotic Agents in Peritoneal Dialysis

• High Volume Exchange Peritoneal Dialysis

• Intra-abdominal Pressure During Natural Activities in Patients with Intraperitoneal Fluid

• Peritoneal Equilibration Test

• Nightly Intermittent Peritoneal Dialysis

• Tidal Peritoneal Dialysis

The following sections are included:

• Alicja Balicka — Intrapericardial Corticosteroids for Uremic Pericarditis

• Maria Zieleniec-Madejska – Constant Site (Buttonhole) Method of Needle Insertion

• Mitzi Rosen – Nightly Intermittent Peritoneal Dialysis and Using Intraperitoneal Contrast to Diagnose Leak Sites

• Joe Brodhacker – Swan Neck Catheter

• Hugh Blattner — Daytime Ambulatory Peritoneal Dialysis

• Lucille Shirley — Daily Dialysis on a Personal Hemodialysis System

The following sections are included:

• Peritoneal Dialysis Catheters
  • Swan Neck catheter
  • Swan Neck presternal catheter

• Intravenous Catheters
  • Multiple lumen catheter for hemodialysis
  • Clot resistant multiple lumen catheter
  • Interference
  • Patient tailored catheter

• Home Hemodialysis Machine

The following sections are included:

• Constant Site (Buttonhole) Method of Needle Insertion into Arteriovenous Fistula

• Catheter Tunnel Morphology

• Exit Site Study
  • Healed exits [Pu 237, Pu 238]
  • Care and treatment recommendations
  • Exit site healing [Pu 239]

The following sections are included:

• Annual Dialysis Conference

• Presentations on Dialysis Related Topics all over the World — Many Combined with Visiting Places of Interest
  • 1981–1986
  • 1987
  • 1988
  • 1989
  • 1990
  • 1991
  • 1992
  • 1993
  • 1994
  • 1995
  • 1996
  • 1997
  • 1998
  • 1999
  • 2000
  • 2001
  • 2002
  • 2003
  • 2004
  • 2005
  • 2006
  • 2007
  • 2008
  • 2009
  • 2010
  • 2011

The following sections are included:

• 1989 — Kuźnica

• 1992 — Keystone

• 1993–1994 — Branson

• 1995 — Canada and Alaska tour and cruise

• 1996 — Trip with my brother, Lesław, through the American Midwest

• 1997–1999 — Retirement and apartment in Kraków

• 2000 — Great Britain and Ireland

• 2001 — Jurata, Gdañsk and Malbork; Father John Long in Kraków

• 2002 — Jurata, Slovakia and New York

• 2003 — Scandinavia, St. Petersburg and Estonia

• 2004 – Father Edvin Cole's Kraków visit and our Portugal tour

• 2005 — New England tour, Adam in Kraków, and our trip to Bismarck for Thanksgiving

• 2006 — Adam and Ania in Krakó0w, Zamość, Puławy

• 2007 — Crete, Peru tour

• 2008 — Adam and his friends in Kraków, touring London, our golden wedding anniversary, and a pilgrimage to Turkey

• 2009 — Ania's wedding in Minneapolis

• 2010 — Bieszczady

• 2011 — Adam and Gosia in Kraków, and a trip to Ukraine

The following sections are included:

• Epilogue

• Letters to the Editor

• Patents

• Publications

• Selected Abstracts

• Selected Presentations

• Videos

• Index