When most farmers finish their day’s work, they come home, have dinner with their family, watch TV, do paperwork, catch up on reading their Delta Farm Press – the normal things most of us take for granted.
When Floyd Holmes comes home, he has dinner with his wife and daughter, relaxes for a little while and then goes in his bedroom and plugs himself into his dialysis machine. He’ll sleep there until 6 the next morning when he gets up and prepares for his day on the farm.
Floyd Holmes would be the first to tell you he’s not complaining or asking for sympathy. He is grateful he has equipment that allows him to do dialysis at home and continue farming the 1,800 acres of rice, soybeans and wheat on land he owns and rents near Turrell, a few miles north of Marion, Ark.
For the third generation farmer, the nightly dialysis sessions have been a fact of life since January. And they will continue to be until Holmes and his wife, Reena, receive a call from the Kidney Transplant Center in Memphis, Tenn., telling him he has two hours to report to receive his new kidney.
The couple spoke with an editor for Delta Farm Press because they want to help raise awareness about kidney disease and the transplant process. Currently, there are more than 100,000 persons in the U.S. waiting for that call that will change their lives.
Holmes began farming in 1985 when his father retired and turned over the 700 acres he was tilling to the younger Holmes. (Ethyl Holmes, Floyd’s father, then opened a barbecue restaurant and worked another 15 years before retiring again.)
Helped his Dad
“I just kind of grew into it,” says Floyd. “It’s all I’ve ever done. I helped my Dad when he was farming, and, when he decided to retire, I took over his operation.”
Floyd Holmes continued to build on what his grandfather had started years ago. At one time, Floyd was farming 2,100 acres of rice, corn, cotton, soybeans, wheat and grain sorghum. Like many Delta growers, he subsequently gave up cotton and now focuses on the remaining crops.
“Cotton became too expensive for me, and I didn’t have irrigation on the ground that was better suited for cotton,” he said.
This year he grew 360 acres of rice, 400 acres of wheat and the remainder of his farm was planted in soybeans. He was harvesting the soybeans when he sat down for an interview at his home near Turrell in late September.
In 2013, Holmes was diagnosed with kidney cancer. He underwent a nephrectomy in which doctors removed about 30 percent of his left kidney. “That’s when they warned us his kidneys were damaged, and he would probably have dialysis in his near future,” said Mrs. Holmes.
“I think it was a combination of the diabetes for 20 years and high blood pressure for half of those years,” Holmes says. “And then the kidney cancer on top of that, so it was a combination of all those things.”
Rare type of kidney cancer
“There are five types of kidney cancer, but Floyd had a rare type of kidney cancer, and the cancer was in a rare position,” says Reena Holmes, who her husband refers to as his “spokesperson” on medical issues. “When they went in and saw how damaged his kidney was, it was really important to save as much of his kidneys as possible and stave off the need for dialysis for as long as they could.”
The doctors initially predicted Holmes would have a five-year window before needing dialysis. “But we’re already here about three years out,” said Mrs. Holmes. “He started dialysis in January of this year.”
Holmes’ brother lives in Houston, so the couple went to the M.D. Anderson Cancer Center for treatment. Doctors there removed the portion of the kidney that was cancerous and followed him for two years.
“Now he’s being followed by local doctors here,” says Reena. “Last spring, a year ago, they began to notice his creatinine levels had begun to take a nosedive. So around March of last year, they began to tell us, again, that dialysis would be in our very near future.
“Through medicines and management and changing our eating habits we were able to stave it off until January when he actually began the treatment.”
They also began the pre-transplant screening process last summer (of 2015), “because we knew dialysis was in the future and that he would also really need a new kidney — and a donor,” she said. It took them nearly six months to complete it.
“When they start testing, you find other issues, and you have to get those resolved before they can proceed. They found a nodule on his thyroid that was suspicious for cancer. They weren’t able to definitively determine that it was cancerous or not before the surgery, so they removed his thyroid in December, right before Christmas. Fortunately, it came back testing benign.
“But during that period they withdrew him from consideration for the transplant because if you have an underlying cancer issue the anti-rejection medicines they give you suppress your immune system. So if you have cancer it causes cancers to grow.”
“It’s a rigorous process, and it’s funny in that you already have a bad issue with kidney disease, but they have to confirm that you’re healthy otherwise to be able to go through the surgery,” says Holmes. “But I guess it was a blessing in disguise, so to speak, because they said it could have gone bad at some point.”
Holmes undergoes dialysis every night. While some patients receive hemodialysis in which they go to a treatment center for several hours two or three times a week, Holmes uses peritoneal dialysis, in which a sterile cleansing fluid is put into the abdomen through a catheter. After the filtering process is finished, the fluid leaves the body through the catheter.
“It’s a nine-hour process that happens while I’m asleep,” says Holmes. “That’s why I chose that process. I don’t really work anymore, but I still manage the farm, and I have my days free. Then at night I hook up to the machine in my bedroom. All it is is dextrose, or sugar water, and it goes into the peritoneal cavity in your stomach. The sugar attracts the toxins, and the machine does the rest.”
While Holmes is grateful for the freedom to continue to farm, the process can have an impact on quality of life issues. His younger daughter, who is 14, plays in her high school band. Holmes cannot watch her play.
“Once I begin dialysis around 9 p.m., I can’t leave,” he says. “I have a 12-foot tube, which I call my ‘leash’ that allows me to move around the bedroom. The machine is heavy, and you don’t want to move it if you don’t have to.”
“Something happened to the equipment one night, and he came out of the bedroom into the hallway,” says Reena. “My baby, our younger daughter, said she thought she was seeing a ghost because we never see him out of the bedroom at night.”
Holmes says he is grateful that he has good employees who work with him. “Sometimes we have to quit early so I can get home and get ready to hook up,” says Holmes. “But they’re willing to work with me.”
His neighbors have also helped with planting and harvesting to make sure he got his crops out this fall.
In early September, friends and neighbors held a walk-a-thon at the local school to raise money toward the $25,000 that all potential transplant patients must have before they can continue in the program. They exceeded their goal, according to Franklin Fogelman, who farms in the area in Crittenden County.
“Floyd is an inspiration to us,” says Fogelman, who is also one of Holmes’ landlords. “You can imagine the battle. My day is tough enough, but I am not fighting for my health at the same time.”
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