Wholly aligned, wholly alive

There’s no doubt that some kidney patients, faced with the diagnosis of chronic kidney disease (CKD) discover a hitherto untapped inner strength which motivates them to carve out a new and productive life for themselves. 42-year-old yoga teacher and nutritionist Ciara Roberts (below) is one such woman.

Ciara explains, “Our capacity to heal is extraordinary. I was lucky enough, in my childhood in South Africa to be looked after by an amazing doctor who emphasised the importance of wholesome nutrition and good hydration in optimising mental and physical health."

Ciara’s mother was also a firm believer in natural health and knew that she too could play an important role in managing Ciara’s CKD. She ensured her young daughter ate home-grown fruit and vegetables and food cooked with very little sugar or salt. Ciara also spent many hours playing in the fresh air and sunshine.

But when Ciara was 11 she was sent to Ireland to attend boarding school. The idyll was over and rigid school schedules and stodgy canteen food soon saw Ciara’s kidney function plummet, exacerbated by feelings of loneliness and loss. After her family returned to England at 14 and with a kidney function of less than 15%, Ciara commenced haemodialysis (HD). Not wishing to put herself through what she perceived to be the terrifying ordeal of a transplant she reconciled herself to a life on dialysis, believing she could and would ‘heal’ her CKD and get better one day.

She continued HD for seven years. The inner strength cultivated in her by her mother and her South African nephrologist had set her up mentally to 'just get on with life' around her dialysis schedule. Now self-caring at home she dialysed through her years studying at school, college, and university.

At 17 Ciara re-evaluated her view of transplantation and was placed on the UK Transplant Waiting list. Four years later she was called into Oxford for her kidney transplant.

"One of the things the transplant did for me was open up the world of travel and I took time out to travel the world."

Some patients carry what is called the 'tolerance gene'. This means they have no, or a much-reduced need to artificially suppress their natural immune system so that it does not recognise a transplanted organ that is not 'self'. Obviously, this very small group of patients is of great interest to researchers tasked with discovering ways to minimise the sometimes adverse side-effects of our powerful immune-suppressing drugs. Ciara was part of this trial after ceasing all drugs in order to determine if she had the markers for tolerance*. This was following seven years on monotherapy (ciclosporin) and two years completely drug free.

*Warning: Do not alter the dose of, or stop taking prescribed medication, or start any alternative, complementary, herbal, or over-the-counter treatment or therapy, without full consultation with your nephrologist and medical team. Doing so if you have chronic kidney disease can be risky and, if you have a functioning transplant, could result in your transplant failing.

A bout of the flu and sepsis triggered more serious medical problems for Ciara. Soon her blood pressure and creatinine levels were rising and proteinuria (protein in the urine) diagnosed, with no immediate signs of abating. Her transplanted kidney was struggling.

Ciara decided that this was the right moment to call time on her frenetic life in the City of London given her change in kidney function. So, on the crest of a wave of good will she left the City life behind and turned her mind, energy and the experience she had gained over almost two decades to building a life and career around her real passion - nutrition and yoga.

Her chosen method of dialysis this time has been (nocturnal) automatic peritoneal dialysis (APD), which frees up the days for her one-to-one private yoga and nutrition classes and her group yoga classes for her extensive list of corporate clients. Her PD catheter does not hinder her yoga practice, which ensures Ciara remains at peak cardiovascular health in preparation for her second transplant.

And her business expands further,

"In February 2018, I became involved in what is called 'social prescribing'. There is now, finally a much-needed shift towards focusing on community engagement to help heal some of the deeply-embedded societal issues we face around social isolation, depression, and hopelessness.

Her work with the NHS is in its infancy and is now widening to addressing the health of medics. Yoga classes and raising an awareness of the importance of good nutrition and an uncluttered mind will, Ciara believes, improve the mental and physical health of a nation... one stretch at a time.

NOTE: This article was first published in August 2019 in Issue 6 of our Kidney Matters magazine