A hope and a hero

For most Arkansans, Dec. 10 will be like any other Wednesday in the heart of holiday shopping season -- busy malls, gift wrapping, office parties -- nothing particularly out of the ordinary.

But for two local men, it will be the beginning of some drastic changes.

At 5 a.m. that day, both will check into the University of Arkansas Medical Center in Little Rock for a life-changing operation. Brian Smothers, 25, will donate one of his kidneys to 19-year-old Hunter Phifer. The two men have met twice.

Smothers became aware of Phifer's life-and-death struggle this summer when he was picking up his daughter from daycare. Phifer's mother, Amber Atwood, had been watching 2-year-old Emory several days a week while Smothers and partner Stephanie Olson established themselves in a city new to both of them.

"I found out about Hunter's illness pretty early," Smothers said. "They were trying to find a donor. Family members were going through tests, but those were not working out."

Several members of Phifer's family, including both of his grandmothers, had gone through the lengthy and sometimes painful process of donation evaluation. Both were ruled unable to donate due to their own health issues.

Defeated, the family went back to waiting, simply hoping an anonymous good citizen or deceased organ donor would make a viable kidney available.

"We never lost hope," Atwood said. "We knew he would get a new kidney; we didn't know when. We were completely surprised when Brian said he was a match."

Smothers decided to try for donation after meeting Phifer this summer, he said. Smothers watched the 19-year-old run around with Emory in Atwood's backyard and felt an overwhelming desire to help.

"I thought to myself, what would I do if it were my child suffering?," Smothers said with tears in his eyes. "The decision came so easily. I knew I wanted to try to help him. It's what I would want someone to do for my daughter."

Smothers began the long process of testing on Aug. 28, Phifer's 19th birthday. By October, Smothers was ready to tell Phifer and his family the good news.

"He didn't even tell us he was going to get tested," Atwood said, remembering that Oct. 6 evening. "He sat down in our living room and said 'I have something to tell you.' I had no idea -- and then we were talking dates for surgery."

In December, Smothers will save Phifer's life. But it will come at a price.

Hunter's hero

Brian Smothers is new to Northwest Arkansas. The Glenwood native moved with Olson and their daughter in May.

"We have family here," Smothers said. "And we've liked this area. It seemed like a good move for our family."

But it wasn't easy for the couple to get settled in Springdale. Although Olson quickly found a job with the city, Smothers wasn't as lucky.

He had dealt cards professionally in Hot Springs with a company that also employed Olson, he said. "I really enjoyed doing that, and I brought in some good money. That's how Stephanie and I met. But there isn't a place for me to do that here."

Smothers works nights waiting tables at Houlihan's in Rogers to support his family and looks forward to possibly starting classes at NorthWest Arkansas Community College.

Although he said he is comfortable with the idea of giving a new life to Phifer, his first concerns rested with the safety of his family.

Kidney disease can strike any person at any time, and that doesn't exclude Smothers' daughter.

"I asked a lot of questions about how this could impact Emory," he said. "If she were to need a new kidney someday, I wouldn't have one to give her. But the doctors assured me that I would be no closer to a match for her than a stranger. So there was no reason in my mind to not do this."

But despite his relief, family and friends voiced concerns for the financial impact his donation will cause.

"The first thing I thought was how much money this must have cost them -- just to go down and do the testing," Atwood said. "Had I known they were doing this, we would have helped. That's what our fundraising has been for. For this miracle."

Smothers will miss six weeks of work, he said. Expenses such as lost wages, travel, further treatment and some follow-up expenses will not be covered. However, the cost to the family will be alleviated by sick leave, Atwood's fundraising and Phifer's insurance.

"I don't have a large amount of money that I can contribute to a charity or to someone in need," he said. "This seems to be the way I can help. So I am."

A new life

Hunter Phifer looks like he feels better.

It's been five months since his last visit to the newspaper office, and the 19-year-old looks tanned, muscular and still-dimple cheeked. He smiles broadly under a wool cap and sun glasses. The young man has been busy.

He's graduated from Rogers High School, dated, traveled across the country, stayed out too late with friends and enrolled in college at NWAAC.

And he's started nightly dialysis.

Phifer has end-stage renal disease. In fact, he has no kidney function at all. In order to survive, the college freshman must hook himself up to a medical device which pumps a special solution into him, filtering it in place of a working kidney. It makes him feel better, but it's far from an adequate solution for the active teen.

"I have a tube that goes into the port in my stomach," Phifer said, pointing to his belt line. "I usually plug myself into it around 10 and get in bed. The cord is long enough that I can get to the bathroom and few other rooms. I can't stay at my dad's place because my room isn't close enough to the bathroom. I'm really limited in what I can do."

Every night, Phifer goes through peritoneal dialysis. One year ago, a small catheter was inserted into his belly, creating a access point to for the fluid. As he sleeps, fluid pumps into his abdomen, filling it with up to 6 pounds of fluid, he said.

"I can watch my stomach expand as the fluid is going in," he said. "Or watch as it goes down as it all drains. I can gain or lose six pounds of water weight a day because of the dialysis."

As the dialysis solution, called dialysate, fills the abdomen, extra fluid and waste products are drawn out of the blood and into the solution. The solution is then pumped out by a special machine called a cycler. The process is repeated every hour and a half throughout the night.

"I could go to college with this machine, but it would be difficult to live in the dorms and have a roommate," Phifer said with a bit of a laugh. "He'd have to be OK with the noise of the machine and not shut the tubing in the door."

Although dialysis is making Phifer feel better, it's not a permanent solution. According to the National Kidney Foundation, as his body adapts to the dialysate, the treatments become less effective. Some patients are able to survive 30 to 35 years on dialysis, but the average is between 10 and 15 years.

"We'll get the last package of solution on Nov. 7 for the last month of dialysis," Phifer said. "Because of Brian, I'm not going to need any more shipments again."

Looking ahead

The December 10 surgery is part of what the National Kidney Foundation calls a living kidney donation.

Living donation differs from typical donation in two simple ways. First, the kidney is donated from a living person, as opposed to an individual who has died recently. Second, the kidneys are typically better received, leading to lower chances of rejection, according to the foundation.

However, unlike typical organ donation, with living donation there are two patients.

Early that morning, Brian Smothers will be prepared for a laparoscopic surgery that is expected to last anywhere from three to five hours, he said. Although the incisions will be small, the young father can expect to spend up to a week in the hospital, require two weeks of near-bed rest and must not lift his little girl for six weeks.

As with any surgery, Smothers is accepting several possible life-threatening risks.

According to the John Hopkins Comprehensive Transplant Center, living kidney donors are more likely to have high blood pressure and reduced kidney function after the surgery, which can lead to severe health conditions years later. Odds of life-ending complications are low but still possible at one in 10,0000.

At 25, Smothers is not worried. But his partner, Olson is concerned.

"He will be out of work for quite some time, and the recovery will be hard on him," Olson said. "But he's very healthy. And I have some vacation time, and our family will be here for Christmas, so we will be able to take care of him."

Despite her concern, Olson supports her partner's decision to go ahead with the surgery, and like all others involved, feels an awe and gratitude for what Smothers is doing for Phifer.

"I am so proud of him," she said with tears. "He's always looking for ways to help others, and this seems to be just another way for him to do that. What he is doing is truly amazing. He's amazing."

Atwood agrees.

"How do you thank someone for this?" she asked. "I mean, I can't thank them enough. I can't thank Brian enough for giving my son his life back."

Although to outsiders, giving up a kidney to a stranger may seem like an extreme decision, for Smothers, it was as simple as donating a dollar.

"I can," Smothers said matter-of-factly. "So I should."