Thriving despite two kidney transplants: With limitless determination, Stanford physician conquers health challenges to compete in National Senior Games

STANFORD, Calif.— Growing up in Palo Alto, Randall Stafford often biked his way up and down the curving roads that wind through the hills of Santa Clara and San Mateo counties. He achieved his first long distance trek at the age of 13 when he made it all the way to Pescadero Beach, a round trip of 52 miles.

It was the first of many long distance solo bike rides and road races in which he would compete. This August, at the age of 50, Stafford will once again find himself biking through his hometown as a competitor in the 2009 National Senior Games—and as the survivor of two kidney transplants.

His cycling became a powerful therapy as he went through dialysis and then the transplants. And he established himself as a competitive cyclist. His experiences now drive his work as a physician at Stanford Hospital & Clinics Preventive Cardiology and Internal Medicine clinics, where he treats patients who have multiple chronic conditions such as high blood pressure, diabetes, and obesity.

Always on Stafford’s agent of patient advice is the value of exercise. “That I was able to do a 100-mile ride while on dialysis is indicative of the real value of physical activity,” he said. “Even people who have chronic diseases can benefit from exercise.”

Stafford credits his daily exercise as one reason he recovered so well from each transplant. He recalls the thrill of fresh air, sunshine and breezes, and the taste of freedom as he routinely logged 60 miles each week on his bike as a boy and then as a young man, building strength and stamina. Still fresh in his mind is the shock he felt, when at 24, doctors told him his kidneys were failing.

“I had no inkling that there was a problem with my kidneys until I had a pre-employment physical and lab tests for my first job after graduate school,” said Stafford. “I didn’t feel too bad but discovered I had about 30 percent of my kidney function left. After quite a bit of investigating, my doctors decided that I had been born with only one very small kidney and that it gradually failed.” His only option then was to begin dialysis, a grueling four-hour treatment three days a week in which waste, salt and extra water are removed from the blood.

The news came at a time when Stafford had just finished graduate school in public health and was starting a job as a health care policy analyst. In what would become his primary method of survival, he pushed himself to stay as active as he could. “I would cycle on the days when I wasn’t in dialysis, usually the day after I received treatment because I would feel better then,” he said. “I didn’t do a lot of cycling, maybe 20 miles.” Yet, it was enough training to get him through what’s called a century ride—100 miles—through Napa Valley.

Even for one so physically active, dialysis is a demanding regimen. With two parents and three siblings offering to donate a kidney, one year after his diagnosis, Stafford’s youngest brother, Derek, was selected as the best donor for Stafford’s first kidney transplant. “It was unbelievable to go through this experience. My brother’s generosity has shaped much of my life, particularly my decision to pursue a career in medicine and public health research.

“It worked great. I basically went from feeling very poorly to suddenly having a lot of energy and I couldn’t wait to get out of the hospital,” he said. Despite having to take two anti-rejection medications for the rest of his life, Stafford was soon back on his bike. In 1984, he participated in his first World Transplant Games in Amsterdam. It’s a competition that the Stanford professor has made a tradition. The next World Transplant Games will be held this August in Brisbane, Australia, and Stafford will be there to compete in the cycling events. He may even add to the medals he has won through the years: 18 gold, 11 silver, and 9 bronze.

Stafford has not been content to compete only in the World Transplant Games. In the decades since his first kidney transplant, he has participated in the U.S. National Transplant Games, California Transplant Games, the Escape from Alcatraz competition in San Francisco, and dozens of road races. And, when he is not competing, he rides his bike to work every day to his job at Stanford Hospital & Clinics and the School of Medicine. He cycles, too, when on vacation with his wife, Deirdre Crommie, and their two daughters, Marissa and Zosia.

After his first transplant, Stafford was inspired to become a physician. Now, as an internist at Stanford Hospital & Clinics and associate professor of medicine and director of the Program on Prevention Outcomes and Practices in the Stanford Prevention Research Center, his work life centers around researching disease prevention and health policy, treating patients, and teaching Stanford undergraduates and medical students.

In 2004, however, after 20 years of good function, Stafford’s kidney began to fail, at first gradually and then rapidly. Just as doctors started to discuss dialysis, Stafford’s wife offered him one of her kidneys. “For the second time, I exchanged bleak expectations for renewed forward momentum,” Stafford said.

Stephan Busque, MD, transplanted Deirdre’s kidney into Stafford. Busque, director of the adult kidney and pancreas transplant program at Stanford University School of Medicine, said he was amazed at Stafford’s physical condition. “When I did the surgery, I didn’t see someone who had 20 years of immunosuppression and chronic disease. I did surgery on an athlete and that was really obvious with his recovery and also the quality of his tissue.”

The new transplant worked well from the start. Stafford set a new goal: to participate in the national Senior Games, the largest multi-sport event in the world for people aged 50 and older. Stanford Hospital & Clinics is a sponsor of the Senior Games. Stafford will compete in two cycling time trials and two road races.

The Senior Games gives Stafford a new view of his physical training. “I need something that will be a long-term motivation for me to keep in shape. I also enjoy the camaraderie of being with others who care about their health and are intent on preserving their quality of life as they grow older. I am always inspired by cyclists who are faster than me despite being 20 years older. Fortunately for my ego, I don’t encounter them every day.”

Besides staying in shape for cycling, Stafford has another goal: “to have people recognize the value of prevention and to have prevention integral to how we provide health care.” Just watching him whiz down Foothill Expressway is enough to make anyone a believer.

For a complete schedule of Stanford Hospital & Clinics’ lectures and activities, visit stanfordhospital.org/seniorgames. For more information on the Senior Games, visit www.2009seniorgames.org.

About Stanford Hospital & Clinics
Stanford Hospital & Clinics is known worldwide for advanced treatment of complex disorders in areas such as cardiovascular care, cancer treatment, neurosciences, surgery, and organ transplants. Consistently ranked among the top institutions in the U.S. News & World Report annual list of "America's Best Hospitals," Stanford Hospital & Clinics is internationally recognized for translating medical breakthroughs into the care of patients. It is part of the Stanford University Medical Center, along with the Stanford University School of Medicine and Lucile Packard Children’s Hospital at Stanford. For more information, visit http://stanfordmedicine.org.

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