September 24, 2004/Tishri 9 5765, Vol. 57, No. 4
Ailing Tucson man seeks help
STEPHANIE N. HENSCHEL
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 In an old photo, Alan Riman, now 55, sits with his "mongrel" terrier poodle, Wilber. Riman suffers from end-stage liver disease and is waiting for a liver transplant. Photo courtesy of Alan Riman |
Riman, 55, is suffering from end-stage liver disease.
Diagnosed with the debilitating disease in October 2003, Riman was placed on the National Waiting List for a donor liver in May 2004.
The liver disease, according to Riman, is the end result of many years of health problems, such as asthma.
"In the '70s, adult-onset asthma (medicine) of choice was steroids, in order to get you to breathe again," Riman says. "Little did they realize the steroids caused toxicity."
In the early '80s, doctors discovered Riman had inflammation of the liver. Despite attempts to correct the problem, liver disease developed.
"They just couldn't conquer it," Riman says.
But it was not a major problem at the time.
"I was living with it, but it was kind of in remission," he says.
Now, almost 20 years later, Riman knows this could be the end of the line.
"It's like there's a time bomb in my system," he says.
The Boston-native-turned-Tucson resident lives with his best friend of more than 30 years, David Downes, 47, and a "mongrel" terrier poodle, Wilber. Until recently when his disease got worse, Riman cared for his friend, who suffers from multiple sclerosis, as well as Downes' older brother Charlie, who died of Lou Gehrig's disease in February 2001.
The move to Tucson fared well for Riman. The warm, dry climate helped alleviate pain caused by spinal injuries and his asthma disappeared.
"But it didn't do anything for the liver disease," he says.
Because of his illness, Riman is under constant care. He has to have blood work every month, but if a doctor calls and tells him to go in, he must oblige.
On top of that are the visits he must make to Banner Good Samaritan in Phoenix, not to mention medications.
The bills are piling up.
Riman, a former civilian federal employee, is on a disability annuity. He receives a little more than $1,000 a month. This has to cover his living expenses, such as rent and food, as well as his medical bills. Riman estimates he spends about $600 a month in medical expenses alone. Operation costs aside, he will have to remain on many medications for the rest of his life - taking about 20 to 40 pills a day.
He is not eligible for Social Security until he is 65. He cannot get Medicare. He has no family to help him. Jewish Family Services of Tucson sends him $300 and $25 in food stamps a month.
"I've never had to do what I'm doing now and that's make an appeal on my behalf," he says.
He does not have the resources to establish fund-raisers to help him out.
And he needs the help. According to the American Liver Foundation, medical expenses, including the operation, pre- and post-operation visits and the first year of medication costs on average $210,000.
In order for him to receive a liver transplant, he not only has to undergo exhaustive tests, but his MELD score - Model for End-Stage Liver Disease - must deem him an eligible candidate.
According to Charlie Thomas, Riman's primary liver transplant social worker at Banner Good Samaritan, Riman's score is low, meaning he does not have immediate need of a liver.
But that could change quickly.
"It's hard to say when (the score will increase)," Thomas says. "It could change gradually, or it could happen overnight."
Thomas says a team consisting of physicians and liver specialists continue to monitor Riman's health closely.
Should a liver become available that matches Riman's blood and tissue type, there is a small window of time when the organ can be transplanted - about 15 hours maximum. But when the time comes, Riman will be ready.
"I've already got it set up," he says.
In the meantime, Riman is trying to wait patiently.
"I sleep a lot, sometimes 16 hours a day," he says. But his dog does persuade him to get out of bed and walk him from time to time.
"I loved to walk," Riman says. "Now even the shortest walk is becoming a problem for me."
The disease makes it difficult to walk these days. His muscles are atrophied, causing him pain. He has lost weight and experiences blood sugar problems and headaches.
"There is pain," he says. "There's no question about it."
Riman knows as time goes by, chances are he'll get sicker. He also is aware that donor organs are not readily available.
"A few years ago, I would have thought, 'Oh a transplant, anybody can get them and it's all free,'" Riman says. "But that's wrong.
"Everyday 17 people die just waiting for a donor organ," he says. "I hope that won't happen to me."
To make a donation, or to find out more, contact Alan Riman, P.O. Box 8774, Tucson 85738-0774, or e-mail him at AlanRiman@aol.com.