Vanessa Underwood: Leading a Full Life

Many people have looked at a glass half filled with water as the indicator of their personality. Those who see the glass as half full are considered optimists. Those who view it as half empty are considered pessimists. Vanessa Underwood, a 39-year-old, two-time kidney transplant recipient doesn't ponder over whether her glass is half full or half empty; instead, she manages to fill her glass completely.

To Vanessa, living well is doing everything in her power to fill her life with all the richness, joy and vitality her glass could possibly hold. She doesn't use one source for her fulfillment, but uses many -- exercise to be fit in body, good nutrition for necessary fuel, a proper medical regimen to maintain good health, a close family for love and support, continuing education to expand the mind and the rewards of helping others. Through all of these, Vanessa has turned the half-empty glass of water to a full glass, to be continually filled, then poured out to refresh herself and others, and filled again.

"I like to share the message about giving," she says. "When you give, you get back so much more in return. Everything good ultimately comes back."

While these are the words of a positive person, they are not spoken by someone who has had an easy life. Adversity grew from an unfortunate set of circumstances when Vanessa was 13 years old. That was when her mother, a single parent, was in the process of moving. Vanessa stayed at the home of friend for the summer so that she could live awhile longer in the town where she grew up.

While at her friend's house, Vanessa started to suffer from a sore throat and persistent cough. Not wanting to be a burden to her hosts, she said nothing. While she was suffering in silence, the infection, later found to be caused by the streptococcus (strep) bacteria, got worse and attacked her kidneys. She ignored the pain, and the blood in her urine, which her friend's mother, a nurse, finally detected. But by that time, permanent damage had been done.

"To this day, my mother feels unnecessary guilt because she wasn't with me during that time. In reality, she was a wonderful mother, particularly when you consider the overwhelming fact that she raised six children by herself. She has always been a great source of love and support. Unfortunately, parents just can't keep things like illness and pain from striking their children."

Despite the injury to her kidneys, Vanessa led an active life, from being the captain of the cheerleading squad in high school, moving on to college where she graduated with a degree in social work and then starting her career at a family planning clinic in Dover, New Hampshire. That was when, in 1979, Vanessa's kidney problems culminated to end-stage organ failure.

After a few weeks of hemodialysis, accompanied by stresses and difficult side effects, Vanessa decided that dialysis would be a temporary treatment; she felt that transplant would give her the best chance to live well. Vanessa is convinced that the love and prayers of her family got her through those days. "Everyone was so supportive and truly believed in me. Because of their faith in me, I didn't want to let them down," Vanessa says.

Vanessa's mother and five siblings rallied around her, each one being tested to see who could be good antigen match to donate a kidney. They hit the jackpot twice with good matches from both Vanessa's mother, Caroline, and Vanessa's sister, Grace. Since Caroline wouldn't hear of two daughters being hospitalized if there was another route, she insisted that she be the living-related donor. "There was no question about it," Vanessa remembers. "My mother donated without fear, only with love. She was the pillar of strength that gave me the courage and stamina to face the transplant."

The transplant surgery gave Vanessa a new lease on life, but left her "feeling like Miss Roly Poly" because of excessive swelling and weight gain. "During the time in which my health was failing I never thought I would be well enough to do anything, most of all exercise," Vanessa explains. "After my transplant, I was in poor shape, but I was determined to get my weight and my physical condition under control. I began swimming and progressed to a couple of miles every day." Exercise, Vanessa declares, was paramount to her physical and emotional recovery process. It also continues to be the key to her good health.

"I took small steps and progressed slowly. I challenged myself and continually set new goals. I feel that's the only way to be the best you can be." From those tiny steps, Vanessa's endurance and vigor increased by leaps and bounds.

Today, Vanessa is a professional fitness consultant, certified by the American Fitness Association of America and the American Council on Exercise. She serves as a fitness counselor, focusing on lifestyle evaluations, health status classifications, fitness assessments and weight management. She works as a personal trainer to develop customized programs providing non- or low-impact aerobics, strength training, conditioning and flexibility. Vanessa also works as an aerobics instructor in areas of body sculpting, step aerobics, body walk, circuit training and specialized women's training.

Vanessa was one of the four featured participants in the Stadtlanders Stars for Life Fitness Video, a patient education project of Stadtlanders Pharmacy. Stadtlanders produced the medically-designed workout video specifically for transplant recipients. "This video was like my dream come true," explains Vanessa. "It's based on a philosophy that I have tried to share with many other people in my life. From the bottom of my soul, I believe that exercise is as significant in maintaining health as taking daily medication. It is crucial to living well, especially for those of us who have to deal with illness."

She continues, "The benefits of exercise are enormous. It reinforces the immune system, it strengthens bone and bone marrow, it builds cells, it releases toxins and the list goes on. More and more medical professionals are advocating, even emphasizing, exercise. It's one thing to hear about the value of exercise from a medical person, but it bears even greater weight when the message is from a fellow transplant recipient."

Vanessa has served as an instructor at the International Transplant Nurses Society Symposium, at the Transplant Training Symposium, the North American Transplant Coordinators Association and the National Kidney Foundation U.S. Transplant Games, sponsored by Stadtlanders Pharmacy. She serves on the medical advisory board of the New Hampshire National Kidney Foundation. Vanessa is also a regular participant and medal winner in the Olympic-style competition of the U.S. Transplant Games.

Some people say it's good that Vanessa enjoys exercise, because she certainly spends enough time doing it. On a regular basis, she participates in aerobic activity (step class, aerobics class or running) at least three times a week and lifts weights three times a week. She also teaches aerobics class six times a week. For good measure, she builds informal physical activity, from water skiing to racquetball, hiking, or riding bikes with her children, into her daily life.

Vanessa also feels that a key aspect to living well is eating well. She scrimps on the fat, cholesterol and salt, but piles on the carbohydrates, fruits and vegetables in her daily diet.

"I'm careful about what I eat," she says, "but I am not a fanatic. I don't deprive myself. If I want a piece of cake, I'll eat it."

She is also careful about following her prescribed medication regimen. This daily regimen has actually become a shared ritual between Vanessa and her two daughters. Each night, the girls open Vanessa's medication and lay them out for her on the night stand. "My daughters are not sheltered from the reality of life after transplant. They're part of the process now," Vanessa explains.

Vanessa has been a patient of Stadtlanders Pharmacy since 1989. "My medication is important to me, so my pharmacy is, too," she comments. "The people at Stadtlanders are competent, confident and caring. They stand behind me in a pinch, provide important information through LifeTIMES and actively support organ donation. I wouldn't get my medications anywhere else."

She has high praise for her medical team, too. Her accolades go back to her first encounter with Dr. Stephen Steinmuller, who got her through her first transplant, and to Dr. Eduardo Haddad, who later became her nephrologist. She calls them both "assets to the medical profession, as well as warm and caring individuals." In 1979, and again in 1989, she received kidney transplants from the team of Dr. Rubin, Dr. Auchincloss, Dr. Cosimi and Dr. Delmonico at Massachusetts General Hospital in Boston.

Another important source in keeping Vanessa's glass continually full is her family. Her mother and siblings have seen her through the rough times. And, at a low point after her transplant, Vanessa met Tom Underwood, whom she calls her "gift from God." Tom, introduced to her by a mutual friend, was special from the start. Their relationship blossomed and resulted in a marriage that is still strong today. Vanessa says that from those early years he has remained her loving husband and best friend. "No matter what's going on in my life, he is the eternal optimist, which keeps me in balance when I am doubtful. He is the light during my darker times."

While Vanessa knew she wanted children, her medical team was shocked and concerned when she became pregnant the year following her transplant. At that time, there wasn't much precedence for pregnancy following transplant, so there was a lot of fear about the safety of both mother and child. Vanessa didn't consider having children to be a risk, but a necessity in her life. From the onset of her pregnancy, Vanessa knew that the baby would be a girl and that she would name her Caroline, after her mother who had twice given life to her. The pregnancy was difficult, Vanessa remembers, but the baby was beautiful. Caroline Grace (named after both Vanessa's mother and sister) was born at the small size of four pounds. "And I was 200!" Vanessa laughs.

Five years later, after another difficult pregnancy, Vanessa and Tom had their second child, Katherine, "another miracle." Today, the girls are ages 13 and 8. "I can't imagine life without my girls. I love being involved in their lives and everything that goes along with being a mother," expresses Vanessa.

While Vanessa and her daughters read many books together, there is one book which tops their list of favorites. It's a children's book called "Love You Forever" by Robert Munsch. Vanessa talks about its significance: "This book is about the love of a mother to her son throughout his life. At the end, he was there for her. Times changed, but the love was always constant. This describes so clearly how I feel as a parent. No matter what my daughters are doing in their lives or what stages they are in, Caroline and Katherine will always be my babies and I will always love them unconditionally. Nothing will ever change that."

The book Love You Forever also illustrates that death is part of the cycle of life. That's an important message for Vanessa, who has faced her own mortality, to pass along to her children.

In 1989, ten years after her first transplant, she had to again face the challenge of life and death as she experienced her second kidney failure. The condition was caused partly by organ rejection and partly by disease. While all of her siblings stepped forward and again volunteered to donate a kidney, only Grace, who was known to be the best antigen match, was tested. Older, wiser and with more knowledge than she had prior to her first transplant, Vanessa had difficulty accepting the idea of another member of her family going through surgery and losing a precious kidney at her expense. Grace was angry, Vanessa says. "She asked me if the situation was the other way around, would I do it? Of course, I answered. I'll never forget what she said. 'I have this one chance in my lifetime to do something truly worthwhile. Don't take this away from me.'"

Deeply touched and appreciating Grace's sincerity, Vanessa accepted the selfless gift of life from yet another member of her family. The transplant took place that year and now, after five years, Vanessa is again in the best of health. "I've been so blessed with a wonderful family. Everyone wanted to donate, and my mother and Grace feel fortunate that they were able to. Actually, I'm the fortunate one."

Another important area of Vanessa's fulfillment is in her continuing thirst for knowledge and quest for further education and growth. Vanessa will soon receive her paralegal certification from Northern Essex Community College in Haverhill, Massachusetts, which is not too far away from her Plaistow, New Hampshire home. She enjoys taking classes and is now considering a law degree or a masters degree in exercise physiology. Vanessa also believes in using her education.

In addition to the many hats she wears, Vanessa is now working with the local police department to develop a victim's advocate program -- using both her social work and her paralegal expertise. "Eventually, I'll work with cases where the victim needs support," she explains. "That could be from an emotional standpoint or even procedural, such as how to move through the court process."

One of the things Vanessa likes to do best is helping others -- another source from which Vanessa fills her glass. "Even my fitness instruction is rewarding. A lot of times poor physical condition can cause people to have low self-esteem. And good physical fitness can have very positive image benefits. I know because I've been on both sides of the spectrum. When I'm able to help people improve their fitness level, I feel great."

Vanessa teaches regular classes for groups such as elementary school teachers and parents, town hall employees, senior citizens from area centers and other community groups. Additionally, she works with individuals at a number of different sites. She says that sometimes she feels disorganized because she's always hurrying, rushing from one place to another. "I call myself the traveling trainer," she adds with a chuckle. "I schedule appointments close together, one after another. But that way I can get a lot done."

She also enjoys giving presentations regarding health and fitness to fellow transplant recipients. Vanessa says, "I know it's difficult to get started. After you've had a transplant or are living with a chronic health condition, you just don't have that much energy to perform daily activities, let alone exercise. I tell people, 'Push yourself a little bit beyond what your body is used to doing. Take your time, go slowly. Be constant and persistent. Don't get discouraged. With time and work, you can lead an active, full life." Vanessa coaches cheer leading to girls ages eight to 13 three times a week prior to and during the football season, from August through November. She is working with the DARE program to design and implement health activity, such as fitness socials, for seventh and eighth graders. There are even more activities in which Vanessa is involved, with the common thread of helping others as the center of each.

When Vanessa is asked what she feels is important in living well, she doesn't have to think too much before answering, "Enjoying life. Taking advantage of every positive opportunity. Striving to be your best. Setting realistic goals and challenging yourself. Not quitting. Finding balance. Laughing. Playing. Spending time with those most important to you. Realizing that life is short -- and embracing every experience."

There's no half-empty glass here; indeed, Vanessa has found a way to fill up her glass and let it overflow, refreshing herself, those who love her, and those who come into contact with her.

This article originally appeared in LifeTimes magazine (Issue 3, 1994) and now appears on TransWeb courtesy of Stadtlanders pharmacy.