When Rhona Pulman learned she would have to begin dialysis treatment, she was scared. She was scared because some people told her that she wouldn’t be able to sing. For most people, singing is not at the top of their list of concerns regarding what might happen as a result of dialysis. But for Rhona, it meant everything.

Rhona uses her voice as part of her job as an opera singer under the artistic direction of Placido Domingo at the Washington Opera at the Kennedy Center, where she has performed for 26 years.

When Rhona Pulman was 12 years old, she learned she had been diagnosed with a rare autoimmune disease that affects the arteries. This disease led to several medical problems, heart surgery and eventually to kidney failure. Now 53, Rhona explains that doctors were monitoring her kidneys due to her illness and high blood pressure for many years.

”They were watching it even when I was young. My blood pressure has been out of control since I was 12,” Rhona said.

She knew that dialysis was a possibility for many years but didn’t really know what to expect. When doctors told her she would indeed have to begin dialysis, she didn’t like what she was hearing from certain “kidney coordinators” helping her train. ”They told me I would have to go on dialysis and that I couldn’t sing and my life would be totally restricted. They had me really scared and just made dialysis sound horrible,” Rhona said.

Once on dialysis, she noticed an immediate improvement. “I was very anemic but I did feel stronger and better after dialysis. I had much more energy. I have found that I was just able to keep going with my life,” Rhona exclaims. So what did she do a few weeks after starting dialysis? Naturally, she performed in an opera in Virginia.

”I was a little weak and it was a very active opera. But I was excited to do it and it was a tremendous amount of fun,” Rhona said.

She has undergone dialysis treatments for the past three and a half years through the use of a leg graft. This type of access was deemed necessary by Rhona because it doesn’t interfere with her piano playing or the costumes she must wear when performing.

Recently, Rhona was able to participate in the Washington Opera’s 18-day tour of Japan , including the cities of Tokyo and Yokahoma. She was quite surprised that the opera house permitted her to take part in the trip.

”I never expected them (the opera management) to let me go on this Japan tour. They said if you arrange the dialysis schedule and if it won’t interfere with your rehearsal schedule, then you can go. I was very surprised that they approved me,” Rhona admits.

With the exception of the long flight to Japan , things went wonderfully for Rhona during the tour. Her 19-year-old daughter joined her for a portion of the trip and she performed in three operas. The work schedule was long and demanding but Rhona did find some time for herself to walk around and explore the city life in Japan .

During the course of the tour, Rhona underwent six dialysis treatments in Japan . She noticed a few differences in the Japanese style of dialysis treatment. For example, the dialysis clinic was on the 7th or 8th floor of a building, several doctors were present and the chairs were considerably more adjustable.

”I found the people at the dialysis unit in Japan to be incredible. Instead of an alarm, each machine had its own tone of classical music,” Rhona admits. “I also noticed that the doctor stuck the needles instead of the technicians. And they served you tea and sushi!”

In addition to her work with the opera house, Rhona provides music and voice lessons to adults and children. She maintains a studio in her house and owns two grand pianos. Her teaching repertoire includes what is known as the “Suzuki” style of piano-playing; a Japanese style, it involves listening, the creation of a musical environment and repetitive learning.

Rhona acknowledges that her work and her ability to teach others serves as an excellent motivational tool when she experiences setbacks in her health. “I find motivation in the desire to be here for my two children and I really love what I’m doing. I can get lost in that world and not worry about my physical ailments,” Rhona said.

Rhona has discussed the option of a kidney transplant with her family. Her sister-in-law has already agreed to donate a kidney to her if doctors consider Rhona eligible for a transplant. For now, Rhona accepts her dialysis schedule and looks forward to another opera in the spring.

When asked about advice for others who may be in a similar situation, Rhona recommends patience and understanding of the things that matter.

”I would say to them give yourselves time to adjust. If you focus on the joy in your life and what makes you happy, then you can still live a very fulfilling life on dialysis,” Rhona said. “When they first told me about dialysis, I really thought I would have to stop singing. But they were wrong. I was able to continue.”

This article originally appeared in the January 2003 issue of aakpRENALIFE, Vol. 18, No.4.

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