Jasmine was first. Jeremy came an hour later. Twins, born to Matt and Doris Ioane 23 years ago today at The Queen’s Medical Center.

They were always close, as twins usually are. They were teammates as little kids on baseball and basketball teams. When they got to high school at Punahou, Jeremy was a state champion in football and baseball and Jasmine starred in softball.

"Definitely, he was always the better athlete," Jasmine said. "But of course I would never tell him that."

They often celebrated their birthday with bowling parties.

"When we were little, pretty much always. Dad was in a bowling league. It was always fun, and it would get competitive."

The family lived on Evelyn Lane, right near their school.

On this birthday, though, the twins are separated by 300 miles. Jasmine, who played softball at Weber State, is completing her final semester at the Ogden, Utah, campus and helping out as a volunteer assistant coach. Jeremy is with the rest of the family in Boise, Idaho, where they moved in 2012.

But the twins are closer than ever in their hearts.

Jeremy needs a new kidney. Jasmine is his best bet. She is undergoing tests to see if she is a match for a transplant.

"When I actually think about the possibility of surgery it’s a little scary, but I just think about getting my brother better," she said. "I just want to get him a kidney as soon as possible."

Jeremy has a rare disease, IgA nephropathy, that has wracked his body for more than 21⁄2 years, including decreasing his kidney function to 1 percent.

If he were healthy, he might be at the NFL Combine this week, preparing for a chance at a pro football career.

Instead, he continues to deal with dialysis five times a week — including hemo dialysis three times a week, which requires a catheter in his heart for an infection there. That takes three to four hours, at a dialysis center. The other treatment is at home, but takes eight to 10 hours while he is sleeping.

And he continues to await a transplant.

Jeremy has a high pain tolerance, but sometimes it is even too much for him. On Tuesday he had to go to the ICU at a Boise hospital for treatment.

"But he’ll be home for his birthday and hopefully feeling a bit better," Doris Ioane said.

He is grateful to be with family, including his girlfriend, Brynne Asing, and their son, Raydor.

"I try to do as much with them as I can," he said.

But he often doesn’t have energy for even minimal physical activity. He can’t work out, can’t even exercise recreationally.

"Not much really. This drains me and there’s not much of anything at all that I can do," Jeremy said. "I mean, it’s hard. But I kind of learned to just accept it and be thankful I have a son and a family that I have that is so supportive."

Although he was known as a fierce hitter from his linebacker and safety positions at Punahou and Boise State, Jeremy has always been quiet and private away from the football field. That is why very few people knew what was wrong with him, until a story about his condition ran in the Idaho Statesman newspaper last November.

He seemed fine on Dec. 24, 2013, when he led the Broncos with 10 tackles in the Hawaii Bowl against Oregon State.

"During that time it was kind of in between and we didn’t know what to do, as far as treatments," he said. "Things started building up toward the end of the season. But going into the next season was when it got worse."

It is incredible how long he was able to perform at a high level, despite his worsening medical condition.

Ioane describes his treatment in matter-of-fact and understated terms.

"In 2012 we did chemotherapy (once a month). During the next year, 2013, it was mostly taking pills. That didn’t work too well. The following year, after testing, I found that my kidneys weren’t working good."

Despite all this, he made 70 tackles in 2012 and 59 in 2013 on his way to All-Mountain West second-team honors.

Headed into last season, he was a preseason nominee for the Jim Thorpe Award, which goes to the nation’s best defensive back.

But his body finally could take no more and he played in just a few games in 2014. Ioane made one final tackle in limited playing time on Senior Day against Utah State.

Assuming a successful transplant, he can live a fairly normal life. Playing football will not be an option, but Ioane is excited about the idea of coaching.

"Yes, that’s something I’m anxious to get started with," he said. "But there’s still a lot up in the air."

His high school teammate, Dalton Hilliard, has no doubt Ioane will recover.

"I can’t imagine how it is for him not having that opportunity (to play professionally)," Hilliard said. "But life throws you curveballs, knuckleballs and what defines you is how you respond. I think Jeremy is one of those guys who will respond well."

Medical and associated expenses, even after insurance, will be huge. Ioane’s coverage as a Boise State athlete expired in January, and catastrophic injury insurance via the NCAA is not available because the illness is not from playing football. Insurance will likely cover a sizable amount, but far from everything.

There will also be Jasmine’s expenses to consider, even if she isn’t a match as a donor.

A donation fund organized by Boise State has raised $74,000 and a group in Hawaii is initiating fundraising efforts; there is an email account at 808forjeremyioane@gmail.com, and donations to "Friends of Jeremy Ioane" can be mailed to PO Box 300333, Kaaawa, HI 96730 or dropped off at any First Hawaiian Bank branch.

The Ioane family also just received more bad news, as Jasmine and Jeremy’s grandfather, Mike Ioane, was recently diagnosed with pancreatic cancer. Matt and Doris are flying home to Honolulu on Wednesday to be with him.

"You know, it’s hard, but we’re all staying positive," Doris said. "Jeremy’s blessed with another day, another year. He’s going to be 23. He’ll get his hugs, his home cooked meals."

And, hopefully, soon, the gift of life from his twin sister.

Reach Dave Reardon at dreardon@staradvertiser.com or 529-4783. His blog is at hawaiiwarriorworld.com/quick-reads.