Destination Dialysis – Taking Your Care on the Road

P & PThe idea of setting out across the country, continent or even farther can be daunting when you rely on regular dialysis treatments to stay healthy, but many individuals don’t let dialysis get in the way of hot holidays and visits with family and friends.

“Originally I thought I’m not going to travel,” says Art Matthews, who has been on home hemodialysis for about two years. Art says he was in a sort of “fortress mode,” feeling safe at home and uncomfortable with the idea of changing his routine to travel. But eventually he worked up the courage to step out of his comfort zone.

Art Matthews with his home hemodialysis set up.

He decided to head to Calgary which has one unit that takes “transient” patients. He worked with staff at Health Sciences Centre to get his paperwork in order and explains that different units have different requirements. For this unit, he needed to send a chest x-ray. “It was in a strip mall, “ he says, noting there would be no immediate hospital access for patients with potential heart problems.

It’s important all the requested information is sent to the destination unit in time or else they could refuse to dialyze the visitor. The destination unit booked Art’s appointment but said they could not guarantee it until within two weeks before. “That was the only thing I saw that was negative.” This may be standard in some units across Canada, who need to ensure they can accommodate their own patients before accepting transient patients. In Art’s case, everything turned out fine.

While he normally dialyzes five to six days a week during the night, Art dialyzed three days for the week he was away. He felt well during the week, received great care in Calgary and would definitely be willing to travel again. He’s hoping to visit Halifax, where he was based in the navy for almost two decades, and to Duluth to visit friends and family.

Blair Waldvogel took his travels even farther, heading to Mexico and Florida. “Initially you’re kind of apprehensive about it. I think my wife was more uncomfortable than I was,” he says with a laugh. Going through home hemo training helped ease the 47-year-old’s concerns because he became so familiar with the process of dialysis and the mechanics of the machine. He says scheduling and costs were two big factors in planning.

Trying to book dialysis while at the same time trying to book a vacation for certain dates at the best price was a bit tricky. In addition to that, Manitoba Health only covers a portion of out-of-country dialysis treatments, so there are added costs to the trip. “You feel a bit like you’re paying to not be on vacation,” Blair explains, talking about getting over the idea you will have to take time away from your vacation to dialyze. He found a dialysis unit within walking distance of his Puerto Vallarta resort to minimize time spent away.

Blair made initial contact with the unit, which he researched, negotiated cost and booked his appointments. His health-care team helped coordinate paperwork and a social worker also provided information. Blair checked to ensure his destination unit didn’t use practices such as reusing dialyzers, something that may be done in places outside Canada. “If they do, than you can take dialyzers with you.”  He had letters for border crossings, explaining his medications and supplies, and kept his health care team informed. He had great experiences both in Mexico and Florida and would definitely consider going back. He encourages other people considering travel, whether international or in Manitoba, to really utilize the advice of their health-care team. “They’re very accommodating…they really want to help people.”

Peritoneal Dialysis

For Marie Fielding travel plans were part of the reason she transitioned onto peritoneal dialysis (PD) when she did. Doctors decided that with her kidney function declining, it would be best to go on dialysis before she headed out on an annual trip to Texas. That transition didn’t go as smoothly as Marie would have liked, because of a cancer diagnosis, but eventually her health stabilized and she was able to get back to her routine which included living down south a good chunk of the year.

Marie Fielding

“We’ve done everything,” she says. “We’ve gone on cruises, travelled by vehicle, travelled by plane.” Marie averages about four or five trips a year whether it’s a vacation or visits with family. She plans ahead and makes arrangements to have certain PD supplies shipped to her destination. Baxter, who provides Manitoba Renal Program PD supplies, will deliver supplies to most anywhere in the world so that supplies are at your destination when you arrive. Individuals receive one free international delivery annually and two free national deliveries annually. “It is just like being at home,” explains Marie about the delivery process.

For the most part Marie’s had good experiences and says Baxter has been incredibly helpful when she’s away from home. If there is a problem with supplies or equipment, she can call them at any time of the day. “You phone Baxter and they talk you through it.”  Marie uses a form of peritoneal dialysis that is cycler-assisted and done at night. She used to check her night cycler in a special case with her luggage but now brings it as carry on. “It got jumbled around and didn’t work when we arrived,” she says about a past experience. She called Baxter who sent a replacement cycler quickly. “We take the cycler on the plane and they don’t always like that. I just feel it’s safer.” Marie also carries a letter explaining her cycler and any other supplies she carries with her. She often carries extra bags of solution and an extra catheter just in case. “They’ve been pretty good about it. I haven’t had any problems.”

Marie says adjusting to travelling while on PD has been fairly seamless. “I don’t think of it as being any different than before – it’s just a part of my life.” For anyone travelling outside of Canada, they should look at their travel health insurance and consider what coverage they can receive with a pre-existing health condition. Both Marie and Blair had coverage through either theirs or their spouses’ employee benefits.

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