Travel may be hazardous to dialysis patients

[OZfan]

Travel may be hazardous to dialysis patients

Patients on dialysis must take extra care when traveling
If you're sick, traveling to a foreign land may boost your spirits, but jeopardize your health, according to a paper being presented at the American Society of Nephrology's 42nd Annual Meeting and Scientific Exposition in San Diego, CA. The findings indicate that dialysis patients who travel on vacation risk infections, anemia, and other complications that can compromise their dialysis treatments.

In a study conceived and led by nurses, Claire Edwards, RGN; Kathleen Lynch, RGN; Neill Duncan, MRCP (West London Renal and Transplant Centre, Imperial College Kidney and Transplant Institute, United Kingdom); and their colleagues collected health information on patients who traveled on vacation at some point between April 2008 to March 2009. Their analysis included 69 patients of diverse ethnic background who traveled to Europe, the Middle East, India, the United States, Africa, the Pacific Rim, and South Asia.

One patient died during travel and two damaged or lost their fistulas or grafts (surgically created sites that provide dialysis tubes access to the blood). Seven patients required blood transfusions soon after their return, and several acquired blood stream infections.

The investigators concluded that travel among dialysis patients is associated with significantly increased infection rates, loss of vascular access, and anemia. "Many patients wish to travel freely around the world. This study empowers patients with information in order for them to make choices about their lifestyle," said Edwards.

The study is limited by the fact that the precise details of treatment received by patients, including treatment duration, blood loss, infection, antibiotic starts, etc while patients were on vacation was not always clear. There is no data for non-dialysis travelers, but the risks are expected to be significantly lower.

http://www.eurekalert.org/pub_releases/2009-10/ason-tmb102009.php

[getlife]

I have never traveled outside the country while on dialysis..hmm..never really traveled outside the country...period.  Hehe.

I have traveled in the U.S.  I have experienced the good and the bad...but not to the extreme bad. 

I was in CA, dialyzed at a unit that would only dialyze me for 3 hours instead of 4.
Another one, they did 2 and a 1/2 instead of 4. 

Lesson learned.  I call the unit I am arranged with, ask them if they have a spot for a 4 hour treatment...I go from there. 
I have had good experiences also.  I like to find units that do the nocturnal...which I am use to. 

I can see where problems can arise.  It's important to know what your needs are...check ahead...and take caution.

Another words....advocate for yourself! 

[Bill Peckham]

Travel isn't the issue, lack of self care is the issue

[Angie]

It's very true that traveling is hazardous for dialysis patients as it affects other people also. Due to traveling they can loose their life.
So it's better for them also and for other passengers that they should not travel.
Acai berry

Don't click the links of that user. I suspect this person is a spammer as their post and links seem odd to me.

[OZfan]

Thanks Angie.  He in fact was a spammer.  Trying to sell colon cleanser. 

[Angie]

Thanks Angie.  He in fact was a spammer.  Trying to sell colon cleanser. 

Glad he was caught and no one clicked on the links. That worried me.

[getlife]

Good catch Angie.  You know this stuff well!

[Jester]

 Jean Louis Clémendot  sets up this website to tell you the story of his travels across the Atlantic while undergoing Peritoneal Dialysis! Thanks to the Internet, you will be able to follow his story every day and his progress on a map.

http://www.jeanlouisclemendot.fr/index.php?post=80&lang=en

[jolie3]

I have traveled a few times in the last year.  Some of the things I have learned to do is call ahead and makes sure  they have an ISO unit and space available.  I also ask what kind of machine they have and what is there tech to patient ratio.  As I put in my own needles, that part is not scary anymore.
I took a trip to ABQ last summer and when I showed up they did not have a spot for me and wanted me to wait another day for dialysis.  As this was already over the weekend, I said no.  I had to take my time and go the the ER and get a stat potassium.  It was 5.7 and I decided I didn't need emergency dialysis, I could wait until morning.  It took me 6 months of phone calls to finally speak with someone who could take responsibility for the screw up.  Come to find out, when the girl in the regional office forwarded the info to the ABQ clinic, she didn't send it all.  She sent just the part she thought was important.  She had no medical training, and obviously not too many brain cells.  Fresenius now handles that paperwork differently simply because I refused to let it go.  I also told them I would not be paying as this was not stipulated before hand and I sent them the bill from the hospital for the ER run.  The Fresinius office took care of it.
I just got back from a trip to the middle of nowhere NE.  There is a perfectly lovely unit in Columbus, NE.  They have no techs, just RNs.  They wanted me to pay $150 per tx.  Since I have medicare, and it pays, I was really annoyed.  So was my sister, as we were going to NE together.  My sister called the president of the company to see what the deal was, he said it was just to make sure everything was covered.  I guess we were supposed to get a refund!  I think it is also against the law to bill medicare and the patient.  Anyway, it came down to $30 a tx and I got it in writing so there were no surprises.  I also took my own medications.  EPO and benedryl.
I pretty much refuse to go overseas as you don't really know their policys or laws and if they speak a different language, you're just out of luck.  If I did at home dialysis, peritoneal or hemo, I might give it a try, but if you can't ship the supplies, you're pretty far away from home if anything goes wrong.
When I write it all down, it doesn't seem that bad but when I was dealing with all these nitwits, there was a lot of words like irresponsible, incompetent, unprofessional, uncaring, all said in a low, menacing tone.

[jolie3]

I just took a look at Bill's website, its been a while.  He credits Cheryl with helping him set up his visits and how much work it is.  Most dialysis units have you go thru their office, who send the info forward, and get everything arranged.  I have yet to go someplace and not have some sort of issue.  Sometimes big, no ISO room, sometimes small, a lab test, but always some sort of issue.  Its exciting to know it is possible and if I could do it myself, I know I could get it done but, frankly, I just don't trust Fresinius to do it right.  In CA I used RAI and they couldn't do much better.  When I went to DC with WeKan, that unit didn't have an ISO room either, but they ran me on the last machine in the group.  Its frustrating and annoying and it always takes time out of my day to get it worked out.  As tho I have nothing better to do than the job these people are getting paid to do.  Do I sound annoyed? :

[BJ275]

It does sound awful, from a "uninititated" perspective.  I would think if you made arrangements ahead of time, that it would be "good to go" unless there was an emergency! 

[jolie3]

You would think so wouldn't you?  Hardly ever happens.  I even call the unit I want to visit before I leave but after the visit is all set up, just to make sure and I have still had problems.  I called Columbus the day before I was due to leave and before I went to dialysis here in my home town.  When I showed up at dialysis, there was a lab to draw that Columbus had remembered!!