By Marshall Owens

Recently, I reached end stage renal disease (ESRD) and began receiving hemodialysis treatments. This occurred after my career had taken me all over the United States and to many countries overseas. After the diagnosis, I was worried dialysis would limit my ability to travel again. I would like to share my first vacation trip as a dialysis patient. I visited my son stationed in Fort Hood, Texas. I hope my experience will encourage you to take a vacation yourself.
My planning for the trip began with notifying my dialysis technician, Abby Neighburs. She looked for a clinic in the Fort Hood area that had an available chair for my treatment. If the clinic in your destination is affiliated with your hometown clinic, it can make this easier. Otherwise, you may find the new clinic may have additional requirements.

In my case, this meant taking a new TB test, a new physical and a copy of a recent EKG. Fortunately, the staff at my clinic is very helpful and dedicated, making the process painless. I imagined finding a clinic was as easy as opening a telephone book, but that’s not always the case. Most dialysis clinics operate on a profit basis. To achieve this profit, clinics try to fill every chair on every shift. This means many clinics don’t have open chairs to treat travelers. You may find your plans have to be adjusted to compensate for this.

It turned out the only clinic that could take me was in Temple, 30 miles from Fort Hood. Because of scheduling, the clinic could only treat me on Tuesday and Thursday. Based on my normal schedule, this meant I would receive dialysis on Friday and wait until Tuesday for my next treatment. Depending on the details of your own ESRD, this long delay in treatment may not be advisable.

To reduce the number of days between my last treatment before flying and my next treatment in Texas, Abby scheduled a final treatment at another clinic in my hometown. I found myself receiving dialysis at an unfamiliar clinic in my hometown on Saturday, instead of my usual Friday. The different machines, patients and staff created the feeling that I had already started my vacation.

I have a fistula and had opted for a buttonhole technique. This caused an additional concern during the planning stage. While I am a big fan of the buttonhole technique, some clinics do not practice it. The staff at my visiting dialysis clinic had never done a buttonhole. I was given the option of having a technician stick me away from the buttonholes or to stick myself. I opted for sticking myself and for two weeks prior to departure I practiced self-cannulating. Another drawback of not having anyone familiar with buttonholes at my traveling clinic was the facility did not have the type of needles required in stock. This meant I had to bring my needles and equipment with me.

Based upon my pre-dialysis experience and flying in the post 9-11 environment, I anticipated significant difficulty flying with needles. I called the airline prior to departure. I was told a simple letter from my doctor would satisfy Transportation Security Administration (TSA) agents and allow me to carry-on all my medical supplies. So here I was on the day of my flight out at a new dialysis clinic getting topped off for the trip. Fortunately, everyone was very nice and only somewhat freaked out by my self-sticking.

My flight to Texas was uneventful. I informed the TSA personnel about my illness and needles and they were very courteous. I had been forewarned to carry all medication in their original bottles and the security personnel didn’t even check them.

Good dietary habits are critical for all dialysis patients and travel presents unusual challenges. Most airports only have fast food restaurants, which sell foods high in potassium and salt. In the past we could request the no salt/low potassium meals during the flight, but most flights today do not serve meals. Once again, planning is critical. Make sure to stock up on healthy foods to carry on the flight and avoid the temptation to eat fast food. I figure it’s better to save that one “bad” eating day for sometime more enticing than the food at the airport.

To save money on the flight, I had opted to fly into San Antonio, more than two hours from Fort Hood. We arrived near midnight and spent the night in a hotel. Most of the next day was spent touring the sites of downtown San Antonio, visiting the Alamo and Riverwalk. It was great fun and I was careful to avoid wearing myself out by doing too much. We finally arrived at my son’s home near Fort Hood the following day.

On Tuesday morning, I arrived at the dialysis clinic in Temple, Texas, for my first transient dialysis treatment. The staff was very pleasant and professional. The staff was pleased I had brought my own needles and very supportive of my self-sticking.

One of the first things I learned at the clinic was how little I know about my own dialysis. They asked me questions about my usual flow rate and medications, some of which I didn’t know the answer. Prior to my arrival, Abby had faxed detailed information on my treatments, but there were still questions. This experience pointed out how little I really pay attention during my treatments. In the future I will carry a simple index card with all of my pertinent dialysis details. This is just a simple bit of planning my technician can easily help me prepare.

The point of my trip was not dialysis, but to have fun visiting family and seeing the sites of Texas. The rest of my week was spent with my family, touring Fort Hood and nearby sites. I always try to eat well, but on vacation it becomes more difficult. I am still learning about my diet and when presented with unfamiliar foods such as “real” Mexican or sushi I let common sense guide me. I ordered food based upon content and was satisfied with the results.

At the end of the week, I returned to the San Antonio airport for my return flight. I had no difficulty passing through security. I approached the TSA security and told them I was a dialysis patient carrying my own needles. And again, they did not ask to see my doctor’s letter. My 12-year-old daughter’s prosthetic legs caused her much more scrutiny than I received.

We arrived home after a week away and on Monday morning I was telling everyone at my dialysis clinic all the details of traveling with my dialysis supplies. The trip went so well, my daughter and I are planning our next trip. Possible destinations are Hawaii or Italy, who knows? One thing I do know is I will be planning ahead.

It’s never too late to take the vacation you’ve dreamed. It just takes a little planning on your part. If you are planning on going to a popular tourist area such as Florida, California or Hawaii, start your search for a dialysis center in those areas at least three months in advance. Don’t let concerns about medical care or your ability to handle unexpected situations hold you back. Remember, the key is planning. Be flexible and have an adventurous attitude. It will be worth the effort!

Marshall’s Tips for Trip Planning:
1. Notify your home dialysis clinic well in advance of your travel plans. This allows them sufficient time to schedule treatments while you are away.
2. Schedule your travel time wisely. Most of us have good and bad days. If you plan for full day after full day of vacationing, you can wear yourself out and jeopardize your health. Give yourself plenty of time to rest and recuperate.
3. Identify your special needs. In my case this was buttonhole needles. You may differ. Find out your airline’s requirements to carry special needs equipment.
4. Always wear something to identify you are a dialysis patient. This can be a simple bracelet. You may also want to carry more detailed healthcare information. One good medium for this is a portable flash drive or even an index card with the information on it.
5. Eat well! If your airline has meals, order the salt free/low potassium meals ahead of time. Carry healthy food and snacks for the flights and layovers.
6. Foreign foods. Every dialysis patient has struggled to learn which foods at home are good and which are bad. What happens when we are exposed to foreign food? Talk to your dietitian before traveling and have them research what you should and should not eat while traveling.
7. Have fun. Don’t be afraid to travel. Dialysis should not prevent anyone from traveling. With good planning and preparation anyone can do it. Don’t let your dialysis become a ball and chain. Plan ahead and see the world.

Marshall Owens recently retired from government service after 20 years spent in the museum and archaeology fields. He now spends his time writing, working on his 1968 Land Rover and writing grants for non-profit organizations in Council Bluffs, Iowa.

This article originally appeared in the March 2008 issue of aakpRENALIFE.

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