Dec 23, 2013

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Traveling with Dialysis

Even though you are on dialysis, you can travel safely to many places on earth, provided that you plan ahead.  What you need to plan for depends on what type of dialysis you do. Following are tips on traveling with dialysis. 

traveling with dialysis

 

Traveling with In-Center Hemodialysis

If you are on in-center hemodialysis, you will need to locate a dialysis center in the locale to which you will be traveling.  See article Where Do I Get Dialysis Treatment.

Note that dialysis centers are typically very busy.  You may need to make an appointment at the dialysis center at least two months in advance; even longer for trips to busy vacation spots or during holiday times.  Your social worker can help you make the arrangements.  He or she can also see to it that your dialysis prescriptions and any other vital medical information about you are forwarded to the dialysis center.

There are numerous vacation packages and even cruises available for hemodialysis patients and their families. Dialysis cruises are special cruises that feature dialysis centers with nephrologists right on the ship.  

Traveling with Home Dialysis

If you are on home dialysis, “You can take it with you!”  You may be able to do that same type of dialysis wherever you are traveling.   You can take some of the equipment along with you, and ship the rest ahead so it arrives at your destination before you do. Bear in mind that you will be performing your dialysis treatments in unfamiliar surroundings.  Thus there is a greater chance of making a mistake:  Losing something or having something drop on the floor accidentally and get contaminated.  Always take plenty of spare parts with you.

Traveling with Home Hemodialysis

If you have been doing home hemodialysis with a portable machine like the NxStage System One, you can take the NxStage with you on your trip.  NxStage System One is portable and flexible enough that you can use it on travel wherever water and electricity are obtainable.  (This woman dialyzed with it during a camping trip with her family.)

NxStage’s policy requires you and your partner to transport the System One yourselves on local trips of up to three days.  For trips of four days or longer, NxStage can ship fluid bags and other materials to your destination.   If you are traveling by air, the System One must be checked in the plane’s luggage compartment.  Note that NxStage only supports travel within the U.S. at this time.

Traveling with Peritoneal Dialysis

Peritoneal dialysis is more conducive to frequent travel and weekend getaways  than is hemodialysis.  With peritoneal dialysis, you can do your exchanges on your own in most places, provided you have the necessary equipment with you.   If you’re going on a short trip by car, you might even be able to fit the cases of dialysate fluid in the trunk of your car.  

If you’re going on a longer trip that might expose the dialysate solution to extreme heat or extreme cold, you should not take the dialysate with you in your car.  Nor can you hope to store the heavy cases of dialysate in the overhead compartment of a typical airliner.  Instead, have your supplier ship them ahead to the hotels or resorts at which you will be staying.  You will need to arrange this a few weeks in advance if you’re traveling within the U.S.  If you’re traveling overseas, arrange this more than a month in advance.

You should also notify your hotels or resorts in advance to expect all this heavy equipment, and to store it safely in a clean area out of direct sunlight until you arrive.   Just before you start your trip, call your hotel or resort to check that the supplies have arrived safely.

The other equipment needed for exchanges—masks, clamps, etc.—can be carried in a car trunk or in the overhead compartment of an airliner.    If you do Continuous Cycling Peritoneal Dialysis (CCPD), try to take the cycler on the plane with you and store it somewhere in the cabin.   If you check it instead, it could get lost.

Air Travel Security

Whichever form of home dialysis you do, if you travel by air you need to get yourself and your equipment through airport security checkpoints as quickly and easily as possible.   As part of planning for your trip, let your airline know what equipment you are planning to take along with you.  Ask them if the security screeners are likely to find any of it problematic.  Also, ask your nephrologist for a signed Letter of Medical Necessity stating that all this equipment is for a vital medical purpose.

Recently, the U.S. Department of Transportation issued guidelines for the transport of portable dialysis machines such as NxStage System One.  Such a machine is to be considered an “assistive device”; that is, a device to assist a disabled person in coping with his disability.  Consequently, an airline carrier must allow portable dialysis machines, medications, syringes and dialysate fluids on airplanes.  And since a portable dialysis machine is considered an assistive device, it will not count against the dialysis passenger’s carry-on limit.   

Medical Emergencies

There is always the possibility that during your trip you may need urgent or emergency medical care.   You should take along sufficient medical information to enable doctors and dialysis centers to treat you properly.   The National Kidney Foundation and the Nephron Information Center have developed several standard forms for that purpose:  The Uniform ESRD Transient Hemodialysis/Peritoneal Dialysis Form, the Hemodialysis Encounter Form, and the Peritoneal Dialysis Encounter Form. Have your nephrologist or dialysis center fill out the appropriate forms and attach any required information, and take them with you on your trip. (Do not pack them in luggage you will be checking.)

Paying for It All

Because you are a dialysis patient, you need to have regular dialysis treatments everywhere you travel—but not all insurers will pay for that.  You may have to pay a large sum out of pocket as part of the cost of your trip.

Some private “managed care” insurance may consider treatment far from home as “out of network” care.  Your insurer may not cover much of it, or you may have to pay a much higher co-payment.  Check with your insurer.

Medicare and Medicaid coverage for dialysis is limited to treatment within the U.S.         

Dialysis on cruises is not usually covered by Medicare or Medicaid; furthermore, you may have to pay in advance for the dialysis treatments, prior to the start of the cruise.

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