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Author Topic: Down the river with a cycler - NxStage conquers the Rogue  (Read 6875 times)
Bill Peckham
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« on: July 26, 2010, 12:38:55 PM »

Cross posted from DSEN
Down the river with a cycler - NxStage conquers the Rogue

By Bill Peckham

The trip was a 100% success. The only disappointment was that one of the dialyzors, Jim, wasn't able to go due to illness in the days before the start. We were able to fill Jim's two spots at the last minute; Megan and Sasha didn't know they were going until three days before they found themselves running rapids on the Rogue. Dan and Connie drove in from Salt Lake City on Sunday, both he and I dialyzed the night before the trip so we could take the first night off (both our machines went down the river in their air travel cases).

The other seven members of our twelve person party (we had 19 total, three people just happened to have signed up for the trip before I picked the date, plus four guides) were a great mix: Doug, Kathy, Cheryl, Lauren and Kyle all came in from DCI. Kay from NxStage (previously working at DCI). And Gary who runs RenalWEB. Our group got along really well, no doubt assisted by the copious amounts of alcohol that also went down the river .... but, what happens on the Rogue, stays on the Rogue. In this post I'll just overview the logistics and dialysis component.

I drove down to Grants Pass on the 17th and dialyzed that night in the hotel for the forth night in a row (I dialyzed the fifth night too). On Sunday while everyone else arrived during the day and into the evening, I stopped by Rogue Wilderness Adventures (RWA) to meet up with Scott who would be leading our trip. Scott took one look at the NxStage's metal air travel case and knew exactly how he'd pack it to take it down the river. From that moment, until we were hauling the rafts out of the river at the end of the trip, the RWA staff were consummate professionals. If you're going to take a trip down the Rogue, with or without a dialysis machine, the guide service is no place to cut corners. Go with the best, most experienced service you can find; on the Rogue that's Rogue Wilderness Adventures.

Scott used some straps and the metal frame that's lashed to the large inflatable raft to create a cradle for the travel cases. In this way the frame could hold the two cyclers side by side, suspended about 3 or 4 inches above the actual raft floor. It was perfect. Aside from the NxStage cycler I had to keep dry the NxStage dialysate warmer. Scott had a solution for that too. I have the original foam packaging and together, the warmer and its packing foam, fit perfectly in a water tight ammo box Scott had on hand. It was as if the box was made to hold the warmer. The rest of the dialysis supplies (and personal gear) fit in various dry bags - waterproof duffel bags, able to hold about two carry on sized pieces of luggage.

We started down the river Monday morning with four inflatable kayaks and four rafts, one guide per raft. The guides: Scott, Gina, Keith and Mike are awesome. Mike's raft had a pile of dry bags and provisions. He stayed ahead most of the time getting to the lunch spot or to the lodges before us. Keith's raft had the cyclers and room for up to three people to ride down river, no paddling required. Kyle used the perch at the front of Keith's raft to shoot a lot of good action video of the rest of our group running the rapids in the two smaller rafts and four kayaks.

We took turns between using the kayaks and paddling in the rafts. The inflatable, one person kayaks are a lot of fun. That said, I am a terrible kayaker. I fell in the water twice just trying to get into the things and I was the only one who wiped out twice in the white water ... I think there will be video of me going over backwards in the first rapid we came to, an easy rapid that I found a way to make a lot harder. Aside from the kayaks the other exciting way through the rapids was in Scott and Gina's rafts, which were propelled by the paddling of the passengers, up to six at a time. I'm sure Scott and Gina could have gotten through the rapids using their long oars at the back of the raft but we provided their turbo, paddling forward or back at their command.

Having to paddle also meant that you had to perch on the raft's outer pontoon, exposed to the rapids breaking from all sides, but those riding in the front saw the most water. With temperatures in the high 80s/low 90s the water felt refreshing. During a few stretches we floated the river in our life jackets. Three people swam (on purpose (not me)) a rapid, but for the most part we only swam on the flat sections. RWA does not condone jumping off of rocks into swimming holes but if I did jump off any rocks into a swimming hole it would have been at a little swimming hole on a creek just up river from Paradise Lodge.

The lodges were outstanding. The first lodge Black Bar, is rustic with about 10 cabins and a main building strung along a forest path above the river. There is an upper and lower Black Bar lodge, we were at the lower, but I believe they have about the same amenities - hot showers, hard beds and lights off between 10PM and 7AM. The main cabin had a deck that we dragged a couch onto and from there we recounted the day's adventures while being refreshed by cold beverages. Inside two large tables could seat the whole group for dinner and breakfast.

As nice as Black Bar is, Paradise Lodge is a whole other level. Paradise has over 50 beds in five or six structures. We had the Garden House that is across the cow pasture/landing strip from the main lodge. It has an assortment of rooms with four, two or one bed. I don't know what I expected but this was ideal. In addition to being able to sleep 14 or 15 people the Garden House has a large conference room with couches, a long table and recliners! Dan and I set up our dialysis right there, I couldn't have been more comfortable.

I admit to some nervous excitement as I set up my machine for my treatment Tuesday night. We had run Blossom the big rapid of the trip, just before arriving at Paradise. To keep the cycler dry I had taped the seam of the travel case; between the tape, the slings Scott rigged and Keith's expert handling of the raft I really had nothing to worry about, the machine worked without a single hitch. I dialyzed Tuesday night and took Wednesday completely off. Dan dialyzed both Tuesday night and Wednesday afternoon.

Wednesday was a free day - we stayed at Paradise all day. I hiked up to the top of Deak's peak over looking the ranch and the Rogue River valley. It was a treat to have a day just to relax and hang out without any electronic communication. I wondered if our highly connected group would miss 24/7 email access but after the first rapid I don't think anyone gave email or the "Bundle" another thought (well maybe a few thoughts).

Dinner is family style in the main lodge. Wednesday night after we had finished eating we took turns giving our personal highs and lows of the trip. No one had any lows to speak of, the mosquitoes got an (dis)honorable mention but even they weren't that bad. It was a fantastic trip that proved you could take the NxStage cycler down a river on a raft, this trip was a proof of concept. With planning, a little ingenuity, and electricity there is a world of travel opportunities. If it could be done in 1983, we ought to be able to do it in 2011.

A few additional notes on the logistics of traveling down the Rogue with the NxStage cycler.
  • I had dialysate delivered to the guide service a few weeks before the trip so they could take it down river a little at a time.
  • Consider worst case scenarios. While the Rogue is remote we did know that we could come out early if something happened disrupting our ability to dialyze.
  • I planned ahead for "what ifs?" by noting my cycler's serial number and figuring out how to initiate a cycler swap from the river.
Just as with the cruise the cyclers preformed flawlessly but a little planning brings piece of mind.
« Last Edit: July 26, 2010, 12:41:27 PM by Bill Peckham » Logged

http://www.billpeckham.com  "Dialysis from the sharp end of the needle" tracking  industry news and trends - in advocacy, reimbursement, politics and the provision of dialysis
Incenter Hemodialysis: 1990 - 2001
Home Hemodialysis: 2001 - Present
NxStage System One Cycler 2007 - Present
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« Reply #1 on: July 26, 2010, 02:19:37 PM »

Sounds like you had a well deserved vacation. Our family has rafted  & this is encourging that we will be able to do the things we want after our training for Nxstage.
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« Reply #2 on: July 26, 2010, 04:40:44 PM »

sounds like an awesome trip. not really my style.. I'm a small town girl who loves heading to the big city. *G*  I've never had any trouble travelling while on dialysis, with either toting the Home Choice in it's suitcase (which fits under the seat on most airplanes), or doing in centre hemo.

I think it's  pretty cool, Bill, that you are doing some of the more exotic trips, if for no other reason, to prove they can be done.
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« Reply #3 on: July 26, 2010, 07:40:32 PM »

Outstanding!

8)
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« Reply #4 on: July 26, 2010, 11:04:07 PM »

I was waiting in anticipation to here how it went.

You are the most inspirational person on dialysis I have ever come across.

I would love to meet you. Please do another trip to South Africa . We can do dialysis together!!!!! :cheer:
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« Reply #5 on: July 26, 2010, 11:28:20 PM »

Great stuff, Bill!
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« Reply #6 on: July 27, 2010, 06:50:31 AM »

Way to go Bill.    :2thumbsup;  I've done many whitewater canoe trips, eleven in total, to very isolated locations in Northern Canada including the Arctic and I know what's involved in the planning and executing of them.  It's hard work and can be very physically and mentally challenging.  I did them with a transplant which is a piece of cake compared to being on D and I applaud you for refusing to accept any unnecessary limitations on your life.   :clap;   Great adventure.
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« Reply #7 on: July 27, 2010, 09:44:38 AM »

 :clap; That's awesome - where are the photos?  :pics;
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« Reply #8 on: July 27, 2010, 11:23:51 AM »

I still haven't seen any photos or video but I know there was something like 10gigs of video shot and probably hundreds of photos - just none by me.

When I get them I'll be sure to share :-)

I'd love to get back to SA Des, when I'm asked my favorite trip I always put SA at the top of the list though I have to say the Rogue is top five - recent trips always rank higher.
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http://www.billpeckham.com  "Dialysis from the sharp end of the needle" tracking  industry news and trends - in advocacy, reimbursement, politics and the provision of dialysis
Incenter Hemodialysis: 1990 - 2001
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        * 4 to 6 days a week 30 Liters (using PureFlow) @ ~250 Qb ~ 8 hour per treatment FF~28
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« Reply #9 on: August 08, 2010, 09:00:54 AM »

Pictures are starting to come in, here are a few.

Bill, I am already missing it. Let's start planning the next one.
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« Reply #10 on: August 08, 2010, 09:49:27 AM »

 :beer1;
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~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
No transplant.  Not yet, anyway.  Only decided to be listed on 11/9/06. Inactive at the moment.  ;)
I make films.

Just the facts: 70.0 kgs. (about 154 lbs.)
Treatment: Tue-Thur-Sat   5.5 hours, 2x/wk, 6 hours, 1x/wk
Dialysate flow (Qd)=600;  Blood pump speed(Qb)=315
Fresenius Optiflux-180 filter--without reuse
Fresenius 2008T dialysis machine
My KDOQI Nutrition (+/ -):  2,450 Calories, 84 grams Protein/day.

"Living a life, not an apology."
Bill Peckham
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« Reply #11 on: August 08, 2010, 01:08:37 PM »

Pictures are starting to come in, here are a few.

Bill, I am already missing it. Let's start planning the next one.


I think you have a good point Dan.


Paradise would be a good place for an annual meetup
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http://www.billpeckham.com  "Dialysis from the sharp end of the needle" tracking  industry news and trends - in advocacy, reimbursement, politics and the provision of dialysis
Incenter Hemodialysis: 1990 - 2001
Home Hemodialysis: 2001 - Present
NxStage System One Cycler 2007 - Present
        * 4 to 6 days a week 30 Liters (using PureFlow) @ ~250 Qb ~ 8 hour per treatment FF~28
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« Reply #12 on: August 09, 2010, 11:22:25 PM »

Agreed Bill!

And for all our readers, can you believe that to do a dialysis treatment at this place, you will need a boat and run the river?
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AKA Dialysis Dan
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« Reply #13 on: August 10, 2010, 07:42:36 PM »

Here's a photo of a cycler properly equipped.


I'm just starting to go through the video - there's a lot of stuff, hundreds of 10 to 30 second segments. I have to relearn my video software.
« Last Edit: August 10, 2010, 07:51:39 PM by Bill Peckham » Logged

http://www.billpeckham.com  "Dialysis from the sharp end of the needle" tracking  industry news and trends - in advocacy, reimbursement, politics and the provision of dialysis
Incenter Hemodialysis: 1990 - 2001
Home Hemodialysis: 2001 - Present
NxStage System One Cycler 2007 - Present
        * 4 to 6 days a week 30 Liters (using PureFlow) @ ~250 Qb ~ 8 hour per treatment FF~28
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« Reply #14 on: August 10, 2010, 07:54:53 PM »

 :yahoo; Great - I love photos!!
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Admin for IHateDialysis 2008 - 2014, retired.
Jenna is our daughter, bad bladder damaged her kidneys.
Was on in-center hemodialysis 2003-2007.
7 yr transplant lost due to rejection.
She did PD Sept. 2013 - July 2017
Found a swap living donor using social media, friends, family.
New kidney in a paired donation swap July 26, 2017.
Her story ---> https://www.facebook.com/WantedKidneyDonor
Please watch her video: http://youtu.be/D9ZuVJ_s80Y
Living Donors Rock! http://www.livingdonorsonline.org -
News video: http://www.youtube.com/watch?v=J-7KvgQDWpU
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« Reply #15 on: August 11, 2010, 12:04:02 AM »

Properly equipped cycler???? Oh, you mean the beer. Maybe NxStage can make a drink holder on the new and improved.

I did not think we had any alcohol on this trip………Yeah right.

This is the Cycler during its down time.
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AKA Dialysis Dan
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Doing it the best way I can by making it Nocturnal
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« Reply #16 on: August 11, 2010, 11:24:38 AM »

Nxstage allows us to dialysize in "style"!
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