Foreign travel on dialysis is something you can do

[okarol]

Foreign travel on dialysis is something you can do
By Bill Peckham

Here is a revised post to answer questions I'm often asked: How many countries have you been too? How many have you dialyzed in? The answer depends on what you count as a country. I primarily used Wikipedia as my reference source and after a full accounting (see footnotes for the complete list of countries visited under in each category) I can now say that in my life:

    I have visited 34 countries with general international recognition including:

        * 33 member countries of the United Nations(1)
          I have dialyzed in 20 countries with general international recognition, on five continents
        * 1 country with general international recognition but not UN membership(2)

    In addition I have visited 7 nations that are not fully independent countries, dialyzing in 2:

        * 1 oversea territory of France, governed as an overseas collective(3)
        * 2 oversea countries in the Kingdom of the Netherlands(4)
        * 3 British dependencies(5)
        * 1 Chinese territory under (temporary) Portuguese administration(6)


(1) * USA – Home base Seattle, Washington (Dialysis in over 20 States)
* Canada - multiple; Dialysis Sydney (aboard Grand Waltz) '06
* New Zealand - CKD '87; Dialysis Auckland '99
* Australia - CKD '87; Dialysis Freemantle, Sydney, Noosa & Cairns '99
* Nepal - CKD '87
* Thailand - CKD '87
* Mexico - weekend '94; Dialysis Cancun '05; NxStage Freedom Cruise, Cozumel '10
* Costa Rica - Dialysis San Juan '95
* Netherlands - Dialysis: Amsterdam '96, '98, '99; Dialysis: Hilversum '00; Dialysis: Utrecht '03,'04
* Germany - Dialysis: Straubing '96; Dialysis at Sea, Wilhelmshaven '98; Dialysis: Trier '02
* Czech Republic - weekend '96
* Italy - weekend '96; Dialysis: Florence & Rome '97
* Switzerland - Dialysis: Lugano & Interlaken '96; Dialysis: Interlaken '02
* France - Dialysis: Dijon & Tassin '96; Dialysis: Marseilles '97; Dialysis: Paris '96, '98, '00, '02; Dialysis: Arles '01
* Austria - weekend '96
* United Kingdom - Dialysis: London '97, '98, '03; Dialysis: Edinburgh '03
* Portugal - weekend '97
* Spain - Dialysis: Seville, Madrid, Barcelona '97; Dialysis: Ibiza '03
* Belgium - Dialysis: Brugge '98; Dialysis: Brussels '04
* Sweden - Dialysis at Sea, Stockholm '98
* Norway - Dialysis at Sea, Oslo '98
* Finland - Dialysis at Sea, Helsinki '98
* Russia - Dialysis at Sea, St. Petersburg '98
* Estonia - Dialysis at Sea, Tallinn '98
* Denmark - Dialysis at Sea, Copenhagen '98; Dialysis: Copenhagen '04
* Monaco - Dialysis: Monaco '99
* South Africa - Dialysis: Capetown, Port Elizabeth & Nelspruit '99
* Turkey - Dialysis: Kusadasi & Istanbul '00
* Luxembourg - weekend '02
* Bahamas - Dialysis: Centerville '03
* Singapore - Dialysis: Singapore '04
* Honduras - NxStage Freedom Cruise, Isle Roatan '10
* Belize - NxStage Freedom Cruise, Lamanai River '10
(2) * The Vatican - weekend '97
(3) * Saint Martin - weekend '02
(4) * Saint Maartin - Dialysis: Philipsburg '02
* Aruba - Dialysis: Oranjestad '07
(5) * Hong Kong - CKD '87
* Cayman Islands - 1989 Post Transplant; NxStage Freedom Cruise, '10
* Anguilla - weekend '02
(6) * Macau - CKD '87

Whew, that's a lot of travel! I never expected to be able to travel at all once I transitioned into CKD5 and now here it's been over 20 years of CKD5 travel - the majority of the time visiting units and dialyzing incenter, however, recently I've been able to travel using the NxStage to meet my renal replacement needs.

I've met a number of people who say just knowing I've done all this gave them hope when they heard that they are facing dialysis and that makes me happy. I have a wanderlust co-morbidity and the thought that I would never travel - let alone travel extensively abroad - was the most depressing thing about my kidney disease diagnosis. Now I think I will reach a personal goal of visiting 50 countries and six continents (not sure about Antarctica but with with future NxStage innovations maybe that too will be an option).

My choice would be to visit South American next. I'd like to see Machu Picchu and Iguazu Falls and the Amazon and Chile and ... well you get the idea. Having a wanderlust co-morbidity means I want to see it all. And it can be done - even when you need renal replacement. Happy travels!

Posted on January 10, 2010 at 07:23 AM

http://www.billpeckham.com/from_the_sharp_end_of_the/2010/01/travel-on-dialysis-is-something-you-can-do.html

[kitkatz]

Maybe you can help me. I want to visit Australia but do not know the 1st thing about getting Medicare payments or payments to the dialysis units there.

[murf]

Goodness me you have travelled wide and far. Have you dialyzed with HD or PD on your travels? BTW my ambition is to travel to Las Vegas. I just love neon.

[Hanify]

Maybe you can help me. I want to visit Australia but do not know the 1st thing about getting Medicare payments or payments to the dialysis units there.

I think if you decide where you want to go, then contact the local hospital there - and they'll tell you how it works.  Richardmel could tell you the names ofwho to contact in different areas.  It's not like the States where there are lots of options - so in a way it's easier - if that makes sense.

[murf]

I would be more than happy to help whereever I can if you come to the West.

[BigSteve]

Kit: I was under the impression that Medicare will not pay for hemo outside the United States, which is why
you must paid yourself for "dialysis at sea". Better check with the Australian health officials about cost.

[Bill Peckham]

Kit: I was under the impression that Medicare will not pay for hemo outside the United States, which is why
you must paid yourself for "dialysis at sea". Better check with the Australian health officials about cost.

Australia is actually one of the pricier place to travel. My secondary insurance through the carpenters union reimbursed me for dialysis expenses I ran up traveling abroad. BigSteve is right that Medicare only reimburses Medicare approved facilities - which are all in the US but include places like Puerto Rico, US Virgin Islands, Guam but sadly not Oz.

I updated the post on the 11th when I realized I left something off - here's the update.

UPDATE 1/11/2010
While answering a commentto an old Dialysis in Fiji post I realized that I had made a grievanceoversight when I posted this without crediting the Northwest KidneyCenters' highly skilled visitor dialysis services for their help in making it all happen. All those trips were facilitated by the most awesome dialysis transientcoordinator in the business. Without Cheryl it would have been a lotless fun to organize the travel that has meant so much to me.All that travel only happened after all the paperwork was faxed to aunit. I took my first trip within four months of starting dialysis;there was no internet back in 1990. Cheryl made it happen no matter thelanguages and besides all the languages involved, there is also thefact that each unit has their own particular way of setting up thevisit all their hoops.
I wish everyone dialyzed at the but I know that isn't possible. Instead, I'll wish all dialysisproviders followed the Northwest Kidney Centers model of  promoting theoptimal health, quality of life and independence of people with kidneydisease. They do this through patient care, education, research ... andCheryl.   

[Bill Peckham]

I should say too that with the NxStage or PD you can have your dialysis reimbursed while you travel abroad because you are still being treated by your home unit even if you are not home.

NxStage is trying to break out of the 48 states so I hope someday supplies will be available for us to use ... so that all you have to do is bring the machine. Right now though, you need so much dialysate that it makes it logistically difficult. That's why we started our Freedom cruise from a US port - our supplies were shipped to the dock. We finished in the US but you wouldn't have to - you could finish "there" with extra supplies and then fly home once you ran out of dialysate. there is also the issue of technical support outside the US which is the idea behind getting a group together.

So I am thinking that it would be possible to join a cruise ship in San Diego and go to S America with enough dialysate to be in Ecuador for a week. From there I could take a dialysis weekend and go to Machu Picchu.

[Jie]

For the PD, although the supplies are covered by the insurances, the patients need to pay the handling fee and shipping costs to foreign countries. For some countries, these costs may not be cheap.