I'm leaving for Aruba on Sunday (11/11) and I will post to a travelogue here if I have internet access during the trip or after the fact if I don't. So far I have dialyzed in 21 countries on five continents (and visited 31 countries in my life) but this trip wont extend my all time list unless I go to Venezuela for the day because according to about.com Aruba is not considered a separate country since it is part of the Netherlands Antilles. This is also why I don't count St. Maartin, Bahamas and the Caymans - not to mention Hong Kong (pre-turnover) and Maccau. At home I dialyze on the NxStage but for this trip I am dialyzing incenter at the
http://www.nebuladigital.com/posada/ Posada Clinic Aruba and in the Chicago area - where I'll be for Thanksgiving - I'm doing incenter nocturnal at a Neomedica unit in Evanston. All together I'll be gone for two weeks which is a short trip by my standards.
------------I started setting this up in the spring. It was all done through email which makes life much easier. They needed the usual tests: chest xray, ekg, labs, HbsAg but also MSRA. I had to do the last two within a month of the trip so I finally got the all done and submitted last week. The place my brother and I are SCUBA diving through wants a note from my doctor but I'm still waiting for it so it'll have to be emailed as I travel. I looked for expert opinion (I found this
http://scuba-doc.com/kidprbs.htm ) but I'm not sure how big a problem dehydration could be with no kidney function so I don't think there are any contraindications other than the usual fitness stuff - I can tread water for over 10 minutes so I think I am good to go.
Saturday 11/10It's 11 AM and I've just gotten on dialysis in the comfort of home. I leave tomorrow at 1:40PM so my plan is to wake up early and get on dialysis by 7AM, 6AM would be better. I'll leave the house at noon or so; it'd be nice to have a little time between dialysis and the airport. I'm running 30L today and ran 30L yesterday. On Thursday I ran 25L getting on about 8:30PM. So I've been getting on about five hour sooner each day. My experience is that you can "bank" dialysis a bit, so I hope be well dialyzed going into the trip will leave me feeling good as I transition to an incenter schedule.
In Aruba I'm dialyzing on the 13th, 15th, 17th and 19th at 1:30 in the afternoon - a Tuesday, Thursday, Saturday, Monday schedule. I travel back to Chicago on Tuesday the 20th and have incenter nocturnal dialysis scheduled the Neomedica unit for 7PM Wednesday the 21st. Then my plan is to have a weekend, Thursday and Friday off, before returning to Seattle and home hemo on Saturday. If I'm feeling too under dialyzed I could do another nocturnal run Friday night.
Sunday 11/11I got on dialysis at 5:45AM this morning, off at 9:30 which gave me enough time to finish packing, go for a short walk with the dog and get to the airport by 12:30. The flight was fine. I am writing this from the Chicago area where I am spending the night at my mothers condo. My brother and I leave for Miami tomorrow at 10AM and then on to Aruba and the Manchebo Beach Resort
http://www.changes.com/resorts/best-western-manchebo/.
I haven't traveled with Jim since childhood trips 30 years ago. A lot of water has gone under the bridge since then. Jim gave me his kidney in 1988 but the FSGS reoccurred in the transplant (blood test indicate it is still active). We were both disappointed by that outcome but at least we're both still here 19 years later and can go on this adventure together. Back in those days after the transplant in 1988 if you had told me that Jim and I would be traveling to Aruba in 2007 it would have seemed unlikely - it just goes to show you never know what the future will bring.
Monday 11/12Made it to the airport and through security. Usually I'm the travel agent in the family but this time I left all the arrangements to Jim. So I shouldn't complain but ... I doubt I would have booked a ticket with a three hour layover in Miami. We're due to get in to Oranjestad a bit past 9PM after about 6 hours of air travel (9 hours total). I'll have tomorrow morning to get orientated, maybe go for a swim before reporting for dialysis at 1:30. I brought buttonhole needles with me along with everything else that I use to get myself on - BP cuff, 4x4s and the paper tape that I like - Wednesday will be my first real day of vacation.
I'm typing this on my laptop. My plan is to write trip reports at dialysis and then transfer them via zip drive at an internet cafe (there are always internet cafes). I also have my old camera so there should be pictures and maybe even video.
------------I'm now in Miami, one more 3 hour flight and I can kick back for a week. The first daiquiri of the trip has been consumed - it will not be the last.
Tuesday 11/13Woke up at 7 with my brother - he went out diving; I napped on the beach. There is a four hour time difference between home and here. I realized this after a quick dip so I felt totally not guilty taking a nap - it was four in the morning my time!
I'm at dialysis right now - wi-fi and sandwiches - who cares about the machines this is great dialysis. Just kidding the machines and the staff matter of course. Brand new 2008Ks; single use optiflux kidneys; the staff English speaking and experienced. Petra put me on after I cannulated myself with buttonhole needles from home. She's based in Germany and is visiting here for a few months. The charge nurse talked with me while I waited for my chair to open up. She started in dialysis in 1982 and remembered Scribner shunts after I mentioned that I was from Seattle. I think she Googled me because she new a bit of my history that isn't in my medical records.
The unit is 10 stations, each with TVs and they're running full. I'll have pictures eventually I need to use the card reader back in my room to get them off my camera.
There was a traffic jam getting through Oranjestad - dialysis is close to the airport; the Manchebo resort is on the opposite side of town. Three cruise ships were docked, a daily occurrence, so the sidewalks were busy. Last night we got in about 10PM (there was a delay leaving Miami) and when we went through town there were a fair number of revelers out having fun. To get food Jim and I walked a couple blocks to a casino noting a number of party buses shuttling people from club to club. Not sure if I'm up for that.
Tomorrow I have two dives scheduled, so it'll be a quiet night tonight.
Wednesday 11/14Some times the best laid plans go astray. There was no diving today. Before I tell that sad story here are a couple short videos that I shot during dialysis yesterday - it took about a day for them to show up on Google.
I took this one during treatment
http://video.google.com/videoplay?docid=3917888941255113676 and this one post treatment after weighing myself
http://video.google.com/videoplay?docid=5026137483682890551 they show a bit of the unit but my video skills are somewhat lacking.
So SCUBA was a no go - I am still waiting for a note from my neph in Seattle okaying me to dive. I also am having a problem with my certification that I did back in 1979 not showing up in the computer records. The shop here called PADI in CA and they said they looked through their pre-computer era records and could not find my certification records. My brother and I went through certification together and he has his card which is labeled basic but the company here wants to see a certification of "open water". I'm not sure what is going on but it may be that all this time we've been diving with the wrong certification, which seems odd. I don't know. First I need to get the medical authorization then I can try to figure out the PADI situation.
On the bright side I had another nice morning of swimming in the ocean followed by naps on the beach. I'm about ready to hit the beach again. The water is still warm, the sun hot and the drinks cold. Diving may have to wait 'til Friday.
Thursday 11/15Writing from dialysis - started at 9:30 this morning, just finished a nice snack of fresh fruit and a ham & cheese sandwich, washed down with tea. In my experience coffee is awful in the Caribbean - there seems to be a preference for instant. So I switch over to tea because I just can't abide bad coffee.
I heard back from my doctor - he had mailed the note authorizing me to dive to my house. It has now been faxed so I should be underwater some time tomorrow. Usualy I seem to stay pretty busy on vacations but this one has mostly been napping on the beach when not on dialysis, and reading. My beach reading has been truly frightening.
I've been reading
The Great Influenza - The Story of the Deadliest Pandemic in History by John Barry. The parallels to today are throughout the history of 1918. I'm about done and I'll switch to one of the page turners my brother brought.
Saturday 11/17Back at dialysis. I received a message yesterday asking me to change my time from 1:30PM to 8:30AM which I was willing to do - I spent yesterday swimming and napping on the beach even playing Frisbee with my brother. And there were several rum drinks involved.
I had my lounge chair set in the shade of a palm frond shelter but it would seem palm fronds do not provide total protection from the sun. I have patches of sunburn on my chest and right shoulder which I discovered while taking a shower this morning.
My back is not burned which will allow me to get my much anticipated massage this afternoon. After all it is the Manchebo Beach Resort AND Spa so it would be rude to not use the services of the spa.
A bit more on the Posada Clinic - I'm running on a FMC H machine so they are not all Ks as I reported. They've asked me for suggestions to improve the facility; I have two. One the lighting - I dislike running under fluorescent lighting which is the setup here, much better would be to have them individually switched so they could be off between the on/off procedures. Two: since they're running full why not add an evening shift? I like to dialyze and then go to bed and most people visit Aruba for sun fun so an evening shift would be a good fit. That's all I got. They're talking about opening a unit on Bonaire I promised to visit if they do.
Monday 11/19I went horseback riding on the beach yesterday, while Jim was scuba diving and then we went out to a dinner at a French restaurant called La Dome
First course
http://video.google.com/videoplay?docid=-6687939195326836709Second course
http://video.google.com/videoplay?docid=8903096924517464843Third course
http://video.google.com/videoplay?docid=6309010426231518394and desert
http://video.google.com/videoplay?docid=7295888616458690400Jim is astounded that there is video of our dinner on the internet. I also uploaded a few pictures - pretty self explanatory: the one is of the outside of dialysis clinic and one is the view from our room's balcony - a great place to read a book. The only disapointment on this trip is that I did not manage to go scuba diving (I need to sort out my certification and Dr. permission before traveling) but that did lead to plenty of rest and relaxation which is what I really needed.
Tuesday 11/20They tell you to come to the airport three hours early because of all the hoops you need to jump through to get to the gate. The nice thing is that Aruba is one of three islands that you go through customs here rather in Miami. SO Jim and I showed up three hours early and 40 minutes later we're sitting at the gate. I still have internet access through the island wide wi-fi but I would much rather be spending the time lying in the sun.
It's been a great trip - I'll post a recap once I'm back in Chicago.
Friday 11/23I've been in the Chicago area since Tuesday night or rather Wednesday morning - flight got in right about midnight.
Had a seven hour nocturnal treatment scheduled at a DSI unit in Evanston, IL for Wednesday night. Got on about 7:30PM and off about 3:30AM with a splitting headache. I don't know why I keep using this center - something about the settings on their FMC K machines give me a headache just about every time. At least the lights are off and it is pretty quiet which makes for a better dialysis environment then the video arcade like atmosphere of the day time runs. I've had a couple salty meals which has me fluid overloaded. I'm due to return to the unit tonight and I can feel that I have 4+kg of fluid on so I'm going but I think I'll run for five hours and call it good. Baring flight delays I should be back home and dialyzing daily by Saturday night.
Had the whole Giant Chicken Day experience with the family last night, which is nice. There were some snow flurries here yesterday (when I was going out to the car at 3:30AM and throughout the morning) which was a shock to the system after Aruba. Definitely could have spent another week lying on the beach.
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