Holiday Dialysis in Singapore
Background, in December of 2013 I started dialysis (hemodialysis) at 39 years old. Dialysis is three days a week for three and half hour commitment hooked up to a machine that filters my blood to replace kidney function. Amazingly, you can live with zero kidney function. My loss of kidney function was due to SLE (Lupus) damage in the early 1990s. At that time, I knew that my kidneys would get worse and i would have problems, but at 18, I didn't really have a clue what it would mean. Fast forward to 2007, when I was in the hospital for high blood pressure and was told it was kidney related. So for the past six years, I've been seeing a nephrologist tracking my kidney decline. It was helpful having a trained kidney doctor guiding me. He had me get a fistula on my arm, i.e. connect an vein to an artery on the arm to make an enlarged vein that would allow a huge amount of blood to flow back into the arm. He also pushed for me to get listed on the kidney transplant list. Because of that, I received my call on the first potential donor three weeks before I started dialysis.
I'm on in center hemodialysis. There are other methods of dialysis, and many people manage dialysis at home. I hope to be the recipient of a kidney transplant at some point relatively soon I'm no planning on moving from the center. That means if I travel I will need to get in center hemodialysis.
So dialysis is a change, and ties down Susan and myself a bit. But, I'm generally healthy, my lupus has been in remission since 1993 and am able to handle work and daily functions, which is a blessing. So my goal is to let it change my life as little as possible. And our pre Dialysis life is lots of travel - in 2013, we visited Austin and Petersburg, Alaska for my 20-year high school reunion, St. Louis, Cape Cod, Budapest, San Antonio, San Francisco, and Cabo San Lucas.
I was happy that our next trip was Singapore - a truly modern location and a good place to my first out of the country dialyses. My Davita center will help schedule dialysis at other Davita centers in the US, but only will help fill out the intake paperwork for other faculties - so I was on my own to find my Singapore center. And it's still unclear if my heath insurance will pay for international dialysis, it should cover it as out of network but I envision having some issues completing the reimbursement paperwork - so the overall cost was important to me.
Google searches for Singapore Dialysis found Raffles Dialysis Centre which even had a web page setup for their center. An email to them resulted in rates that were $500 each session plus one $125 doctors consultation. (All rates are in Singapore Dollars which are at a bit of a discount to USD, so the prices end up being a bit lower, but not significantly lower.) That pricing is much less than my center charges ($1,400) but seemed a bit high. I was having problems finding other centers so I moved to the Duck Duck Go search engine and found the Fresenius Medical Care Singapore website which had a holiday dialysis webpage that listed various centers by region of the city of Singapore (
http://www.fmc-sg.com/patients-and-caregivers/holiday-dialysis). Through that site I emailed a few locations and finally settled on NephroCare S&J Dialysis Centre (
http://www.fmc-sg.com/nephrocare-s-j-dialysis-centre) which charged $400/session, plus one time $60 registration and $80 doctors consultation fee. The ideal thing is I was able to setup the two sessions entirely via email. The more complex requirement is that they needed an HIV test, which my dialysis center would not order, so I had to go to my primary doctor to get that filled.
So how is Singapore dialysis different than here in the US? For one thing, they didn't think I would fit in their seats so they put me in a (short) bed. In my center, the techs prep all the material they need in advance in a bundle and distribute it to the machines - in Singapore they had a commercial pack that included everything that was needed, but they they don't use single use alcohol pads, the pack included a plastic box like a lunchables container, which they added both saline to, as well as alcohol, so they could pull what they had needed from. Then, they did use a single use alcohol pad to wipe the needles before they were removed from my arm.
Best of all - likely due to the British influence in Singapore - they offered tea or coffee and crackers mid-dialysis!
So looking forward to 2014 we will take more domestic quick weekend trips from early AM on Saturday to Sunday or Monday so I don't need to scheduled dialysis away from my center. And for international travel we have a trip to South Africa in September, there we will give up one of four safari days so I can get my dialysis in the Johannesburg area twice, before moving on to Cape Town and completing a few more sessions.
I think we will do more travel to Europe and more developed destinations and I will end up being dialysis at more Fresenius centers since they seem to be a global brand with centers throughout Europe and even Asia. Of note my center uses Fresenius dialysis machines.
Photos attached of me on dialysis, the tea and crackers, and then a shot of Susan and myself in transit.
(Quick note to ihatedialysis readers - hello, this seems to be my first post. I intended to do an introduction post, but did not get around to it. Here is the US people with good credit have the ability to earn huge amounts of airline miles via credit card sign up offices - so I do that - and use the points for international first class flights - thus the flights in the photos at the end are courtesy of American Express and Citibank...)
(This post will be cross posted on milepoint and the flyertalk forums.)
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