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Traveling

Travel Tips: A guide for patients on dialysis

For many patients who are on dialysis or have had a kidney transplant, the ability to travel is important to their self-esteem and lifestyle. A family event such as a wedding, graduation or family reunion may require travel away from home. At times, emergencies such as illness or a death in the family may require travel.

Don't panic.  With the below travel tips, your travelling plans will be a success!

How should hemodialysis patients plan a trip?

Many dialysis centers have a staff member who is experienced in arranging dialysis performed away from home, known as transient dialysis. Some centers will help patients make their own arrangements. Ask your social worker or nurse if there is such a person at your center.

It is important to start planning at least six to eight weeks in advance. More time should be allowed for popular vacation spots or travel during holidays. Be flexible about the dates for your trip as space in dialysis units may be limited. If you would prefer to have your treatments on specific days and times, let the center know in advance. The unit may not be able to honor your request, however, because space is limited.

You or your patient travel coordinator may need to contact several centers to find one that can provide dialysis for you. Check with the center as soon as you arrive to confirm your appointment. You may also want to visit the center and meet the staff so you will feel more comfortable. Before doing this, however, make an appointment with the social worker or nurse manager of the dialysis center you plan to visit.

What if I need to travel in an emergency?

Dialysis centers make an effort to accommodate patients in the event of an emergency, such as an illness or death of a family member. 

Most centers require the following information in order to assess your health and plan your treatments:

  • The dates you need dialysis treatment
  • Your name and contact information
  • Medical history and recent physical exam reports
  • Recent lab results
  • Recent EKG
  • Recent chest x-ray
  • Your dialysis prescriptions
  • Three to five recent treatment records
  • Dialysis access type
  • Any special dialysis requirements
  • Information about your general health
  • Insurance information
  • Where you will be staying in the area

Dialysis records can be faxed or you can hand carry them with you. 

This information will be sent to your destination center for review. It is important for the doctor and transient center to know your needs while visiting their center. 

How will I find a dialysis center?

If you plan to visit friends or family out of town, ask for the name and address of a dialysis center near them. Resources that list dialysis centers that accept transient patients may be available at your center. Your social worker or the patient travel coordinator will be able to assist you.

How can I make sure I receive quality care?

Ask the following questions when checking into dialysis centers:

  • Does the center reuse dialyzers?
  • What types of dialyzers are used? Can you use the same type of dialyzer you use at your home center?
  • Does the center reuse bloodlines?
  • What is the average length of dialysis treatment?
  • Can they provide the treatment time your doctor has prescribed?
  • What are the hours and days of operation? (Traveling patients often are placed on an evening shift, which could end as early as 7:30 p.m. or as late as 2:00 a.m.)
  • What types of dialysis machines does the center have (conventional, high flux capability)?
  • Does the center provide lidocaine?
  • Are patients permitted to eat or drink while on dialysis?
  • Is an ice machine available for patients?
  • Is public transportation available to get to the center?
  • How many patients are assigned to each nurse or patient care technician?
  • Can you get all of the medications you need?
  • What if I get sick while I am visiting another center?

What can I do to prevent doing too much when traveling?

Be realistic when planning activities. Allow enough time to enjoy sightseeing outings and activities without becoming overtired. Also, be sure to watch your diet and fluid intake.

Before you begin your trip, you will most likely have a doctor assigned to you by your transient dialysis center. Find out how to contact the doctor when you first arrive. If you do become ill, call the dialysis center or doctor as instructed.

It is possible that a transient patient may require hospitalization. If this should happen to you, your transient doctor is prepared for this possibility and will care for you during your hospital stay. He or she will probably talk to your regular doctor to coordinate your care.

Being hospitalized while away from home can be a stressful experience for any patient, and it certainly can change your travel plans. Preparing ahead for this possibility can help make the experience less stressful. The following suggestions may be helpful:

  • Make sure your family knows your travel plans.
  • Have important phone numbers such as your nephrologist, dialysis center, etc. 
  • Keep a copy of your medical records.
  • Confirm that those traveling with you know where you keep your records and your medical needs.
  • Bring enough of your medications to last the entire trip, plus extra to deal with possible emergencies such as lost luggage or a spill. Carry written prescriptions just in case.

Is home hemodialysis possible on a trip?

Yes, however most home hemodialysis patients make arrangements for in-center treatments while traveling. Patients who wish to continue doing their own treatment should check with their dialysis care team. Some patients travel with their machines, supplies, and portable water treatment equipment. An example would be people who dialyze in campsites equipped with electricity.

Even if you do your own treatment, it is important to know the location of the closest dialysis center. Let the center know when you will be in the area and ask if they would be willing to provide medical assistance, if needed.  Most dialysis and equipment companies have toll-free numbers for assistance 24 hours a day. 

Be sure to have your medical information and emergency phone numbers.

What should peritoneal dialysis patients know about traveling?

Traveling is easier for peritoneal dialysis (PD) patients because they are not dependent on the availability of a dialysis unit. PD patients should plan for adequate clean space to do their exchanges while traveling.  Smaller cycler machines are now available, which are easy to carry on airplanes and use in hotel rooms, campers, etc.

PD patients should have enough supplies for the length of the trip plus some extra supplies, just in case. It may also be possible to arrange for the delivery of supplies to your destination for longer stays. Make sure these supplies have arrived before you leave on your trip. 

PD patients should plan ahead and arrange for backup medical care during their trips. Even if you do your own treatment, it is important to know the location of the closest dialysis center. Let the center know when you will be in the area and ask if they would be willing to provide medical assistance, if needed. Be sure to have your medical information and emergency phone numbers.

Is it possible to travel if you are on a transplant waiting list?

Yes. Inform your transplant coordinator about your travel plans. The coordinator will help you decide whether to be "on hold" during the trip or to keep you on the list if you would be able to return, within a reasonable amount of time, if a kidney became available. Make arrangements to be contacted in the event a kidney becomes available.

What should diabetic patients know about traveling?

Since the unexpected may happen during a trip and meals may be delayed, you should carry glucose tablets and appropriate snacks. Some examples are low potassium juice boxes or hard candy, to treat low blood sugar. It's a good idea to travel with a "brown bag" lunch or nutritional supplements in case of delays. Managing your diabetes can be made simpler by having insulin, syringes, and blood glucose monitoring supplies handy.

Will my insurance cover treatment during travel?

Medicare will pay for 80 percent of your treatment costs within the U.S. and its territories. You will be responsible for the remaining 20 percent not covered by Medicare. If you have secondary insurance, it may cover this 20 percent. However, you may have to pay this 20 percent "up front" and bill your insurance later. Check with the transient center about their policy on this.

Most state Medicaid programs will not pay for treatment outside of your home state.  

If you have commercial insurance as your primary insurance, you may need to request a letter from your insurance company stating they will pay for your treatment at the transient dialysis center. Some commercial insurance will pay for dialysis outside of the U.S. Transient dialysis centers will often call and verify this coverage themselves.

A doctor's fee may be charged by the transient dialysis center. Be sure to ask what portion of this charge will be your responsibility.

Be sure to allow enough time to make these arrangements.