Pleasant Departures with PD
By Contributing Writer and PD Patient
PD stands for Peritoneal Dialysis, but it also could mean Pleasant Departures. Because no other form of dialysis offers the travel flexibility of PD; business trips or weekend getaways with family and friends can be as worry-free as ever – with just a little advance planning.
I am a happy and active PD patient who chose this form of treatment because, as a professional writer who travels frequently on assignment, I wanted the freedom to go when and where I needed. What's more, I felt I had the physical ability and emotional dedication to administer dialysis to myself on a daily basis, without being surrounded by strangers in the confines of a clinic multiple times each week like patients on hemodialysis. I don't know about you, but when I work, I like to be comfortable.
Before starting any trip, the most important thing you can do is contact your dialysis nurse or nephrologist and inform him or her of your travel plans. Your medical professional can recommend how many PD supplies and other materials you'll need to take along, advise you on the most appropriate places to conduct Continuous Ambulatory Peritoneal Dialysis (CAPD) exchanges, and notify a dialysis center near where you'll be staying just in case of any emergencies. Besides, it's much more enjoyable talking about your upcoming getaway than discussing your potassium levels.
Some other preparations you should make:
Find Your Solution: Can we all agree on this? Cases of dialysis solution are heavy and awkward to carry! If you're traveling by plane or driving long distance, you can arrange to have fluid and supplies drop-shipped to your destination. In most instances, you need to give your supplier two to four weeks advance notice to deliver to a location within the continental United States, a month or more if you're going abroad.
If you're staying at a hotel, call ahead to let the staff know you're expecting important medical supplies – and be sure to mention that the shipment will include several heavy boxes! (You already know this, but why should the poor hotel workers be surprised?) Tell them the boxes need to be stored in a dry, clean area away from direct sunlight. Then call again a day or so before check-in to make sure everything has arrived. It's an extremely reassuring feeling to open your hotel door and see your dialysis supplies neatly stacked in a corner.
You Can Take It With You: Because I make most of my trips by car, I simply carry my dialysis fluid with me in the trunk. If you do, consider buying a small, inexpensive dolly to help haul those cases around, and remember not to leave the fluid in your trunk too long; sustained exposure to extremely hot or cold temperatures may cause the product to be unusable.
Since I routinely stay at a friend's condo when on assignment in Detroit, I keep a few extra cases of solution there in a cool, dry corner. (The shelf life of this stuff is pretty amazing.) If you're a frequent guest at a hotel, motel or someone's home, ask if they'll let you keep a case or two of fluid there for emergencies, and to lighten your load on future trips.
I once knew a wealthy media executive who always stayed at a small family motel off the interstate even though he could easily afford more lavish accommodations. He preferred the quiet surroundings and eventually knew every employee by name. I'll bet they'd have let him stash anything there if he asked politely.
Papa Get a Brand New Bag: Traveling with PD requires taking along a heap of necessities (clamps, masks, minicaps, hand sanitizer and so on) you've probably never left home with before. I purchased an inexpensive three-pocket shoulder bag that can hold all the accoutrements needed for a complete CAPD exchange – smaller items in the front pocket, bulkier things in back – and is sturdy enough to be checked through as baggage on an airline flight. You might want to create a checklist and place it inside the bag to ensure that you don't forget anything.
In your carry-on bag, include enough room to pack a "first aid kit" with two days worth of essential supplies to tide you over in case of an unforeseen complication, like lost or delayed luggage. Make sure in advance that your carry-on baggage meets all security and airline regulations: As I learned to my regret, carrying a razor blade on board so you can slice open cases of solution later is not the wisest move.
My advice: Always bring more equipment than you'll need for the exchanges you plan to do while traveling. On my first trip on PD, feeling fairly confident that I had mastered the technique, I packed exactly one minicap for each exchange I expected to perform on the road. While showing one of our 10-year-old girls, Madison, how to remove the minicap from its packaging, I pulled the seal apart with a flourish only to watch the minicap soar through the air and land on the bathroom floor! Sheepishly, I had to call the local dialysis center my nurse had notified about my visit and ask them to supply me with one minicap! (Taking one look at me upon my arrival, they gave me several.)
Hitting for the Cycler: If you use an Automated Peritoneal Dialysis (APD) machine, or cycler, never check it as baggage on an airline flight. Keep it with you at all times; you don't want to know how much it costs to replace should it get damaged!
It's a great idea to have your doctor give you a letter stating that the cycler is a medical device that must remain in your possession and the bags of solution, should you ever have to fly with them, are for medical treatment and must not be opened. If your doctor is a kidney specialist, he already should have such a letter prepared; if not, urge him to create one and make copies for other patients in the future.
Note: The cycler does not always fit conveniently into overhead airplane compartments. No matter. On one flight, I placed the APD machine under the seat in front of me and flew with my feet on top of the machine, knees up around my ears. Better to be uncomfortable for a short time than to watch your cycler come off the carousel in pieces.
At your destination, make sure there's a grounded electrical outlet close enough to your bed so you can use the APD machine and that the voltage and type of outlet are compatible with the unit.
Oh, and have a good time on your trip!