Dialysis from the sharp end of the needle

Taking Peritoneal Dialysis to Sea: Jean Louis Clémendot Crosses Atlantic Alone; Eyes Tour of the US East Coast and then the Pacific!

By Bill Peckham

UPDATED 2/14
The Kidney Foundation of Canada has a brief article (in English) about the remarkable Jean Louis Clémendot who successfully made a solo crossing of the Atlantic, while administering his own peritoneal dialysis treatments:

A 59 year-old sailing enthusiast and continuous ambulatory peritoneal dialysis (CAPD) patient, Jean-Louis Clémendot left the island of Lanzarote in Spain on November 30, 2009 to sail solo across the Atlantic, heading for the Carribean island of Martinique. He completed his journey in less than four weeks, as expected, arriving at his destination on December 24, 2009.

What a trip!

Clémendot has a website with updates in French and a companion site in English. Unfortunately for we mono linguists, the English site is at times a bit behind in translating Clémendot's posts (Google translate does a fair job, though not nearly as good a job as Clémendot's own translations). To follow the entire saga check out his history page. The journal begins in September 2009, French on the left of the page, English on the right.

The trip begins with an initial run from Marseilles to Lanzarote (the eastern most Canary Island, off the NW coast of Africa), for this leg he is accompanied by two friends. Clémendot then waits about a month for the winds to take him alone to the Caribbean. Before leaving he has "a biology internship to learn what to do in the event I contract peritonitis" and buys a microscope so that he can identify which antibiotics would be best in the event of an event. This is but one of the logistic challenges he faces and overcomes.

He has what he calls the longest Atlantic crossing in history but there are many exciting moments and he shares a number of pictures and video. Clémendot's goal is to raise awareness of peritoneal dialysis and his website links to a number of interviews and articles, one with his doctor is available via Google translate. His December 29th entry led me to believe his next destination was the East Coast of the United States after a sail along the eastern arc of the Caribbean. That sounded like a great trip, however, via email correspondence he pointed me to his later posts (particularly from 1/18, available as of yet only in French) and wrote that his plan is to now leave for the Pacific.

He writes that he "will start from Martinique on the midle of mars and i expect to reach Tahiti on mi mai." Through the Panama Canal, to the Galapagos on to the Marquesas Islands and then to Tahiti by mid May. That's an epic voyage. He speaks of having crew for the canal, after that I am not sure. I'll definitely be keeping track of his adventure as it continues to unfold.

Holiday dialysis in Scotland; visiting the Festival Fringe

The Edinburgh Festival Fringe is next  month (August 3-25), it's the largest arts festival in the world. Not only is it a great event to visit, in a very visitable city, it is also easy for a dialyzor to visit the city. Scottish Holiday Dialysis  is a great private dialysis unit in Edinburgh which makes dialyzor holiday travel a joy. I was able to visit the festival in August of 2003. The following is a repost from my proto-blog over at GlobalDialysis.com.

With the dollar so weak I am glad I traveled when I first had the chance. I dream of returning to Edinburgh, though it will be tough to travel in the shadow of this perfect 2003 trip. Someday. Until I can engage my wanderlust I will live with the memories and the wanderdesire.

Dialysis in Fiji

Both the Fiji Times Online and FijiLive have articles announcing plans to build a dialysis center in Suva. According to the Fiji Times Online article

In the South Pacific there are only two Dialysis Centers, one in Samoa, which started three years ago and the other is now in Fiji.

I supposed this would be between Hawaii and New Zealand but there is dialysis in Tahiti according to globaldialysis.com (even a helpful comment indicating the possibility of extended treatments dialyzing into the early morning). This may be a cultural divide since geographically they seem pretty close (considering the size of the South Pacific). The odd thing about both articles is that they focus on the promise of increased tourism as opposed to the promise of allowing people with severe kidney disease to remain in their communities.

Who wouldn't want to go to Fiji? Build the unit and the dialyzors will come. Both articles quoted a number I had never seen. As the Fiji Times Online put it:

Dr Benjamin [who heads the Cancer Services in Auckland] says there are about 50,000 people around the world in need of dialysis and this will lead them to seek treatment in Fiji.

And the great news is that there will be tourists coming for dialysis as there are over 50,000 rich people around the world who need dialysis and they want to come to places like Fiji, Dr Benjamin said.

In the FijiLive article Dr. Benjamin's quote is a little different

Dr Benjamin, who has volunteered to provide assistance to the new dialysis centre and is also head of Cancer Services in Auckland, says that apart from saving the lives of kidney patients, the Dialysis Centre would greatly promote tourism in the country. 

There are 50,000 patients all over the world who would like to visit places as well as get their treatment done and Fiji provides them with both, according to Dr Benjamin.

That 50,000 number of course caught my attention. Most likely this is a well meaning cancer doc pulling an number out of his a the air. Besides generate wanderdesire and make me want to lie on a beach in the South Pacific, the article did cause me to wonder how large is the dialyzor visitor market for Fiji? I'm not sure you need to be rich. It may be that there are funds to reimburse for treatment for dialyzors from the UK, EU or Australia/New Zealand. Australia and New Zealand would be the target markets, just due to proximity. I might fly through Hawaii to visit Fiji but I am not sure how many other Americans would.

Video wanderdesire

In case reading about the Arcus Polyclinic Dialysis Centre in Medulin, Croatia wasn't enough to make you want to travel to Croatia, there is now a video.

It is about 6 minutes long. It starts with the attractions of the area, followed by the accommodations, food, view and spa. Then in the fifth minute we see their state of the art dialysis unit, with internet! I am so there - you'd think they'd fly me in to review it in person (hint, hint). Watch and dream:

Egyptian wanderdesire

I came across the slow to load site of the Egyptian Medical Services, which has dialysis destinations across Egypt. It looks like one could put together a great visit by going to several of EMS's units. I'm not clear on the unit near Luxor, whether it is on a boat or merely a embarkation point for Nile cruises but it sounds nice - the list of leisure facilities is intriguing. I have never been to a dialysis unit with a swimming pool. Fish tanks but not a swimming pool. Cairo, Luxor and Sharm el-Sheikh, that would be a good two or three week trip.

Dialysis travel to Turkey

I received an email over the weekend

I started with my own travel agency for dialysis travel to Turkey, and have from lots of country's kidney patients coming with a group or individual. Mostly of them I guide by myself and its a pleasure for me. As Turkey is a famous country with the civilizations and rich on culture, I started with the mini-Anatolian tours to much famous places in Turkey, such as Cappadocia, and of course Istanbul

Ah Turkey. I had a great trip to Turkey in 2000. The above note was sent to me by Ms. GÜNEŞ at www.dialysisandholiday.com.

It would be fantastic to get back to Turkey. My host in 2000 is now in residency in Detroit, I'm very glad I went when I did. Ms. GÜNEŞ could do for you what Dr. Eke did for me - organize treatments and act as a guide. Sancar and I have been friends ever since that trip - in fact he called while I was typing this post. He must have sensed that I was thinking of him. I used the Way Back Machine at archive.org to access an article I wrote for iKidney that I thought was gone forever. As I recall the article was meant to discuss the intersection between the internet and travel. I've done a bit of editing - the links were mostly still good - I resisted the temptation to substitute dialyzor for patient. It was a great trip and I owe it all to the internet.

More wanderdesire

My previous waderdesire posts are here and here; now via email:

While looking through the dialysis entries on the web, I came across
your information.  Although Cairns Private Dialysis centre is no longer
functioning, the Holiday Dialysis Unit at Cairns Private Hospital has
taken over its function.  If you ever choose to come back to Cairns,
give us a call.  We'll love to see you.

Ah Cairns. I have very nice memories of Cairns - I've been there twice. In 1987 pre stage 5 on my first attempt to travel around the world and again in 1999 when I was able to stay for five weeks and enjoy dialysis at the Cairns Private Dialysis centre (photos here and here). I asked what dialysis cost at the Holiday Dialysis Unit at Cairns Private Hospital and was told for overseas visitors the per treatment charge is $920 Australian. Nothing like a cold splash of financial reality to wither the wanderdesire.

Thinking back to my 1999 trip I recall dialysis in Sydney was about $550US per treatment which seemed expensive at the time. The exchange rate as I remember it was 2AU to 1US so that would have been about $1,000AU. So it isn't that dialysis has gotten more expensive per se it is that because of the weak American dollar dialysis in Australia (and Europe) has gotten more expensive for me.

When I visited the Cairns Private Dialysis centre in 1999 they offered foot or face messages with every treatment. At over $800US per treatment  I would hope that the Holiday Dialysis Unit at Cairns Private Hospital continues the tradition.

More wanderdesire

My post yesterday on the Arcos holiday dialysis center led me to Google "Holiday Dialysis"; One of the top results is for HDI - Holiday Dialysis International. I used their service to help set up dialysis on my 1997 trip. From the website:

Holiday Dialysis International (HDI) which is part of the Fresenius Medical Care group offers you the unique opportunity to visit selected dialysis facilities around the world with the guarantee of Fresenius Medical Care's high quality technology and superior products. HDI can offer you maximum comfort, multi-language assistance and friendly service during your holidays.

I clicked through to their Destinations map of South America and saw numerous units in Brazil and Argentina. Two units - one in San Paulo Brazil and one in Mansilla Argentina - look to be close enough to Iguazu Falls to support a visit. This is sure to provide months and months of wanderdesire.

Croatia - holiday dialysis

I like browsing sites like this one for the Arcus Polyclinic Dialysis Centre in Medulin Croatia. According to the website the 20 station unit features B Braun Dialog machines, Internet access and they serve food during the treatment. I can tell you right now that this unit would get a five star review from me unless something is terribly wrong with the staff. Give me internet access and a sandwich and I'm a happy dialyzor.

Not to mention I've never been to Croatia. This is an under appreciated benefit of a wanderlust comorbidity: wanderdesire - the pleasure of imagining a trip not yet taken.