If you're on dialysis, travel takes careful planning, but a cruise vacation is possible. Here's what you need to know about cruising with kidney disease.
About 90 percent of dialysis patients use hemodialysis, which is normally done in a clinic. The most realistic way for them to travel is to take a cruise planned for dialysis patients, which lets passengers continue with the treatment schedule they use at home.
For example, the company Dialysis at Sea regularly offers cruises with Royal Caribbean and Celebrity Cruise lines. It brings hemodialysis machines onboard, along with a renal care specialist team, including a nephrologist, dialysis nurses and certified medical technicians. The treatment takes places in the ship's infirmary. Unfortunately, the treatments are not covered by Medicare or Medicaid, although some patients do get partial reimbursement from supplemental insurance carriers.
In Europe, Dialysis While Cruising partners with MSC Cruises.
Going on a group cruise will be the easiest way to travel because planning dialysis during cruise port visits is complicated and risky since patients are at the mercy of shifting schedules and port changes.
However, those patients who use home hemodialysis can bring their machine with them. First, make sure the cruise line allows this. Then alert your supply company several months in advance to order extra materials.
For the 10 percent of dialysis patients who use peritoneal dialysis, a home-based treatment, it is also possible to travel with a machine and supplies and attend to your own health care, says Kelli Collins, vice president for patient engagement with the National Kidney Foundation. Generally, experts recommend that patients have a year's experience with the treatment before traveling, and some cruise lines require this.
"Peritoneal dialysis is a little bit more manageable," Collins says. "Anything is possible. We have people who go camping in the woods with their machines."
While it might seem convenient to have supplies sent directly to the ship, it's easy for them to get lost. One solution: Arrive at your port a day early, stay at a hotel where you can have your supplies shipped, and pick them up yourself. Also make sure you have basic materials like gauze sponges, antiseptics, disinfectants and gloves.
Whatever path you take, it's important to bring medical documents with you, including your doctor's dialysis prescription, medical histories and charts. Also, bring contact info for your dialysis machine manufacturer and supply company, and copies of your drug prescriptions.
Finally, send a note to your ship's disability services department before you travel to inform them about your dietary needs, and to request a refrigerator, if necessary, for your supplies. Also, ask to meet with the maitre d' to review your dining restrictions once you're aboard the ship.
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Patients can fly with dialysis equipment. A peritoneal dialysis machine can come aboard as carry-on, but a home hemodialysis machine is too large and must be checked as luggage. However, airlines aren't supposed to charge for taking medical supplies as long as the packed machine meets weight and supply limits.
In addition, medical supplies are not supposed to count against your carry-on limit, according to FAA rules, and actually take priority over other passengers' carry-on luggage. To avoid problems, bring a printed copy of your airline's policy on dialysis machines, usually found on its website under "disabilities."
As with other medical conditions requiring special equipment, have a doctor's note to show Transportation Security Administration (TSA) agents and airline personnel. With proper documentation, a patient can bring aboard syringes and dialysis fluids. It also makes sense to ask for a wheelchair beforehand, since that will alert the airline that you have a medical condition. Also ask for preboarding, which will help assure you have room for your machine and supplies onboard.
Finally, have a backup plan. If your machine gets lost or delayed, have the names of a local treatment center you can visit. If you do have any problems, ask to speak with the airline's complaint resolution official (CRO) or call the FAA's disability hotline.
Onboard Your Cruise
Once you arrive at the ship, have the machine and supplies delivered directly to your room. You may have to ask for a supervisor and explain that it's expensive medical equipment and you can't be separated.
If you're using needles, ask your steward for a sharps container for disposal, and for a refrigerator, or a refrigerated place to store supplies, if necessary.
As for the cruise itself, make sure the staff knows your dietary restrictions. "On vacation it might be harder not eating the wrong things," Collins cautions. "Passengers need to be very careful about not eating too much salt, and limiting the kind of fluid they drink."
For information about cruising with a different medical condition, see our articles on: