Roam around the world on dialysis

For many people, travel brings them great joy and awakens a sense of adventure. Traveling outside the United States and seeing other cultures can be incredibly rewarding, both in terms of the sights and the insights it can bring. However, the prospect of leaving the country while receiving dialysis treatments is understandably daunting, and many on dialysis may think their dream of going abroad is not possible.

Traveling internationally as a dialysis patient does involve its challenges. Since health insurance typically does not cover foreign medical expenses (and Medicare does not cover care outside of the U.S.), international travel can be too expensive for some dialysis patients. However, with adequate planning and research, traveling to other countries can be possible for people on dialysis. 

First and foremost, if you are considering a trip abroad, talk to your doctor to make sure you are healthy enough to travel. Once you've done that, give yourself plenty of time to plan. You should make international travel arrangements no later than 10 weeks (about 2 and a half months) prior to when you'd like to travel, which means you should conduct research on potential destinations, the state of dialysis and dialysis centers in those locations before this 10-week period begins. This is especially true for countries with a language barrier, as the barrier may slow the planning process down a bit. If you use in-center dialysis, you can ask your social worker if they have copies of Dialysis and Transplant magazine, which maintains a list of dialysis centers in the U.S. and abroad (commonly referred to simply as "The List"). 

If there is no language barrier in your destination, contact the dialysis facility you plan to use abroad and reserve time slots for your treatments. If there is a language barrier, ask the facility if someone on staff speaks English (or your native language). You will need to work with the facility to transfer your dialysis medical records to them. 

For those who are on peritoneal dialysis (PD), ask your PD nurse if they can help you coordinate the transfer of your supplies. People on PD can often have their supplies delivered to major cities in many parts of the world. If you do hemodialysis at home, you will need to either book treatments in a dialysis facility at your destination or bring your dialysis machine with you. The Air Carrier Access Act of 1990 prohibits airlines from discriminating against people with disabilities, including those on PD or home hemodialysis, and this applies to both domestic and foreign flights. For more information on traveling with dialysis equipment, click here.

Unfortunately, when you travel outside of the U.S., health insurance will not always cover the cost of your dialysis treatments. If Medicare is your primary source of insurance coverage, it will only cover the cost of dialysis in the U.S. and its territories. If you have commercial insurance as your primary insurance, contact your insurance provider to see if they will pay for dialysis outside of the U.S. Be sure to ask the dialysis center that you will be utilizing abroad how much they charge for treatments if you will be footing the bill on your own, or if there are any co-payments involved when insurance does cover the cost. 

When it comes to following a kidney-friendly eating plan while traveling abroad, it is important to do your research on the types of foods you will likely encounter in your destination, since it can be difficult to track how much salt, phosphorus or potassium is in new and unfamiliar foods. Once you've done your research, talk to your renal dietitian about the types of foods you'll encounter so you can develop a plan for how you will eat while you are away. In addition, be sure to pack plenty of kidney-friendly snacks – though be aware that for many countries, there are rules and regulations on bringing agricultural products (this includes fruits and vegetables) across international borders due to concerns around preserving ecosystems – see the U.S. policy here. For more information on a specific country's regulations on traveling with agricultural products, visit that country's border services website. 

As is the case with domestic travel, be sure to bring all the medicines you need to take when you travel internationally plus extra to account for any travel delays. It is especially important to bring medicine in the original pharmacy bottle with a prescribing doctor's name on the label, as this will reduce the likelihood of confusion when you go through customs at the border. It is also helpful to have a note from your doctor explaining what the medicine is and why you need to take it, since drugs are regulated differently across nations. Make sure to pack medicine in a carry-on bag, as checked baggage can get lost and it can take time to get your bag back to you. 

Finally, be aware that each country has its own laws regarding discrimination and accessibility for people with disabilities. Before you travel out of the country, visit travel.state.gov/destination and find information in the Local Laws & Special Circumstances section. 

Being on dialysis doesn't mean you have to give up your wanderlust. If seeing other countries and cultures is important to you, there are ways to make it happen – just make sure to do your research ahead of time and take care of yourself while you are traveling. Don't overexert yourself, inform your medical team and those close to you about your travel plans and most importantly, have fun!