people enjoy a holiday and kidney patients - and their carers - are no
exception. Holidays are possible for all kidney patients as long as you
are in reasonably fit and all it takes is a little planning.
first step is to talk to your renal unit. You will need a letter from them
confirming you are fit to travel in order to obtain holiday insurance and
you will also need their advice regarding immunisation. If you are on dialysis,
you will need their help in planning your treatment while on holiday
deciding on your holiday, ask your renal unit about the medical support
near your chosen destination in case of emergencies. Take with you the
foreign hospital telephone numbers - and - don't forget your own unit's
contact number and the foreign dialling code. It is always handy to have
a telephone card with you at all times that can be used to dial the UK
accommodation - check that the accommodation you are considering is
suitable for you and any special requirements that you may have. For example,
if it is a hotel, do they cater for special diets? Is your apartment on
a hill? How far are the shops?
FOR PEOPLE ON HAEMODIALYSIS(HD)
is possible for haemodialysis patients but it has to be planned in advance.
are many holiday destinations that provide HD facilities for patients
abroad. Talk to your renal unit about your plans as they may be able to
provide you with details of recommended units. It is important to note
that the unit abroad will need to have the same quality of dialysis treatment
that you are used to.
actual treatment may be slightly different abroad; for example, the equipment
and procedures may not be the same so ask your unit what to expect so
that you are prepared.
a Haemodialysis unit abroad
, based in France, publishes a directory of units around the world in
booklet format and on the web. They also have a travel agency who can
help with recommending accommodation, arranging insurance, and booking
have lists of useful phrases for HD patients, such as "the arterial
needle is placed here", and "May I have a blanket", in
French, Spanish, German and Italian.
Dialysis also has a worldwide database of renal units and lots
of other useful information.
Dialysis is an excellent site for dialysis patients which includes a searchable
database of renal units worldwide, details of kidney patient associations
and national kidney charities around the world, plus lots of other useful
information and links for the travelling kidney patient!
- If you are visiting Spain, you will need a special Spanish form called
a P10, which you will need to obtain before leaving the UK. Your UK renal
unit will organise this for you.
cost of Haemodialysis abroad
sure you are aware of any costs involved for your dialysis while on holiday.
Some countries have reciprocal arrangements with the UK for dialysis (including
the countries covered by E111 ). However, since the reciprocal agreements
allow UK citizens the same care as would be provided to the citizens of
the country you are visiting, there may be a portion of the cost which
you will need to pay.
to your holiday dialysis unit
sure you make arrangements for travel to and from the unit you will be
using while on holiday; how long it takes, the cost etc.
FOR PEOPLE ON PERITONEAL DIALYSIS(PD)
dialysis fluid and ancillary supplies can be delivered to a wide range
of destinations around the world. This will be arranged through the company
who manufactures them and your renal unit. However, the dialysis company
needs to have details of your holiday destination, travel plans and dialysis
needs well in advance of your travel date. The dialysis company will also
supply addresses and telephone numbers of the nearest renal unit in the
area in which you will be staying.
is important to remember that the delivery of your PD supplies to your
chosen holiday destination takes time and you will need to find out from
your unit how much notice is needed. The notice required for delivery
can take up 16 weeks for some destinations (the average is around 8 weeks).
you choose your accommodation, check that:
PD supplies can be delivered to your selected destination a few days
before your arrival. Your accommodation (hotel or self-catering) must
be prepared to receive and store this. It is important to make sure
they understand the size of the delivery (for example, it could be a
dozen boxes and not just a couple of bottles of medicine!). Make sure
they also understand that the supplies should be stored away from direct
sunlight, but do not need refrigeration.
sure you call the destination 2 or 3 days before departure date to check
supplies have arrived safely. Take the name of the person you speak
to and ask where the supplies are being stored and where they will be
when you arrive, especially if you are likely to arrive late at night
or early in the morning when a skeleton staff may be on duty.
sure you know who to contact if you find there are any bags or ancillary
items missing when you arrive. This is extremely rare and if it should
occur, the dialysis delivery company concerned will do whatever is necessary
to get you what you need urgently.
Note: your travel agent should be able to make all the above enquiries
out CAPD exchanges while travelling
gold rule when travelling is - "When in doubt, don't drain out!"
Always try and make sure that the environment where you carry out your
exchange is clean and dust free. Better to miss an exchange and 'catch
up' on your dialysis at a later time than risk getting peritonitis. It
us worth noting that most people actually take more care with their exchanges
when in a different environment, and the percentage of people who get
peritonitis when on holiday is actually very small.
If your itinerary means you won't have to carry out an exchange until
you reach you destination, it is still advisable to carry one dialysis
bag in your hand luggage in case there are delays.
your travel itinerary with your PD nurse who will advise you on the most
suitable exchange plan for your outward and return journeys. Most airports,
ports, stations and tourist attractions also have a medical room or St
John Ambulance treatment room, where it should be possible to carry out
a CAPD exchange - call in advance to check what is available.
of APD machines - None of the holiday insurance companies will provide
cover for APD machines. It should usually be possible to arrange cover
through the insurance company you use to cover household contents.
- Ask your doctor for a letter confirming that your APD machine and bags
of fluid are for medical treatment. The letter should also state that
the bags of fluid are not to be opened.
currency (APD) - When you select your accommodation, check that there
is a proper AC ground outlet (earthed), and that there is a powerpoint
close enough to the bed for the APD machine to be used. Check also that
the voltage and frequency are compatible with your machine, in which case
you can use a good quality travel adapter suitable for your destination.
If the voltage and frequency are not compatible (eg North America), you
will require a transformer, which will normally be loaned free of charge
by the manufacturer of your machine.
- Swimming is usually possible for PD patients and is a very good form
of exercise. However, check with the renal unit for advice on swimming
or any other sports you want to try while on holiday. NEVER bathe in water
that is not clean or if your exit site shows any sign of inflammation.
If you intend to swim in the sea in the UK, check out the Good
Beach Guide, an independent survey of the quality of the seawater
at major UK resorts and beaches.
PD fluid - If you do not own a portable electric bag heater, try the
simple way to heat your PD bags is to use a soft cooler bag and one
or two hot water bottles. Wrap the hot water bottles in a small towel
to avoid overheating the fluid.
way of warming the fluid is to leave it on the back ledge of a car (in
heat your bag in hot water because tap water is notorious for dangerous,
use a microwave because it can damage the plastic covering, caramelise
the sugar in the fluid (which can damage the peritoneum) and heat the
to hang your PD bag - plastic overdoor hooks are extremely useful
when travelling and can be purchased from many household stores. Avoid
hanging your bag on sharp hooks or nails as there is a danger of puncturing
- make sure you know how you will dispose of waste - arrangements may
need to be made with the nearest hospital. Never leave waste behind in
hotels or apartments - it is considered a health hazard and may deter
the proprietors from accommodating PD travellers in the future.
FOR TRANSPLANT PATIENTS
out of the sun
important message for all transplant patients going on holiday to sunny
destinations is - "Avoid the sun and you can avoid skin cancer".
Transplant patients are three times more likely than other people to get
skin cancers after a transplant because of the immuno-suppressant drugs
they need to take. However, skin cancer can be avoided and, if
detected early, can be easily treated.
sunblocks - The effectiveness of a sunblock is rated by an SPF (sun
protective factor) number. The number indicates how long you can stay
in the sun before your skin burns. For example, if your skin would normally
burn after 10 minutes out in the sun, an SPF of 15 means that you can
stay in the sun fifteen times longer before burning than if you were wearing
no sunscreen; in this case that would be 150 minutes. However, this information
is supplied for the general public and because some transplant medication
makes the skin extra sensitive to the sun, all transplant patients are
advised to use an SPF factor of 25 or higher.
that you cannot "add" SPF numbers. If an SPF 25 sunblock will
protect you for two hours, you will need to apply a stronger SPF if you
want to stay in the sun for more than two hours, rather than just applying
more SPF 25.
simple ways to avoid exposure to the harmful rays of the sun:
your skin with suitable clothing. Clothing offers the advantages of
even, non-sticky protection that you don't have to remember to reapply.
However, many summer-weight fabrics don't give enough protection and
fibres like cotton offer even less protection when wet. As the incidence
of skin cancer is increasing globally it is now possible to buy protective
clothing. Ask your pharmacist or high street chemist for information.
a wide-brimmed hat to protect your eyes, ears, face, and the back of
sunglasses that block 99 to 100 percent of UV radiation. Check the label.
the midday sun - 10 am to 2 pm when UV radiation is strongest.
that the sun's rays can be reflected by snow, sand, water and even concrete.
using sun lamps.
cancer and mole watch - Examine your skin regularly. If you find any
unusual blemish, moles, or other marking on the skin, especially one
that changes in size, shape or colour, see your doctor.
infections while on holiday
immuno-suppressant drugs also reduce a patient's ability to fight infections.
Simple precautions include:
contact with people who have a cold, flu or any infectious disease such
bottled water abroad or use boiled water (especially in far eastern
salads unless you have washed them and/or made them yourself, and avoid
ice cubes unless you have made them from bottled water.
ice cream from street vendors.
sure you have been appropriately vaccinated.
travelling to countries where the risk of catching an infection is high
- MASTA and British Airways Clinics can help advise you on this in this
- Transplant patients should never be given 'live' vaccines. See your
renal unit for advice on live vaccines and also make sure your GP is
informed. Vaccinations and advice can be obtained at your local GP clinic
or at any of the British Airways Travel Clinics.
assistance at ports, airports, etc - If you tire easily, or have problems
with mobility, most airports now offer wheelchairs and/or chauffeured
"buggies", which will whisk you through check-in, the departure
procedures and passport control in minutes. Ferry ports, railway stations
and many special attractions also offer this type of assistance. You will
need to book this in advance - your travel agent should be able to help
you or you can simply ring direct to see what help is available and book