Yes, we can

For me, this trip to the US and Canada has opened up a whole new world of possibilities. Before I actually did the trip, I never really thought it would happen. I never really thought I could do it. But now that it is done, it doesn't seem so difficult after all.

There were many obstacles - the visas, dialysis, costs and many other smaller ones as well. I proved to myself that everything can be resolved. Provided I have the will to do so. I was very keen to go on this trip. I badly wanted to do a cruise. I badly wanted to see the Niagara Falls. Dialysis was probably the biggest obstacle mentally. How would I manage the dialysis? In the need it all turned out all right.

There are differences in the way dialysis is done in the US from how it is done in India. Obviously. What would you expect?

For example, in the US they generally use much higher blood flow rates than we do in India. They also use bigger needles (15 gauge as opposed to the 16 gauge we use here). They also have differences in the starting and closing techniques though this does not affect us as much. One difference in the closing method is they use a 'closed' method of closing where the bloodlines are not disconnected from the needles until the blood has been completely returned. This seems to be a better method of closing. The only problem is about 500 ml of saline is pushed into the body towards the end which means you need to adjust for that in the UF goal.

Some tips for people on dialysis visiting the US:

- Start planning as early as possible. Dialysis bookings take time. They need to accommodate you into their schedules. They need a lot of paperwork to be sent.

- Book your flights after your dialysis sessions have been booked. Some cities operate only some shifts. If you plan a flight on the same day as dialysis, then you may need to adjust your flight timings based on the dialysis slot you are able to get. Also, often a lot of flights are available. Dialysis availability is not so easy.

- Carry your needles if you are used to 16 gauge. I carried my 16 gauge buttonhole needles and I was allowed to use them everywhere.

- Carry xylocaine (lidocaine) if you cannot do without it. Many units don't use this. Carry some insulin syringes to inject it as well.

- Know your blood flow rate, UF goal and how much heparin you are used to. Find out from your dialysis center. Though these things will be asked as part of your prescription, you may need to fine tune some of this based on how you are feeling.

- Plan to carry a blanket and pillow to the center. They don't provide this and centers can get quite cold.

- Carry cash with you for the payment. They don't accept credit cards, cheques or any other form of payment. They do accept money orders but it is difficult to get money orders once you're there.

I definitely think we, on dialysis, can do international travel. In fact, if anything, it would be easier for people who are not used to daily, nocturnal dialysis to do this since the dialysis dose is the same. I was not used to in-center four hour sessions so I had a little difficulty adjusting. However, for those used to this, it should really be a cakewalk.

Travel gives us a change. It gives us something to look forward to. Apart from all the fun we have on the trip, it also reinforces to us that we are normal but for dialysis. Dialysis really need not restrict us from doing what we want to do. All it takes is a little determination and willingness to do it.

I feel so liberated after this trip. I am already starting to think about my next destination. Switzerland perhaps? :-)