Photo by Mitchel Willem Jacob Anneveldt on Unsplash
Ah, Spring! It's that time when everyone’s buzzing with vacation plans. And guess what? If you’re on dialysis, cruising is a perfect vacation! Bask in the chilly ocean breezes while watching seals play in Alaskan waters. Wander through art museums in Rome, Copenhagen, or Athens on a European cruise.
Follow these steps to ensure a successful high-seas adventure while maintaining dialysis treatment.
Choosing Your Cruise Line
Cruise lines have differing requirements depending on the type of dialysis you receive. Some cruise lines accept guests on home hemodialysis (HHD) and in-center dialysis, while there are more cruise line options for guests on peritoneal dialysis (PD).
Depending on your dialysis needs, determine which cruise lines will be available. Most cruise lines require you to be stable on your current dialysis routine for at least one year.
Some cruise lines partner with commercial companies such as Dialysis at Sea or UK-based Cruise Dialysis to provide hemodialysis onboard to a limited number of guests. These companies offer renal care experts to perform dialysis on sea days, so you don’t miss any fun while the ship is in port.
Choosing your Itinerary
While the world is yours when it comes to cruise vacations, some itineraries are better suited for guests on dialysis.
First-time cruisers may consider taking a 3–5-day cruise to gain experience and confidence. If you are ready to venture further, consider the number of consecutive sea days and the remoteness of the ports on the itinerary. A 30-day South Pacific cruise may be doable, but is transferring 30-plus days of supplies feasible?
Vacation planning should be all good vibes, but sometimes things go sideways. When choosing a cruise vacation, consider what may happen if you need emergency care. An itinerary with multiple consecutive sea days offers few options for emergency medical evacuation. Remote port stops may have limited options for medical facilities or opportunities to obtain extra supplies or replacement equipment.
Arranging in-center dialysis in port cities is risky. Weather and other factors beyond the cruise line’s control may cause the ship to miss the port where you had dialysis scheduled.
Larger cruise lines have medical centers onboard staffed with doctors and nurses. While the centers are well-equipped, the medical staff is not specialty trained in nephrology. They operate more like urgent care centers. They can stabilize emergencies but not manage complex medical conditions for an extended time. They are not able to troubleshoot dialysis equipment.
Booking Process
Cruise lines are accustomed to assisting guests with medical needs. During the booking process, inform the cruise line of your type of dialysis and your needs, such as supplies delivery, sharps containers, disposal receptacles, biohazard waste bags, etc. Discuss the process for having supplies delivered to the port and transferred on and off the ship. When choosing a cabin, consider the space you need for your equipment and supplies.
Major cruise lines contract with travel insurance companies. Purchase the comprehensive package that includes medical coverage. Most primary health insurance policies, including Medicare, do not cover medical care outside of the U.S. and onboard. You can buy travel insurance independently from the cruise company. Be sure it includes coverage for pre-existing medical conditions and air ambulance transfer back to the U.S.
Preparation and Packing
Smooth sailing depends on detailed planning. Here are some critical steps:
1. Get your travel order.
Speaking to your treatment team about your cruise vacation plan is the crucial first step. Most cruise lines require a fit-to-travel form signed by your doctor dated within 30 days of embarkation. Discuss a backup plan for potential equipment failure or missed port where in-center dialysis was scheduled.
Discuss medications that can be used (dialyzed) if you become sick and need antibiotics or other classes of drugs.
For HHD guests, contact your equipment provider no later than 60 days before your departure date to discuss travel needs for your equipment, such as renting or buying a hard travel case.
Work with your nurse to make a packing list.
2. Collect your relevant medical documents – hand carry these in a binder:
A recent EKG
Medication list, including doses
Dialysis orders
History and Physical
The last 3 treatment (flow) sheets
List of safe medications that can be dialyzed
Travel insurance paperwork
3. Travel with a care partner.
Some cruise lines require you to travel with a care partner who is trained to use your equipment and supplies. Plus, it's more fun to travel with a friend.
4. Send your supplies to the ship.
Arrange to have all supplies delivered to the embarkation port at least 2 days before joining the ship. Another option is to stay at a hotel in the port city where you will join the cruise. Have your supplies delivered to the hotel, and plan to transfer them to the ship upon embarkation. Always have more than you need. Remember the basics, like gauze sponges, antiseptics, disinfectants, and gloves. Cruise ships have limited power outlets. Don’t forget a backup battery, a heavy-duty extension cord, and a converter if needed.
Embarkation
Yeah! Embarkation day has finally arrived. Embarking on a cruise ship can be a frenetic experience, with thousands of people coming and going in a busy cruise terminal. A positive mindset can lessen the stress. Give yourself plenty of time to arrive and go through the process.
If you have hand-carried equipment and supplies, find a porter to arrange delivery to your stateroom. Communicate clearly that these are lifesaving supplies to be hand-delivered with care. If the porter needs help understanding, ask to speak to a supervisor. Ensure that all equipment and supplies are onboard before the ship leaves port.
Onboard
Supplies
Your stateroom stewards are wizards who can make things happen for you while onboard. You will have at least one, maybe two, assigned to your cabin. Get to know them. If your surplus supplies take up too much space, speak with your steward to see if storage space can be found elsewhere on the ship. Arrange to have them delivered to your cabin as needed. They can also supply waste disposal items such as sharps containers, biohazard bags, and receptacles.
Dietary Needs
Don’t leave your dietary choices to chance. Arrange a meeting with the manager of culinary operations or executive chef to review menus and help you make choices that fit your dietary needs. Because sugar and salt are liberally used in food on cruise ships, it is essential to ask questions. Eating in the dining room, rather than in the buffet restaurants, will allow you to make better decisions as the waiters can answer more specific questions.
Weight/Fluid Management
If weighing yourself is a part of your fluid management regime, the gym or medical center will have a scale. However, an accurate weight cannot be measured while the ship is at sea. For accuracy, measure your weight during a port stop.
Disembarkation
A day or two before the end of your cruise, visit the guest services department to arrange to have your surplus supplies and equipment carried off the ship. Again, reiterate that the lifesaving nature of these supplies does not allow them to go off the ship with luggage. The guest services team should tell you where you and your supplies can be reunited in the terminal.
Cruising on dialysis requires thoughtful planning, clear communication, and careful consideration of your needs. By choosing the right cruise line and itinerary, you can embark on a cruise adventure with confidence! Assessed and Endorsed by the MedReport Medical Review Board