Since we took our big 31-day road trip last September, Linda and I have heard from many people who followed our adventures at this blogsite or through the National Kidney Foundation. That was quite heartening, partly because we did some cool things we wanted to share with family and friends, and partly because we wanted to enlighten people we don't know about the possibilities of traveling successfully on hemodialysis.
Well, we're hitting the road again soon, so it's time to return to this blog and invite all of you to come along with us again. We leave a week from Saturday, on August 24, and will return on September 16. Our departure is one week earlier than it was last year, and we're staying on the road one week less. We admit that we were dragging on the final week of last year's trip. We had had too many restaurant meals, too many hard motel beds, and too many long drives. So we'll push ourselves a bit less this time.
A bit. We still have an ambitious itinerary with a fair amount of exploration. Last year we focused on the southwest, spending ten days in southern Utah and northern Arizona. This year's main target is Wyoming, one of my favorite states, a vast landscape of mountains, forests, and range land. It is the most sparsely populated state, with fewer than 500,000 residents; it is 10th in square miles and 50th in population. That's more than wide open enough to attract us. I've seen a fair amount of it, especially the two big parks in the northwest corner, but Linda and I will be traveling some areas I've never seen before.
Wyoming is also sparse in terms of dialysis centers, with fewer than ten in the entire state. As I began planning this trip and contacting dialysis centers, I quickly ran into problems. One key to my goal of spending the most time in the Yellowstone/Grand Tetons/Jackson Hole are was getting dialysis in Cody. Located 50 miles east of the east entrance to Yellowstone, Cody is a terrific little town with a trio of wonderful museums (my favorite features the Western art of Charles M. Russell and Frederic Remington) and a summer rodeo (we might catch the final night). It also has the only dialysis center in that quadrant of the state. So when the nice lady at the dialysis center explained in June that the center was moving over the course of the summer and they weren't accepting visiting patients at this time, it was a big setback.
If Linda couldn't get dialysis in Cody, the nearest centers were well over 100 miles away. To the east--the direction we'd be coming from--was a center in Sheridan, about 150 miles away. To the southeast--the way we'd head when we left the Tetons--was Rock Springs, closer to 200 miles distant. In theory, it would be possible for Linda to have dialysis on the way in to Cody and again on the way out, though that would leave us just three days in between for Yellowstone and the Tetons. I didn't want to rush through that area. I wanted to do what we did last year around Lake Powell and the Grand Canyon, namely take the time necessary to explore the side roads, the different views, the special places that can emerge as the most memorable of the trip.
There was another problem which arose when I called the centers in Sheridan and Rock Springs: they are open only on Monday-Wednesday-Friday. Linda's normal days are Tuesday-Thursday-Saturday. It appeared that if we wanted to travel in Wyoming, we'd have to switch her dialysis days. Another alternative would be to have dialysis in South Dakota before heading west into Wyoming, but calls to centers in the Rapid City area only helped me learn that there were no chairs available in that area. I was told that there are a lot more dialysis patients than there were a year ago, making it more difficult to allocate chairs for visitors. Suddenly the whole itinerary was in danger of collapsing like a house of cards.
We decided to commit to a Monday-Wednesday-Friday dialysis schedule for the whole trip. It will actually be better for her at the start of the trip. We're leaving, as we did last year, right after her Saturday morning treatment, and instead of having her "stretch day" on Monday, she'll have dialysis that day and won't have a stretch day until the following Sunday. The inconvenient part will be the end of the trip. If she has dialysis on our last Friday on the road, she can't wait until the following Tuesday for her next treatment back in Cooperstown. So she'll have an extra dialysis treatment on Saturday, making two days in a row that will start with a five-hour chunk of life-saving.
It was time to get on the phone with Davita, the company that runs the majority of independent dialysis centers around the country. They were tremendously helpful in making last year's trip go smoothly, but I hadn't called them yet because they don't operate any centers in Wyoming. The only place last year where Linda had dialysis somewhere other than a Davita center was in Cheyenne, Wyoming, where the center is operated by FMC, their competitor.
Once again, the call to Davita was a long one, as we had ten treatments to discuss and officially request. He got right on the phone to centers in western South Dakota. That was the tough one. We knew her first two treatments would be in Wisconsin, where we're visiting friends. But we had found nothing between the western border of Wisconsin and someplace in Montana to be named at a later date if that turned out to be the only possibility.
He called eight or nine centers and called me back twice, first to tell me what the two or three possibilities were (90 miles in different directions from where I really wanted us to be), then to tell me which one has a chair for Linda.It's in a little town called Rosebud, on the Oyate section of the Pine Ridge Reservation, near the site of the Wounded Knee massacre and uprising. Last September we visited the Navajo Reservation in Arizona, and this time we'll be in Sioux territory. That should be interesting.
With the first week taken care of, we moved on to Week Two, beginning on Labor Day, September 2. Ideally, we could get dialysis in Cody Monday and Wednesday of that week. We could get there sometime over the weekend and not have to be to the next destination--somewhere else in Wyoming--until Friday. That would give us a good amount of time in the Tetons. To that end, I had sent a copy of the blog from last year's trip to the woman at the Cody center, so she would see how serious we are about doing everything we can on our travels. Davita found a chair available in Bozeman, Montana. That could work, though it would be 100 or so miles in the wrong direction. The first 45 miles of the drive, from the north entrance to Yellowstone and Gardner, Montana, is one of the most spectacular in the northwest, with Jim Bridger Canyon winding through a valley spread out on both sides of the road. We could make a loop up there, west a little, then south and back into Yellowstone through the west entrance.
That call was about three weeks ago. As I write this, the second Friday treatment site remains uncertain. By the time the Davita agent talked to the center in Rock Springs, they had no chair available. Same in the little center in a small reservation in the center of the state. Casper might have a chair. They wanted to wait until closer to the requested date to make it official. So we're optimistic about that. Meanwhile, a few days ago, I called my friend in Cody, who told me that they haven't even made their move yet. Now they're not sure what the timetable will be, which means she can go ahead and do what she wants until they tell her otherwise. What she wants is to set aside a chair for Linda on the first Monday and Wednesday in September. Now we're all set. Except for Casper and the last two sites on the trip.
That was the main part of the puzzle, and with dates and places set, I could move ahead with the rest of the preparations. That's an obvious key to travel on dialysis: take care of the dialysis first, know where those time and place commitments must occur, and build the rest of the itinerary around it. With eight more days of planning available, I'm sure it will all fit into place by the time it matters--and we'll be on the road again!
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