Dialysis problems at home hospital leaves Castlegar teen in Vancouver for months
Credit to Author: Gordon McIntyre| Date: Thu, 06 Feb 2020 02:36:58 +0000
A 16-year-old from Castlegar is camped out at Ronald McDonald House in Vancouver with his mom because the dialysis he requires is unavailable to him near home at the Kootenay Boundary Regional Hospital.
Zach Tremblay recently was forced to switch from peritoneal dialysis because it was losing its effectiveness and has been transitioning to hemodialysis, which he had to go to B.C. Children’s Hospital to receive.
Zach is 16 and the Trail hospital, while it has a dialysis unit, has not provided hemodialysis care to younger patients, according to the Interior Health Authority.
“We’re going to be here until the end of March,” Jana Tremblay said. “IHA limbo, I call it. … We were told Trail doesn’t accept patients who are not 17 years old plus a day. Zach turns 17 on March 18.”
The family has been asked to consider home hemo, but Jana said they are not comfortable with that option, as their mobile home and septic system is not equipped to handle the needed equipment.
Zach has had one transplant operation, on June 1, 2017, but the kidney donated by a high-school friend of his mom’s did not survive the operation and had to be removed.
For his latest travail, he and his mom arrived in Vancouver on Jan. 6, but the journey had been delayed for a few days by weather.
“We were stuck two days in Trail, then had an ambulance ride to Kelowna and stayed overnight there,” Jana said.
Zach attended a Canucks game at Rogers Arena against St. Louis on Jan. 27 — section 107, row 4, near the blue line — tickets, cab ride and dinner all donated by an anonymous season ticket holder and set up by the Children’s Organ Transplant Society.
“Our view was amazing,” Jana said.
Zach was wearing a gift, an Elias Pettersson jersey, and after the game got to meet defenceman Chris Tanev. It was so nice to see her son smile and be carefree, she said.
But the hemodialysis he gets three or four times a week wears him down.
Zach’s school in Castlegar is sending a laptop so he can keep up with the new semester’s work (there’s a teacher at Children’s), but he’s already two weeks behind.
“He’s really upset and wants to go home,” Jana said. “He wants to go to school, he wants to see his friends, see his dad and his brother.
“We’re both tired of this.”
While hemodialysis is performed three to four times a week, peritoneal dialysis is a daily, home-based treatment once the patient and family are trained, according to a B.C. Children’s spokeswoman. Neither form is considered more rare or more specialized.
Which treatment is chosen is decided on a case-by-case basis, she said.
“Some patients do transition between hemodialysis or peritoneal dialysis over the course of their kidney disease journey. However, for patients with end-stage kidney disease, kidney failure is permanent and dialysis or a transplant is required to stay alive.”
Interior Health cannot discuss individual cases because of privacy rules, said Paula Hann, regional director of renal services, said.
But “we recognize how challenging it can be for young patients and families to travel and stay in Vancouver for dialysis and other care,” she said. “Interior Health’s priority is to support care as close to home as possible for all patients and when we rely on B.C. Children’s Hospital, it is in the best interest of each patient.”
Recognizing the impacts travel has on patients and families, age would not specifically rule out service in Trail, she said, and Interior Health would look at each situation on a case-by-case basis.
“A decision to admit a younger patient to the Trail program would require more discussions between our Trail nephrologists, our renal care team and the team at B.C. Children’s in order to ensure we could meet the specific needs of that individual.”
Kootenay Boundary has had several new renal patients admitted in the last two weeks, she added, so the unit is busy.
“The renal program is recruiting new staff to meet the increased demand we are seeing.”
There are eight chairs in the Trail renal unit. Interior Health has held preliminary discussions about adding a ninth, but no decision has been made, Hann said.