By Chris Marchand
Over one hundred people crammed into a small, stifling conference room was an apt setting to illustrate the indignities and hardship faced by Dryden-area renal patients and caregivers in trying to manage their chronic illness over a hundred kilometres from the nearest dialysis unit.
What the bristling crowd may not have anticipated is how easy it would be to have the panel of health care professionals assembled concede the fact that efforts to form a local dialysis unit should face no further delay.
Spearheaded by Kenora-Rainy River MPP Sarah Campbell, the town hall style meeting gathered a panel of medical practitioners and administrators from Dryden Regional Health Centre (DRHC), the Local Health Integration Network (LHIN) and the Ontario Renal Network (ORN) to delve deeply into the issue and the steps forward to make it a reality.
While Sioux Lookout, Kenora, and Fort Frances each feature ‘in-centre’ dialysis units to service patients, the region’s medical decision makers have long used a number formula to justify the absence of a local unit. Needing 12-18 patients to be sustainable, the assertion that Dryden had less than six patients in need of in-centre dialysis was summarily rejected by the crowd, many of whom hailed from surrounding communities and First Nations in the catchment area from Ignace to Ear Falls.
“It’s kind of a moving target,” said Dryden Regional Health Centre CEO Wade Petranik. “We don’t how many people choose peritoneal dialysis (at-home), just because they know there’s no hemodialysis in Dryden. We don’t know how many people chose to relocate from the community to live in a community where they have dialysis. That’s another factor.”
Sioux Lookout Nephrologist Dr. Paul Watson, Medical Lead for the Ontario renal Network’s Northwest Regional Renal Program, says that while the patient numbers game can get ‘fishy’, he’s confident that a local unit could reach a sustainable number of patients in a short period of time.
“Because I’ve been a nephrologist here for 20 years I know that Sioux Lookout didn’t start with 12, Fort Frances didn’t start with 12 — in fact Sioux Lookout started with two patients and now they’re over 24. I firmly believed if we start a unit with less than 12, we’ll be at 12 in less than two years.”
Local renal patients in need of in-centre hemodialysis can make up to 156 trips per year in all manner of road conditions while coping with the physical effects of dialysis.
Jo-Anne Petiquan-Moore says communities surrounding Dryden need to collaborate on the issue because the stress placed renal patients and their caregivers is unbearable.
“My husband goes to Sioux Lookout from Waubaskang (First Nation) three times a week,” said Petiquan-Moore. “That’s three hours there, four hours of dialysis and three hours back. I watched my good friend, Dave, just give up because it was too much travelling. We lost another young guy two years ago. That’s three people in a community of less than 100. If you look at the other First Nations around here there’s got to be a lot more than 12 (patients). We’ve got to work together as First Nations and non-natives. This is a chance for us, this is our time now.”
Dr. Watson says he believes Dryden should pursue a four-station hemodialysis clinic three times per week. He adds the big challenges in establishing it will be finding a suitable venue ideally within the hospital setting, maintaining quality of care and obtaining nurses with the specialized training to work with renal patients.
Aaron Skillen, Regional Director for the Northwest Renal Program, says that while discussions had begun before the meeting, the incredible turnout reinforces the need for the service in the community.
“The planning process is initiated already,” said Skillen. “The process involves the partners you see here today. There’s a pre-capital submission to sort of describe what you might like to see in the community. After these three parties get together to figure that out, it would go to the Ontario Renal Network for approval. There’s a second and a third step: planning the program itself and more specifically a functioning program where we figure out exactly what the layout in a hospital setting might look like.”
Finding that perfect spot at Dryden Regional Health Centre could prove challenging says Petranik, who adds the right spot requires access to medical infrastructure like oxygen, suction water supply and proximity to lab services among other factors.
“We don’t know how much space we need unless we know what capacity we’ll start with,” said Petranik. “Do we build enough for 24 patients or 12 patients? We have to look at where the space is and bringing in all the medical services that they need. It does take some time to do that. Hopefully, we can narrow down the scope of the project and then we can move on.”