The Renal Support Network has published a KidneyTalk podcast on Fluid Overload – Signs, Symptoms, and Prevention. Find it at https://www.rsnhope.org/kidneytalk/dry-weight-fluid-overload-signs-symptoms-and-prevention/.
As an example of new regulations that allow utilities to preemptively shut off power to areas with high temperatures, low humidity, and high winds, Southern California Edison has announced that it may shut off power to parts of the Coachella Valley later this week (July 2-4, 2019); see https://www.sce.com/outage-center/major-outages. Different regulations apply to different areas, depending on perceived risk, as defined by the California Public Utilities Commission. You can find a good summary of these issues, including a map of the areas most likely to be impacted, at https://microgridnews.com/california-utilities-plan-power-shutoffs-to-avoid-2019-wildfires/. While these issues currently apply to California, they may soon also apply to Network 16 states.
Dialysis facilities are already required to be prepared for power outages, though many facilities share backup equipment because outages have been more local in the past. Facilities will want to review their backup power plans to include preemptive outages and consider whether sharing backup power equipment is still practical when all nearby facilities have also gone dark. Dialysis facilities with patients on home dialysis modalities, particularly home hemodialysis, will want to assure that all of their patients have access to adequate dialysis even if power is out for a week or more, which could occur if hot, dry, windy weather persists in an area. Facilities will also want to assure that their home patients are well trained in how to respond to preemptive outages. The occurrence of preemptive outages is intended to be announced by utilities in advance, but if weather changes rapidly, or individuals are difficult to locate, it may not be possible to notify everyone before the fact, so facilities may want to develop their own phone trees or other strategies, being mindful of HIPAA.
Since dialysis is not the only situation where patients and facilities are vulnerable to preemptive power outages, it may be helpful to coordinate with your county or regional Healthcare Coalition; see https://www.kcercoalition.com/en/resources/professional-resources/cms-emergency-preparedness-rule/state-healthcare-coalitions-list/california-healthcare-coalitions/ for contact information, or check with your county Health Department (Tulare, King, Kern, Orange, and Riverside Counties are absent from the KCER list). CMS requires all facilities to report to their Network any lapse in the ability of patients to have access to dialysis because of emergency events; for details see https://nwrnbulletins.wordpress.com/2019/06/04/notify-network-of-emergencies/.
A few resources that may be useful for facilities and patients in this context:
There are only six months to go on the transition to the New Medicare Card. To help prevent identity theft, the New Card removes a patient’s Social Security Number from their Card and replaces it with a new, randomly-assigned “Medicare Beneficiary Identifier” or MBI. MBIs must be protected as confidential PII. All patients should have received their new card by now, barring mailing address problems. After December 31, 2019 billing with the old “Health Insurance Claim Number” or HICN will be disallowed. If your facility has patients that don’t have a New Card, refer to https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE18006.pdf for instructions. Railroad Retirement Board Medicare cards are going through a parallel transition.
The UCLA CORE Kidney Program has announced that they’ll be participating in the 115th Annual Huntington Beach Fourth of July Parade & Festival. For more information on this and other UCLA CORE Kidney and UKEEP events, see https://www.uclahealth.org/core-kidney/upcoming-events. For instance, their webinar on Alport Syndrome is coming up on July 11, 2019, as well as UKEEP’s patient meeting on High Blood Pressure on July 14. Recordings of past UCLA CORE Kidney and UKEEP webinars, on topics such as Transplantation, Fabry’s Disease, Adult PKD, and more, can be found at https://www.uclahealth.org/core-kidney/past-events.
They’ve also announced the date for their 2020 UCLA Kidney Health Fair & Spirit Walk for Kidney Disease, May 17, 2020. Find more information at https://www.uclahealth.org/core-kidney/kidney-health-fair.
NKF has scheduled 2019 Kidney Walks for the following places and dates:
- Irvine CA September 22, 2019, http://donate.kidney.org/site/TR/Walk/NKFServingtheWest?pg=entry&fr_id=9035.
- Boise ID September 29, 2019, http://donate.kidney.org/site/TR/Walk/UtahampIdaho?pg=entry&fr_id=9172.
- Encino CA October 13, 2019, http://donate.kidney.org/site/TR/Walk/NKFServingtheWest?pg=entry&fr_id=9026.
There appear to be none scheduled for Washington, Oregon, Montana, or Alaska. For more information on Kidney Walks, see https://secure2.convio.net/nkf/site/SPageNavigator/kidney_walk_splash.html.
The Oregon Health Authority has announced a #SummerBummer collection of strategies for Preventing and Responding to common hot-weather risks, including drowning, poor air quality, mosquito-borne and tick-borne illnesses, algal blooms, fecal beach bacteria, food poisoning, and extreme heat. Find their recommendations at https://www.oregon.gov/oha/ERD/Pages/StaySafeHealthyWithSafetyTipsFromOHAAsSummerKicksOffJune21.aspx.
CDC has a comparable program that sends out a weekly email on Five Minutes or Less for Health Weekly Tip, which also covers skin cancer, hydration, and communicable diseases. Review their Tips or sign up at https://www.cdc.gov/family/minutes/tips/summersavvy/index.htm.
Homeland Security’s “Ready.gov” website has a thorough discussion of how to stay cool and safe in extreme heat, at https://www.ready.gov/heat, and one to help you Prepare Your Home for Wildfire Season at https://www.ready.gov/wildfires.
And of course people with ESRD have special issues with food and water in the summer:
- AAKP has a HealthLine webinar on Summer Eats: Staying Healthy, Hydrated and On Your Kidney-Friendly Diet which can be found at https://www.gotostage.com/channel/6927452477730326277/recording/c21ada4c697042f18ea3383e674c0db1/watch?source=CHANNEL.
- ESRD Network 16’s tips on Fluids Management reside at:
- While they’re several years old, NKF’s advice on summer fruits and vegetables in their article on Healthy Living in Summer are still valid. Find them at https://www.kidney.org/blog/staying-healthy/healthy-living-summer.
NKF has launched Kidney Pathways, an interactive education tool that uses an online kidney health assessment to provide a series of steps for people at any stage of CKD to learn about their condition and how best to respond to it. Start the Kidney Pathways program by answering the question on the right-hand side of the screen at https://www.kidney.org/phi/1245/health. Find a description of the tool at https://www.kidney.org/news/national-kidney-foundation-unveils-kidney-pathways-curated-kidney-health-education-curriculum.