by Lies Hoekstra

My email/dialysis friend Barbara	Boarding our Alaskan cruise

This article originally appeared in the Dutch journal Wisselwerking (Exchange Working), published by the Nierpatiëntenvereniging LVD (Kidney Patient Union).

This English version was kindly translated by Lies

We hebben ook de oorspronkelijke Nederlandse versie.

July 23

Our daughter is not too happy about the idea that we will start our journey on her 28th birthday, so we have her birthday cake at Schiphol airport. We get a family send off from both our sons and their wives, our daughter, and our granddaughter.

On the plane to Toronto I finally have time to look back on the last three months. When it became clear that I would have to start dialysis soon, my first question to the nephrologist was: 'Will it be possible for me to travel to Vancouver this summer?'

'Of course', he said, 'you can skip the exchange on the plane, and your dialysate bags will be sent to you.'

Still, it's small miracle I am on this plane at all: an unfortunate start with the dialysis on May 6, very low blood pressure, a urinary tract infection and an allergic reaction to the antibiotics: I've bought my plane ticket at the very last moment.

It's hot in Toronto! We are met by my 'American sister' and her husband. I've known her since 1954, when I spent a year with her and her parents as an exchange student. The trip from Toronto to Buffalo, over the Niagara bridge takes quite a long time: I do not want to know how much time has elapsed since my last exchange! A music stand on a table gives enough height to hang the dialysate bag.

July 24-28

What a relief to find the trusted Fresenius boxes with their bags here in the cellar; a vote of thanks to the girl at Fresenius who organised it at the last moment, difficult custom declaration forms and all.

It's still hot: I do not need to heat the bags.

We eat all the wonderful food I remember from 45 years ago: hot dogs, water melon, corn on the cob, grilled chicken, fried clams, clam chowder.

I visit another good friend from 45 years ago in Rochester and leave some vital equipment behind: a few clamps and a hook. Fortunately the centre at Buffalo provides me with some.

July 28

An early start, because our plane from Toronto to Vancouver leaves at 9.45 a.m., or so we thought.

At the check in desk we hear we'll have to wait until 5.30 p.m., which means doing an exchange in the baby room at the airport, with my husband holding the bag.

The flight over Canada is magnificent: the lakes, the prairies, the Rocky Mountains and finally Vancouver basking in the evening light.

It's a lot cooler here than in Toronto and I have a chance to try out the machine I bought after a long search and for quite a lot of money: the 110 V in Canada and the US has to be converted into 220 V in order to warm the dialysate bags on the warming tray. It works! And the boxes have arrived as well.

July 29-August 3

The whole purpose of this trip is the congress of the International Association for Religious Freedom, which has been trying to promote religious freedom for almost 100 years now. It started out as an organisation of liberal Christians in Europe and the US (mostly Unitarians), but in the last 30 years many other liberal religious groups have joined: Buddhists, Hindus, some Muslims, Sikhs. I have been a member of the Executive Council for the last six years and I was fascinated by the fact that people of six or seven different religions, nationalities and cultures can meet and work together and accomplish something.

Because our hotel is a 20 minute walk from the venue, I do my exchanges in the office of the general secretary, very convenient!

One afternoon we take a break from all the lectures, workshops and religious services: time for a walk in the Botanical Gardens of the University of British Columbia; to our great surprise and amazement we see a humming bird.

August 4

The end of the congress, and still one day to go before the start of our cruise to Alaska. This is going to be a special day: a meeting with a friend from the Internet.

Before I started dialysis I left a distress call on an American bulletin board for dialysis patients: 'I am starting dialysis and would love some cheerful advise.' Barbara from Vancouver answered and cheered me up with stories about doing exchanges in her husbands van on the beach.

She now has offered to show us Vancouver. First we do our exchanges in our hotel room, and then she takes us to Stanley Park, Prospect Point and Queens Park. After another exchange at her house we are taken out to dinner. We try very hard not to talk about kidneys and dialysis all the time, but it is very special to meet someone who knows exactly what you are going through and what you are talking about. The spouses exchanges views on their women who will be running around at one moment and collapsing the next.

August 5

Today is the start of our 6 day cruise to Alaska. We, and some other Dutch tourists are taken to the Royal Yacht Club, where we get a briefing on what to expect. This must be the classiest place I have ever done an exchange: the library at the Royal Yacht Club, all brass handles and polished wood. I do have to sit on the floor to get enough height for the bag though.

Boarding is quite easy: a friendly lady guides us and our boxes past the custom officers. We feel quite at home on a Dutch ship and in the evening have a very decadent Dutch gin while watching the sunset.

August 6-12

A few days at sea, but also excursions to three towns.

The highlight of our trip is the excursion in Juneau where we go whale watching in a small boat. We are in luck: within ten minutes there is a whale with her calf. Add to this sea lions, seals and bald eagles and very enthusiastic and knowledgeable guides and you have a recipe for a very special day.

In Skagway we take the train to the White Pass, where the gold diggers and their mules travelled on their way to the gold fields. Unfortunately the famous Alaskan fog obscures most of the view.

In Glacier Bay during breakfast we see the ice flows drifting past. It's cold and foggy on deck, but the view of the glaciers is very impressive. Dutch pea soup is served on deck at 10.30 a.m. and very welcome it is.

August 13

We have another day in Vancouver before our plane leaves. The hotel is very accommodating about using our room, so no problems with exchanges. In the anthropological museum we see real totem poles, which are much more impressive than the modern ones we saw in the park at Kethican.

Another exchange in the baby room at the airport and a nine hours flight home. Some of our children have come to meet us and we drive to our oldest sons house for another exchange at my favourite spot: the ironing board. And then we here that there is another grandchild on the way. It's a good thing I bought her mother a large Alaskan t-shirt.

(We also have other travel stories)

Glossary

• Schiphol Amsterdam International Airport (AMS)
• Fresenius Worldwide provider of dialysis care (FMC)
• Toronto, Ontario, Canada. Lester B. Pearson International Airport (YYZ)
• Buffalo, New York State, US.
• Niagara Bridge Map of Toronto-Buffalo
• Rochester, New York State, US. Map of Buffalo-Rochester
• Vancouver, British Columbia, Canada. Vancouver International Airport (YVR)
• 110v/220v Voltage used for electric appliances. 110v is used in the US, 220v is used in most of Europe, both are used in Canada depending on the location.
• Juneau, Alaska, US. Discover Juneau
• Dutch Gin. Gin is made with Juniper berries, there are 2 types Dutch or sweet gin and English or dry gin.
• Skagway, Alaska, US. Local Guide
• Dutch Pea Soup or Erwtensoep. The traditional recipe uses pigs foot and ear, but we also found a recipe that uses ham on the bone.