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Posted: March 12, 2013

Dialysis closure odyssey continues for Kirt Sellers

He approaches Mondays, Wednesdays and Fridays with the same small sigh and the determination of a mountain climber.

He climbs into his compact sedan, acquired because it is good on gas, at about 10 a.m. each of those days and drives 140 km south down Highway 93/95 from Invermere to Cranbrook.

Now, it is not uncommon or strange for Invermere residents to travel to Cranbrook. Some work in the region’s market centre; others come to shop or use a service; some take/pick up people at the Canadian Rockies International Airport; others trek south to enjoy a flick at Columbia Theatre; many others head down to support the Kootenay Ice.

However, it is likely safe to assume that most come to Cranbrook for similar reasons as Kirt Sellers – to receive some medical attention at the East Kootenay Regional Hospital.

What separates Kirt from most who must attend the hospital is that he has to do it three days a week, month after month, ever since the Interior Health Authority (IH) closed the Invermere and District Hospital’s Dialysis Unit.

With his computer case in hand, the on-long-term-disability Interior Health employee heads to the Cranbrook-based hospital to receive dialysis. Once at the hospital’s dialysis ward he is seated next to a machine like the one sitting idle at Invermere, awaiting proposed transport to the Sparwood Health Centre after IH suddenly opted to close the Invermere unit early last summer (2012) without warning to Kirt or local Kootenay East Regional Hospital District directors, who in February lambasted IH for what they charged was a poorly considered action.

Kirt met with e-KNOW Feb. 20, almost three weeks after the hospital district directors unanimously agreed to send a strongly worded letter to IH demanding the Invermere dialysis unit be left in place and re-opened. The hospital district is comprised of regionally elected officials (basically the Regional District of East Kootenay along with some elected officials from the Columbia-Shuswap and Central Kootenay Regional Districts), who determine ‘yea or nay’ to provide 40% funding for the IH in this region.

While encouraged by the hospital district board’s strong stand, Kirt said he was remaining guardedly optimistic, as blood flowed out of his body into a hemodialysis machine and then back into his body.

According to medicalnewstoday.com, “Dialysis is the artificial process of eliminating waste (diffusion) and unwanted water (ultrafiltration) from the blood. Our kidneys do this naturally. Some people, however, may have failed or damaged kidneys that cannot carry out the function properly – they may need dialysis.”

With needles inserted into a regular place in Kirt’s chest and one of his arms, he gets hooked up to a hemodialysis machine. Blood is removed from his body and passed through an artificial membrane (artificial kidney) and poisons in the blood are removed. His blood is then pumped back into his body. The entire process takes between four and five hours.

Once this arduous process is complete, the avid conqueror of rock faces and survivor of a double open-heart surgery (1999), as well as a broken back (1995 while climbing), gets back in his car and drives back to Invermere.

In the winter, that means he drives back in the dark. Anyone who has driven from Cranbrook to Invermere (or from any point A to point B in the East Kootenay) knows that the experience often contains ‘highlights’ involving elk and deer. In the case of the Invermere-Cranbrook drive, there are about four to six herds of elk to navigate through. Don’t forget about the potential weather hazards, which alone makes the drive a risky proposition for someone completely healthy who hasn’t spent an afternoon having his blood filtered in a hospital.

“Once you leave – you’re committed, you are going big, you are going home,” Kirt said. “It’s not like there is anywhere for me to pull over and stay.”

Kirt said he opts to return home after dialysis, rather than bed down in Cranbrook for the night, because “I’m well enough I can drive” and “I’m a well-trained driving machine.”

He admitted that driving in winter has required the skills of a well-trained driving machine.

“We’re through the worst of winter, but the risks are way up” with the elk in the valley bottoms for the winter.

Sometimes, he said, “I have to stop to rest.”

Sellers’ medical odyssey started when his kidneys became infected and after a transplant failed he found himself heading to the Invermere dialysis unit on a regular weekly basis. Two other people also used the service each week. When the only nurse trained to operate the dialysis went on a leave of absence, the three patients found themselves cut adrift, having to head to Cranbrook or Trail for treatment.

One of the patients has moved to Penticton where treatment is available and another opted for home treatment – which is a path IH and B.C. Ministry of Health is encouraging.

“Only 30 per cent, at most, can go on home dialysis,” Kirt points out, adding the province has the highest rates of people having home dialysis in the country.

Not able to avail himself of the home treatment path and not willing to move, Kirt  has become intimately familiar with the road and landscapes between the Key City and Columbia Valley.

Making the matter all the more infuriating, he points out, is that he was told the service would return to Invermere when the on-leave nurse returned to work.

“They said all along they were reviewing things, but we were told it was going to open. And then not – it was quite a shock,” Kirt said. “The service has been going here for 12 years.”

The service was supposed to re-open Jan. 14 but was permanently closed with only three day’s notice.

Moving “is not an issue,” he said. Thanks to his past heart problems, he periodically must see a heart specialist in Calgary, less than hours from Invermere and more than four hours from Cranbrook. There are only two heart specialists in the nation who can provide Kirt with the expertise he needs. The other is in Toronto.

“Move? That’s my home. I’ve been there 25 years. I have put my heart and soul into it, as a worker, as a climber,” he stated.

Kirt worked for Interior Health for 25 years, as a health inspector.

“I tried really hard to represent government. The irony just kills me,” he deadpanned. “I know it’s not personal, but…” he trailed off with a chuckle. “You have to laugh or you go crazy after a while.”

And while he is on disability, he watches good jobs he would have been in line to go after pass him by.

He shrugs it off and in his deep ‘radio’ voice says it is “personal hubris – it’s just the way life works.”

Kirt said he finally decided to speak out because he feels for others who are doing what he must do each week.

East Kootenay Regional Hospital in Cranbrook.

“It’s not about me,” he strongly notes. “I’m atypical. I’m young and relatively healthy. There are other worse off people and the people from Golden,” he exclaimed, they also have to head to Cranbrook for treatment – a further 90 minutes of driving, with half of it along the treacherous, wildlife-lousy and often slippery Highway 95 winding alongside the Columbia River Wetlands.

“It’s all principle to me now,” he said, adding that if he received a transplant he would continue to fight to keep the dialysis unit in Invermere.

“I think of the families – the people who want to be around them (patients) and what they’re going through. Me, I’m mostly alone in the world. I’ve got two lovely daughters but… I’m also much younger, atypically, than most people who have to undergo dialysis.”

Kirt’s fight has begun to resonate beyond the barriers of the Purcell and Rocky Mountains.

Beginning with the powerful challenge by the hospital district (https://www.e-know.ca/news/kerhd-board-rips-into-ih-over-invermere-dialysis/ ), the fight is now on the floor of the Legislature in Victoria, where Columbia River-Revelstoke MLA Norm Macdonald is representing his constituent.

MLA Norm Macdonald

“Kirt Sellers, a resident of Invermere, used to have to drive five minutes for the dialysis treatment he needs to stay alive,” said Macdonald in the Legislature recently.  “He has treatment three times a week.  But thanks to cuts by the Liberal government, the dialysis unit in Invermere is closed, and Kirt now has to drive nearly two hours each way for the same treatment.

“Because of the closure of the clinic, at least two more dialysis patients from Invermere have been forced to leave the community.  The Invermere clinic also provides services to people visiting from other provinces, either as second homeowners or occasional visitors,” Macdonald continued.

“The fact of the matter is that there is no good explanation for this closure.  The equipment is there, the staff is there and the patients are there.  How can the minister support this widely-criticized decision to close the dialysis unit in Invermere?”

(Hansard transcript: http://www.leg.bc.ca/hansard/39th5th/H30228y.htm )

Macdonald has also written to Health Minister Margaret MacDiarmid to reconsider this decision as the communities of Invermere and Golden do not “accept” it.

“The people of Golden and the Columbia Valley continue to be very disappointed in your Ministry’s response to the closure of the Invermere dialysis unit.  Although it is clear that some efforts have been taken to brief you on this issue, and that understanding is apparent in your responses, I believe that you are not fully aware of the whole story. I would like to correct that situation now.

“Thus far, three main arguments have been used to defend the closure: low patient volumes, limited staff, and that home dialysis is Interior Health’s preferred method of treatment. None of these arguments stands up to scrutiny.

“First, the permanent closure of the Invermere Dialysis Unit has caused at least two dialysis patients to move from their homes and families in Invermere to be closer to dialysis treatment. And, the closure of the unit has stopped the ability of out-of-province visitors to come to the Columbia Valley and still receive the treatment they cannot live without,” Macdonald stated in his letter, adding he has also just learned of a “another out-of-province patient who is no longer able to travel to Invermere for his regular vacation. “This removes not only the revenue to the dialysis program, but it lessens the attractiveness of this area to visitors and second homeowners. This has real economic impacts on this valley.

“These facts discount the argument that there is only one patient and therefore the unit must be closed. The truth is that there would be three dialysis patients at this time if the unit had remained open,” he outlined.

“Second, it is a conscious choice on the part of Interior Health to reject the creative solutions offered by renal staff throughout the region. Health providers in rural areas are often expected to travel to provide service and to work alone in challenging situations. And programs lauded by Interior Health are often provided with these strictures. This clinic is no different,” Macdonald continued.

“It has been suggested by renal service providers that this clinic could be supported by a number of means including relief provided by travelling staff, patients travelling occasionally to another centre to provide relief, and training back-up staff within the existing nursing staff in the Invermere area.

“While some efforts were made as part of the implementation of a ‘return to work’ plan that effort was suddenly halted when the last-minute decision was made to permanently close the clinic.

“Third, the claim that Interior Health’s preferred method of renal treatment is home dialysis is, as you know, only medically supportable in some cases.  As a doctor, you understand better than anyone that for some renal patients home dialysis will never be an option. Kirt Sellers is only one of these patients,” Macdonald concluded.

E-KNOW asked IH’s communications department to provide an update on the Invermere dialysis in a Monday, March 4 email, as well as to provide comments on what MLA Macdonald said in the Legislature, and asked “would someone care to provide an official rationale as to why this is happening?”

We provided a March 7 deadline for the reply – and stretched it to today, March 12.

As of publication of this feature story, IH has refused to comment on this issue.

Ian Cobb/e-KNOW


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