The long and windingroad… has been a pleasure

I am going to have a break from writing my blog for a while.  For the last six months, I have been unwell and it is a real struggle most days to just to do basic living and the things I enjoy most. I am still finding enjoyment in many of my favourite activities especially catching up with family and friends, reading, watching the occasional movie doing all our business related stuff and of course, having such an intimate time talking and sharing with you.

But being on dialysis for the past 24 years is impacting on my health now.   Many of my body systems don’t work as well as they use to.   Hopefully, in time I will pick up.   For now, though I am concentrating on getting better. This phase is quite a challenge.

This blog has always brought me great please and I am humbled by the number of people who read it and found it helpful for themselves or a family member or friend who is on dialysis.   I am also very pleased that I have been able to work with clinicians and improve the experiences and knowledge for people of dialysis.  Thank you all for being part of my audience.

The future? who knows?

Searching for ways to reduce errors in diagnosis

Nearly everyone will experience at least one diagnostic error in their lifetime. Most chronic (kidney) patients can expect to experience many more.

Last Monday I had the great pleasure of presenting the consumer’s viewpoint at the second Australian Diagnostic Error Minimisation conference, held here in Melbourne. Speakers and attendees came from around the world and it was great to hear from so many world-renown senior clinicians working on the problem (and making progress).

My job was to tell the attendees how we patients feel about getting the diagnosis wrong – how badly it can affect us – and to make suggestions on how we can help to minimise the problem.

Below is an edited version of my speech.

How Diagnostic Errors affect us

Medical Errors we know about are the tip of the iceberg

Personally, my experience with diagnostic error has been much like most. Being put on the wrong medicine sent for unnecessary tests or procedures, or refused necessary tests, procedures or even blood when I needed it. Some errors causing more harm than others.

Glen’s Experience

Sometimes it can take a huge personal toll on a patient. For example, my friend Glen  – who has a kidney transplant – woke one morning to find his whole left side numb and immobile. He went to ED and after tests, was told he had early-stage MS and he was put on the associated medication.

Fairly quickly Glen found himself in a wheelchair, and gradually believed, and began to behave like he was an MS patient. So, after a heartbreaking talk with his wife, he left his job and they sold their house and moved to a smaller one, more suited to his condition. He eventually joined the MS Society and during his interview, they raised serious questions about whether he really did have MS.

He went to another specialist; who sent a sample of spinal fluid to the US for testing. Result: no MS, just a small mini-stroke.

This diagnostic error cost him not only a year of normal living but his career and a needless move from the home he loved. A huge emotional toll and hundreds of thousands of dollars.

Of course, it could have been worse – there are many recorded examples of patients dying because of diagnostic error. But Glen’ story is bad enough.

To me, Diagnostic Error is a lot like the road toll: both will never be entirely eliminated because both involve humans in charge. But like the road toll, we must find ways, to reduce Diagnostic Error and to do so sooner rather than later.

My Suggestions

Two things about diagnostic error have become clear to me over the years:

  1. Diagnostic Error rates reduce the more we patients take responsibility for our own healthcare
  2. Many incorrect diagnoses are the result of clinician overconfidence and jumping to conclusions.

1. Patients taking responsibility

In line with the ePatient approach, over the years I have gradually taken more and more responsibility for my own care.

I have achieved this in several ways, but the most powerful is the quality of my relationships with what I think of as my Healthcare Team. At present there’s six of us collaborating on my care:

  • GP
  • Nephrologist
  • Cardiologist
  • Infectious Diseases Physician
  • Haematologist
  • Me!

I’ve been collaborating with some for over 30 years, others for a shorter time, but the relationship, which enables effective, two-way communication. is wonderful.

In fact, I am pleased to say that consultants not only send letters about each consultation to each other, they also send them to me. I recommend this as a way to stay in the loop. For most consultants, you only have to ask.

For my part, I keep a file on my health record in Evernote, on my phone: letters, blood results, ECGs, referrals, scans, discharge summaries, etc.

I also keep a detailed list of my meds, hospital details, latest blood tests, etc. (my ED Elevator Pitch). You never know when you need them, especially when you go to ED.

When we patients take responsibility for our own healthcare, the resulting better relationships, communication and collaboration with clinicians absolutely reduces the chance of Diagnostic Error.

Being an ePatient

Over the years I have worked on this blog, part of my personal growth has resulted in me gradually becoming an ePatient, that is, someone who takes responsibility for their own healthcare.

From Wikipedia: e-Patients are health consumer who participates fully in their medical care, primarily by gathering information about medical conditions that impact them and their families, using the Internet and other digital tools.

ePatients report two effects of their health research: “better health information and services, and different (but not always better) relationships with their doctors

ePatients are expert patient: equipped, enabled, empowered and engaged

Guardian AngelIn short, over the years I’ve become my own Guardian Angel. And very much part of this involves collaborating with clinicians and working to minimise Diagnostic Error together.

2.   Clinicians Jumping to Conclusions

Here’s a Jumping-to-Conclusions example that happened to me recently:

For the last 3 or 4 years, I have regularly visited the ED with a very painful hip. The first time I was treated with Vancomycin, which seemed to work. A year later I presented a second time, with the other hip the problem. The doctor looking after me read my discharge Report and jumped to the conclusion that if Vancomycin worked once, it would do so again. It did, and I returned home.

The next year it happened again. Yet again, I found myself in bed with a Vancomycin drip. Staff were puzzled, but it seemed the obvious answer.

Then, to Julie’s and my delight, one very switched on Infectious Diseases Physician decided to do some in-depth thinking. She read the file in more detail and realised that these weren’t independent issues, but a single, recurrent problem that vancomycin was not actually solving. She changed the treatment, and wallah, here in sit, in front of my PC, the picture of health (sort of).

So, what is a consultation?

If we understand what exactly a consultation is, we can better ensure that the clinician has the best chance of not jumping to conclusions.

A consultation is a meeting of experts

One is an expert clinician, the other an expert on themselves

The meeting is a collaboration, and both have a responsibility:

The patient to describe their problem (symptoms) clearly

The clinician to:

  • Diagnose the illness accurately
  • Help the patient recover

From my experience, I think the best ways I can help clinicians to stop being overconfident and Jumping to Conclusions are:

1. When I’m feeling unwell, I go to a reliable medical website, like the Mayo Clinic Symptom Checker or any other Patient Education Web Site Worth Recommending to get an idea of what may be wrong. Many say when I should visit a doctor. If I think I fit the bill, I make an appointment.

2. In the waiting room, before the consultation, I think about and maybe even make a list of my symptoms. This can be helped along if I ask myself two questions: “Why am I here?” and “What do I think it is?” This helps me to be ready with useful information when I see the clinician.

3. Just before the consultation ends, I ask the doctor ”Could it be anything else?”

Asked at the right time (after the doctor has pronounced their diagnosis, but before leaving the surgery), it forces them to think again – and maybe even change their mind.

Bottom line

As I said at the outset, Diagnostic Error is a lot like the road toll: both will never be entirely eliminated because both involve humans in charge. But just like we can reduce the road toll with smarter cars and damage-limiting techniques like mandatory seatbelts and speed limits, we can reduce Diagnostic Error:

  • When we patients take responsibility for our own healthcare – the resulting strong relationship with clinicians reduces the occurrence of Diagnostic Error
  • And helping clinicians avoid Jumping to Conclusions by:

.     Being well prepared when we walk into the doctor’s surgery

.     Just before the consultation ends, ask the doctor: ”Could it be anything else?”

Impressive new holiday booking service for dialysis travellers!

New dialysis holiday booking service, BookNowMed.com, wrote to me recently, to introduce their holiday dialysis booking service, and it looks great.
The post about it is ideal for our sister Blog, associated with the TravelDialysisReview website so you can find the full story here: TravelDialysisReview Blog.

It’s all pretty simple and easy to use: Booking dialysis is a lot like booking a hotel on Bookings.com.

For those of you who missed its release, check out the details. it is a very impressive service. More…
Another GREAT travel story from Travel Dialysis Blog.

Solidarity with Christchurch Muslims

MosqeToday, along with thousands of other non-Muslim Australians, Julie and I visited the mosque nearest to us (in Preston) to show our solidarity and express our sympathy.

Flowers 2When we arrived, we were delighted to see long lines of visitors’ shoes, a swathe of flowers and hundreds of mostly white Australians walking barefoot through the mosque.

Prayer roomSome were silent and thoughtful, others were talking to individual worshippers. All in their own way expressing their horror of the Christchurch massacre and their solidarity with the worshippers as fellow Australians.

Most of us had never been inside a mosque before and would have been rather self-conscious talking to Moslems we didn’t know. Now that barrier has dissolved and people of both sides felt the warm glow of finding new friends.

Julie approached one youngish woman in a veil, standing at the entrance to the women’s prayer room. They chatted about Christchurch for a few minutes, then Julie asked her if she experienced intimidation or racism in her day to day life. The woman went quiet and looked uncomfortable. Then she said quietly “On public transport”. Julie apologised and said that maybe this will change because of this catastrophe (not entirely believing it).

That’s because it’s up to us to stop it if we can. If we are brave enough. I have heard of a low-stress way to help stop abuse on trams, buses, etc. If someone is being abused, ask them if they would like to come and sit with you. Often most of the other passengers will make room for them and form a barrier to further abuse. There’s strength in numbers. It’s worth a try.

Perhaps the only good thing that will come of this massacre will be an improved relationship and acceptance between our peoples, the exact reverse of the perverse thinking that triggered this terrible crime.

I know Julie and I do.

Every now and then you have a win

img_8360

About six months ago, B.Braun took over all Diaverum dialysis units in Australia and New Zealand.

BBraun logoSince then, much has changed in our Unit: admin, HR and IT systems. But the biggest change for patients has been the arrival of all new singing and dancing (maybe not dancing) dialysis machines and weighing scales. Why replace everything? So that the new equipment could form a new network, linking machines and scales to the IT System and the patient records.

Now each patient has a card they put into a slot at the scales before and after dialysis. The before weight is combined with the patient’s online dialysis prescription, to load and set up their machine. The after weight records their post-dialysis weight in their record.

Pretty flash.

But what happened to the old equipment you ask?

Dialysis machines in storageThe machines were a mixture of new and old Gambro machines – Artis, AK200s and AK 200 Ultras. While the Artis machines were sold, the AK200s etc were stored in the basement, along with the almost new weighing scales. For months, gathering dust.

Until, at the Unit’s end of year Christmas Party, some patients asked the question: what are we doing with the old machines?

Chris, our Unit Manager, was keen to use the space, and there seemed to be no plan for their disposal. The option of landfill loomed large.

Donations-in-KindI happened to know of a Rotary program for recycling/reusing discarded medical equipment, usually for developing countries. I contacted Bob Glindemann, the Manager of Rotary’s Donations In Kind (DIK) Program. He was immediately excited about the value of the machines to many of his client hospitals.

 

img_8357

All aboard!

Yesterday, it all came to pass. The Rotary Pick-up van arrived. Two strong and enthusiastic men loaded the machines and the scales and took them to the DIK warehouse in Footscray.

 

 

 

 

 

 

Snug and secure and ready for their new life
The parting of old friends is such sweet sorrow

Like Marie Kondo, we thanked them for their service and waved goodbye with heavy hearts.

Search for HospitalNow it’s Bob’s role to identify recipients in the Pacific, Africa and the Middle East in greatest need, who are equipped to properly use and maintain them. (Medical equipment donations are expensive for hospitals to receive; the initial equipment value is often only 20 per cent of the total lifetime cost of the equipment. The remaining costs are based on the need for consumables, spare parts and maintenance for three to five years.)

So it takes time to find the right hospitals. But certainly, within the next few months, our dialysis machines will be wending their way across the world to the right hospitals. Hospitals with medical staff who can use them to help reduce the needless suffering and deaths of the thousands of people with End Stage Renal Failure who currently have no access to care.

Now That’s a Win!

Have you seen this before? Can you help?

I have a friend, George (not his real name), who, apart from being on dialysis, has an unusual bursa problem. Talking about it with him, it occurred to us that other people may have the same thing and have some advice about how they manage it.

IMG_8236

George’s swollen bursa

scapulothoracic-bursitis-shoulderThe problem is with his infraserratus scapula bursa. A bursa is a thin cushion of lubricating fluid located at a point of friction between a bone and the surrounding tissue/bone. George’s problem is the bursa just below his right scapula (that is just below the wingy part of his shoulder). Its job is to lubricate where the shoulder rubs against his rib cage.

 

IMG_8233

Time for draining! – About 150mls of bursa fluid and blood

In his case, his bursa decided to fill itself with fluid, to the point where it has become a 150ml-plus bag of fluid extending down the right side of his back. At first (when it was small and manageable), his local doctor worried that it was cancer, so he was referred to a specialist surgeon, who ordered an MRI of the area. It identified the bursa as the problem, so his cancer worries disappeared.

But how to deal with the bursa? It was not painful, just annoying and embarrassing. After some detailed research (using Dr Google and his army of medical partners, here and here), he discovered that it probably began as an overuse problem, following 20 years and hundreds of hours extending his right (fistula) arm for dialysis. This is not a common problem, but it is (yet another) known outcome of long-term dialysis.

1-infraserratus-bursaAs an interim measure, the surgeon drained much of the fluid and sent him home. Over the next three years, he had several Cortisone injections aimed at stopping the fluid flow and the bursa drained about once a month. Nothing worked: it just kept coming back, each time a little larger. It is now interfering with his sleep (and dressing – T-Shirts especially!). He finally decided to see if there was a better way to deal with it. He saw several specialist surgeons, most of whom recommended removing it surgically.

The trouble is that as a long-term dialysis patient, George has all the co-morbidities associated with that: AF and other heart problems, compromised immunity, bleeding and general fragility that makes an operation quite dangerous. After long discussions with his Cardiologist, he has decided to wait about six months. He has been told that the bursa may reach a certain size, then stop growing (when the fluid pressure on the bursa bag holds back the production of more fluid). This is not certain, but he’s giving it a try.

If it does not stop expanding, then his Plan B is to risk surgery.

crowdsourcing

Crowdsourcing! Tapping into the wisdom of the crowd.

But even though it is rare, surely someone has or had something similar. And perhaps they have found a better way to manage it. That’s why he decided to put his story on BigDandMe, to reach as many dialysis patients as possible, and maybe find another way to deal with it.

So if you can help, or know someone who may be able to help, please add what you know to the comments, or email me directly (see About).

Who knows what can be achieved with the power of crowdsourcing!

 

Update

img_8252George’s bursa was aspirated (drained) a week ago and the doctor collected 220mls of fluid and blood.

img_8254It seems that there is no limit to how big the bursa can get. George has now decided to talk to a surgeon about having it removed. But he is still keen to hear from others who have experience with this kind of problem and would appreciate any further feedback or advice.

A new logo for a new GreenDialysis website

This the story of how we (the Green Nephrology Action Team and Swinburne University) developed a new logo (and soon a new website) for GreenDialysis.org.

 

The fun thing was that soon after the designs were finished, Julie and I were invited to the Design Exhibition and Awards Ceremony for the Swinburne Advanced Diploma of Graphic Design course, which delightfully and unexpectedly, included many of the new logo designs (see the pics sprinkled throughout!).

 

Green Dialysis?

I have always been uncomfortable about just how resource-hungry dialysis is: the mountains of plastic waste, lakes of water and Megawatts of energy needed for its delivery.

So, when I went to a renal conference in 2017, I was delighted to find that I was not alone and that many people were doing exciting work to help make dialysis more sustainable.

Way back in 2003 the leading light of the Green Dialysis movement, Dr John Agar (Google him), was doing amazing things at the Barwon Health Renal Services in Geelong (about an hour down the road from me), to save and reuse water, reduce power use and even find ways to turn all our bloody plastic lines into a concrete additive.

By 2014 he was publishing worldwide, both via Papers and his new GreenDialysis.org website.

By 2016, John’s lone preoccupation had gathered steam and had become a dedicated team. First as an informal group of various renal stakeholders, and then in 2017, as a formal working group of the Australian and New Zealand Society of Nephrology (ANZSN). as the Green Nephrology Action Team (GNAT).

After the conference, I contacted the GNAT Chairperson (Dr Katherine Barraclough) and asked to join as a consumer representative: a brief discussion and I was in!

 

New Logo, New Website

Over 2016 and 2017 the GreenDialysis website had been revamped and updated several times to include information about GNAT and more on various projects and initiatives. However, without a central website plan, people found the website a little approachable and wordy.

After several reviews, it was decided to completely redesign the website and to create a GNAT logo. Since I had just completed the new TravleDialysisReview.com website as a collaborative project with IT students at Swinburne University, I had a rush of blood to the head and volunteered to help create a new GreenDialysis.org.

I contacted the wonderful Sarah Cleveland, Manager of Collaboration and Partnerships at the Swinburne University, and after discussions, the Swinburne Design and ICT Departments agreed to help complete the new Green Dialysis Website project.

Designing the Website

 

They proposed breaking the project into two parts, with Advanced Diploma of Graphic Design students working on the aesthetics, visuals and graphics during Semester 2 of 2018, then handing over the selected logo and Website design to the ICT students for implementation on the website during Semester 2 of 2019.

Thanks to the excellent Hue Pham, Swinburne Graphic Design teacher and supervisor, all the design work has been completed for the new logo and the new website.  They have done a fabulous job – as shown in the exhibition shots, and in more detail on the Voting Page.

The GNAT Team has voted for what they consider the best logo. They will vote for the best website in January (the best logo and the best website design are selected independently).

Your Vote for the best logo!

Here’s a sneak peek at the new logo designs. I thought you may like to vote for the best too (a Peoples Choice Award!). If so, go to the Voting Page and make your selection. No prizes, just a nice warm feeling.

I look forward to seeing your votes!

The new website design will be selected in early January. Look out for another sneak peek then.

Oops. The voting link doesn’t work properly on some platforms, so you can now also vote directly, below. Cheers!

Getting away: not always easy!

Over the last six months, we have managed to get out of town occasionally, for one or two days around dialysis.

Mini Holiday!By around dialysis, I mean that leave for our mini holiday accommodation (usually a hotel about an hour away) straight after dialysis on Wednesday night. We spend the night and have breakfast and a leisurely Thursday morning there, then, around lunchtime, we return for my afternoon dialysis. At the end of dialysis, we go back to the hotel (all in all about a 4 hr round trip). We then spend Thursday night and all of Friday at the hotel (no dialysis Friday) and check out Saturday morning in time for midday dialysis.

Basically, this gives us three nights away, with one (shortish trip) to dialysis in the middle.

Works for us!

 

Healesville

Beautiful Healesville

A couple of weeks ago we did this to go to a flash hotel in Healesville and had a great break.

Healesville swimming pool

Just before my big splash

I even went for a swim in the pool! I haven’t done that for about five years when we went to Bali. Back then it was a private pool attached to our room, so there was skinny dipping. But not this time. Lots of oldies there in bathrobes: a naked body may have caused a heart attack – and not just mine.

The other thing I enjoyed a lot was the breakfast: free and as many courses as you like. For me, that’s gotta be the best part of the stay.

Naturally, we are always on the lookout for a mini holiday.

But they don’t all turn out as expected.

About six months ago I was invited to speak a renal conference in Bendigo (about two hours north) on the consumer’s viewpoint of dialysis.  Julie and I thought about it. It would be a great opportunity for a break: we could go the night before, maybe I even dialyse there and stay another couple of extra nights, for a real getaway. So I said yes.

Then. about two months before to conference, Liam (our no.2 son) who was turning 40, sent out an invitation for all and sundry to go to his birthday party, to be held on Cypress, in the sunny Med (he lives out that way). So our daughter Katherine and her husband asked if we could look after the kids if they went too.

Of course, we said yes.

I wasn’t great timing. It meant we were looking after them on the day I was speaking in Bendigo. No mini holiday now.  We would have to get up early with the kids, drive to Bendigo, I’d talk and drive home the same day.

As the conference approached, I spent more and more time working on the speech, which was playing hard to get. Sometimes a little unwell, cursing that I had accepted, and I even considered weaselling out. Looking after the kids was a good excuse. But Julie encouraged me to stick with it (she can be very persuasive).

Then, two days before the speech, I came home from dialysis with AF (Atrial Fibrillation) and was quite weak and useless. Good excuse not to go? No says Julie, let’s wait and see. The AF went away the next day.

As expected, three days before the conference the kids came to stay. About 4am the morning of the conference, I woke up to the kids crying – there was a blackout and their comfort lights had gone out. We lit a couple of candles. Then I checked our alarm – it had reset to 5am. If the kids hadn’t cried, we may have slept in and missed the conference anyway!

Julie and I both set our phone alarms.

Up about 6am. Organising and shepherding kids, we left about 7am. We arrived with 15 minutes to spare. I checked my notes, sat and waited until the previous speaker finished.

I walked to the lectern and looked at my notes. The first page was missing. Great…

Luckily, I remembered most of what I was to say. After a little heart flutter, all went well.  I delivered my speech, left the stage, and called Julie. She arrived with the kids 10 minutes later and we drove home.

Bendigo from the car

Bendigo from the car

Not the break we’d imagined.

But a week after, I had an email from the organiser. They loved the speech. Lots of praise. Would I like to speak at the next conference, to a larger audience, in June? Only thing, it is in Auckland (New Zealand).

Hmmm. Maybe this could be the Bendigo holiday, done right? I could arrange holiday dialysis for a day or two Auckland. I’d need to be a lot fitter and stronger to travel: working towards this trip could be a good incentive. So I said yes.

I started my first gym session in three months today. I walked on a machine for seven minutes, rode a bike, rolled around on the floor, did some pretty pathetic sit-ups and we went home. Sound like a good start to me.

Now I’m looking forward to NZ!

Getting away on a mini holiday is not always easy, but, with a little thought and perseverance, like life, it can be delightful.

 

How to Manage Fatigue

Am I fatigued, or just exhausted?

Fatigue1All of us BigD-ers feel weary at times. I’m often most tired just before I dialyse. Some days I arrive at the unit, dragging one foot after the other, dead tired. Putting my needles in can be as marathon effort. And once I’m on, I sit back, suck a couple of ice cubes, close my eyes and I’m in dozy land.

But half an hour later, I wake, bright and rested.

Thinking about it, most times I’m physically tired from my physical activity throughout the morning – my early morning walk, house stuff, running around, computer work. By the time I get to dialysis, I’m exhausted and ready for a long sit-down. And the sit-down solves the problem.

Exhausted manOn the other hand, fatigue is a lingering tiredness that is constant and limiting. With fatigue, you have unexplained, persistent, and relapsing tiredness, that is not relieved by naps or long periods of rest. So how can we manage fatigue?

Guest post: How to Manage Fatigue

This pithy and practical guest post is from Constance Peng, Provisional Psychologist / PhD student at the University of NSW in Sydney, Australia. It has some great advice and ideas to help us BigD-ers put a little more energy into our day.

At least 60% of dialysis patients say they often feel fatigued

Fatigue makes it difficult to participate in enjoyable and meaningful activities, can lead to depressed moods and overall poorer quality of life. If you are one of the 60 per cent, and your doctor has not identified any medical reasons for your fatigue (e.g. anaemia, hyperparathyroidism), then it is worth thinking about making some lifestyle changes.

Studies have shown that dialysis patients who have poor sleep and are physically inactive tend to experience more fatigue.

Some tips to help you improve the quality of your sleep and increase your physical activity

Go to bed and wake up at the same time every day (even on weekends). This will train your body to know when it should be asleep.

Limit your daytime naps to 30 minutes and have them before 3pm, unless your doctor advises you to nap more often. Try not to nap during your dialysis treatment. However, if you do, remember that napping excessively during the day makes you more awake at night.

Sleep only when you are sleepy. If you cannot fall asleep within 20 minutes, get up out of bed and do something boring until you feel sleepy.

ActiveSchedule in daily exercise you can easily fit in between your dialysis treatments and other commitments. It can be as simple as 15 minutes of slow walking, stretching or gardening. Stick to this no matter how tired you feel.

Pump it higher!Practice pacing. If you try to do too much on days you feel good, then you will feel too tired the next day to do much. This is a called a “boom and bust cycle” and you will end up doing less over time. Instead, aim to gradually increase your physical activity over time. For example, you can increase the length of your daily walk by five minutes every fortnight. Stick to this plan no matter how tired or energetic you feel.

If you would like further information on how you can tackle fatigue by changing your behaviours and patterns of thinking, it may be worth speaking to a Clinical Psychologist, who can explore the underlying causes of your fatigue and use effective techniques to help you get more out of life!

The BeanThis article first appeared in The Bean, the newsletter of the Concord Hospital Renal Unit, Concord, NSW.  Thanks, Constance for sharing it with us!

If you would like read more of The Bean, or sign up, click here.

Purple House – life-saving, community-saving, inspirational or all three?

I fact it’s so much more! I wrote about this amazing group of people, led by the fantastic Sarah Brown in August 2017, and she and the House have gone from strength to strength.

But don’t just take my word for it. This astonishing interview on the ABC’s Conversations is just a glimpse of how she has changed the world not just for people on dialysis and their communities, but for all of us.

Sarah brown 2

Bringing life-saving dialysis to the bush with Sarah Kanowski. Sarah Brown always wanted to be a remote area nurse. Then she began a medical revolution 51mins 25secs, Wed 3 Oct 2018

 

Just a reminder: Western Desert Dialysis reaches 18 communities

18 Communities Strategic Plan

Part of Purple House’s 18 Communities Strategic Plan

 

Purple House Alice Springs

Sarah Brown in front of the purple walls of Western Desert Dialysis in Alice Springs

On dialysis at the Purple House

On dialysis at the Purple House