Fort Bragg Dialysis Clinic: A Gift of Life

Story by Debbie L. Holmer

We must remember that one determined person can make a significant difference, and that a small group of determined people can change the course of history. –Sonia Johnson

And that’s just what happened in our little town of Fort Bragg, California.

History of the Mendocino Coast Dialysis Project
Marilyn Ward, past historian and newsletter editor for the Mendocino Coast Dialysis Project shared the following with me:

Kathy Branam Warner, who was patient advocate at Mendocino Coast District Hospital at the time, was asked if hemodialysis was available on the coast. At the time there were about twelve to fourteen Mendocino Coast residents who had to travel to Ukiah or Santa Rosa for the dialysis procedure, so many heartbreaking stories.

Mendocino Coast Dialysis Project started from the bud of an idea in the brains of a few caring individuals in August of 2000. There were seven individuals at the meeting room of the local library, in response to a notice in the local newspaper inviting persons interested in a dialysis clinic on the Mendocino Coast. Attending the meeting were two registered nurses (R.N.s), three dialysis patients, and two people interested in volunteering.

The individuals at this meeting realized what an awesome challenge they were faced with. Kathy Branam Warner was elected to be the chairperson of the MCDP. A local church offered the group their meeting room for the monthly board meetings. Hundreds of volunteers came to the aid of the dialysis project. Fund-raising events occurred frequently over the next six years. Businesses contributed, organizations put on benefits, and churches gave fund-raising dinners. The money that was donated went into a fund established by the Community Foundation of Mendocino County.

A newsletter was voted upon and was named The Gift of Life to be published three times a year until the end of the dialysis project.

Funding
In 2002 the Mendocino Coast Dialysis Project received its 501 (c)3 nonprofit status. The cost of bringing dialysis to the coast was significant. In addition to grants, the funds were raised through private and corporate donations, and numerous community fund-raising events.

A caring gentleman by the name of Gordon Westerling approached the MCDP board, and offered to help the project by purchasing the building site for the dialysis clinic plus constructing a building suitable to be used as a clinic. This very generous, thoughtful offer was accepted and ground-breaking occurred in February of 2005.

The Mendocino Coast Dialysis Project provided the finances to finish and furnish the interior of the clinic plus it purchased ten new dialysis machines. Tony Canclini provided ten TV sets for the clinic, one for each individual to use with remote control during the three hours necessary for the dialysis treatment.

As one of its final acts in Fort Bragg, Georgia-Pacific Corporation donated a ten-kilowatt, electric-start generator, in excellent condition to the MCDP for the planned dialysis clinic. Having a generator at the dialysis clinic is so important. Without the generator, patients, who are lying down with a tube in their arm, have to get up and hand-crank the machine to keep the flow going and to keep the blood from coagulating.

An alphabetical list of every contributor was made and placed in a memorial binder on a shelf in the dialysis clinic.

When your kidneys fail
Healthy kidneys clean your blood by removing excess fluid, minerals, and wastes. They also make hormones that keep your bones strong and your blood healthy. When your kidneys fail, harmful wastes build up in your body, your blood pressure may rise, and your body may retain excess fluid and not make enough red blood cells. When this happens, you need treatment to replace the work of your failed kidneys.

What is dialysis?
According to the University of Virginia Health System, dialysis is a procedure that is performed routinely on persons who suffer from acute or chronic renal (kidney) failure, or who have end-stage renal disease (ESRD). The process involves removing waste substances and fluid from the blood that are normally eliminated by the kidneys (about ten pounds of toxins-filled fluids). If diagnosed early enough, dialysis can prevent the deterioration of other organs. The type of dialysis that is performed at the Fort Bragg Dialysis Clinic is called hemodialysis.

Hemodialysis
Hemodialysis is when a special type of access, called an arteriovenous (AV) fistula, is placed surgically, usually, in your arm. This involves joining an artery and a vein together. After access has been established, you will be connected to a large hemodialysis machine which drains the blood, bathes it in a special dialysate solution (contains chemicals that make it act like a sponge) which removes waste substances and fluid, then returns it to your bloodstream.
Hemodialysis is usually performed several times a week and lasts for four to five hours. During treatment you can read, write, sleep, or watch TV.
Side effects are avoided by following the proper diet and taking medications, as prescribed by your physician. A dietician will work with you to plan your meals according to your physician’s orders.
Although dialysis treatments are not cures for end-stage renal disease, they will help you feel better and live longer.

Dialysis machine
The dialysis machine is about the size of a dishwasher. This machine has three main jobs:
• Pump blood and watch flow for safety
• Clean wastes from blood
• Watch your blood pressure and the rate of fluid removed from your body

Some interesting facts
According to the National Kidney Foundation, over 355,000 Americans currently are on dialysis. Virtually all these patients would die if not for the aid of ongoing kidney dialysis. In 1992, there were approximately twenty-one ESRD patients in Mendocino County; in 2008 there were approximately seventy-five to eighty.

Thomas Graham, professor of chemistry at Anderson’s University in Glasgow, Scotland, coined the term dialysis in 1861.

In 1913, Abel, Rowntree, Turner and colleague constructed the first artificial kidney. They used hirudin, produced from leeches obtained from Parisian barbers, as an anticoagulant. We’ve come a long way since then, that’s for sure!

DCI Fort Bragg Dialysis Clinic
Before the Fort Bragg Dialysis Clinic officially opened in October 2006, dialysis patients on the Mendocino Coast traveled more than two thousand miles a month over narrow, winding mountain roads to dialysis centers in Ukiah or Santa Rosa. One way, this trip takes at least ninety minutes, longer if there is rain, snow or landslides, which are common. Many individuals were forced to move away from the community because the time, travel and disease-related obstacles just became too great. Others, unable to muster the needed resource, chose to die, rather than leave their lifelong homes to be close to a dialysis center.

Oh yes, there were glitches. At one point the cubicles needed to be redone as they weren’t wide enough to accommodate gurneys or low enough to allow the nurse to sit at her station and see the patients from the waist up.
The Mendocino Coast Dialysis Project broke ground for their new dialysis clinic in February of 2005. In 2006 the initial provider of renal care broke ties with the Mendocino Coast Dialysis Project, however in April of 2006 the Dialysis Clinic Inc., a Nashville-based company, agreed to provide dialysis services at the Fort Bragg clinic. Shortly afterwards, the clinic passed state inspection and their first patient was Fort Bragg resident Rose Turner.

According to Chris Keen, corporate administrator for DCI, the company saw two reasons to provide dialysis services on the coast. One was the need. While he was here visiting in early 2006, there were two slides on Highway 20, resulting in road closures and delays. “It certainly indicated the difficulty patients on the coast have in accessing care,” he observed.

The second reason was the effort the coast community put into making the clinic a reality. “DCI was founded with the idea of providing dialysis to patients who don’t have ready access to care,” Keen said.
The DCI Fort Bragg Dialysis Clinic has been open for over two years now, with ten dialysis stations. DCI is a nonprofit organization that uses any profits to go back into research for better dialysis methods and transplants. DCI enables small clinics like Fort Bragg Dialysis to be open for patients. Many people have asked if the clinic is part of the hospital and it is not.

The clinic does accept visiting patients but because there is a tremendous amount of paperwork involved they must have a couple of weeks to get it all completed and get the insurance sorted out before they can visit. The clinic loves to get visiting patients and some of those that have visited have even come back again because they like the clinic and staff so much. The Fort Bragg Dialysis Clinic had thirty out-of-town visitors between May and October of 2008.

On my recent dialysis clinic tour I was pleased to walk into a bright and cheery space. The walls are painted a soft green with beautiful artwork by Yvette Schnaubelt at every station. One feels “comfortable” and “welcomed” here. My tour “guides” were Shari Jacobzoon, R.N., nursing manager of the Fort Bragg Dialysis Clinic and local businessman Jeff Rickard. (When Kathy Branam Warner moved back East, Jeff Rickard took over as chairperson for the Mendocino Coast Dialysis Project.) Jeff became involved in the dialysis project after seeing what his mom had to go through in order to get dialysis treatments.

Shari graduated in 1992 from the College of the Redwoods nursing program (Mendocino Coast campus). A dedicated medical professional, she commutes from her home in Redwood Valley. She has been working with dialysis patients for many years. “We establish a very close relationship with our patients and also their families. Each dialysis ‘treatment’ is tailored individually to the patient. It’s not a ‘one-size-fits-all’ situation. Our dialysis clinic here in Fort Bragg is well outfitted.

The Fort Bragg Dialysis Clinic staff also consists of Dr. Chris Ives, medical director; Maureen Seifert, social worker; Andrea Ambler, R.N.; Willie Anton, patient care technician; Michelle Yamanoha, dietician; and Shannon Wilson, secretary.

Recap: The vision and dream become reality
It’s been quite a journey for all of those involved with the Mendocino Coast Dialysis Project and the Fort Bragg Dialysis Clinic. Fund-raising began after the initial August 2000 planning meeting with people pressing fives and tens [dollar bills] into Kathy Branam Warner’s hands and saying, “Here’s something to get started with.” It was a “short” five years later that the Mendocino Coast Dialysis Project broke ground for a new dialysis clinic. In April of 2006 Dialysis Clinic Inc. agreed to provide dialysis services in Fort Bragg. The clinic passed state inspection in October of 2006 and celebrated with their official grand opening in December of 2006.

In 1992 there were approximately twenty-one ESRD patients in Mendocino County; in 2008 there were approximately seventy-five to eighty. The Fort Bragg Dialysis Clinic currently has twelve full-time patients.

The Fort Bragg Dialysis Clinic is located at 512 Cypress Street. Their phone number is 964-1610.