Katrina's Angels

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Helping Hurricane Katrina Kidney Patient Storm Survivors

Date: 10/6/2005

Helping Hurricane Katrina Kidney Patient Storm Survivors

Compiled by Gordon Lore

During this past week, we have all seen the horrific images of the terrible destruction wreaked by Hurricane Katrina, and they do not need to be recounted here. The destruction to New Orleans, LA, was the worst. For all practical purposes, it has made the entire city unlivable for some time to come, and the Louisiana Governor has said that the death count will be in the thousands.

Some 4,000-5,000 dialysis patients in Louisiana and Mississippi were affected by the hurricane. Many of these patients have gone a week or more without any dialysis treatments, and the situation has become dire for them. Sadly, many have died. As of September 4, about 66 dialysis units in both states have been confirmed closed.

The good news is that dedicated nephrologists, other healthcare professionals, renal care organizations, state, government, and local officials, pharmaceutical companies, dialysis providers, and many others have joined forces to set up evacuation shelters with makeshift dialysis units.

Miller and Wal-Mart

One person who is doing his best to provide emergency dialysis services to hurricane victims in Louisiana is Paul E. Miller, MD, owner/operator of Miller Dialysis. He is in the process of setting up distribution and other operations in an empty Wal-Mart store in Opelousas.

In an interview with iKidney.com, Sue McManus, RN, a Nurse Practitioner for Miller Dialysis, said that both the Miller facility and a Fresenius Medical Care North America (FMCNA) center "have been running to capacity with their own patients in addition to those needing emergency dialysis. These centers are working round-the-clock."

"There are a lot of heroes [in times like this] in the dialysis field," McManus remarked. "We are a tiny town, but I have gotten calls from dialysis nurses and others as far away as Portland, OR, New Jersey, and Minnesota, offering to come here to help as well as opening their own homes to patients and their families… We are still in the process of setting up our emergency services. It's hard enough right now to get shelter for our staff. It would be ideal if dialysis staff members from other areas can get here and, perhaps, get housing from family or friends. At the moment, however, we are simply not set up to house any staff members who are willing to come here to help. It's also very heartwarming to know that we also have dialysis patients themselves who are helping others at the various shelters and running emergency errands. We are all really exhausted. Please be sure to thank everyone across the country who have been calling to offer their help."


In an interview with iKidney.com on Labor Day, Dr. Miller said that, three years ago, when Hurricane Lilly struck the area, he and other dedicated healthcare professionals and government and state officials started the Louisiana Dialysis Emergency Evacuation Plan (DEEP). A plan was prepared, "but it kind of fizzled out… Last year, when the hurricane hit Florida, we were asked if we were still interested in putting out proposed plan in effect there. We said we most certainly were."

Miller added that a strategy was laid out for emergency preparedness evacuation.

"The ultimate goal was to raise enough money to begin setting up specific command post shelters where dialysis could be performed in-house," Miller told iKidney.com. "We figured this could be a prototype for the whole nation. The American Kidney Fund (AKF) became involved, and they were wonderful… Then ESRD Network 13, Homeland Security, the dialysis vendors, and many others became involved and were possible resources."

Strategies were developed for certain disastrous conditions. Their last meeting was about two months ago.

"Then Hurricane Katrina struck, and we quickly prepared to dialyze those who needed it," Miller explained. "Last Sunday [the day before the hurricane struck], we dialyzed everyone in our unit. After they were dialyzed, many of the patients were immediately sent to Baton Rouge, which overwhelmed them, but the Renal Associates group headed by Robert Kenney, MD, did a wonderful job triaging and [accommodating them]. I can't say enough about the outstanding job they did."

"Get In and Get Out"

On a daily basis, Miller and others teleconferenced with the ESRD Networks, the dialysis providers, and others around the country.

"We quickly triaged in the manner of war and recovery," Miller stated. "It was the principal of 'get in and get out.' We called for volunteers, for school buses, anything we could to help us get the patients in and out [of the shelters]. We dispersed the patients to special needs dialysis shelters throughout the state… Right now [Labor Day], we have buses going to Baton Rouge to bring back patients for dispersal to other shelters with dialysis facilities. Meanwhile, I am setting up a command post at the old Wal-Mart store here. Thirty-six dialysis machines with ancillary equipment are being delivered there today by Gambro. Following a conference call yesterday, everyone seemed to think that we now have enough beds, chairs, and other supplies already in existence at the shelters so we can keep the Wal-Mart facility on standby. We are using the location as a depot facility where we store and disperse supplies and donations."

The Acute Facility

Miller said his own dialysis facility is next door to the Wal-Mart location, and "there are enough supplies here now to accommodate about 200 additional patients."

"Because of the plumbing issue, we probably cannot get the acute facility ready to dialyze patients for another 4-6 weeks," Miller remarked. "We agreed to concentrate on extracting patients from other areas and dispersing them to those places with the capability of treating them… Right now, the Wal-Mart location is a last-resort shelter, [but we do plan to have it on an operational status in several weeks]."

Miller said that such entities such as the AKF, Amgen, Inc., Baxter Healthcare, Da-Vita, Inc., DCI, the ESRD Networks, National Renal Associates, the parish government, school officials, the Sheriff's office, and the DHH "have all been of great help to us in [transporting, dispersing, and treating the patients]. We have a communications network that is facilitating setting all this in motion and helping out with it."

Rebuilding Homes

Miller said he was even contemplating asking the television show, Extreme Home Makeover, that focuses on rebuilding homes for needy families, to help out.

"I even found two unused hotels near here that I thought about challenging them to renovate some of their space into mini dialysis facilities…,." Miller mused. "We have so many dislodged dialysis patients that it will probably overburden the existing shelters soon. Better Water, Inc., from Smyrna, TN, has even offered to provide us with portable water treatment systems. Everyone has been amazing. So far, we have been lucky because we have all we need to accommodate the patients we are bringing in. We even got ham radio operators to ride with us to coordinate our efforts more easily… Once we get the patients to acute shelters, we concentrate on transporting them to more permanent destinations. Obviously, however, we still need resources [to keep all this going for the indefinite future]."

"The Ultimate Goal"

Miller stressed that this is all very much a team effort. He said that many nephrologists "have just been bending over backwards to help." The University of Alabama and Wal-Mart "have been wonderful in opening up their doors to needy patients. All the chain prescription drug companies have offered free supplies, including dialysis and transplant medications, no questions asked…"

"The ultimate goal of our DEEP plan is to have all the networks involved in converting several of these unused Wal-Marts or K-Marts to communication and command posts with shelter, depot, transportation, dialysis, and communication abilities," Miller explained. "Ultimately, these pre-planned shelters would already be available when a disaster such as this strikes. We have a foundation called La-DEEP with the AKF and the cooperation of the Federal Emergency Management Agency to deal with these disastrous events and be much better prepared for them."

While this Editor was able to get through to the following phone numbers on Saturday, because the phone lines are only working intermittently, the best way to reach Dr. Miller is through his e-mail address: pna5022@bellsouth.net. The numbers for Miller Dialysis are: (337) 594-8535 or (866) 304-8757. Miller Medical Services: (337) 594-0675, (337) 594-0850, and (888) 747-2669. His answering service number is: (337) 593-4242.

ESRD Network 13

End-Stage Renal Disease (ESRD) Network 13 services Arkansas, Louisiana, and Oklahoma. It reports that patients without any advance contact or medical records "can still be treated. All that is needed is for a physician to write dialysis orders. Please be aware that it appears that this situation may be long-term and that the Network is doing everything we can to assist in the massive effort to help the dialysis patients and providers in the affected areas."

On its websites (www.network13.org/katrina.htm, www.network13.org/patients.htm, and www.network13.org/alert.htm), in addition to other important information desperate dialysis patients and their families should know, including an updated spreadsheet showing the status of dialysis facilities in its region, the network has several important resources that can be downloaded and printed, including "An Emergency Preparedness Guide for Dialysis & Transplant Patients" and a "Boiling Water Advisory." The toll-free number for patients is (800) 472-8664. For dialysis facility staff, it is (877) 700-1196.

HHS Establishes Deployment Information

The US Department of Health and Human Services has established a toll-free number (866-KAT MEDI) and a website (http://volunteer.hhs.gov) in an effort to identify healthcare professionals and relief personnel to assist in the relief efforts necessitated by the destructive hurricane.

HHS said that multidisciplinary healthcare professionals and relief personnel with expertise in many areas are needed. Volunteers must be healthy enough to function under less-than-ideal field conditions, however. These include 12-hour shifts, austere conditions, no air conditioning, long periods of standing, bed rolls, portable toilets, and ready-to-eat meals. The workers will be non-paid temporary Federal employees. Travel and per diem will be paid.

The NKF Effort

The National Kidney Foundation (NKF) has established a relief resource network posted on its website at: www.kidney.org. The network offers dialysis locations and treatment information along with other patient assistance and information for healthcare professionals who may be interested in becoming volunteers.

"The need to connect people with information and resources is so great right now," remarked David Warnock, MD, NKF President, "but it won't go away in a week, two weeks, or even two months. Today, it's providing access to medical care, necessary medication, and information on how to get to a shelter where a makeshift dialysis unit is being set up. Tomorrow, it will be food, temporary housing, transportation, expenses related to relocation, and various needs incurred by both dialysis and transplant patients.'

To contribute to the NKF's Hurricane Relief Fund, visit www.kidney.org or mail checks to the NKF Patients Hurricane Relief Fund, 30 E. 33rd Street, New York, NY 10016. The NKF vows that 100% of contributed funds will go directly toward assisting patients.

Help For Transplant Recipients

The NKF has provided the following contact information for organ transplant recipients needing anti-rejection medications and other help:
Patients in Louisiana can ask for the Transplant Coordinator at the Louisiana State University Transplant Center in Baton Rouge by calling (318) 675-6100. They can also contact the Willis Knight Transplant Clinic in Shreveport and ask for Transplant Coordinator Elaine Kilpatrick at (318) 212-4275.
Those living in Mississippi can call the Transplant Coordinator at UMOC at (601) 984-5069.
Many transplant recipients and candidates may have relocated to other areas due to the hurricane. The United Network for Organ Sharing (UNOS) has provided contact information for transplant programs in areas near the hurricane-ravaged areas that can provide short-term medical care. Transplant patients may also call UNOS' toll-free Patient Services line at: (888) 894-6361).

Following is a partial list with phone numbers of places renal and other transplant patients can call for help:
University of Alabama Hospital, Birmingham. Phones: (866) 884-7387 or (866) 684-2361.
Arkansas Childrens Hospital, Little Rock. Kidney transplant candidates/recipients only. Contact Elizabeth Frazier, MD, at: (501) 364-1479.
Children's Healthcare of Atlanta at Egleston, GA. Phone Don Mueller at: (800) 605-6175.
Emory University Hospital, Atlanta. Call Heather Holley Hambey: (404) 727-0717 or (877) 509-9877.
Piedmont Hospital, Atlanta. Mark Johnson, MD: (866) 610-4010.
Medical College of Georgia, Augusta. Contact Dee Hawkins or Belinda Boedy at: (706 ) 721-2888.
Barnes-Jewish Hospital, St. Louis, MO. Phone Gene Ridolfi at: (314) 362-0885.
St. Luke's Hospital of Kansas City, MO. Call Amy Cirese at: (816) 932-6099.
Oklahoma University Medical Center, Oklahoma City. Catherine Mercer: (405) 271-7498. After hours: (405) 271-5656.
St. Francis Hospital, Tulsa, OK. Call Judy Ward at: (918) 549-3278.
Methodist University Hospital, Memphis, TN. Phone Barry Marshall: (901) 516-7070.
St. Thomas Hospital, Nashville, TN. Mark Wigger, MD: (800) 456-6618.
Vanderbilt University Medical Center and Nashville Veterans Administration Medical Center. Edward Zavala: (877) 317-0654.
Methodist Specialty and Transplant Hospital, San Antonio, TX. Contact the Transplant Coordinator on call: (800) 888-0402.
North Austin Medical Center, TX. Phone Karen Evans at: (512) 832-9999, ext. 232.
Memorial Hermann Hospital, Houston, TX. Leslie Duncan: (713) 704-4000.
The Methodist Hospital Baylor College of Medicine, Houston. Phone Sherrill Lanthier at: (888) 393-3986.
St. Luke's Episcopal Hospital, Houston. Call Karen Christos at: (832) 355-3952.
Medical City Dallas, TX. Michelle Currier: (972) 566-7325.
Methodist Dallas Medical Center, TX. Transplant Coordinator on call: (877) 425-4837.
Baylor University Medical Center, Dallas. Phone Mike Donnell at: (214) 820-1711.
FDA Advisories

The US Food and Drug Administration (FDA) has issued several advisories, including:
"FDA offers Valuable Information About Drug Use and Safety in the Aftermath of Hurricane Katrina." Website: www.fda.gov/cder/emergency/default.htm.
"Information Regarding Insulin Storage and Switching Between Products by Victims of Hurricane Katrina." Website: www.fda.gov/cder/emergency/insulin.htm.
"Medical Devices That Have Been Exposed to Heat and Humidity." Website: www.fda/gov/cdrh/emergency/heathumidity.html.

The Editor has confirmed that most of the phone numbers listed above are in working order, but, because of intermittent communication problems in areas affected by the hurricane, interested callers may have to keep trying to get through.

Dialysis patients who have not had access to regular treatments since the hurricane are in the most need of life-saving help. In addition to the medical care, temporary housing, transportation, and other services will be needed for weeks and months to come. The response from the entire renal community has been overwhelming and could serve as a template for future disasters.

Other Resources
Alabama Emergency Management Agency, Clanton. Phone: (205) 280-2200. Fax: (205) 280-2495. Website: http://sacserv.com/links.jsp?linkid=22452&subid=242733&custid=76&campid=143311&type=0.
American Red Cross. For shelter information in Louisiana, call (800) 469-4828.
America's Second Harvest. Provides food to victims. Phone: (800) 771-2303, ext. 232. Fax: (312) 263-5626. E-mail: agonzalez3@secondharvest.org.
CNN.com List of Hurricane Katrina Survivors. Website: http://sacserv.com/links.jsp?linkid=22450&subid=242733&custid=76&campid=143311&type=0.
Disaster Relief Organizations. Website: http://sacserve.com/links.jsp?linkid=22458&subid=242733&custid=76&campid=143311&type=0.
Federal Emergency Management Agency (FEMA) contacts. Website: http://sacserv.com/links.jsp?linkid=22465&subid=242733&custid=76&campid=143311&type=0.
Emergency Management State Offices and Agencies. Website: http://sacserv.com/links.jsp?linkid=22460&subid=242733&custid=76&campid=143311&type=0.
Federal Government Information Resources. Includes locating missing relatives and friends, evacuees and disaster victims, emergency personnel, emergency declarations, etc. Website: http://sacserv.com/links.jsp?linkid=22463&subid=242733&custid=76&campid=143311&type=0.
Food For the Hungry. Website: http://sacserv.com/links.jsp?linkid=22459&subid=242733&custid=76&campid=143311&type=0.
Habitat For Humanity. Builds homes for low-income, poverty-stricken families. Website: http://sacserv.com/links.jsp?linkid=22471&subid=242733&custid=76&campid=143311&type=0.
Hurricane Katrina Official Government Website. Website: http://sacserv.com/links.jsp?linkid=22470&subid=242733&custid=76&campid=143311&type=0.
Hurricane Katrina Survivors. Website: http://sacserv.com/links.jsp?linkid=22472&subid=242733&custid=76&campid=143311&type=0.
I am OK Website Posting For Disaster Victims & Relatives. Website: http://sacserv.com/links.jsp?linkid=22473&subid=242733&custid=76&campid=143311&type=0.
Locate Missing Relatives & Friends. Website: http://sacserv.com/links.jsp?linkid=22475&subid=242733&custid=76&campid=143311&type=0.
Louisiana Disaster Recovery Foundation. Website: http://sacserv.com/links.jsp?linkid=22476&subid=242733&custid=76&campid=143311&type=0.
Louisiana Office of Emergency Preparedness. Website: http://sacserv.com/links.jsp?linkid=22478&subid=242733&custid=76&campid=143311&type=0.
Louisiana State Police Road Closure Hotline. Phone: (800) 469-4828.
Medical Assistance Programs International. Website: http://sacserv.com/links.jsp?linkid=22479&subid=242733&custid=76&campid=143311&type=0.
Missing Persons Website Posting. Posts information about missing people in New Orleans. Website: http://sacserv.com/links.jsp?linkid=22481&subid=242733&custid=76&campid=143311&type=0.
MSNBC Missing Persons Websites. Website: http://sacserv.com/links.jsp?linkid=22482&subid=242733&custid=76&campid=143311&type=0.
Nola.com. A website in New Orleans for posting news and information for people trying to locate family members. Website: http://sacserv.com/links.jsp?linkid=22485&subid=242733&custid=76&campid=143311&type=0.
Operation Blessing International Relief. Based in Virginia Beach, VA, this organization transports water, food, cleaning kits, and other emergency supplies. Website: http://sacserv.com/links.jsp?linkid=22487&subid=242733&custid=76&campid=143311&type=0.
RenalWEB. Website: www.renalweb.com.
Salvation Army. Phone: (703) 684-5500. Fax: (703) 684-3478. E-mail: NHQ_Information@USN.salvationarmy.org. Website: http://sacserv.com/links.jsp?linkid=22491&subid=242733&custid=76&campid=143311&type=0.
Tips on How to Assist the Disaster Victims. Website: http://sacserv.com/links.jsp?linkid=22492&subid=242733&custid=76&campid=143311&type=0.

-September 2005