The closest clinics with a nephrologist (kidney specialist) on staff are in Redding and Medford, Ore. And although there are vans that transport Siskiyou County residents to these facilities, the drive is an hour or more each way. The treatment itself takes three or four hours each time, making dialysis a time-consuming and costly prospect.

Siskiyou County residents with end-stage kidney failure have a tough decision ahead of them. In addition to the harrowing diagnosis, accessing life-extending medical treatment is a major hurdle, as dialysis is not offered in Siskiyou County.

The closest clinics with a nephrologist (kidney specialist) on staff are in Redding and Medford, Ore. And although there are vans that transport Siskiyou County residents to these facilities, the drive is an hour or more each way. The treatment itself takes three or four hours each time, making dialysis a time-consuming and costly prospect.

Depending on the type of kidney failure and the type of dialysis (hemodialysis or peritoneal), treatments must be done either three times a week or daily. Extenuating factors, such as poor weather and delays on Interstate 5 can get in the way of receiving timely treatment.

This is the case for a 77 year-old McCloud woman who has called the small town her home for 15 years. She has been diagnosed with end-stage kidney failure as a result of diabetes.

Although Mercy Medical Center Mt. Shasta and Fairchild Medical Center in Yreka are excellent choices for most medical care, neither Siskiyou County hospital offers dialysis.

The woman, who has children, grandchildren and a great-grandchild who all live in McCloud, will most likely need to move to access the medical care she needs to extend her life.

Home dialysis gave her a glimmer of hope, but she found out that the arteries in her abdomen cannot support the fistula physicians would have to insert to make at-home dialysis possible.

A McCloud man who also has end-stage renal failure undergoes dialysis nightly at his home. Each treatment takes nine hours, so he does it while he is sleeping, he explained.

The back room at his house is now filled with boxes of supplies needed for the nightly treatment and even with good insurance, the man said it is costly.

Although he is lucky enough to be able to have dialysis at home, he still must drive to Redding twice a month for his nephrologist to monitor him.

The kidneys are a filtering system for the body. When they fail, dialysis does what the kidneys can’t – remove waste, salt and extra water from the body, keeping the body’s chemicals balanced. Dialysis also helps to control blood pressure and is the only treatment for end-stage renal failure.

Heather Gold, a patient advocate at the nonprofit Dialysis Clinic Incorporated in Redding, agreed that transportation is a big hurdle for patients living in rural areas. It’s also costly, Gold said, because even good insurance doesn’t cover all the expenses.

Joyce Zwanziger, spokesperson for Mercy Medical Center Mt. Shasta said the hospital years ago looked into offering dialysis, but there aren’t enough patients in the area to make it a viable prospect.

“It is highly unlikely that we will ever have this specialized kidney care,” Zwanziger admitted, since Mercy Mt. Shasta is a “Critical Access Hospital,” meaning they are a small facility with 25 beds or less that serves those who would otherwise be a long distance from emergency care.

Another hurdle for rural patients is inaccessibility to chemotherapy treatments. While this was once an offering at Mercy Mt. Shasta, 21st Century Oncology Radiation Center, which leases the hospital’s cancer center building, no longer offers chemo infusions. They do, however, offer radiation there, Zwanziger said.

“It is exhausting driving back and forth from a rural community (for medical treatments),” Zwanziger said.

A local physician spoke frankly about the diagnosis of kidney failure in a rural county, but due to patient confidentiality, he does not want to be identified.

The physician said there is naturally a high mortality rate with end-stage kidney disease and it is not completely due to a lack of facilities, but instead due to complications of the disease and patient’s understanding.

“‘End-stage’ is a terminal diagnosis,” the physician said. “If someone wants to live so much, they need to make a choice (between) living in a medical environment or ... a rural community.”

This is the choice facing the McCloud woman, who is nervous about the prospect of finding a new home in a new place with little means to afford it.

She will be trading McCloud Garden Club meetings, Bingo on Thursday nights, her church life and proximity to her family for a new home in Redding or Medford.

“For me, it won’t work to have dialysis from McCloud,” she said. “You cannot miss an appointment and I was told that the hospital in Mount Shasta doesn’t have the means should I have complications.”