The medical 'heroes' who help save the lives of kidney-dialysis patients when massive storms hit the US

• One in 500 Americans is on kidney dialysis. Extreme-weather events can threaten their lives.
• Renal-care experts told Insider how they keep patients alive when big storms hit.
• The moment the phone rings with a weather notification, teams slam a metaphorical red button.

On Christmas Day 2022, while most residents in upstate New York were getting ready to enjoy the festivities, Michael Sloma was on a mercy mission to save a life.

The region was still reeling from a once-in-a-century blizzard that had left dozens of people dead, and Sloma was determined that a woman who needed dialysis wasn't going to join their ranks.

Sloma, the group vice president of operations at US Renal Care, is one of many unsung heroes who leap into action when snowstorms, hurricanes, or wildfires hit the US. 

One in 500 Americans is on dialysis, according to the National Kidney Foundation, and each knows it is their lifeline. The chaos of an extreme-weather event can put many of them at risk of missing their all-important treatments. 

When snow and hurricane-level winds hit Buffalo, New York, for four days straight last Christmas and residents sheltered in their homes, Sloma took to the dangerous roads.

"We're used to dealing with snow and removing snow, so that really doesn't bother us," he told Insider. "But they were starting to say on the news that this was going to be a really bad storm — generational-type blizzard storm. Conditions were such that you could not see literally a foot in front of your car. We had a total of 23 people stuck inside various clinics — about half were patients, and half were staff."

Most worrying was a nursing-home resident trapped by the snow who required dialysis and needed to be evacuated as soon as possible.

"Six of us dug through the snow for three hours, creating a path that was 30 feet long by 4-to-5 feet tall to the parking lot, but that didn't reach the road. We were able to convince a nice gentleman who had some construction equipment to dig a path for us to get our vehicles into the parking lot to the main road," Sloma said.

The team triumphed and got the patient to Sloma's vehicle on the road, but the plan to get her to another nursing home fell through because it was also blocked by snow.

"So, I put her into the back seat of my car, and with the nurse, we transported her to the local hospital. She's now doing great," he said.

By car, by boat, by snowplow

As Hurricane Harvey devastated Texas and Louisiana in 2017, Ariel Brigham sat on the roof of her Houston home, waiting to be rescued. 

She watched the water engulf her house and flood the area around her. She was trapped. 

But the rising water level was not the only danger Brigham was facing. The hurricane meant that she could not get kidney dialysis for seven days. 

Even after she got to the safety of a friend's house, Brigham was still in mortal danger.

"I gained 30 pounds of fluid, and I was extremely swollen — my face, my hands, my legs, my whole body was super swollen. It was tough, and pretty much all I could do was sleep," she said. 

When she finally reached a hospital, she said, "I was basically at the point where they said my heart was slowing down. But even then, I had to wait another four hours before I could dialyze."

Like many dialysis patients, Brigham needed treatment every three days to replace the function of normal kidneys. Dialysis patients need their blood cleared through this procedure. Each missed session increases the risk of death by 10%. 

LaVarne Burton, the president and CEO of the American Kidney Fund, told Insider: "I have known of people who skipped even one session and unfortunately passed away."

To meet the extreme-weather health challenge, dialysis-care providers across the US have created disaster-preparedness teams to keep their patients alive. The units are made up of meteorologists, advisors from utility companies, and patient-care staff who meet twice daily when extreme weather endangers patients' lives.

Mary Dittrich, the executive vice president and chief medical officer of US Renal Care, and Phil Sarnowski, the senior vice president and business-transformation partner at US Renal Care, described how the teams combat a potential weather disaster. 

The disaster-response teams can be a lifeline, whether that's by driving a car driving through a storm, sailing a boat during a flood, or riding a snowplow through a blizzard.

The moment the phone rings with a notification of an imminent weather event, the teams slam a metaphorical red button. The disaster-preparedness teams move quickly to rearrange dialysis appointments and ensure patients can access care facilities, food supplies, and clinical goods. 

Members of the Red Cross and the National Guard deploy, government offices receive notice, and health commissioners and fire departments remain on standby. 

Sarnowski told Insider that they also have companies ready to provide water and electricity generators with just 24 hours' notice.

Most US renal-care patients have their dialysis at home. There are two types of dialysis: one, called hemodialysis, uses a machine; and the other, peritoneal dialysis, uses a tube in the abdomen.

"For peritoneal-dialysis patients, which is the majority of our home patients, we train them to do manual exchanges, meaning they can continue their treatments, even in the absence of electricity, manually connecting and disconnecting and running fluids into their stomach or their abdomen and then draining," Dittrich said.

For many reasons, but largely because end-stage kidney failure often halts a person's ability to work, many dialysis patients live within a low-income bracket. 

This can be financially crippling, Burton said. Patients often pay roughly $10,000 a year out of pocket for treatment, she said.

That's why the American Kidney Fund has developed a disaster-relief program.

Patients can receive $250 when a weather emergency hits, and it can "replace medications if they've lost them, it can fund renal-friendly food, cost of transportation, temporary housing. Whatever they need in order to survive that crisis," she said.

'Extraordinary levels of commitment'

Dittrich said she is deeply concerned about the increasing number of adverse-weather events and emergencies.

"I'm solidly in the camp that those are due to climate change and will worsen," she said. "I'm dismayed by the number of these that we're seeing and have to prepare for, while, at the same time, being confident in our ability. But they challenge us, they're very stressful and difficult."

Dittrich and Sarnowski said the heroes of these stories are the staff who provide the care. 

For patients that receive their treatments in clinics, they see care staff for 12 hours a week at minimum, Dittrich said, and patients and staff "become like family," hence the "extraordinary levels of commitment."

The dialysis-disaster program has produced a "blueprint for coordinated efforts between historic competitors," Dittrich said.

"Medical companies work together. We take other providers' patients, we take hospital patients, they take ours, we share supplies, we share generators, we share water," Dittrich said. The collaborations were "validating, affirming, and inspiring," she said.

For Sloma, who organized the lifesaving rescue of one dialysis patient in snowbound upstate New York, this is certainly true.

"All things considered, even having to shovel a lot of snow, it was probably the most meaningful Christmas Day that I've ever had," he said.