Sixty-seven-year-old Richard Marietta, who flew into Las Vegas from his home state of Connecticut on Tuesday, sips a Bud inside the Fiesta Rancho casino and remembers where he has traveled for good times in the last year-and-a-half.
He has flown to Phoenix once; Palm Desert, Calif., twice. And there were four trips to Jacksonsville, Fla., and six to Hilton Head, S.C. This makes his fifth visit in 18 months to Las Vegas.
"I thought you were going to go to England, too," said his friend, Tom Hudeck, who is sitting at a table with Marietta and his wife, Pauline. "What happened to that?"
"Medicare won’t pay for dialysis treatments when you’re out of the country," Marietta replied.
You read that right: The only thing that keeps Marietta, whose failed kidneys require dialysis treatments three times a week to keep him alive, from traveling even more, is money.
In other words, he’s basically just like you and me.
"All I do is call my dialysis provider and tell them where I’m going in the country, and then they make appointments for me there," Marietta said. "I just have to work the treatments into my trip. They’re the same wherever you go. It’s great."
If ever a man debunked the notion that dialysis — the filtering of waste and removal of excess fluid through artificial means — has to mean paralysis when it comes to living life, it’s Marietta.
"I just love the glitz and glamour of Las Vegas," he said. "My wife and I just love driving down the boulevard looking at everything."
Marietta said he has been to Las Vegas 60 times since the age of 11 and he’s hoping for another 60 visits. He’ll definitely be back for all the upcoming Super Bowl festivities in town.
"You’re basically only tied down as much as you want to be by dialysis," said Marietta, who continues to work as a permanent substitute at the high school where he retired about a decade ago after 34 years as a social studies teacher. "I’m not saying that there aren’t people who have a much harder time with it than I do. But what holds a lot of people back is just attitude. I’d say it’s a public misconception that everybody on dialysis stays at home basically just waiting to die if they don’t get a transplant."
Representatives of both Fresenius Medical Care and DaVita Inc., companies which account for well over half of the outpatient dialysis centers in the United States, support Marietta’s position.
They say tens of thousands of dialysis patients travel to be with family or go on vacation on a regular basis, with Las Vegas the top vacation destination for their patients.
Both companies, which have nearly 4,000 dialysis centers between them, offer a free appointment service that takes only a phone call from a client to set in motion.
If either Fresenius or DaVita doesn’t have a dialysis center where their client is going, treatments will be set up at no cost to the client at a competing center. Patients must pay their own travel expenses.
U.S. citizens with end stage renal disease automatically qualify for Medicare to cover dialysis costs, which typically range between $600 and $800 a session.
"I would have had to pay about $2,400 for three treatments in England on top of my travel expenses," Marietta said. "That was the end of my trip to England."
According to the American Society of Nephrology, more than 300,000 Americans are dependent on dialysis to stay alive.
"We know that patients who maintain as much of a normal life as possible do much better with their health," said Fern Parlier, an administrator for Fresenius, which is overseeing Marietta’s dialysis. "End stage renal disease doesn’t mean the end of life. We’ve seen some patients live for more than 30 years on dialysis."
On Wednesday morning Marietta, who is staying at Texas Station, drove a rental car to the Fresenius dialysis center on North Tenaya Way. He couldn’t find a Broadway song to sing along with on the radio.
"I wish they had more Broadway songs on the radio," he said. "I love Broadway. I drive down to New York City for shows all the time. Have you seen ‘Million Dollar Quartet’? It’s about the night Elvis, Jerry Lee Lewis, Carl Perkins and Johnny Cash got together for one night at Sun Records in Memphis. It’s so good. You should go see it."
At 7 a.m. Marietta, a former high school tennis coach who also officiated high school and college basketball games, began his four-hour dialysis treatment. He was scheduled to meet his wife before noon at the casino to play bingo.
Tethered by tubes to a dialysis machine behind his reclining chair, Marietta smiled and stroked his white mustache and goatee as blood flowed out of, and then back into, his body.
"Once you get used to working this into your schedule, it’s just part of your life," he said. "I get a little tired but after I take a short nap I’m fine."
If a doctor finds that his heart is strong enough, Marietta would like to get a transplant. Several relatives have said they will be happy to donate a kidney if tests show they are compatible.
"I’m lucky right now that dialysis doesn’t take too much out of me, but it does for some people," he said. "It might happen to me next week."
For reasons that aren’t entirely known — though other medical conditions suffered by a patient certainly play a role — some people have agonizing side effects that come with a dialysis machine slowly vacuuming their blood clean three times a week: dizziness, cramps, vomiting and fatigue so debilitating that getting out of bed feels like a hard day’s work. It can be a tortuous end to life.
More than 80,000 Americans are on transplant lists for kidneys, with fewer than 20,000 kidney transplants done each year. More than 4,000 die each year waiting for a transplant.
That his kidney failure could one day rob him of much of his freedom makes Marietta even more compelled to get out and enjoy life while he can.
"I just don’t understand people who don’t have bad side effects from dialysis not going on with their lives because they’re afraid something will happen. That’s no way to live. I know a lady like that back in Connecticut. Her husband would really like to travel, but his wife is afraid to because of dialysis. But she’s never sick from it. It’s so sad. You have to try to see and experience everything you can. Do you want to die knowing you could have done something but were afraid to? How awful."
Marietta admits that when he was first diagnosed with kidney failure about two years ago — his high blood pressure and a prediabetic condition had killed off his kidney function — he thought death was imminent.
"I asked the doctor how long I had to live and she just laughed," he recalled. "She told me that with dialysis I could pretty much continue to live life the way I wanted. So I’ve been trying to do that ever since. Life is short. You have to enjoy it while you can."
When the Mariettas watched a cable TV food channel program recently, they noted professional chefs in Las Vegas dine at Nora’s Italian Cuisine on West Flamingo Road when they aren’t dining on the Strip.
"We decided we just had to go there," said Pauline Marietta, a retired math teacher.
They were at the restaurant Wednesday afternoon, with Richard feasting on the linguine and clam sauce and Pauline savoring the orange roughy. Though Richard Marietta loves beer, his doctor says he can only have an occasional one.
"I drink it like it’s liquid gold," he said.
Before they leave on Wednesday, the Mariettas will also watch the building of the Hoover Dam bypass bridge, hear Cher croon, take in "Ka," try to beat the slot machines, explore the new CityCenter, visit the Pinball Hall of Fame, and drive down to Laughlin — all, of course, scheduled around two more dialysis sessions.
"You got any other ideas?" Marietta said.
Contact reporter Paul Harasim at email@example.com or 702-387-2908.Medical Tourism in Las Vegas