Challenges of Living in a Rural Community

By Moriah Frisbie

3 min read

Today I wanted to talk to you about something that is a personal obstacle for me when it comes to my healthcare: distance. I live in a very rural community in the middle of Washington. To give you an idea, it’s about a 3 hour drive to my cystic fibrosis (CF) clinic, assuming we’re driving in good traffic and weather - and if you know anything about Washington, that’s a BIG assumption. This means that when I have to go in for a check-up, it’s AT LEAST a 6-hour drive round trip. That’s not counting the time I spend in my actual appointment, which is often around 3 hours in and of itself - we’re up to 9 hours, people.

All in all, a day trip to and from my CF clinic takes about 12 hours when you factor in food and potty breaks. (Gotta get those calories!) Not only is there a substantial commitment of time, but there’s also the monetary cost of gas to get there and back, any food or snacks along the way, and the less obvious cost of vehicle maintenance and wear-and-tear.

Factors to plan around

If I have appointments across multiple days (e.g. CF on Monday, diabetes on Tuesday) that means that we also have to make sleeping arrangements. In some ways this is easier than going up to Seattle multiple times a month, as it cuts down our travel time; It also means that we have to plan and pack overnight bags, reserve a hotel room for a night, and mostly eat out (unless we want to heat up Marie Callender's in our hotel room for two days).

Another factor to plan around, at least for me, is the social aspect. Not only do I hate going on long trips by myself, it’s also impractical - especially if I’m feeling ill. This means that not only do I have to schedule appointments around my own life, but also a caregiver who can go with me. I’m lucky enough that my dad is around and usually willing to drive me. He’s my go-to person for these trips. Having company helps to ease the stress of the day, and stave off the boredom. Plus, if the doc decides that I need to be admitted, the car doesn’t have to sit in the parking garage for a week or more.

Nearest CF hospital

Not only does living out in the sticks make my normal appointments a hassle, but if I have an exacerbation and/or need to be admitted, the nearest hospital that has the facilities to care for a patient like me is over an hour away. This makes planning for admittance extra important. If something is forgotten, it’s not like my family can just run home and grab it and be back quickly. I have a specific list of things that I pack when I go to the ER, just in case they decide to admit me. Some of these things are necessities, like CF-specific medications that most hospitals don’t carry (e.g. Trikafta); and some are creature comforts to make my stay more comfortable, like fuzzy socks and my favorite throw blanket. I covered some tips on packing for a hospitalization in a previous article.

Lack of pharmacies

The last obstacle I will share with you is the lack of pharmacies. There is only one “local” pharmacy near me and that is in the next town over - maybe 30 minutes away. Luckily, we live in the age of home-delivery pharmacies (of which I take full advantage), but that doesn’t do me any good if I need medication right away. Having only one pharmacy in our area means that almost everyone uses it, so it’s constantly overloaded with prescription orders which isn’t conducive to filling prescriptions in a timely manner.

Do you face location-based challenges to your healthcare? Share your thoughts, or any strategies you implement to make it easier on yourself - add a comment below to hear back from others in our CF community!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Cystic-Fibrosis.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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soderick Member
Reading this was like reading my own story! The distance is the single biggest barrier. I've been trying really hard to get my clinic to allow remote visits when I'm healthy, even offered to do frequent home PFT and prove compliance, but they won't go for it unless we're in a covid spike. It's a real shame because sometimes I have to make a 11 hour day out of a doctor spending 30 seconds saying "you look good, see you in 2 months."
1. soderick Member
 <inline-mention username="Janeil Whitworth" user-id="2082195"/> That's wonderful to hear! If you have any tips about how to convince them, I'm ready to try anything. I'm not 100% sure of all the reasons, but from what I gather, it's a combination of CFF requiring at least 4 in-person visits per year for accreditation, the clinic having an established track record of better outcomes with frequent visits (increased compliance, faster to catch dips in PFT, etc.), and a slow ability to pivot. I've told them many times that clinic visits are worse if anything for compliant patients (cross contamination, exhaustion, missed work, unnecessary spending of resources). They reply with "If we let you do it remote, then we have to consider everyone, and not everyone can be compliant independently." And I say "But I am, and you know I am." And they say "Let's talk again in the future." Rinse and repeat every 2 months. In the grand scheme, I realize it's not the worst thing, but it's so unnecessary and has felt absurd for so many years, it's become disproportionately irritating for me.
2. Janeil Whitworth Member
 Thanks for sharing! I am so frustrated for you! I wonder if the 4 in-clinic visits for accreditation still implies post-pandemic. I think I had 1, maybe 2, in person visits last year and I was on IVs 3 times. I don't necessarily agree with their reasoning that if they let one patient do telehealth appts, then every has to. It's the same thought process that some patients can do home IVs and some do better in-patient. No one is the same, and the same type of care is not for everyone. I'm sorry they are putting you in this position. I guess I would ask for a trial basis... see you they will allow it for a short duration to determine what's best for YOU (not everyone patient in their clinic). Then, I would take care of myself like crazy and prove them wrong lol! You could also contact COMPASS and see if they have any information on how clinic are handling in-patient vs telehealth appts. I hope they change their policies soon! Warmly, Janeil (cystic-fibrosis.com Team Member)

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