Lee Guerro has never missed a dialysis appointment. Every Monday, Wednesday and Friday for the past two years, Guerro and his girlfriend of 20 plus years, Rainy Chackee, have risen before dawn to start their drive from Alamo. Driving slowly to avoid elk, they’re at the clinic in Socorro by 5 a.m.

It takes four hours for Guerro to receive the treatment. Afterwards, they have their first meal of the day, often a sandwich from Walmart, then they drive back home.

On the rare days when the center is closed, they travel on to the Los Lunas dialysis center to make sure that Lee doesn’t miss a single appointment. Lee has a goal. He wants to see his 2-year-old granddaughter and 6-year-old grandson graduate.

“That’s why I’m really hanging in there, what the gas price is, what the food price is, I always told her we’ll get by somehow. The good guy upstairs, maybe he’s looking out for us. Something always happens, a little money comes along. We’re still hanging in there ’cause I don’t want to miss the treatment, even though you get tired from it and that kind of stuff. I don’t want to miss dialysis.”

Frenesius Dialysis Center is on Highway 60 in Socorro.
John Larson | El Defensor Chieftain

Guerro has kidney failure. He needs dialysis to live until he can get a kidney transplant.

Inflation, especially rising gas prices, has made budgeting for medical costs, travel expenses and food harder than ever before, while COVID-19 has made leaving home a risky proposition.

“Sometimes we have to pay for his medications. Some are expensive,” said Chackee. “Sometimes Medicaid can’t pay for it. Sometimes we just let it go.”

The medications can be several hundred dollars. Sometimes they also decide to skip meals to make sure there’s money for vehicle costs, like gas and car insurance.

Guerro usually qualifies for mileage reimbursement when he has appointments in Albuquerque, but they’ve been told the 60 miles from Alamo to the dialysis center in Socorro is just five miles shy of the distance that would qualify for reimbursement. The couple could use a taxi or medical shuttle service but are scared that Guerro could be exposed to COVID-19 in a shared vehicle.

Dialysis patients are at higher risk for serious illness and death related to COVID-19. According to CDC guidance on COVID-19 vaccines for dialysis patients, people on dialysis who get COVID have a 50 percent hospitalization rate and a 20 to 30 percent mortality rate.

During the pandemic, the couple has avoided going out as much as possible. They try to keep their outings to medical appointments and the grocery store.

“When we hear somebody coughing somewhere in the store, we just rush out of there,” said Guerro.

COVID also delayed medical testing that Lee had scheduled. In order to be eligible for a kidney transplant, he has to pass a range of tests, like a stress test for his heart and a sleep apnea test. The tests are good for a year. But this year the couple rescheduled the tests for March, because they worried he might be exposed to COVID with more hospital visits.

Some doctors have suggested at-home dialysis.

“But the way I’m looking at it, to me it’s no good,” said Guerro. “Staying home doing dialysis in your stomach, it’s going to cut out my little work. We have little sheep, chickens, and that kind of stuff, so we feed them in the morning and that kind of stuff. If I do that one, it’s just going to cut off everything on me.”

In the days before he had kidney failure, Guerro would sometimes go fishing for three weeks at a time.

Nowadays, if they head out to a lake on a Friday, they have to head home by Sunday afternoon to make sure they can get to the Monday morning dialysis appointment. A kidney transplant would eliminate the need for dialysis. It would also eliminate the long-term cost of driving to Socorro and back three days a week.

The procedure wouldn’t be without constraints. Guerro would have to stay in Albuquerque for three months for follow-up appointments after a transplant and would need to return afterwards for a while every other week for more follow-up appointments.

Whatever happens, Guerro is determined to make it to graduation.

“No matter what comes out, we’re always over here to dialysis. Graduation day is a special day, so I want to be there for my grandson on his graduation and granddaughter. That’s why I put it in second gear again. If I get a kidney, then I’ll be in third gear.”