The Special Traveller: Chronic Medical Conditions
The Boy Scout motto “Go Prepared” applies to all travelers, but especially those with chronic medical problems. There are countless medical conditions with which travelers travel, such as diabetes, heart and lung disease, inflammatory bowel disease and arthritis being the most important conditions I see in my practice.
Why are they different?
- Some may in fact not be fit to travel in the first place.
- They are likely on more medications than others.
- They may be more likely to become ill while away and require medical care.
- They may be adversely affected by the conditions at their destination, such as the altitude, pollution, climate and local food.
- Infections such as Traveler’s Diarrhea may impact them more than others.
How can you minimize the risks?
Of course this might depend upon your particular medical problem, but I think that some advice applies to everyone.
- Give yourself plenty of time to prepare for your trip, not just to get the recommended inoculations, but to ensure that you are in as good shape as possible before you leave. This would involve a trip to your doctor!
- Carry a more than adequate supply of your medications and supplies (e.g. lancets for blood glucose monitoring), and preferably, keep them in your hand luggage. Carry an up-to-date list of your pills as well.
- Take a list of your personal physician, specialists, etc. with their contact numbers.
- Carry a summary of your medical history and perhaps copies of a recent electrocardiogram or blood tests if applicable.
- Wear a Medic Alert® bracelet if you have allergies, bionic parts, are on blood thinners, have a pacemaker or other significant issues.
- Contact the airline in advance if you will need special seating, supplemental oxygen, boarding assistance, a special diet or anything else.
- Ensure that you have adequate medical and travel insurance.
- Should you have other physical disabilities such as arthritis or depend upon a wheelchair, make sure in advance that your transportation and accommodation are accessible.
- Plan your trip sensibly. Be aware of your limitations if you have any. Having said that, Chris Waddell, a paraplegic, just conquered Kilimanjaro on a custom-made four-wheel mountain bike! Limitations are relative!
For those with heart disease...
- Avoid traveling if you have unstable angina, symptomatic congestive heart failure or serious irregularities of your heart rhythm.
- Delay travel for at least 3 weeks following a heart attack or coronary bypass surgery; air travel may be undertaken within a few days of having an angioplasty or stent inserted.
For those with diabetes ...
- Get a doctor’s note if you are carrying syringes or lancets.
- It is likely that your diet and activity will change while you are away, so the dosages of your insulin or oral medications might need to be adjusted. Therefore, close glucose monitoring is essential during travel.
- When crossing many time zones by plane, it is not critical that you have perfect control of your blood sugar. Rather, your goal should be to avoid becoming hypoglycemic (low blood sugar) or too hyperglycemic (high blood sugar).
- Always carry a quick source of sugar – sweet candies, granola bars, orange juice – in case your sugar does dip too low.
For those with inflammatory bowel disease ...
- Be exceedingly careful with your food and water.
- Consider taking the vaccine, Dukoral®, prior to travel to reduce your risk of getting the runs.
- Should you get sick remember that most cases of diarrhea in travelers are caused by bacteria, so the prompt use of an antibiotic such as Cipro®, Zithromax® or Xifaxan® for 1-3 days might give you the quickest relief. Prophylactic or preventative antibiotics are also an option for the short-term traveler with IBD.
For those with chronic lung diseases...
- Make sure that you are immunized against pneumonia and the appropriate flu strains.
- Consider wearing an N 95 mask in crowds.
- Carry antibiotics to use in case you think you have a respiratory infection.
- Avoid the most polluted destinations such as Kathmandu, Manila, Mumbai, and Mexico City.
- Request supplemental oxygen for your flight in advance if your doctor feels it is necessary.
There are numerous other medical conditions for which you will want to plan ahead, so remember that motto... Plan ahead!