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A chronic illness patient has a lot more to do to prepare for a trip than just packing.

4/25/2019

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We are approaching the time of year where folks like to get out of town and explore new and exciting venues.  Even if you have a chronic illness, you should not let that stop you from travelling to new locales.  It used to be that when I traveled, my to do list only included things like what to pack and making sure I had sufficient resources for an enjoyable trip.  But now that I have heart failure, a chronic medical condition, there are so many more to dos that need to be added to my list. 

First, is a task that might sound a little negative.  But let’s face it, bad things can sometimes happen even on the most glorious of trips.  Or bad things can happen in advance that prevent you from making the trip.  So it is important for a significant trip that is costing you money to make sure you have trip insurance, especially one that addresses not only cancellation but medical care and evacuation.  
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Another task you may to do is to make sure that you have the financial resources to enjoy travel and buy mementos, and this applies to all travelers, not just those with chronic illnesses.  You may need to get in touch with the credit card company.  No, I’m not referring to raising your credit card limit so you can buy more.  You may need to let your credit card company know that you are away from your residence area, so that they will not view any charges away from home as being suspicious.  Fortunately, my credit card company no longer requires this, since they notify me of each purchase so that I can alert the company if anything is suspicious.  But if you do not have these alerts, you probably need to let them know when you are traveling outside your normal buying area.  

I usually make sure when I am going overseas to check what is the best way to make purchases.  For example, would it be using a debit or credit card?  Would it be to get money from an ATM machine?  Would it be traveler’s checks (although I suspect that many travelers these days may not even know what this form of currency is).  I also make sure I have a small supply of the type of currency that is used in the country I will be traveling in so that if I can’t change my dollars to local currencies right away, I have some local cash available to take a cab or get something to eat.

Then there are the things that pertain to those of us who have medical issues (and trust me, those medical conditions will want to accompany you on your epic vacation).  Make sure that you have enough medications to get you through the trip.  This means that a month or so before you pack, make sure that none of your prescriptions will be running out while you are away from your pharmacy.  This will give you sufficient lead time to renew a prescription, and get any authorizations you need from your drug company to get an early renewal.  Always make sure that if you are flying, you put your medications in your carry-on bag.  You don’t want to be in a hotel room worried because the airline has not delivered (or perhaps even found) your luggage and you have just taken your last doses of your heart medications.

Here is some travel advice from the American Heart Association’s (AHA) website that had not occurred to me.

  • Some people feel more comfortable bringing a copy of their original prescriptions in case they lose their medication. That’s fine, Gandy said, but it’s sufficient to have a list of your medications and your cardiologist’s phone number.  * * * It’s also a good idea to let your cardiologist or internist know where you’ll be. Your doctor might know physicians or reputable heart institutes in the area if help is needed.

I have a medical card that indicates that I have a pacemaker/defibrillator.  You can show it to the people that screen you at various airport and cruise ship security screening points to explain why you might need a pat down search.  I find the most effective way to broach this subject with the screener is to point to the device in your collar bone area and present the card that explains what you are talking about and why you are concerned. 

This doesn’t mean that you won’t have some strange responses (like the screener who told me to throw my defibrillator into the bin.  Make sure you pack your patience in your carry-on bag as well so you can calmly explain that this is not a freestanding device but one that resides in you).  But most of the time, the screener gets it and will either find you a screening area that has a non-magnetic screening device, or will find a female screener to conduct a pat-down search.

When you have a heart pumping issue, you might also want to avoid any circulatory issues.  Those issues can be magnified when you are up in an airplane.  So here is what the AHA website advises:
Sitting immobile on long plane flights can slightly increase a normal person’s risk of blood clots in the legs, but associated medical issues usually contribute to it. If someone has peripheral artery disease (PAD also called vascular disease or a history of heart failure, the clot risk increases. Getting up and walking around when possible is recommended for long flights, just be sure the seatbelt light is not on when you do so.

Tell your doctor about your travel plans to get the best advice on what precautions, if any, you may need to take. For example, some people might need compression stockings or additional oxygen. Others might need to watch fluids closely or avoid alcohol. And some may not be able to fly.

My heart failure doctor also offered to something that had not occurred to me.  He said that he could give me some documents to share with doctors while I was travelling in the event that I had a medical issue away from home.  This would make sure that the doctor in my temporary location would know the extent of my condition, and the details of my treatment.

I learned on my last cruise that while I have energy to have a really great cruise, I do not have the energy that a lot of passengers of my age possess.  So I should make sure not to overschedule my days during the cruise.  For me that has translated into doing only one shore excursion a day, probably limited to about 3 or 4 hours.  I may deviate from this occasionally if there is a really special tour. 

If you are cruising, you may be able to request diet restrictions 90 days prior to the cruise.  I found this out on my cruise with Viking in 2016.  So I put in a request for a low sodium diet.  This means that all the restaurants on the ship are aware of my restriction, and the waiters and waitresses will be apprised when they serve me.  I still recall that they would say something like:  “Does someone at the table have an allergy?”   While it’s not an allergy per se, I was always relieved to know that someone was aware of the sodium issue when they approached the table, and would help me make good menu choices, and would be able to instruct the chef to hold the salt when necessary.

During that 2016 cruise, I learned that there were also a excursions passengers could book at each location.  There was at least one excursion per location that was included in the price of the cruise.  There were others that have an additional charge, but all seemed like interesting choices.  But if you only looked at the picture of the location, you would be hard pressed to determine if engaging in the excursion would create physical stress or fatigue.  Fortunately, my cruise line provided a key word that will let passengers know the challenge of the physical activity level:  easy, moderate or demanding.  Each word had a paragraph describing why the cruise falls within that particular category.  For example, the description indicated the type of terrain you would be walking over (stairs, inclines or uneven ground); how long you could expect to be on your feet either walking or standing, whether you had to board or disembark from transport, whether you would be at a high altitude, etc.  I found these descriptions to be helpful, especially for someone who can experiences shortness of breath and might be challenged by climbing stairs or inclines.  I used these descriptors to make decisions and I was never overcome by exertion on any of my excursions. 

To summarize, travel is absolutely possible when you suffer from a chronic condition.  You just have to make sure you do your prep work ahead of time and make informed decisions when determining the extent of activity you will engage in during your trip.  If done right, I think travel can be as much of a facet of your treatment plan as medication, exercise and diet – and God know, it’s a lot more fun!
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    Melanie discovered that she had heart failure in 2013.  Since that time, she has been learning how to live with the condition, and how to achieve balance and personal growth.

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