For those living with heart disease, diabetes or some other chronic illness, the prospect of travelling overseas can seem as daunting as climbing Everest. But, risks can be managed and challenges overcome given good planning, preparation, and professional advice.
The other crucial element is time as the demands a chronic disease can place on overseas travel shouldn’t be underestimated. It’s a good idea to start the planning process months ahead – in fact, before you book flights and accommodation. Destinations like New Zealand, Europe or North America hold few concerns, and 6 to 8 weeks is plenty of time for pre-travel medicals.
But, someone with a chronic illness planning to travel to a developing country should start preparing even earlier. That’s especially so if your destination is in Africa or South America, where yellow fever may be a risk and proof of vaccination is often required for entry.
Vaccines may be need to be spaced out
Scheduling yellow fever and other live vaccines should begin at least three or four months before departure because they may need to be spaced out over a period of time and take into account your regular medication.
Some would-be travellers may need to rethink their itinerary so as not to jeopardise their health as the nature of their illness, particular destinations or types of travel may pose too many risks for some patients.
At that point, selecting another destination with fewer challenges might be recommended. So, it’s better to have a clear idea of what trips are possible – or not – before you pay a deposit.
It may also take time to find affordable travel insurance that allows for their pre-existing condition.
So, if you have a chronic illness and are keen to travel, here are our pre-travel tips:
SEE YOUR DOCTOR – EARLY
You can’t start talking with medical professionals about your travel plans too early. Besides your GP, other medical appointments may need to be scheduled: Your doctor may suggest that you consult your specialist as well as a doctor experienced in travel medicine. A travel doctor will interpret your illness in terms of any pre-travel vaccines and travel medication (i.e. malaria, traveller’s diarrhoea, altitude sickness etc.) that may be relevant, as well as suggest what should go into your first-aid kit.
KNOW YOUR CONDITION
Your doctors will want to ensure your condition is under control and that you understand how to monitor it while you’re away. Critically, both you and your partner or travelling companion need to know what to do if your condition suddenly becomes unstable.
PACK YOUR PAPERWORK
If you consult a doctor overseas, he or she may need to contact your doctor back home. Don’t rely on your memory – ask for a detailed letter on the practice’s letterhead with business and, if possible, after-hours emergency contact details.
The letter should:
- Outline the history of your condition and any complications.
- Its current status and treatment regime.
- Include an overview of the most recent test results, such as an ECG.
Ask your doctor to supply the name and contact details of a doctor or clinic at your destination who can provide quality, continuing care – should you need it. (A travel clinic is more likely to be able to do this.)
TAKE PLENTY OF MEDICATION
Don’t rely on filling prescriptions overseas. It can be very expensive and the medication may be of dubious quality. (In many developing countries, counterfeit drugs are a big problem.) Instead, take a supply of your regular medication along with meds you might only take occasionally, and carry them in their original packaging. Decanting your pills into a Webster Pack can cause awkward questions and result in unnecessary delays at Customs (although, in our experience, it’s not likely to result in your medicines being confiscated). It’s also a good idea to carry two lots of the medication you take every day – one lot in your carry-on bag, the other in your luggage – just in case your bags briefly go astray.
GO WELL EQUIPPED
Managing or treating your condition may require some ‘hardware’ that needs to make the trip, too. Diabetics may require blood glucose monitoring equipment and insulin needles, while asthmatics should carry a spare inhaler, spacer and, if required, a peak expiratory flow meter. Whatever you even think you might need, take sufficient supplies to last your entire trip – plus a little extra in case of flight delays. If you use a wheelchair, walker, oxygen mask, or electronic monitor, have it checked out to ensure it’s in good working order before you leave. Finally, wear a medical alert bracelet or pendant to quickly inform someone of your condition in an emergency.
IN THE AIR
Long flights can be taxing and leave you fatigued on arrival. During your flight, keep well hydrated (drink plenty of water – alcohol dehydrates), wear loose fitting clothes, and move around the cabin at regular intervals to avoid deep vein thrombosis, the potentially fatal condition.
BE PROACTIVE ON ARRIVAL
Who could you turn to if you need medical assistance during your trip? Do they have the equipment you may need, do they speak English, and how much do they charge? These are all questions you need answers to, especially if you’re staying for an extended period in a developing country. You may be able to get this information from the management of your hotel or resort, or through an online search. If that’s not possible, make finding a clinic a priority after you’ve settled into your accommodation.
TRAVEL INSURANCE – GET SOME
It hardly needs to be said again, but travel insurance is VERY IMPORTANT for all travellers, but especially for someone with a chronic medical condition. Check the fine print for inclusions and exclusions to ensure your pre-existing condition is covered. Your policy specifically needs to also include:
Trip cancellation – in case you’re too sick to travel.
Health insurance – covering your existing condition and meeting the cost of health care while you’re away, and
Medical evacuation – This type of insurance, which covers the cost of transportation to a western-standard health care facility, is particularly important in the event of an emergency in a rural or remote area.
Insurance: you hope you won’t need it, but if you do you’re glad you have it.
A FIRST-AID KIT – A TRAVEL MUST
Finally, a travel health first-aid kit is another ‘must have’ for all travellers. It should include anything you need to manage your illness, along with any other general first-aid items to manage day-to-day needs. Travel first aid kits come is various sizes to suit the type of travel and length of stay, and can be shared among the people in your group.
For further information on specific chronic illnesses and links to relevant websites, see the chapter on travelling with a chronic illness in the CDC’s Yellow Book.