Travelling With Chronic Disease

Chronic disease is not an absolute contraindication to travel abroad, but you should consider the following.

• If immunosupressed through illness or medication, live vaccines may be contraindicated and inactivated vaccines may not be as effective.
• If travelling by air, specific advice about health problems and facilities can be obtained from the medical department of the individual airline concerned. It is important to inform the airline when booking, of any special equipment needed i.e. wheelchair or stretcher and oxygen.
• Insurance policies should be checked to ensure that cover is provided for any illness relating to the existing medical condition. Travellers with chronic health problems should obtain information on the medical facilities available in the country to be visited.
• A Medic-Alert Foundation International bracelet may be considered for those with conditions such as asthma, diabetes and severe allergy and those taking steroids or anticoagulants. The Medic-Alert bracelet includes a statement of the medical condition, any medication/treatment being taken and usual doctor or clinic name. This can also help if there are any problems when taking medication through customs. See contact details below.
• Drugs and medicines should be kept close at hand to minimise the risk of loss or damage to medication. Travellers should take a list of medication with them, noting down the generic names of drugs, in many countries it is useful to have a copy of the original prescription. In the event of loss or damage to drugs it may make it easier to replace medication in countries that use different trade names. Extra supplies of drugs should be carried and, if required, extra syringes, needles and urine and blood testing equipment to cover the whole trip and any possible delays.
• Diabetic travellers should be aware that diarrhoea and vomiting, altered diet, unaccustomed exercise and anxiety may all contribute to an upset in blood sugar levels. A supply of easily absorbed carbohydrate i.e. sweets or sweet drinks should be close at hand in the event of hypoglycaemia (low blood sugar). A travelling companion should know how to recognise and treat the early signs of hypoglycaemia. See section on diabetic travellers.
• Hot climates can exacerbate diseases of the cardiovascular and digestive systems. On the other hand, rheumatic pain and chronic respiratory conditions may be alleviated in hot climates. 

Air Travel

Modern civil aircraft maintain a cabin pressure equivalent to an atmospheric pressure at an altitude of approximately 6,000 feet. This fall in pressure has two effects, firstly a reduction of the pressure of atmospheric oxygen. Blood oxygen saturation can drop between 3 and 10% which does not usually pose a problem to healthy people but for those with serious respiratory and cardiac disorders this may prove hazardous. Heavy smoking and alcohol consumption and those who are fatigued or have head colds may experience hypoxia (reduction of the oxygen concentration of the blood). Signs and symptoms include personality change, euphoria, mental and physical incoordination and blue tinge to the lips, earlobes and nail beds. The treatment is administration of oxygen; this may be given by cabin staff where hypoxia is suspected.

Secondly, the reduced air pressure in the cabin will cause an expansion of the gases in the body cavities. The volume of enclosed gases will increase by about one third. This may just give rise to "popping" of the ears or a bloated feeling but it may cause more serious problems with recent gastrointestinal surgical wounds. Wear loose fitting, comfortable clothing, and avoid carbonated and alcoholic drinks to help prevent some of these symptoms.