European Stars and Stripes (Newspaper) - August 29, 1991, Darmstadt, Hesse                                Chronic diseases need not be a Handicap to travel by Jane Brody the new York times people with heart problems should use a wheelchair if any leg of the journey seems too strenuous even some taxis Are now equipped with ramps. A 63-year-old woman with insulin dependent diabetes takes a three week trip to Eastern Europe. A 65-year-old Man who has had coronary bypass surgery goes trekking in Nepal. A 62-year-old Man with a pacemaker and a 58-year-old woman with emphysema Complete a three week tenting safari in Kenya. People with chronic diseases Are no longer confined to Short Quot Safe Quot vacations close to Home. Travel to far off and exotic lands is common today among the growing millions of people with serious but controllable illnesses physical disabilities and other health related conditions including allergies and pregnancy. Such travel has been eased by do it yourself and portable equipment to treat and Monitor health problems and by modern communications a including the ability to transmit cardio Grams by Telephone. Careful planning tailored to the traveler s health status helps to assure that trips result in a minimum of complications. And maximum enjoyment. Here is what medical experts recommend for people with three common conditions. A heart disease today most people with heart problems can travel safely. Almost anywhere they choose. Don t go if travel  recommended for those with severe angina uncontrolled High blood pressure an unstable cardio ram Reading or congestive heart failure or for those who have suffered a heart attack within four weeks of the proposed trip. But air travel is considered Safe for those who can walk a Block or climb a flight of stairs without becoming breathless. Before you go begin a medically supervised daily exercise program several weeks or More before the trip and continue the exercise regimen while away. Choose trips that have a Pace you can manage preferably ones that spend several nights in one place. Avoid places with serious air pollution. Plan to travel with a companion who like you should have a copy of your medical records Electrocardiogram tracings medication information pacemaker data and the like. Find out if the drugs needed for travel for example Anli malarial interfere with your Normal medication. While you Are away being on vacation is not a License to abandon your usual diet or attempt activities you would not do at Home. It you Are travelling by car Stop every few hours for a rest. Choose an aisle seat on planes so you can get up easily and walk about the Cabin every 31 to 60 minutes to reduce the risk of blood clots. Drink lots of Plain liquids water and juice but avoid alcohol and carbonated beverages. If you become Short of breath ask the flight attendant for oxygen. Do not carry heavy Luggage use a Porter or a cart and use a Backpack for hand baggage. Leave plenty of time to get where you Are going to reduce the stress of Rushing. Request a wheelchair if an Airport walk seems too strenuous. Get extra rest after a Long flight and set your own Pace you Don t have to do everything everyone else does. A diabetes the ability to Monitor one s own blood sugar closely and give oneself various types of insulin has made it possible for most people with diabetes to go almost anywhere. What to take pack in your carry on bag enough medical supplies a insulin disposable syringes batteries for the glucose meter Etc. A to last the entire trip plus one extra week. Include a bottle of Short acting insulin for emergencies. Keep the syringes in their original package and carry a physician s letter attesting to your need for insulin to avoid customs problems. In addition take a prescription for insulin and other supplies. Store the insulin at body comfortable temperatures not in the Glove compartment or trunk of a car. Ii you Wear glasses or Contact lenses take an extra pair since you May have trouble measuring your insulin if you lose or break them. Always carry enough food to last you until you reach your destination and never go anywhere without carbohydrate snacks like fruit raisins or Graham crackers and hard Candy or glucose tablets. Since acute illness can throw your blood sugar off take along medication for fever diarrhoea and vomiting. Also pack sugar free cough medication antacids lozenges and if you use it a sugar substitute. On route if you Are flying across More than four time zones you will have to adjust your insulin schedule so before you leave be sure to ask your physician How to do this. Wear is Toner Type support slippers to avoid circulatory problems during flights. Move around every half hour on Long trips. If necessary do exercises while standing in place. Check your blood sugar More often than usual. During the trip be especially diligent about food and water borne infections. Drink Only bottled water and never use ice cubes. Do not eat raw seafood undercooked meats unpeeled fruits or raw vegetables and avoid Dairy products gravies and sauces. Test your blood sugar before and after any vigorous activity and after strenuous exercise repeat the test every four hours for several Days. Also test your sugar More often than usual if you become ill but do not Stop taking insulin even if you lose your appetite. Drink lots of liquids. If your diabetes gets out of control resulting in ketones in the urine drink salted water or Broth Tomato juice or Chicken soup. Avoid heatstroke by staying out of the Sun spending As much time As possible in air conditioned places and drinking lots of cold liquids. A lung diseases severe respiratory disorders including those that require supplemental oxygen need not preclude Long distance travel As Long As arrangements Are made before the trip. In Advance your ability to tolerate High altitudes in air planes without extra oxygen can be assessed in Advance by measuring the oxygen in your blood while you breathe air that simulates the in flight oxygen level. If supplemental oxygen will be needed the airline must be notified at least 72 hours ahead. Airlines do not allow travellers to take their own oxygen tanks into the Cabin. An oxygen Supply for when you get off the plane also must be arranged for in Advance. Estimate your average oxygen usage and plan your trip around refill Points. Your local distributor should be Able to help you make arrangements. Since oxygen is considered a drug carry a prescription for medical Grade oxygen. On route people with asthma and chronic obstructive pulmonary disease should drink lots of Plain a carbonated fluids during flights to avoid dehydration which worsens their breathing problems. 24 stripes Magazine August 29, 1991 and