by In the UK, around 30 per cent of the population has a long-term health condition that is controlled by medication. These can range from asthma to epilepsy and involve anything from two pills a day to multiple daily injections and diet control. Traveling in such conditions can be a challenge, but you shouldn’t be deterred. I have Type 1 Diabetes, which requires frequent insulin delivery, managing my food intake and checking and responding to my blood sugar levels. Despite this, I managed to spend six months traveling in Australia, New Zealand and south-east Asia.
During the trip, I learned a lot about how to manage my condition away from the safety net of home. I made some mistakes along the way though. Early on in the trip, I left a critical piece of medical equipment (my Personal Diabetes Manager) behind for a day until I realized. (Happily I was able to retrace my steps.)
This experience taught me to be more aware of where my medication was kept and to double check everything before packing up and leaving one place. Losing medication is a big risk when traveling with a medical condition, so it’s worth investing in air tags or similar to keep track of where your vital supplies are at all times.
Unless your doctor advises you, anyone with a health condition should be able to travel, not just for a short trip, but for longer periods. Just follow the simple steps.
Know how much medicine you use
You will know, of course, what your daily consumption of medication is. From this, calculate how much you will need for your trip, and double it.
Mindy Levitt, a diabetes nurse specialist, advises people to “take more medication than you think you need – at least two or three times more.” This applies to all conditions, not just diabetes. Be sure to order your medication in advance, allowing time for approval by your doctor and medication provider, your delivery and the dispensing pharmacy.
Plan how to transport or collect your meds
Once you indicate how much medication you will be taking with you, you can arrange another bag to take on your trip, if necessary, or plan to have it delivered to your destination, as some companies deliver internationally (more on couriers below). I took an extra bite that I always brought with me as cabin baggage. Although it was a small load to lug around for six months, it lessened as time went on. If I were to travel that far again, I would use a courier.
Although DPD UK does not ship medication, DHL Express and UPS can assist with the transport of medical supplies, although destination countries may have different laws, custom rules and fees that must be met. DHL Express says “the prescription medication must be included and accompanied by an invoice that breaks down what each individual drug contains, how much there is and how you take it. This invoice can be downloaded as a template online, or via the DHL Express website or in selected stores where DHL Express provides services.” Their vans are not temperature controlled, so if some medication needs to be kept cool, like my insulin, you should bring it with you, and your non temperature controlled medication can be put on your courier to you.
Brian Duggan, pharmacist and general manager of Polar Speed (a UPS company which is part of their healthcare business) says: “The patient is required to obtain the country-specific medicine import authorization and provide the relevant documents for UPS.” To arrange this, you should “contact the embassy of the destination country for specific information on sending medication for personal use. The patient can nominate an authorized recipient to collect the medication from a pharmacy on their behalf. UPS can act as the designated authorized recipient. When collected by UPS, on behalf of the patient, the medication can be sent to the desired country in temperature-controlled packaging.”
Brenda Walcott, a clinical adviser with Diabetes UK, recommends that before travelling, you find out “where you can get supplies of insulin at your destination in case of an emergency. Contact your insulin manufacturer before traveling to find out if your insulin is supplied in the country you are traveling to.” Ultimately, she says, “the safest approach is to have your own supplies in some countries.” This applies to other medicines too, not just insulin. As a UK national traveling abroad, Walcott advises you to check the health information of the country you are visiting by following the links on the Government’s online Foreign Travel Advice page.
Check with your airline to ensure you can bring your medication on board. I like to know where my medication is, and my insulin needs to be kept cool, which I can only guarantee if it is in the cabin with me. The temperature in the stomach is often very cold and this can damage medicines.
Some airlines require medicines to be in their original packaging labeled for clear identification. If this is the case, and you need to reduce space, you could cut up the labels and put them in a separate folder so you can still provide the packaging if requested.
Get your doctor’s letters in advance
Dr Anthony Patiniott, the clinical director at Enigma Healthcare, says “it is vital that you clearly document your medical problems and prescription medications, and keep them with you in the cabin if you are flying to prevent loss” . These may need to be shown at airport security, and will come in handy if you ever need medical assistance or need to replace medication. Importantly, he also recommends that you “include allergies and emergency contact information on you, in case you are unable to communicate”.
Walcott also recommends that if you have medical devices, “you print a Medical Device Awareness Card from the Civil Aviation Authority website to accompany your letter. This sets out screening advice for you [the passenger] and the security officer who carries out the checks.”
If you need to carry needles, as I do, you should declare them at the screening point. You should also think about how you will dispose of them when they are used. In my experience, you can go into a pharmacy or doctors practice almost anywhere and they will safely dispose of them for you. Otherwise, you may have to keep them to yourself to dispose of them in a pickle bin at home.
If you are planning to go skydiving, scuba diving or similar, you will probably need to have a letter of confirmation with your doctor’s approval showing that you are able to participate. If you cannot present this to the company running the activity, they may not allow you to participate. Take photos of these letters as a backup.
Anticipation of environmental changes
Levitt points out that “temperature, time zone and routine changes can affect your energy levels”. If you get tired and dehydrated in a hot country, you are more likely to experience problems with your health condition. Frio packs (cooling pouches designed to keep temperature sensitive medicines at a safe temperature of 18-26°C for at least 45 hours) are very handy if you need to keep your medicine cool and you are go somewhere warm, not guaranteed enough air con or fridges – they just need water to activate.
Plan for the worst and expect to get sick
If you prepare for the worst, you can deal with the worst. Dr Patiniott recommends researching your travel destinations to be aware of suitability, access to healthcare in an emergency and pharmacies if needed. He also says that if you are in a foreign country, to help communicate your needs it would be wise to learn phrases related to your condition and medication.
You have to accept that it may be harder for your body to deal with illness as effectively as others without conditions. It is important to let people know if you have a medical condition, especially a medical condition such as diabetes, because if you slur your words or have trouble walking, people may assume you are drunk and that they will not understand that you need help.
Get cover for pre-existing conditions
My insurance covered the hospital stay and the medication I needed. I only had to pay an excess of £70: a small fee compared to the total bill. I had a few more appointments while I was away and all my claims were approved when I got home. I used 4 Medical Travel Insurance. You don’t need to use a travel medical insurance specialist, but you should make sure your policy includes medical cover.
Book a package holiday
This is not always possible, but if you can, it will mean that the provider has a duty of care to ensure that you get help if you have a medical problem during your trip, and you will always have a useful point of contact.
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