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TRAVELING AND LYMPHEDEMA

LYMPHEDEMA AND TRAVELING 

TRAVELING AND HOLIDAYS - TIPS ON TRAVELING - AIR TRAVEL - HEALTH TRAVEL INSURANCE

VACATION HEALTHCARE - HEALTHCARE ABROAD - AIR TRAVELER WITH A DISABILITY

Just because you have lymphedema doesn't mean you can't travel, have vacations and do "fun" recreationaal activities.  It just means that you may have to do a little bit of extra planning and untake a few extra precautions.  Until the last couple years when my health with lymphedema and lymphoma had deteriorated significantly, I have always been hoping on a jet flying off to somewhere, or on the road for those marvellous long car trips that I loved to go on.

I'm not going to include and lot of do's and don'ts as the articles listed below cover that quite well. 

So, read these, plan that trip, enjoy.

Be safe, be well, be prepared, have fun on that vacation

Pat O'Connor

June 5, 2008

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TRAVELING AND LYMPHEDEMA

THE LYMPHOEDEMA ASSOCIATION OF AUSTRALIA

TRAVELING AND HOLIDAYS

Before leaving.

1. Check with your doctor that you have enough prescription drugs (if you need them) to see you through your holiday. Get them filled by your pharmacist before you leave, however, carry the scripts with you in case of mishap, or for checking by foreign Customs Officers (which may happen).

Ask for a prescription for antibiotics as a precaution if you do get an infection, and carry them with you. (Penicillin is the one of choice, unless you are allergic to this). If you are travelling to a tropical country in the wet season, where filariasis is endemic, take D.E.C. with you. Take one dose/week. If you feel ’flu-like symptoms after taking it lasting for 24 hrs., then take another dose the following week etc.

2. Buy a top quality sunburn cream SPF 20-30+. Remember you can get sunburnt through a compression garment, especially the synthetic fabric makes. Take moisturising lotion and body wash -mineral-oil based. (not soap)

3. Travel Insurance (that covers health as well as luggage) is worthwhile providing you read the small print. You may have to state that you have a pre-existing condition to claim payment if you need treatment. (This may need to be signed by your Doctor.)

4. Buy some insect repellent, and take something to treat stings if you do get them. A good perfume seems to work as well as repellent - buy some duty free!

5. Pack some antifungal powder and use it, especially between the toes! This may only be a prophylactic measure (to prevent infection), but hotel bathrooms, pool areas and warm moist climates in particular, can lead to the onset of tinnea (Athletes foot). This can be easily transferred to the groin or under the breast fold areas, especially when lymphoedema is present. Apart from inflammation, it also causes breakdown of the skin so that bacterial entry is facilitated, which may lead to bacterial infections. This powder may also need to be "puffed" into your shoes especially if you are wearing sneakers or boots.

6. If you need vaccinations, do not have them in the affected limb! Sometimes you get a reaction to these, so if possible have them at intervals, if you need more than one.

LUGGAGE

1. Cases. For flight take a small and as light a case (or two smaller ones if need be) as possible, unless you are travelling with someone who can carry it for you. A case with wheels is advisable (but you can only manage one)! If you are by yourself, get a porter to help you if one is available. I know this can be expensive in some airports but if it means you have a safe and happy holiday it may be worth it! Don’t remove a case from a luggage carousel with a lymphoedematous arm. If you have a lymphoedematous leg/s, be careful not to bump them when you remove luggage from the carousel or when you try to load cases onto a trolley. Try not to let someone run into you from behind and cause damage! I know this is often difficult in big airports, but it is better to stand back and let impatient people get their luggage first than to risk damage!

2. Hand luggage. Realise that you really do not need much, even when on long flights e.g. a sweater, a book, minimal makeup and a change of shirt or blouse in case something gets spilt on you during travel! Don’t carry this with an affected arm! Include your travel documents in this rather than carry a separate bag. Carry your medication with you, or at least enough to last you for a few days.

3. If you are going to a holiday home by car, please get someone to help you move cartons (of food etc.), or anything that is heavy. Onset of lymphoedema has often been triggered by this situation. Get help also loading and unloading pre-bought supplies from the supermarket etc.

4. Clothing. Clothing for travelling should be light, loose and non-constricting, especially around the waist (or under the breasts). Be careful of belts and jewellery. Clothing should preferably be layered so that you can remove a jacket if you are going from a cold to a hot climate or vice versa. Wear comfortable shoes. If you have lymphoedema of the leg/s it would be better not to remove them during travelling. Don’t travel in short skirts or shorts if you have lymphoedema of the leg/s - infection can be easily picked up from the aircraft seats.

5. Compression garments. Check that these are in good condition before you leave. If you have an old one, take it as a back-up garment in case something happens to your good ones! If you have been wearing a sleeve that stops at the wrist or stocking that leaves the toes exposed, then a glove on the hand is necessary during flight and it would be a good idea to bandage the toes and any exposed foot area before donning the stocking.

6. If you are travelling in some countries e.g. China, realise that the pressurisation in aircraft is not necessarily of the same standard as in International Aircraft Companies. As an extra precaution you could consider taking a blow up "splint" which one patient used most successfully in place of a garment under these circumstances. She said this got "very tight" during flights, but she returned without any onset of lymphoedema. The alternative is to wear two garments - one over the other- or to bandage as well as wearing a garment, if you can, to provide extra pressure. If you are bandaging, remember to pad at the back of the knee for comfort and to stop chafing and also around the ankle with leg lymphoedema and at least in the elbow fold with arm lymphoedema.

BOOKING THE TRAVEL

1. If travelling by air, some airlines may still allow you to request an emergency exit (or a bulk head seat). This means that your "light" travel bag can be used as a foot rest in front of a much larger space! Economy classes put seats so close together these days that someone with long legs often cannot sit with their feet properly on the ground or foot rest. This is dangerous, not just for patients with lymphoedema, but also can cause D.V.T. (deep vein thrombosis) when this position has to be maintained for many hours. Consider an up-grade to Business Class (?) even if it means a good holiday every 2 or 3 years rather than one each year!

2. If the flight is a long one, try and arrange a "stop-over" for 1-2 days on the way. Some airlines include this as part of their package.

3. If a long bus-trip is being booked, choose one with as many stops as possible and get out and move when these occur! If you have a long car trip then you can stop frequently and have a 5 minute exercise break! Remember to protect your limb from the sun with a white cloth or shirt etc. if you are sitting on the sunny side of the vehicle. If, on a bus, work out which side the sun is going to shine on the bus and request a seat on the opposite side.

4. If going to a Ski resort or mountains realise that the lowered atmospheric pressure as you ascend can either trigger or worsen lymphoedema. Take the same precautions as you would during flights, (or watch the limb carefully) and apply pressure as needed.

DURING FLIGHT

1. Keep your seat belt loosely fastened so that you have room to move as much as possible, except during take-off and landing or during real turbulence, when it should be properly tightened.

2. Get up and move around as long as the "fasten-seat-belt" sign is not alight.

3. Exercises and self-massage can be done whilst seated. Shoulders can be rolled and breathing exercises done. Appropriate nodal clearance e.g. under arm and/or in the groin as is appropriate for your situation, and then trunk clearance towards these nodes, with light stroking towards them, can be done, especially under a blanket which is supplied during flights. Feet can be flexed and pointed and ankles rotated, as can be fingers and wrists.

If you have lymphoedema of the arm you could take a ball to squeeze, or clench your fist and twist your arm outwards and inwards much like you would "wring" a wet towel, with your arm above your head if possible. If you stop on a longer flight and are allowed to enter the terminal, get out and walk around.

During long bus trips

The same applies to these as to aircraft flights.

Entertainment

Watch a funny movie whilst travelling if it makes you laugh - this is good exercise -and it will relax you which means better flow of lymph. I suppose that one that is exciting so you tense, and then gets hilarious, so that you relax and laugh (which means breathing and exercise) is the best of all!!

WHEN YOU ARRIVE

1. Do not remove your garment for a few hours or until you reach your hotel etc.

2. Then have a cool shower and a rest with the affected limb elevated. Use a "Body Wash" -(mineral-oil based cleanser) and then a good moisturiser on the affected limb particularly.

3. Some more exercise would be good at this point!

4. Wash all your travelling clothes (or dry clean) before wearing again.

5. Then start to really enjoy your holiday!

DURING THE HOLIDAY

1. Many of the above points still apply.

Avoid sunburn
Avoid insect bites (especially spider bites)
(iii) Don’t overdo sports that you are not used to. Be wary of the more strenuous excursions that may cause trauma (or bumps and stress) to limbs.

(iv) Beware of fungal infection (tinnea) (see p.1)

(v) Wear buckle-up plastic sandals if you have lymphoedema of leg/s, if on the beach or paddling. If on a coral beach or snorkelling near coral, be extra careful. Coral infection can cause lymphoedema in people with normal limbs.

(vi) Use a good skin moisturiser.

(vii) If it is hot, realise that you can cool your limb with your compression garment on just by wetting it! Put your limb under a tap or shower! Evaporation will then cause cooling!

(viii) Be careful shaving, pushing back cuticles etc.- the general "Do’s and Don’ts" (see previous newsletter or Information Book).

(ix) These are just general precautions when travelling, and although particularly applicable to a person with lymphoedema basically apply to every member of your families as well! A lot of it is good common sense! Holidays are a time for enjoyment, but also give you extra space to pamper yourself. Relax and do it.

Try and do all the things that you want to do. Take what simple precautions that you can - and have a wonderful and safe holiday.

Why do aircraft flights trigger the onset or worsen already existing lymphoedema?

This first came to my attention in 1995-1996 when I had about 12 telephone calls in a 3 month period from patients who had developed lymphoedema (suddenly). When I asked for some case history, or the information was volunteered, most of these were post-mastectomy or post-pelvic cancer patients and had undergone a long flight when they felt better and they and their family needed a holiday. The limb had "blown up" during the flight, which situation was of course, a disaster for a happy holiday.

http://lymphoedema.org.au/news_letp.html

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Pink- Ribbon.org 

http://www.pinkribbon.com/

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Air Travel - National Lymphedema Network

*a must read*

http://www.lymphnet.org/pdfDocs/nlnairtravel.pdf

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Travel Insurance - Cancer/Lymphoedema - For our LE family in the UK

This section is about travel insurance and the options available for people who have or have had cancer.  You can scroll down the page to read all the information here.  Or you can use these links to go straight down to sections on

http://www.cancerhelp.org.uk/help/default.asp?page=4343#company

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Vacation health care

Travel health tips

BEFORE LEAVING

ON THE ROAD

http://www.nlm.nih.gov/medlineplus/ency/article/001937.htm

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Healthcare Abroad

Healthcare Abroad

A few minor precautions and strokes of the pen can save you considerable hassle later on. Doing some homework can save you time, money, and offer peace of mind if you encounter health problems while traveling.

Medical practices in other countries may be very different from those found in the United States. Add to this the potential for language barriers and unfamiliarity with your medical history and the value of planning for potential medical care becomes obvious.

The following tips, contact information, medication names, and additional resources will help you be ready for medical needs both minor and critical.

Start with the Consular Information Sheets
If you aren't very familiar with the country you are visiting, the US State Department Consular Information Sheets and Travel Advisories are a good place to start, to see what type of medical services will be available to you once you are there.

Collect Healthcare Contact Information Before You Leave
Write down the following information in your address book, journal, itinerary, or other location, preferably one that you will have with you at all times. Also, ask your doctor for a contact name and number in the event of an emergency that occurs when your own doctor is not available.

- Your regular doctor's office and home phone numbers in case you need a consult while traveling.
- HMO/insurance company contact information in case you need to get approval for treatment.
- Embassy contact info for countries in which you are traveling.

This information should be in your carry-on luggage, wallet, purse, billfold, or fanny-pack and with your primary identification, so that, should you be incapacitated, whoever comes to your assistance will find it.
If you have serious allergies or medical condition such as diabetes, be sure to ask your doctor about medical emergency bracelets.


Obtain Information at Your Location
Before you call your doctor or insurance company, try to obtain complete contact information at your location, including a fax number. Your provider will often be able to fax pertinent documentation to your location.

Know the Generic Names of Your Medications
Common brand names at home may not be available or widely known where you are traveling. Knowing the generic/medical names of common medications may help you find the over-the-counter medications you need, and help you avoid taking the wrong medications. If possible, pack these items in a first-aid kit before you leave. The following generic medication names should help if you need to replenish your supplies while traveling.

Advil/Motrin/Alleve = ibuprofen
Tylenol/Excedrin = Acetaminophen for fevers or pain
Bayer, others = Aspirin
Benadryl (antihistamine) = diphenhydramine
Dramamine = dimenhydrinate, diphenhydramine hydrochloride, meclizine (bonine)
Mylanta or Pepto-Bismol = contains bismuth subsalicylate
Antacids = calcium carbonate, aluminum hydroxide, or magnesium hydroxide

Locating Doctors and Clinics While Traveling Abroad
- Check your guidebook - many include health doctor recommendations.
- Especially at upscale lodgings, ask the hotel concierge for physician recommendations. Some doctors will make "house calls" to your hotel.
- Contact the nearest medical school, where you will often find English-speaking doctors and students.

The following agencies provide contact information for English-speaking doctors throughout the world. Note that the following links are to disclaimer pages on the sites; the Web sites do not guarantee the links or information found, or the quality of the care at the clinics. We recommend that you read the disclaimer, but keep in mind it doesn't necessarily mean you can't trust the doctors and clinics in the list.


- International Society of Travel Medicine (ISTM); P.O. Box 871089, Stone Mountain, GA 30087-0028, (770) 736-7060.
- International Association for Medical Assistance to Travelers; 417 Center Street, Lewiston, NY 14092, (716) 754-4883.
- Highwaytohealth.com
offers an annual membership that grants access to doctors in over 100 countries, including scheduling assistance and more.

Medical Assistance Companies
Membership with a medical assistance company buys you access to an extremely wide range of medical and other services, from the mundane (vaccination recommendations, doctor referrals, and legal advice), to the dramatic (repatriation, emergency evacuations, and emergency cash loans).

Plans, services, and prices can vary widely, so read all information carefully, and compare the various service levels and companies. Some recommended medical assistance companies include:

- AEA International SOS Assistance
- Travel Assistance International

Additional Contact Information
The following government and private agencies provide valuable information for US citizens traveling abroad:

US Department of State Overseas Citizens' Services

M-F, 8:30-5:00 PM: (888) 407-4747 or (317) 472-2328
Weekend/After-hours Emergencies: (202) 647-4000. Be sure to ask for the OCS duty officer.

The American Society of Tropical Medicine and Hygiene
60 Revere Drive, Suite 500
Northbrook, IL 60062
(847) 480-9592

Other Pertinent Information
Travel Insurance

http://www.independenttraveler.com/resources/article.cfm?AID=56&category=5

Additional Contact Information
The following government and private agencies provide valuable information for U.S. citizens traveling abroad:

U.S. State Department Overseas Citizens Services
(888) 407-4747 -- from overseas: (202) 501-4444

The American Society of Tropical Medicine and Hygiene
60 Revere Drive, Suite 500
Northbrook, IL 60062

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Passengers with Disabilities

The Air Carrier Access Act prohibits discrimination on the basis of disability in air travel and requires U.S. air carriers to accommodate the needs of passengers with disabilities. The Department of Transportation has a rule defining the rights of passengers and the obligations of air carriers under this law. The following is a summary of the main points of the DOT rule (Title 14 CFR, Part 382).

Prohibition of Discriminatory Practices

Accessibility of facilities

Other Services and Accommodations

Administrative Provisions

http://airconsumer.ost.dot.gov/publications/disabled.htm

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Quick Tips for a Safe Trip

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External Links and Resources

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Travel.State.Gov

http://www.travel.state.gov/

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Tips for Traveling Abroad

http://www.travel.state.gov/travel/tips/tips_1232.html

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Travel and Business

http://www.state.gov/travelandbusiness/

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Travel Registration

https://travelregistration.state.gov/ibrs/ui/

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Information for the Air Traveler with a Disability

http://airconsumer.ost.dot.gov/publications/horizons.htm

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Air Carrier Access Act

http://www.disabilitytravel.com/airlines/air_carrier_act_details.htm

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How to be Safe in a Foreign Country

http://www.wikihow.com/Be-Safe-in-a-Foreign-Country

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Traveling Abroad? Make Sure Plans Include A Trip To The Doctor

http://www.medicalnewstoday.com/articles/100751.php

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Travel Medicine: Helping Patients Prepare for Trips Abroad

http://www.aafp.org/afp/980800ap/dick.html

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Join us as we work for lymphedema patients everywhere:

Advocates for Lymphedema

Dedicated to be an advocacy group for lymphedema patients. Working towards education, legal reform, changing insurance practices, promoting research, reaching for a cure.

http://health.groups.yahoo.com/group/AdvocatesforLymphedema/

Subscribe: AdvocatesforLymphedema-subscribe@yahoogroups.com

Pat O'Connor

Lymphedema People / Advocates for Lymphedema

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For information about Lymphedema

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema\

For Information about Lymphedema Complications

http://www.lymphedemapeople.com/wiki/doku.php?id=complications_of_lymphedema

For Lymphedema Personal Stories

http://www.lymphedemapeople.com/phpBB2/viewforum.php?f=3

For information about How to Treat a Lymphedema Wound

http://www.lymphedemapeople.com/wiki/doku.php?id=how_to_treat_a_lymphedema_wound

For information about Lymphedema Treatment 

http://www.lymphedemapeople.com/wiki/doku.php?id=treatment

For information about Exercises for Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=exercises_for_lymphedema

For information on Infections Associated with Lymphedema

http://www.lymphedemapeople.com/wiki/doku.php?id=infections_associated_with_lymphedema

For information on Lymphedema in Children

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_in_children

Lymphedema Glossary

http://www.lymphedemapeople.com/wiki/doku.php?id=glossary:listing

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Lymphedema People - Support Groups

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Children with Lymphedema

The time has come for families, parents, caregivers to have a support group of their own. Support group for parents, families and caregivers of chilren with lymphedema. Sharing information on coping, diagnosis, treatment and prognosis. Sponsored by Lymphedema People.

http://health.groups.yahoo.com/group/childrenwithlymphedema/

Subscribe: childrenwithlymphedema-subscribe@yahoogroups.com


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Lipedema Lipodema Lipoedema

No matter how you spell it, this is another very little understood and totally frustrating conditions out there. This will be a support group for those suffering with lipedema/lipodema. A place for information, sharing experiences, exploring treatment options and coping.

Come join, be a part of the family!

http://health.groups.yahoo.com/group/lipedema_lipodema_lipoedema/?yguid=209645515

Subscribe: lipedema_lipodema_lipoedema-subscribe@yahoogroups.com

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MEN WITH LYMPHEDEMA

If you are a man with lymphedema; a man with a loved one with lymphedema who you are trying to help and understand come join us and discover what it is to be the master instead of the sufferer of lymphedema.

http://health.groups.yahoo.com/group/menwithlymphedema/

Subscribe: menwithlymphedema-subscribe@yahoogroups.com

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All About Lymphangiectasia

Support group for parents, patients, children who suffer from all forms of lymphangiectasia. This condition is caused by dilation of the lymphatics. It can affect the intestinal tract, lungs and other critical body areas.

http://health.groups.yahoo.com/group/allaboutlymphangiectasia/

Subscribe: allaboutlymphangiectasia-subscribe@yahoogroups.com

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Lymphatic Disorders Support Group @ Yahoo Groups

While we have a number of support groups for lymphedema... there is nothing out there for other lymphatic disorders. Because we have one of the most comprehensive information sites on all lymphatic disorders, I thought perhaps, it is time that one be offered.

DISCRIPTION

Information and support for rare and unusual disorders affecting the lymph system. Includes lymphangiomas, lymphatic malformations, telangiectasia, hennekam's syndrome, distichiasis, Figueroa
syndrome, ptosis syndrome, plus many more. Extensive database of information available through sister site Lymphedema People.

http://health.groups.yahoo.com/group/lymphaticdisorders/

Subscribe: lymphaticdisorders-subscribe@yahoogroups.com

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Lymphedema People New Wiki Pages

Have you seen our new “Wiki” pages yet?  Listed below are just a sample of the more than 140 pages now listed in our Wiki section. We are also working on hundred more.  Come and take a stroll! 

Lymphedema Glossary 

http://www.lymphedemapeople.com/wiki/doku.php?id=glossary:listing 

Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema 

Arm Lymphedema  

http://www.lymphedemapeople.com/wiki/doku.php?id=arm_lymphedema 

Leg Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=leg_lymphedema 

Acute Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=acute_lymphedema 

The Lymphedema Diet 

http://www.lymphedemapeople.com/wiki/doku.php?id=the_lymphedema_diet 

Exercises for Lymphedema  

http://www.lymphedemapeople.com/wiki/doku.php?id=exercises_for_lymphedema 

Diuretics are not for Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=diuretics_are_not_for_lymphedema 

Lymphedema People Online Support Groups 

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_people_online_support_groups 

Lipedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=lipedema 

Treatment 

http://www.lymphedemapeople.com/wiki/doku.php?id=treatment 

Lymphedema and Pain Management 

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_and_pain_management 

Manual Lymphatic Drainage (MLD) and Complex Decongestive Therapy (CDT)

http://www.lymphedemapeople.com/wiki/doku.php?id=manual_lymphatic_drainage_mld_complex_decongestive_therapy_cdt 

Infections Associated with Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=infections_associated_with_lymphedema 

How to Treat a Lymphedema Wound 

http://www.lymphedemapeople.com/wiki/doku.php?id=how_to_treat_a_lymphedema_wound 

Fungal Infections Associated with Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=fungal_infections_associated_with_lymphedema 

Lymphedema in Children 

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_in_children 

Lymphoscintigraphy 

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphoscintigraphy 

Magnetic Resonance Imaging 

http://www.lymphedemapeople.com/wiki/doku.php?id=magnetic_resonance_imaging 

Extraperitoneal para-aortic lymph node dissection (EPLND) 

http://www.lymphedemapeople.com/wiki/doku.php?id=extraperitoneal_para-aortic_lymph_node_dissection_eplnd 

Axillary node biopsy 

http://www.lymphedemapeople.com/wiki/doku.php?id=axillary_node_biopsy

Sentinel Node Biopsy 

http://www.lymphedemapeople.com/wiki/doku.php?id=sentinel_node_biopsy

 Small Needle Biopsy - Fine Needle Aspiration 

http://www.lymphedemapeople.com/wiki/doku.php?id=small_needle_biopsy 

Magnetic Resonance Imaging 

http://www.lymphedemapeople.com/wiki/doku.php?id=magnetic_resonance_imaging 

Lymphedema Gene FOXC2

 http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_gene_foxc2

 Lymphedema Gene VEGFC

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_gene_vegfc

 Lymphedema Gene SOX18

 http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_gene_sox18

 Lymphedema and Pregnancy

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_and_pregnancy

Home page: Lymphedema People

http://www.lymphedemapeople.com

Page Updated: Dec. 14, 2011