1. “Don’t get mad because it’s raining, just use an umbrella.”
That’s the piece of advice I got from an Australian therapist when my sugar levels went through the roof. I’ve had to learn to deal with type 1 diabetes when dancing, when travelling, with living in foreign lands. And as a group coordinator for educational trips, I have also helped others deal with chronic illnesses abroad.
I start with this metaphor because I believe our attitudes towards chronic illnesses are key to enhancing the treatment (diet, type of medicine and dosage, etc.). So don’t get annoyed at your condition and the challenges it poses for travelling… just use an umbrella.
2. The next, most obvious steps: I always visit my physician before a trip, and I get good travel health insurance.
Even if you have your medical condition under control, you’ll probably need to see a doctor for two reasons: obtaining a letter to present at customs and immigration offices, and going over the vaccines you require. Your physician should be able to explain possible drug interactions between vaccines and your treatment.
The letter from your doctor should state your chronic illness and the kind of treatment you need to carry with you. Ideally, you should have a copy in English and one in the language of the country you’ll visit. It’s also a good idea to carry a summary of your medical records… just in case you have to see a specialist at your destination.
Vaccine requirements, on the other hand, are also available online. Most likely, your government provides official guides for “travel health”, so at least read it and confirm your physician’s advice. Websites such as the Center for Disease Control and Prevention give good recommendations for travellers with chronic illnesses.
3. I do a fair amount of research about the new country rules for my treatment.
Some countries will only allow a certain amount of drugs. For instance, you can only enter Australia with sufficient medicine for three months of treatment, while in Japan you can only bring enough for one month. In case you need more than that, you are required to apply for permissions as if you were “importing” drugs. In my experience, control over the dosage you carry along is not strict, but you should know the rules regardless.
Some types of drugs might even be prohibited at your destination, like herbal treatments or psychiatric medication. Embassies are a trustworthy place to start your research on this matter.
4. Don’t forget airport rules. I did a couple of times, and it sucks.
I run into overly-strict individuals more than once, who couldn’t care less about my medical condition. Last time I left my country (Argentina), local airport security officers accused me of having “too many” syringes and made me carry only enough for my 40 hour plane trip. They didn’t care about the risk of losing my luggage and arriving to a new country with no extra needles for my treatment.
Always check the amount of liquid you are allowed to have on your carry-on. And remember, ziploc bags are your friends.
5. It’s recommended to carry the treatment in its original packaging.
Yes, I know, it takes a lot of room from the suitcase. The benefit of carrying the original box is twofold: it helps convincing custom officers that your drug is legit and it details active ingredients, in case you need to buy more at your destination.
6. I find out the commercial name of my medicine at the new country.
Maybe the lab is the same, but not the local name of the drug. For example, the same NPH insulin was called “Insulatard” in Argentina and “Protaphane” in Australia. Being aware of these differences will help in case you need to talk to physicians and pharmacists.
7. I learn to explain my condition in the local language (or carry a piece of paper that does it for me).
When working as a tour guide in Buenos Aires, I would always made sure foreigners in my groups carry a note with them, explaining their condition in Spanish, such as “I am allergic to peanut” or “I have a gluten free diet”. Attempting to do the same when I visited Tokyo, I used Google Translate for a Japanese version of “I am diabetic”. Unfortunately, Google Translate is not perfect. A gentle Japanese man who could understand English helped me re-write the line in kanji, once I reached my destination.
8. I always let the tour guides know about my condition.
Perhaps chronic illness is not the first thing one likes to explain about oneself to a stranger. But getting rid of taboos about the topic is worth it. Your local guide will be the person that can help you communicate with physicians and emergency services (if need be). If you are the adventurous type, your guide can also provide valuable information regarding risks of the activities you wish to embark in (i.e. the adrenaline rush after bungee jumping, and how to control it).
In my case, I actually enjoy learning how diabetes is treated in different parts of the world. In Ecuador, a shaman and local guide made me try some leaves that supposedly control sugar levels. It’s not about being naive and believing in magical cures… but I remain hopeful of finding complementary treatments that help stabilizing my chronic illness.
9. I don’t take the refrigeration of medicine for granted, but I do count on improvising and trusting strangers.
I have to admit temperatures are one of my biggest headaches when travelling with insulin. In some cases, it was even a constraint: I cancelled a trip to China because I was not certain I would be able to keep my insulin under 30ºC (86ºF). During a road trip in Western Australia, my biggest worry was finding ice at camping sites and gas stations.
The flip side of these challenges is the incentive to trust people. I have no other choice but to put my medicine in the hands of airport waiters, flight attendants and hostel staff. There has been no disappointment so far.
10. I quickly learn key words in foreign language menus and products.
Those of us with chronic illnesses have a real motive to learn words like Penicillin, flour, sugar, salt, sodium, pork meat… Your wellbeing is not only in your hands, but also in your “tongue” and brain. The plus is your vocabulary will definitely get richer than una cerveza por favor.
11. I am mindful of the drug dosage when changing routines.
More (or less) physical activity, new meals (including those usually forbidden from the diet), changing sleeping patterns… it all affects your body. It’s likely that you will have to adapt your treatment during your travels.
As previously said, if it rains, use the umbrella, and if the Sun is out, wear freaking sunscreen! Do whatever you have to in order to enjoy your trip and guarantee your wellbeing. I promise it gets easier with practice.