Protecting Your Health

When You Travel

17

Traveling doesn’t need to be off limits because you have heart disease or are a caretaker of someone who has had a cardiac event like heart attack or stroke. A few precautions can help make your trip a smooth one.

Be as equipped for your trip as you would be at home. Make sure you have your medicine. It’s sufficient to have a list of your medications and your cardiologist’s phone number on hand also. Let your cardiologist or internist know where you’ll be. Your doctor might know physicians or reputable caretakers in the area if help is needed.

Some cardiac medications, such as digitalis (AKA digoxin or Lanoxin), do not have exact equivalents abroad. Always bring extra medication on all trips abroad. As with all medications, cardiac medications should be stored in carry-on baggage. Nitroglycerin tablets, in particular, should also be kept out of extreme heat or sun in order to maintain their potency.

Travelers with a cardiac history should bring a copy of their most recent EKG–this is important. In the event of an emergency it is also very helpful to have a letter from your physician detailing your cardiac history: include results of recent cardiac catheterizations, stress tests, and echocardiograms.

Pacemakers and Defibrillators: These are generally not affected by airline metal detectors. But before long trips these should be evaluated by your cardiologist to ensure that they are functioning correctly and that the battery life is adequate.

Do a little research finding medical facilities at your destination and learn what your health insurance covers. For instance, some insurance policies pay part of the cost of an emergency flight home from abroad. That can help you make quick decisions if a problem arises. Some physicians recommend taking a copy of your pertinent medical records with you while traveling.

High Altitudes

Traveling to higher altitudes shouldn’t necessarily worry you especially if your medical condition is well controlled.

But be mindful of your fluid consumption and salt intake if you have cardiomyopathy or a history of heart failure. A balanced fluid intake is important with these conditions.

High altitudes can make you more symptomatic if you have coronary artery disease because of the thin air and how oxygen is carried in your blood.  Think about a train that’s transporting smaller loads and making more trips. The engine — or in this case, your heart — has to work harder, especially if you already have blockage.

Watch out for shortness of breath or other symptoms that could indicate you’re tipping from a stable to an unstable state.

If you’re traveling to a country where some vaccines are needed to guard against disease, it’s not likely the immunization will affect your heart. The bigger concern is that an exotic place may have less access to good medical care.

Consider making some adjustments, such as selecting an alternative destination in the same part of the world. Instead of a rural safari in Africa choose a more populated part of the continent.

Plane Precautions

Patients who have had a heart attack (myocardial infarction) should not fly in airplanes for at least a month afterwards, and certainly not without clearance from their physician.

Patients with unstable angina or chest pain should not fly at all.  As a general guide, patients with cardiac disease should be able to walk 100 yards and climb 12 steps before attempting a long flight.

Discuss with your physician whether supplemental oxygen should be used during the flight. If required, supplemental oxygen can usually be arranged by calling the airline ahead of time with instructions about what concentration of oxygen is needed and providing a physician’s prescription.

Most passengers don’t want to inconvenience fellow travelers, so they choose not to drink anything during flights to avoid having to get up to visit the restroom. Don’t make this mistake yourself: Dehydration and sitting for long periods of time both can trigger heart problems.

Sitting immobile on long plane flights can slightly increase a normal person’s risk of blood clots in the legs, but associated medical issues usually contribute to it. If you have peripheral artery disease (PAD) also called vascular disease or a history of heart failure, the clot risk increases. Stand and move around the plane at least once per hour. Just be sure the seatbelt light is not on when you do so!

The dry air on a plane wicks moisture out of the body, causing dehydration quickly. Dehydration thickens the blood and depletes the body of essential minerals such as potassium and magnesium. Both of these minerals regulate heart rhythm. Inadequate levels of potassium or magnesium’s can trigger abnormal heart rhythms, including atrial fibrillation (A-fib).

For some, the A-fib symptoms are fleeting and disappear on their own. However, the abnormal rhythm can cause blood to pool in the heart and form a clot. That clot could then cause a stroke.

Jet Lag and Dehydration

Here’s an idea: Drink mineral water, or even club soda.  This keeps you hydrated, and replaces the minerals you are losing. Jet lag is mostly caused by dehydration.  Drinking mineral water both during the trip and after arrival reduces the chances. Drink at least six to twelve ounces per hour on the plane. Yes, you will have to get up and use the restroom.

Tell your doctor about your travel plans to get the best advice on what precautions, if any, you may need to take. For example, some people might need compression stockings or additional oxygen. Others might need to watch fluids closely or avoid alcohol. And some may not be able to fly.

That all sounds scary. Is air travel too risky?  The trick is to stay on top of your condition and stay hydrated!

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