How to travel with HNPP

It’s summer in most of the northern hemisphere which means it’s time for vacation for many people. It can be challenging for many with HNPP who are planning to get away, either at home or abroad, therefore you may need to do some more research to make sure that your destination is going to meet your needs.

Although travelling abroad can be relaxing and rewarding, the physical demands of travel can be stressful, particularly for those with underlying chronic illnesses. With adequate preparation, however, chronic illness sufferers can have safe and enjoyable trips.

Preparing ahead of your holiday

First things first, before you make the journey there are few bits to consider including if you can manage your health while you’re abroad. It may seem like a formidable task, but it’s better to be prepared for any eventuality.

• Ensure that any chronic illnesses are well controlled – it may be useful to see your health care provider to ensure that the management of your illness is optimised.
• Vaccinations – if you are going abroad to tropical climes, make sure you get the correct vaccinations. As you may know, certain immunisations, could have adverse side effects with current medications that you may be taking so it’s essential to check and let your medical practitioner know that this could be a factor. Immunisations may also present symptoms at a later date, so you may have to consider the long term impact as well.
• Think about where you are going – will you have access to your medical needs if required? Or medications if you run out?
• Pack a travel health kit – travellers with preexisting medical conditions should carry enough medication for the duration of their trip and an extra supply, in case the trip is extended for any reason. If additional supplies or medications would be needed to manage aggravations of existing medical conditions, these should be carried as well. Your clinician managing your condition should be consulted for the best plan of action. Consider wearing an alert bracelet and making sure this information (in English and preferably translated into the local language of the destination) is on a card in your purse or wallet and with your other travel documents.
• Medical supplies – make sure you carry on some of your medication if you are travelling by air, and with this a copy of your prescriptions. Take sufficient quantities of medications for the entire trip, plus extra in case of unexpected delays. Since medications should be taken based on elapsed time and not time of day, you may need guidance on scheduling when to take medications during and after crossing time zones.
• Medication restrictions – check with your embassy or consulate to clarify medication restrictions in the destination country. Some countries do not allow visitors to bring certain medications into the country.
• Drug interactions – certain medications used to treat chronic medical illnesses may interact with medications prescribed for self-treatment of travellers’ diarrhoea or malaria chemoprophylaxis. You may want to ask your GP about this ahead of time.
• Provide a doctor’s letter – this can come in handy if heaven forbid you get ill during your travels. Handing this to a practitioner at your destination may avoid any mistakes from happening. The letter should be on office letterhead stationery and should outline existing medical conditions, medications prescribed (including generic names), and any equipment required to manage the condition.
• Medical travel insurance – this is a given. It’s always better to be safe than sorry even if you’re going away for a few days. Three types of insurance policies can be considered: 1) trip cancellation in the event of illness; 2) supplemental insurance so that money paid for health care abroad may be reimbursed, since most medical insurance policies do not cover health care in other countries; and 3) medical evacuation insurance. Travellers may need extra help in finding supplemental insurance, as some plans will not cover costs for preexisting conditions. Make sure to also check the excess, as sometimes you end up paying more in excess than the policy actually pays you back. You must declare your condition. Many online companies now do offer “medical screening” as you go through the ordering process.
• Medical assistance companies – this is less common everywhere and isn’t for everyone, however, there are organisations that can store your medical history so it can be accessed worldwide. Some companies are listed below:
  • The International Society of Travel Medicine maintains a directory of health care professionals with expertise in travel medicine in more than 80 countries.
  • The International Association for Medical Assistance to Travelers maintains a network of physicians, hospitals, and clinics that have agreed to provide care to members. Membership is free, although donations are suggested.
  • The Joint Commission International (JCI) aims to improve patient safety through accreditation and certification of health care facilities.
  • Embassies and consulates in other countries, hotel doctors, and credit card companies (especially those with special privileges) may also provide information.
• Research your destination – check facilities that are available at your destination, such as ease of access and transport options. Consult widely including good guidebooks, disability organisations in the the country that you’re visiting, the embassy or high commission of the country you plan to visit, specialist tour operations and tourist boards.
• Foreign office – check the travel advice by country before you travel and while you’re there which you can find on your government’s websites.
• Contacting beforehand – when contacting holiday providers, airlines, hotels etc, clearly state your needs and what assistance you require – just telling people you have a particular illness doesn’t mean that they will understand your needs, so you may need to clearly explain them. Service providers are required by law in many cases to accommodate travellers with special needs. However, most need some time to make the necessary arrangements. Mention your needs at the time of reservation, and call the provider 24 to 48 hours before your arrival to confirm that proper accommodations have been made. This checklist from the ABTA travel board may help guide you.
• Ensure everything is airtight – confirm enquiries, bookings and reservations in writing. Double check all arrangements before departure.

Resources: UK Foreign Office and Centers for Disease Control and Prevention

Managing air travel

Flying abroad?  Airports are usually enormous, with vast distances to be traversed between check-in areas, and planes. Here are a few things to consider:

• Avoid connecting flights – although wheelchairs are the last items to be checked into the luggage compartments, and thus first to be pulled off, flying direct can save you unnecessary time and hassle. One exception: If you have trouble manoeuvring into airplane lavatories, long flights may become uncomfortable — so a series of shorter flights might be a better option. If you do choose to connect, be sure to allow plenty of time between flights (at least 90 minutes, or two hours if you need to go through customs or security) to get from one gate to the next.
• Allow plenty of time – you will need time before your flight to check in, get through security and transfer to your gate. Arrive at least two hours before a domestic flight and three hours before an international flight — more if you’re travelling at a peak time.
• Mobility access – check in with your flight attendant before your plane lands to make a plan for exit.  All airports provide wheelchair assistance, which is usually excellent, to get from A to B – you can book this through your airline, either at the time of booking by ticking the relevant box, or phoning a dedicated disability booking line.  Make sure you do this well in advance, or at the very least, three days before travelling.
• Transportation – don’t forget about transportation to and from the airport. If you have a wheelchair, make arrangements in advance to have an accessible vehicle pick you up in your destination city.
• Wheelchairs – for those with wheelchairs, bring spare parts and tools. Assemble a small kit of spare parts and tools for emergency repairs. You may also be required to dismantle a wheelchair for certain flights or activities; make sure you and your travelling companions know how to do this.
• Know your rights – before going through airport security, be aware of the rules for travellers with disabilities and medical conditions. I had a few unfortunate experiences with my walking stick.

Accommodation

Be specific about your requirements – ask for whatever you need to make your stay comfortable and ask for written confirmation that they are available. Your travel agent or tour operator should be able to advise you, but you may also decide to call the hotel, resort or cruise liner directly to speak to someone who is familiar with the rooms.

You may want to think about the following:

Wheelchair access

• Is there step free access to all the main areas of the hotel, resort or ship?
• Are there charging facilities for electrical equipment such as a wheelchair?
• If you have mobility needs or are visually impaired, you should check on the access to public rooms, restaurants, bars, toilets, swimming pool, beach etc
• Can any equipment you need be hired locally, such as back rests, bathing equipment, hoists, ramps and special mattresses? Information may be available from local disability groups at your destination
• Is a lift is available and if so, will your wheelchair or other equipment fit?

Location of the bedrooms

• Can you be on the ground floor if you wish, or near a suitable lift?
• Do the bedroom facilities fit your needs, for example, is the door wide enough, does it open outwards or inwards?
• Do the bathroom facilities fit your needs, for example, is the room large enough: is there a roll-in shower or grab-bars?
• Can your dietary requirements be met?
• Are there facilities for assistance dogs?

Rooms:

• Wider entry and bathroom doorways. Easy to open?
• Mid-height light switches and power outlets
• Lever type door handles
• Manoeuvring space on each side of the bed
• Roll in shower
• Wheeled shower chair and/or wall mounted shower seat
• Grab bars in bathroom
• Raised toilet
• Lower hanging space in closet

Neighbourhood:

• Proximity to markets, pubs, restaurants
• Proximity to health services.

Be prepared, in the unlikely event that:

• The hotel does not have the accessible room available for you when you arrive. The hotel will need to find you an accessible room, even in another hotel. You will need to ask “where will you put us up for the night?”
• The complimentary hotel shuttle may not be accessible. The hotel will need to accommodate the service in some other way. “How will you provide alternate shuttle service for us?”

As an avid traveller, being diagnosed with HNPP felt like an end of my solo quests. But with the right information, being prepared, and calling ahead, being on holiday won’t seem like such an arduous task, rather it will be just what the doctor ordered.

Useful Websites and Resources

For more information on travelling with all types of disabilities, check out the websites and other resources below.

• Accessible Journeys: Tour operator for slow walkers, wheelchair travellers and their companions
• Accomable: A guide to accessible lodging around the world
• Barrier-FreeCruising.com: Tips and resources for disabled cruise travellers
• Emerging Horizons: An online quarterly newsletter providing a wide range of information for mobility-impaired travellers
• Limitless Travel: U.K.-based company offering accessible tours in Europe
• Travel on the Level: Tips and destination recommendations for travellers looking for less strenuous walking and fewer stairs
• Tips for Traveling with a Chronic Illness! Blogger from ButYouDontLookSick.com

Read: Is walking good for those with HNPP?