Asthma is a chronic, often debilitating, disease affecting the air passages of the lungs. For some reason–probably a combination of genetic and environmental factors–a person with asthma is unusually sensitive to certain allergens or irritants that in turn trigger a tightening of the bronchial tubes and severe difficulty in breathing.
When a person with asthma starts gasping for breath and wheezing, those around may not understand what is happening, but the condition is serious and possibly life threatening.
The severity of asthma symptoms and attacks varies widely. Some patients may have only occasional episodes of wheezing and coughing; others are bothered with wheezing most of time plus occasional severe attacks.
For the 20 million Americans with asthma, life is rarely easy, but those who do best in managing their disease are determined, as Joel was, not to let it limit their lives. With careful preparation, travel–to a cousin’s house in the next state or to a developing country–is possible.
AVOIDING THE PETS:
A visit to your cousin’s house may seem like nothing at all...until you learn that the family has three cats that like to sleep on top of the bedspread in the guest bedroom.
Cat dander is a common trigger for attacks. Dogs, birds, down pillows and cushions, wood burning stoves, fireplaces, tobacco smoke, molds, mildews and even crowded conditions can also be hazardous–whether at a friend’s house or at a youth hostel.
At the very least, a person with asthma should inquire about pets ahead of time and bring along his or her own allergen-proof pillow and blanket. In some cases, a stay in a motel might be in order.
PREPARING FOR VACATION:
Before going on a vacation trip, either in or outside the country, consider having a physical examination so you can bring up with your doctor specific questions related to the trip and how to handle a possible asthma attack. Learn where medical facilities are located and have your doctor’s phone number with you in case you need emergency advice.
You need to take all of your medications–plus your peak flow meter, nebulizer and other devices–with you and have them within reach at all times–not in the trunk of the car or in checked baggage on the airplane. Take all medications in their original containers, and have more than you need.
You also should have an action plan for controlling your symptoms–whether for long-term maintenance, quick relief or emergency treatment. Have the address and phone number of a specialist who can assist you at your destination site.
KNOW YOUR DESTINATION:
When Joel scheduled his trip to Mexico City, he didn’t account for the diesel fumes and other pollutants in the air. Other cities with high pollution levels include London, Los Angeles and Hong Kong.
On the same trip, he booked a hotel in Oaxaca that had numerous parrots, dogs, cats and other pets in the central courtyard. For most travelers, it was nice setting. For Joel, it meant constant wheezing...and a search for different lodging.
If you’re traveling to France, be aware that it’s quite common for dogs to accompany their owners in restaurants and bars.
Most persons with asthma know the importance of booking a non-smoking room; but in some countries these may not be routinely available. Although they may lack the charm of local hotels, big chains such as Holiday Inn, Marriott and Best Western may be your best bet. Otherwise, try to find a dry, sunny room away from the swimming pool.
Cigarette smoke in restaurants and on subways and buses can also be a problem in some areas of the world. In one recent California study, about a third of subjects reported encountering second hand tobacco smoke during travel; and more than half of subjects with asthma indicated that this smoke exposure made their symptoms worse or necessitated the use of additional inhaled medication.
For the trip to Isle Royale, Joel spent a great deal of time researching pollen counts and insect prevalence in order to find the best time to visit. Although he has no serious pollen or insect allergies, he wanted to be safe. He made sure his asthma was under good control before he left home, and he checked to make sure that he could obtain the medical help he needed in case of an emergency.
In one recent study, 33 of 88 asthma patients suffered their worst ever attack while on an adventure trek. So it’s best not to take risks.
GETTING THERE:
All domestic flights are now smoke-free, but you can’t be sure about an international flight without checking. If smoking is allowed, book your seat early so you can be assured of being as far away as possible from the smoking area.
Particularly on a crowded flight, the air will be dry and stuffy. Drink plenty of fluids and breathe through your nose to warm and filter the air that goes to your lungs.
In a rental car, you may want to run the air conditioner or heater with the windows open for several minutes to get rid of any allergens that might be trapped in the ventilation system. But keep the windows closed while traveling to protect yourself from highway fumes and pollen.
Remember that the glove compartment is not a good place to store your medications while you’re sight seeing, since temperatures will go sky high inside the closed space.
All of the above precautions may sound intimidating, but the idea is not to frighten you away from adventurous activities. If you’ve planned carefully to avoid surprises, it’s then possible to relax and enjoy your vacation.
Tana N Kaefer, PharmD
