Next week, I am heading off on a trip to Europe. I’m really excited because for the first time in over a year, I get to see my daughter in person. I’m really excited because I’ve never been before and I can’t wait to see new sights and experience new things. I’m really really really nervous because traveling is hard on someone with a condition like Crohns.
I worry that every day I’ll be in unfamiliar locations. Will I be able to scope out bathrooms in each area ahead of time (or at least at the very beginning of each excursion) so I feel more secure and prepared? OH AND THEN I’ve heard that sometimes you have to pay for the bathroom in some locations in Europe and that thought just sends my Crohns-worrying brain into overdrive. I worry that the stress of travel flare things up and possibly put a damper on the day. I sure don’t want to spend a vacation in Europe stuck in my hotel room, too sick to go out. I worry that new foods will throw my digestive system off track. If that happens, will I be able to find things that are easier on it?
Of course, worrying about what might happen because of this disease while traveling has already sent my Crohns into a tailspin. Sigh. I’m not even there yet and a travel-related Crohns flare-up is happening. So, what am I doing to calm my fears and get back to the excitement of the trip? For me, being proactive helps. Making whatever plans I can, taking whatever steps I can to take control of my illness – that’s what needs to happen now.
My hints for traveling when you have Crohns disease:
Remember the Crohns survival kit I referred to in a previous post? It’s essential for travel.
I’ll be adding a few things to it as well and taking it in my carry on bag so I’m sure to have it if needed. This will include:
- Imodium, Gravol, and antacids (I’m taking enough for my whole trip. My daughter has found that sometimes they don’t care exactly the same brands and formulations and I know what works for me. I’m not willing to take a chance on something different.)
- my prescription meds (remember to keep them in their original containers and bring enough to last your whole trip – it can be tough to get them refilled while away, Make sure you will still have some to last you at least a few days after arriving back home too! You won’t want to have to get meds refilled while tired and jetlagged from your trip.)
- a change of clothing
- an empty water bottle (to be filled after getting through security)
- hand sanitizer
- antibacterial wipes
- baby wipes
- zipper storage bags (safest way to dispose of soiled items)
- some nutritional supplements (to make up for the deficiencies I suffer during a flare-up and keep my energy up)
- ginger tea bags and chamomile tea bags (Peppermint helps too but I don’t care for it.)
- a couple packages of plain crackers
- a couple of meal replacement bars (carefully chosen – some make the flare ups worse. I actually do better with liquid meal replacements but often they won’t make it through security. You CAN try to show your official medical information and sometimes they will allow it through but plan for it potentially being confiscated)
- a couple slices of cheese (this may need to be tossed out before landing if I don’t eat it because it might not make it through customs – I find cheese sometimes helps provide me with needed protein but doesn’t exacerbate my symptoms. It might not work well for you so it’s important to have a handle on what food does help you and travels well.).
- What I’ve suggested above may sound like a lot of food but you never know what food you may be served on the plane (if any – and even if you order a special meal, there are sometimes mistakes), you may end up delayed, you may not find any suitable food at the airport. Have a few options available just in case.
Other important items you need to take with you:
- any documents pertaining to your condition (if you need treatment while away, you’ll want the doctors to be as informed as possible)
- an “I Can’t Wait” card from the Crohns and Colitis Foundation of America. In the US if you present this card, a business owner is required by law to allow you to use their bathroom even if they don’t have one for the public. I don’t know of other countries with that same law but sometimes by presenting it, out of understanding and compassion, they will still allow you to use their washroom. It can also help when in long lines at TSA or customs or when boarding a plane (they may allow special permission to use the restroom even when it’s against the rules for others).
- Not all TSA agents know about the rights of travelers with medical conditions. Print them out and present them if needed.
- If you have an ostomy, the information here can be really helpful in understanding your rights when it comes to going through airport security. Print it out and carry it with you.
- Look up and print out (or download an app) key words in the language of the country you’re visiting – things like doctor, hospital, toilet, pharmacy.
- Search the Sit or Squat website ahead of time and make note of bathroom locations in areas you’ll be visiting.You can also use the app if you’re able to access it while traveling.
- Take your vaccination record with you. Your immune system puts you at higher risk and makes you more susceptible to illness.
Preparation before leaving:
- I didn’t need any special vaccines for the countries I’m going to but I did make sure to get a flu shot before traveling. People have mixed feelings about these so of course you need to make your own decision but the only time I’ve had the flu in the past 15 years was the one time I neglected to get my shot. I nearly ended up hospitalized because I had such a bad case of it.
- Consider your wardrobe. There are certain items (like my jeans that have a zipper and three buttons and I have to wear a belt with them) that are harder to get off in a hurry when I am having a bathroom emergency. I’m taking them but I’m making sure to take plenty of other clothing that is easier to take off for any days when I’m in a bad flare. I’m also making sure to include extra underwear and some clothing that is looser fitting for any days when I may experience bloat and swelling.
- Be prepared to advocate for yourself. You will need to speak up to TSA, to airline personnel, to customs officials if you are suffering from a flare. Politely explain and ask for your medical needs to be met.
- Get an aisle seat close to the bathroom on the plane (or train). If you are traveling by an airline like Southwest that doesn’t provide for seat selection ahead of time, once again, this is the time to advocate for yourself. They will put a reserved sign in one of the seats for you or allow you to pre-board to ensure that you are sitting where you need to be.
- Talk to your doctor about travel plans. He/she may have suggestions for an action plan should your condition worsen and may be able to help you figure out how to deal with jetlag if that’s an issue. You want to keep on your medication schedule as much as possible but you may have to make some adjustments because of the change in time zone. Your physician can assist you in working out a plan that may involve gradually changing your medication times prior to leaving. The fatigue from jetlag may increase your symptoms and your doctor could have helpful suggestions about minimizing those as well.
- Be extra careful with what you are eating prior to the trip! The anticipation of traveling may make you prone to a flare so try to keep your pre-travel eating limited and on the bland side. You also need to strive to be well-rested before embarking on your travels. You want to be in the best shape you possibly can be!
- Build in time to get acclimated to your new environment and adjust to jetlag before heading out sightseeing. Build in time when you get home to decompress from your trip before going back to work or taking on other tasks.
- Look into traveler’s health insurance. It could well be worth the investment.
- Look into medical care in the country you are going to. For example, I read that in Costa Rica the first line of defense in health care is the pharmacy. Pharmacists actually treat minor conditions. Be prepared and know how health care works there before you go!
- Make sure to get up and move around during a long flight. IBDs make you more susceptible to deep vein thrombosis.
- The pressure change on planes can actually wreak havoc with your digestive system. Your doctor may be able to suggest something as a bit of a preventative but if not, my plan is to be prepared and to deal with the first sign of symptoms when they happen. Traveling is not the time to put on the brave “I can tough this out” face in my books.
- Depending on where you are traveling, be wary of raw fruits and vegetables, food from street vendors, food served buffet style. Be sure to drink bottled water (and only use bottled water to brush your teeth too). Even when going to a country with a safe water supply, just the changes to a different water system can flare up your symptoms and bottled water is often best. Avoid ice.
- When you first get on the plane (train, bus), use some antibacterial wipes wipe down the armrests, seat, headrest, and tray table as much as possible. These are incredibly germy and minimizing exposure to germs as much as possible will help protect your health.
- Bring a travel blanket, inflatable pillow, eyeshades, and earplugs. These can help you get some much needed rest while en route. A fresh pair of socks is a nice luxury too and can help keep your feet warm.
- In some countries you do indeed need to pay to get into the bathroom stall. First order of business should be to get some change in that country’s currency.
- Stay hydrated BUT if you are in a flare that’s causing loose bowels, beware of drinking TOO much and making it worse. It’s a balancing act.
- Be kind and gentle with yourself. Take a break and have a rest when you need to. Don’t overbook your schedule. Build in down time.
It sounds like a lot doesn’t it? It can feel overwhelming to have a chronic illness and even more overwhelming to travel when you have one, but although this is my first overseas trip, I have traveled successfully in North America. I believe it can be done and it’s worth the effort.