Saturday, July 30, 2016

ICYMI: On Travel

In case you missed it, Action for Adrenal Awareness released July's videos on YouTube. The topic this month was on various aspects of travel. We pulled from all of our combined experiences to share some of our key tips and tricks. Below are our four videos:

Kim: On Road Trips and Car Rides

Kim was considered our go to expert for road trips and car rides. Due to where she lives, she travels frequently by car to attend all specialist doctor appointments and to visit relatives. Her key takeaways can be applied to every type of travel and are summed up below:
  1. Know your limits.
  2. Be prepared.
She also has the following tips and tricks:
  • On What to Bring:
    • She travels with her body pillow, and likes to pack a blanket as well.
    • She also carries with her important medical documents that are up to date.
    • Meds:
      • Bring 3x the amount of steroids you would normally need.
      • She'll separate out the meds she needs for that particular day and place them in an easily accessible container in her purse.
      • Before you leave, check and make sure that your emergency injection has not expired.
      • Don't forget anti-nausea medicine. Peppermints can work well.
    • Food:
      • Bring it!
      • Especially if on a restricted diet, be sure to pack safe food for both the trip and the destination. Your destination might not always be able to accommodate your special needs.
    • Fluids:
      • Hydrate. Hydrate. Hydrate.
      • It's sometimes good to add in an electrolyte drink such as Gatorade or Powerade. Just be mindful of the potassium.
      • Some of us are extremely sensitive to small changes in the water. If you fall into this category, bring bottled water.
        • Kim has been adversely effected by this, causing her to triple her HC dose and took her several weeks to recover.
        • For me, we finally tracked down that it was the Malaysian Airline's water that kept causing me to almost crisis multiple times while abroad.
  • On How to be more comfortable:
    • She rests her feet up on the dashboard. 
      • Turns out, both Debby and I do this as well!
    • Keep that AC on. If it's not too hot outside, roll down the windows.
      • This is a big deal for me. I get nauseated much quicker if there is no air circulation in a vehicle.
    • Factor in regular rest and stretch breaks.
      • For shorter trips, Kim stops every 1.5 hours.
      • For longer trips, she'll get out and walk around at least once an hour.
      • For even longer trips, she breaks them up into multiple days, with an overnight stay in between.
      • If you push it too far, you may be doomed before you ever reach your destination.
    • Do not be afraid to up-dose! 

Kim encourages us to do whatever we need to do in order to make it a good trip for us.

Debby: On Camping and Visiting Remote Locations

We also have a resident camping expert on our team! Once a year, Debby goes on her week long solo camping trip with just her dog. She does not let her disease stop her from enjoying the great outdoors, but she does take specific steps in order to be prepared. She stressed the importance of carrying the following three items with you at all times:
  1. Your medical alert bracelet.
  2. Your emergency injection kit.
  3. Extra medicine.
Carry those with you whether you're camping in a remote location, or running a quick errand. Especially that medical alert bracelet. Consider it a part of you now that you never take off. 

Below are a few more tips and tricks:
  • On Meds:
    • Debby's Emergency Injection Kit contains
    • She carries extra medicine in a little pouch with clearly labeled individual boxes
      • Zofran
      • HC
      • Ibuprofen
      • Pink Himalian Salt Crystals
      • etc.
  • On Location:
    • When you arrive at the camp ground, alert the ranger / host / near by campers of your medical condtion.
    • Leave emergency contact numbers. 
    • If camping alone, you can always ask the rangers to check in on you. They don't mind.
    • When go to mountains, make sure to get weather report. This helps you know how to prepare.
    • Cell service might not be always available.
      • Have a backup plan: mechanical compass, physical maps, letting people know where you are going and approximately what time you expect to return.
  • On Hydration:
    • You will dehydrate a lot quicker. 
    • Make sure you always have fresh clean water. 
      • Debby likes to carry a water filtration system
      • She'll also add 3-4 pink salt crystals to water bottle. It ups the salt without a noticeable taste.
    • If taking fludrocortisone, you may require extra. 
      • Chat with your doctor and create a plan before you leave.
  • If you get hurt:
    • Immediately take more HC.
    • Do not trust your brain trying to tell you that you are ok especially if you are not.
    • Sleepiness, disorientation, nausea are all symptoms that you need more HC.
    • If it's not safe to move, just stay put. You should have let people know where you were going so that they can find you.
Debby encourages us to listen to our body and understand it's need for cortisol. Learn our limitations. Once we figure those out, we can enjoy so much. Camping in remote locations does not have to be off limits just because we live with Adrenal Insufficiency.

But if camping seems much too difficult, she reminds us that we can just go enjoy outside and enjoy life.

Amber Nicole: On Airports and Airplanes

I actually filmed my video while waiting to catch a red eye flight for a spontaneous trip back to Texas to celebrate Independence Day. Nothing like filming a video about airplanes and airports while waiting at an airport, right? Here are my main points:
  1. Purposefully factor in rest time.
  2. Watch for dehydration.
Some additional notes:
  • On Hydration:
    • Be very mindful of dehydration and very pro-active for proper hydration. 
    • Feel free to cary an empty water bottle through security.
  • On Navigating Airports:
    • Arrive at airports ridiculously early. It's more fun to people watch than to rush.
    • Wheelchair assistance is available, and there is absolutely no shame in utilizing it.
    • Make sure you are wearing your medical alert bracelet. 
  • On the Plane:
    • If you are feeling apprehensive, speak with the flight attendant. They are there to help you.
    • On longer flights, wear compression socks and make sure you get up to walk around.
    • Keep all important medicine with you at all times and within reach. 
    • You are also allowed to carry on unlimited amounts of critical medicine.
  • On the Timing of Medicine:
    • Do not be afraid to bump up your steroid dose, especially if you find yourself growing increasingly confused and overwhelmed.
    • For significant time zone jumps (6+ hours), double your hydrocortisone. Take it in both time zones to ensure no gap in steroid coverage.
    • For shorter time zone jumps (1-2 hours), it is better to take your hydrocortisone early than it is to take it late.
    • For long traveling days involving multiple layovers and messed up sleep schedules, do not be afraid to take a bump dose of hydrocortisone every 30-90 minutes.
  • And perhaps most importantly, factor in rest time for when you first arrive at your destination.
This tips and tricks were able to serve Wendy well during her recent trip to Thailand.

Nichole: On General Travel and Packing of Medicine

Nichole's video covered travel in general along withe the packing of medicine. She reminds us that travel does not need to be by airplanes, or long car rides, or camping in remote locations to be considered travel.

Her summary is valid for every type of travel:
  1. Pack your meds.
  2. Pack more than you think you need.
  3. Verify that your kit actually contains everything that you think it does.
Below are some additional notes from her video:
  • In her Handbag: 
    • Important Letters:
    • Important Medication:
      • HC and emergency injection kit
      • If medication requires refrigeration, she recommends a Frio Wallet off of Amazon.
    • Glucose Testing Kit
      • So often, hypoglycemia is a common factor with Adrenal Insufficiency
      • It might be low blood sugar instead of low cortisol.
  • Regarding Preparidness:
    • Go check your kit. Now. Does it contain everything?
    • Are any of the medications expired?
    • Pack way more than you think you'll need.
      • Good rule of thumb: 3x the amount.
      • You do not want to have to hunt down a pharmacy on top of feeling unwell.
  • When Traveling Internationally:
    • Check all vaccines with your doctors. If they recommend some, get them.
    • Make sure you have important documents
      • Passports
      • EU health card (if applicable)
    • Be mindful of the local language. Translate important documents beforehand.
      • I did this when I lived in Korea, Malaysia, and traveled to Thailand.
    • Look into travel insurance.
  • General Notes:
    • Always, always, always carry additional medicine (The AFAA team keeps stressing this point because it's very important).
    • Do not be afraid to ask for help
    • Be clearly labeled.
      • Medical alert bracelet?
      • Nichole has a label on her keys.
      • I have a label on my water bottle.

After watching Nichole's video, I went and checked all of my different emergency packs and bags. I realized that all of my Zofran had expired and I was almost out of salt tabs. It felt good to know that my kits are up to date and that if an emergency happens, I am prepared.

I challenge y'all to go check your kits now and report back your findings. Did you need to update anything?

Did we forget anything? Are there any tricks that you would like to add? Please share them in the comments! 

And as always, if there are any specific topics that you would like us to cover, suggest them here.

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  1. My method of checking all meds and emergency pack, when the time changes (fall back / spring forward) check all expiration dates, supplies, emergency kits. It's easy to do at least twice a year. Hope that helps someone else too.

    1. Oh that's clever!

      It wouldn't work for those in Arizona, but that is a really easy way to make sure that your kits are up to date at least every 6 months.


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