Tuesday, September 30, 2014

Travel to Developing Countries - Traveling with Health Problems

Traveling with Health Problems or While Pregnant


Diabetes

People with diabetes who do not require insulin injections do very well during international travel, provided they monitor diet and exercise. Insulin-dependent patients should remember that if they are traveling eastward the first day is shortened, and they will need less insulin. Westward travel means a longer day, thus will require additional insulin. Patients who travel by aircraft and need to carry syringes or needles now require medical documents.

Heart and Lung Diseases

People with any serious medical conditions should check with their doctor before travel. Of note, cabin pressure in aircraft is typically equal to about 5,000 - 8,000 feet above sea level. This can produce a 4% reduction of oxygen in the blood, which can affect patients with heart or lung problems.

Recommendations for Patients with Heart Risks. One study reported that over half the deaths that occurred in overseas travelers were due to heart disease. Generally, the following recommendations may be useful for travelers with a history of heart disease. Individual conditions vary, however, and any patient with heart disease, particularly a history of heart attack, should check with a doctor before traveling.

  • If you have had an uncomplicated heart attack, wait 4 - 6 weeks before traveling. A 2-week wait is recommended after uncomplicated bypass surgery. There are no restrictions after angioplasty, assuming you are not experiencing chest pain.
  • Implanted pacemakers and cardiac defibrillators can trigger metal detectors, so patients should have a card proving they have an implanted device and ask to be hand checked. Pacemaker patients should also carry an EKG taken with and without pacemaker activation. Defibrillators are found on board many commercial airlines. Patients should check to see if the airline trains their flight attendants on their use (rather than rely on traveling doctors, who may or may not be on board).
  • Patients with a history or risk of heart disease might be advised to wear elastic compression stockings and take low-dose aspirin before long trips to prevent blood clots. Patients at high risk for blood clots should ask their doctors about the short-term use of anticoagulant ("blood thinning") medication. They should also take ordinary precautions, including drinking plenty of fluids, taking frequent walks, and performing leg-lifts several times an hour.
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Review Date: 01/30/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)