Travel to Developing Countries - Traveling with Health Problems

Highlights	Infectious Diseases	Resources
General Health Precautions	Travel Precautions	References
Traveler's Diarrhea	Traveling with Health Problems

Traveling with Health Problems

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.

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Heart and Lung Diseases

People with any serious medical conditions should check with their doctor before travel. Of note, cabin pressure in aircraft is also typically equal to about 5,000 to 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 a traveler has had an uncomplicated heart attack, he or she should wait 4 to 6 weeks before traveling. A 2-week wait is recommended after uncomplicated bypass surgery. There are no restrictions after angioplasty, assuming the patient does not experience 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 also available 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. They should also take ordinary precautions, including drinking fluids, taking frequent walks, and performing leg-lifts several times an hour.

Recommendations for Patients with Lung Disease. The following are some recommendations for patients with lung disease:

For reasons of fuel economy, jets now fly higher and cabins are pressurized with up to 25% less oxygen than in the past. Patients with lung problems should consult their doctors about whether air travel might worsen their condition.
People who require supplemental inflight oxygen cannot supply their own and must make arrangements with the airline. This requires a prescription and the patient must call the air carrier at least 48 hours before the flight. Not all carriers supply in-flight oxygen and none supply oxygen on the ground. That must be arranged separately.