Before my IBD symptoms became an everyday part of my world I was a frequent flier - both for pleasure and for business. But, B.C. - before colitis - as I call it, I never thought much about flying, or how to physically prepare to travel, nor did I have fears of flying, or think about what I'd do if I got sick in the air. But, after my colitis kicked-in and it became apparent that is was going to be a part of my life I had to change the way I traveled, and especially how I flew on an airplane.
First, I put together my "Emergency kit," which included a change of underwear, a change of pants, Imodium, my IBD prescription medications (never pack those in your checked luggage, or if you do, pack only half in your checked bag and put the other half in your carry-on), my iPod filled with music I love as well as music that relaxes me, and books or magazines to keep my mind occupied during the flight.
Next, I had to figure out how to keep my symptoms at bay on flight day - not always easy since I also have IBS-D (Irritable Bowel Syndrome with a diarrhea-predominance) which, for me, is usually triggered by stress. So, I learned some meditation techniques that are helpful to do the night before and morning of travel. But, I also tend to really alter my diet for a couple of days before I have to travel. I don't eat anything that I know could possible cause a flare-up, I increase my water and ReCharge intake to make sure I'm well hydrated and my electrolytes are stable, and I take along a few snacks I know I can eat without risking a flare-up - this is especially useful when traveling on longer overseas flights.
But, even with all of these precautions I've had two instances where I ended up in a flare-up while traveling - both times on the outbound trip. The first time was when I was really new at having IBD and I thought the smart thing to do the day before and of my flight would be not to eat, and the day of not to drink anything thing - I reasoned, nothing in means nothing out. Big mistake Our flight took us from Washington, D.C. to Pittsburgh to San Juan, Puerto Rico and then onto St. Maarten. By the time I got to Pittsburgh my gut was not happy and I popped two Imodium which helped to slow things down. But by the time we reached Puerto Rico I'd not eaten for nearly 18 hours and only drunk small amounts of water here and there. A couple of hours later I was supposed to get onto an eight passenger airplane that would take me to my final Caribbean destination. As my husband and I stood in line to check in for our last flight I began to shake uncontrollably, my head began to swim, and I felt nauseous, and as if my gut might let loose. My husband noticed that I'd gone pale in the face and asked what was wrong as I slid down a wall to sit on the floor. After determining that we didn't know what was wrong a woman with an Argentinean accent suggested that I was low on electrolytes. It turned out she was a doctor and, in fact, would be on our flight to St. Maarten. She sat with me while my husband, and our pilot, went to find some juice or Gatorade to get some sugars back into my system. They arrived not only with juice but with a wheelchair to transport me to the airplane. I was very lucky to have had this doctor standing in line behind us, and to have found such a helpful pilot who successfully got all of us to our destination. Before parting ways at the St. Maarten airport the doctor gave me the name of a physician on the island should I need it and instructed me to keep drinking fluids and to reintroduce some food into my system by starting with some yogurt.
The second 'episode' I had was a few years later while traveling to London on business. But this time my flare-up hit while I was in the air between Washington, D.C. and London. When I discussed my situation with one of the flight attendants - she had noticed me going in and out of the bathroom quite a few times and asked if I was okay - she made an announcement asking any doctors on board to come to the rear of the airplane. There happened to be two doctors on board that day and after taking my pulse, listening to my heart, and asking me questions about my symptoms and my previous experiences with IBD flare-ups they asked if I felt I needed, or would need, a hospital. If so, I would have needed to make the decision within half an hour so that the pilot could divert our flight to Novia Scotia - the nearest hospital before we headed out over the Atlantic Ocean. I felt awful, and I knew from previous experience that I could quickly get dehydrated if my diarrhea spiraled out of control. But having an entire airplane diverted to a hospital was a big call - I sat for a few minutes thinking about my options and assessing just how bad my symptoms really were. I finally decided that I could go on - I drank small sips of diluted cranberry juice, took as many Imodium as my doctor had told me was safe, and employed my best relaxation techniques that I'd been practicing for the past year or so. I put my mind in charge of my body, and determined that I would be alright. I was exhausted by the end of my flight but my stomach had settled down and I had made it to my destination.
I was lucky that neither of these incidents were life threatening. Until the last incident I had never considered the consequences of becoming seriously ill while on an airplane. What would happen if I had become seriously dehydrate, or had a heart attack, or stroke, or serious allergic reaction? Well, according to the F.A.A. airplanes are required to be equipped with oxygen, a first-aid kit, a defibrillator, and, an emergency medical kit that includes a stethoscope, needles, epinephrine, and an intravenous set. However, flight attendants are not medical personnel and are only trained in basic CPR and how to use the defibrillator and administer oxygen. A 2006 F.A.A. advisory stated, "Flight attendants should not be expected to administer medications or to start IVs." The medical emergency kit is there to be used my trained doctors or nurses who may be passengers traveling on your flight and able to help in the case of an emergency. Technically, flight attendants aren't even allowed to administer aspirin to passengers without the instructions of a doctor.
So, before your next airplane trip, think ahead. Are you in a flare-up? If so, what could go wrong or awry while you're in the air and how could you handle it if it were to become an emergency. If you have a plan mapped out ahead of time chances are you'll never have to use it. But the reality of air travel is that airplanes are a means of transport - a way to move people from point A to point B they are not fully equipped for all possible issues or problems that could arise.