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November 25, 2009
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Travel Medicine (cont.)

What if I have a medical condition or a chronic disease?

Careful preparation will allow travelers have a safe and enjoyable trip. See your physician before traveling to be sure your understand how to manage your condition while traveling. In some cases, an exercise regimen may be recommended to get in shape before the trip. It is important to check with your health-insurance provider to determine what is covered in the destination country.

Travelers with diabetes may need to adjust their insulin-dosing schedule if they cross several time zones. Frequent monitoring of blood sugar (glucose) by finger stick is usually recommended. Remember to carry insulin in your carry-on baggage (otherwise it will freeze in the cargo hold). An identification bracelet showing that you have diabetes is also recommended. Carry a source of sugar in case your blood glucose drops. Remember that exercise may cause blood sugar to dip, so always carry your supplies on hikes, etc. Finally, keep up with your fluids. Hydration can help avoid complications if your blood sugar jumps.

Travelers with heart disease should carry a recent electrocardiogram and a list of all current medications. Medications should be kept in carry-on luggage. If you have a pacemaker, you should know the name of the company that made it and how to contact someone if it stops working. Travelers with unstable heart disease (unstable angina, severe heart failure, recent heart attack, or unstable heart rhythm) should delay travel until their condition is stable.

Travelers who have problems with their immune system due to active cancer, chemotherapy, or AIDS may encounter special problems. In general, vaccines made from live organisms are usually avoided in people with significantly impaired immune systems. Even non-live travel-appropriate vaccines may not work as well as usual, but they are still beneficial and should be given. Consider delaying travel until the immune system is back to normal, if this is possible. Consultation with a disease specialist and a travel-medicine specialist before departure is strongly recommended.

Travelers with disabilities should know that accommodations will vary widely between and within countries. The Department of Transportation can assist with getting accommodations on airplanes (1-800-778-4838). Service animals such as guide dogs are subject to quarantine regulations and may not be allowed to enter some countries.



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