When it comes to that dream vacation, a business trip, or a road trip to see family, it's all about the details. That’s especially true if you have pulmonary arterial hypertension (PAH).
If you have PAH, you know taking your meds can be complicated. You might be nervous about traveling with oxygen, too. Don’t stress. Experts say being able to enjoy life is important to your overall health.
“If a patient is stable, doing well, and wants to take a trip, there is no reason why they shouldn’t,” says Dinesh Kalra, MD, assistant professor of cardiology at Rush University Medical Center in Chicago.
“To make the trip successful, get checked out by your doctor before your trip, know your health care team will help with anything you need, and then just enjoy yourself,” he says.
These tips and tricks can help make your adventure as smooth as possible. There are, however, some situations in which your doctor will advise against travel.
Let’s say you want to take a trip to Colorado, a state known for its high elevations. That can bring challenges, but none that are impossible.
“When [folks] are traveling to places with higher altitudes, there are lower oxygen levels, and that can be tough for some ... and they may need to adjust their treatment,” says Adriano Tonelli, MD, a lung specialist at the Cleveland Clinic.
That might mean using oxygen, even if you don't normally need it. If you do use it regularly, it may mean changing how you use it.
If you are taking a bus, train, or car, you may need more oxygen once you get above 4,000 feet. The problem is you may not know you're that high up until you have symptoms like shortness of breath, lightheadedness, a fast heartbeat, or a headache.
A flight may cause issues, too. When the plane reaches a certain altitude, compressed air goes into the cabin. Oxygen levels are about 25% lower in a plane, compared with standing on the ground.
None of these things mean you have to cancel your trip.
“One of the most important things a [person] should know is the elevation of their destination as well as changes in elevation if they take a trip on the roads,” Tonelli says.
People with mild PAH, who only use oxygen when they're sleeping or doing certain things, may not need in-flight oxygen. Others with a more severe case may need it.
To find if you should get it, your doctor may give you a special test that shows how much oxygen you need at certain heights. Talk with them about it.
The U.S. Department of Transportation requires passenger air carriers to allow portable oxygen concentrators (POCs) approved by the FAA on their flights. It’s still important to contact your airline, since each may have different rules or options.
“This can be very confusing the first time, but it gets easier,” Kalra says. “Your doctors and the airlines are used to dealing with this and know what needs to happen in terms of oxygen.”
Before you go, contact any travel carrier you're using -- bus, train, or cruise ship -- to make sure things will go smoothly if you need oxygen.
Your Oxygen Checklist
Talk to your doctor about how much you might need while traveling. Make sure to let them know where you're going and how you're getting there. That makes a difference.
If your doctor says you need oxygen during the flight, get a “medical certificate.” It should explain why you need it and the flow rate per minute that you need. This document must also say you're able to use the oxygen on your own and you know what to do if an alarm or warning goes off.
Let the airline know you need in-flight oxygen. Make sure to do it while you book your ticket. Some airlines will provide the oxygen. Each carrier works with their own provider, and charges vary. Your insurance may cover this.
If you have a portable oxygen concentrator (POC), make sure it's an approved one. If you're not sure, ask your doctor.
Bring enough batteries to last through flight time and any delays. Travel can be unpredictable.
Make sure you have an oxygen vendor at your destination, if necessary.
Give yourself extra time between arrival, security checkpoints, and boarding. Don’t be a hero, either. If you feel you need help getting around, airlines can arrange for wheelchairs.
Take Your Meds
Traveling can be stressful. That’s why it’s important to keep up with your medications.
Carry extra supplies. Depending on what you're taking, this could be things like tubing, needles, a backup pump, or ice packs. And always carry about a week's worth of extra meds in your carry-on luggage.
Get Up and Move
Anyone who travels long distances should take a break every few hours and move around. That’s really important if you have PAH. It can help keep your legs from swelling and prevent blood clots.
Even if you’re sitting down, move your feet around to raise blood flow. Consider wearing support stockings, too.
Put Down the Salt
Visiting somewhere new means trying new foods and restaurants. That’s great, but the downside is all those new treats often come with extra salt. That can make your body retain fluid, which makes breathing harder.
“I never want to tell [people] don’t try some new food, but I do tell them to be careful of what they do try when they are traveling,” Tonelli says.
Avoid pickled, smoked, and packaged foods. If you’re at a restaurant that's new to you, see if your chef can go easy on the salt, or you can choose something with less sodium.
Talk with your doctor before you go on your trip. They can give you info on what foods to avoid and what to do if you start retaining fluid.
Keep Names and Numbers Handy
Always carry the contact information for your health care team with you. Depending on where you're going, your doctor may be able to give you the name of a local PAH specialist, in case you need one.
“Emergency rooms are great and can handle a lot of conditions very well, but with pulmonary hypertension, it can get tricky. So it’s a good idea to have the name of a local expert if one is available,” Kalra says.