Help Patients Stay Healthy When Traveling

Larry Calemine, RPh, BS Pharm
Thursday April 26, 2018
Traveling can be stressful, complex, difficult, and fun, depending on the arrangements, distance, time zones, and type of travel. Planning can make traveling an easier experience. Staying healthy is important for all travelers, regardless of whether they have chronic health problems. Below are some guidelines and preventive measures travelers can take to stay healthy.

DIET 
Eating right can be tough when traveling. A limited availability of healthy choices and airport prices can make finding nutritious foods difficult. Bringing along healthy snacks, such as fruits, nuts, and nutritional bars, is an alternative to being at the mercy of convenience foods. Travelers should be informed about the food available at their travel destination, as well as at the stops along the way. Stick with unpeeled fruits and vegetables, in case the foods are not well cooked. A good site for resources and information is Cronometer (cronometer.com). This free site can track a multitude of diets, as well as nutrients, fitness, and health biometrics.1

SLEEP 
Sleep wellness during long travel days may present a variety of health issues. Early mornings, long layovers, and uncomfortable seats can disrupt rest, and lower immunity to infection. One option is to focus on comfort. Earplugs, sleeping masks, and travel pillows can promote rest, and rejuvenation. For long flights that cross many time zones, a sleep aid may be a solution. Always consult a physician first; several OTC choices may be recommended when appropriate, and herbal products are available. Patients may need counseling on the medications prescribed by a health care provider, and information on adverse effects. Health care professionals can review the patient’s prescription profile for any potential adverse effects with the current regimen.

HYDRATION 
Staying properly hydrated is essential. Fluids may not always be readily available, so it is important to be prepared, especially for those traveling abroad. Travelers should be aware of the potential for getting sick from local drinking water. When appropriate, they should use bottled water, and avoid using ice when water safety is a concern. Depending on the destination, traveler’s diarrhea is a possibility.

Traveler’s diarrhea typically develops after ingesting food or water contaminated with organisms from feces that are infectious. These organisms can be bacteria, parasites, and viruses, with enterotoxigenic Escherichia coli the most common.2 The condition presents with abdominal cramps, fever, loose stools, an urgent need to defecate, and vomiting. Staying hydrated is key because of the loss of water.

Most cases improve within 1 to 2 days without treatment and clear up completely within a week, but travelers can have multiple episodes of the condition during a trip.2 Travelers should consult their physician about medications they can take if the condition arises, persists, or worsens.

IMMUNE DEFENSE 
There are many products available to aid in boosting immunity. Airborne, Emergen-C, and Zicam are examples. The ingredients lists vary, and may include Echinacea purpurea, electrolytes, zinc, and vitamins C, B, and E. Liquids, nasal sprays, reconstituted powders, and tablets are available, and can be transported easily.

AIRLINE STRATEGIES 
First and foremost, there are ways to make a flight less stressful. Planning can help avoid some common issues. Here are a few tips:
  • Look for nonstop flights when possible. But for particularly long trips, consider breaking up the flight to avoid fatigue.
  • Plan seat placement. Those with bladder issues should pick a seat close to a bathroom.
  • Consider an aisle seat. This is helpful for 2 reasons. First, it allows those who are nauseated easily to leave their seat frequently without disturbing someone else. Second, an aisle seat instead of a middle seat, in a middle row especially, limits exposure to others who may have the flu or some other contagious condition.
  • Bring disinfectant wipes. The airline may empty the trash and straighten up spaces, but does it really clean the seats? If a person on a previous flight had the flu, the next passenger in that seat will be subject to an infection. This can be serious if a person’s immune system is compromised. To avoid infection, travelers should bring disinfectant wipes and clean the entire seating area, including the armrests, the back of the seat in front of them, the seat belt buckle and strap, and the tray. Bring enough wipes to share. Other passengers may not think of this but will appreciate being offered a wipe. The more they clean their areas, the safer and more germ-free the plane will be for everyone.
  • Carry hand sanitizer. This will help travelers when hygiene is an issue.
  • Those who are sick should wear masks. This will prevent spreading an illness to others, and protect a sick traveler from other germs. Health care professionals can provide advice about the best types of masks and ways to transport them.
  • Follow airline rules for transporting medications. Knowing what to expect and how to follow aviation rules when traveling can help on a busy travel day. Check the Transportation Security Administration website (tsa.gov) for information about security screenings, and what items can be brought on board a flight, as well as other travel tips.3

PRESCRIPTIONS 
Health care professionals can help patients get refills for their trips, and assist with proper storage, especially for products that require refrigeration. Patients with disease states, such as diabetes, may have additional health needs to consider. Regulating blood glucose on a travel day can be challenging, for instance. Having medication, and related supplies can keep travelers healthy, and avoid stress. Travelers should properly label medications, and put them in a carry-on in case checked luggage gets lost. There are many products available that can help keep medicines stable for a long trip.

CDC TRAVELERS’ ADVISORY 
Here are tips from the CDC:
  • Be informed about the travel destination. The CDC website (cdc.gov) has up-to-date information, resources, and travel notices.4 The site is useful for keeping abreast of disease issues and travel warnings. Users can type in a disease or location to get current information.5 The CDC’s mobile app, TravWell, is also useful for on-the-go information.
  • Know the vaccine guidelines and recommendations. The CDC website also provides a wealth of information on areas for which travelers should get vaccinations in advance.6 Simply type in the name of the country, and a list of recommendations will appear. The site is user-friendly and breaks down travel into categories: all travelers, most travelers, and some travelers. These are divided because of several factors, including the level of interaction at the desired location, the length of the visit, and what the visitor plans to do.

PREPARATION 
Each person is different. Regardless of their health status, being knowledgeable, and prepared can keep travelers healthy, and safe. Of course, travelers should always seek advice from a health care provider or physician, as they can counsel based on an individual’s health, and medication history. A provider can even order prescriptions for travelers to take along to avoid shortages and keep them covered in areas where medications are difficult to obtain. Finally, travelers should contact their health insurance provider to confirm coverage and find out whether it will be available at their destination.




Larry Calemine, RPh, obtained his BSPharm degree at West Virginia University (WVU) in 1992 and has spent most of his career focused on ambulatory pharmacy. In 1999, he trained at the Professional Compounding Centers of America to increase his knowledge, and worked for a compounding pharmacy specializing in altered-dosage forms. He obtained certifications in cardiovascular risk management, diabetes, immunization, and medication therapy management through the American Pharmacists Association. He developed a discharge pharmacy in 2012 at WVU Medicine’s outpatient pharmacy to aid in lowering readmission rates for all causes at J.W. Ruby Memorial Hospital in Morgantown, West Virginia. He also started an Advanced Pharmacy Practice Experience program with 6 schools of pharmacy to increase clinical outcomes. 


References
  1. Kalamian M. Keto for Cancer: Ketogenic Metabolic Therapy as a Targeted Nutritional Strategy. 1st ed. White River Junction, VT: Chelsea Green Publishing; 2017.
  2. Traveler’s diarrhea. Mayo Clinic website. mayoclinic.org/diseases-conditions/travel- ers-diarrhea/symptoms-causes/syc-20352182. Accessed February 22, 2018.
  3. Disabilities and medical conditions. Transportation Security Administration website. tsa.gov/travel/special-procedures. Accessed February 22, 2018.
  4. Travelers’ health. CDC website. cdc.gov/travel. Accessed February 22, 2018.
  5. Travel health notices. CDC website. wwwnc.cdc.gov/travel/notices. Updated March 16, 2018. Accessed March 21, 2018.
  6. Disease directory. CDC website. wwwnc.cdc.gov/travel/diseases. Accessed February 22, 2018.


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