Dr. Barbara Giesser, a clinical neurologist who has specialized in MS care for more than 20 years, offers advice about how to travel safely and comfortably.
What should I do if I have an exacerbation while traveling?
The first thing to remember is what an exacerbation is. It’s a worsening of old symptoms or the appearance of new ones that lasts at least 24 hours. This is important because stress, heat, and/or fatigue (all of which easily happen while traveling) could cause a temporary symptom flare, which should clear by the next day. If symptoms persist, do you have any signs of infection? New bladder symptoms? A fever? Symptoms of flu or a cold? If there is an infection, have it treated. Your flare may be a pseudoexacerbation.
In the event of a true exacerbation, seek medical evaluation, preferably by a neurologist. However, if you have a predictable response to steroids and you’ll be traveling in an area where medical help might not be available, your physician may give you a prescription for a brief (12 weeks) supply of oral prednisone to take with you just in case.
I’m packing my injectables in an insulated carry-on bag, but suppose I can’t freeze my gel pack?
Avonex, Betaseron, and Copaxone (before they are reconstituted) can stay at temperatures that don’t exceed 86º for a total of 7 days. Ice can usually be obtained on airplanes, trains, and in hotels. Remember to pack clean plastic bags for ice holders.
Do I need a note from my neurologist to get through airport security with my needles?
Some airports, particularly overseas, may have more stringent security standards. So, yes, it’s safest to have a doctor’s note certifying that you are on injectable prescription medication. Additionally, tours or cruise lines may require a “fitness to travel” letter from your doctor.
What do you recommend for diarrhea? Motion sickness? Or Third World travel?
Over-the-counter anti-diarrheals, such as Kaopectate, Pepto-Bismol, or Imodium, work well. The biggest problem from diarrhea is dehydration. If you are traveling in less-developed areas, it’s wise to pack some electrolyte-rich “sports” drinks. Persistent diarrhea, or diarrhea accompanied by fever or abdominal pain that lasts more than a day, needs medical evaluation. Over-the-counter Dramamine works for motion sickness, or your doctor may give you a prescription for Antivert (meclizine). The Centers for Disease Control posts vaccination recommendations for everywhere in the world. Check this site and follow the advice.