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The perils of traveling when you have PD:by Dr. De Leon

As I have been traveling to promote my book and women in Parkinson’s issues, I am reminded of some of the perils of traveling which can make anyone a bit discombobulated but for those of us who suffer from a chronic illness like PD it can really throw us for a loop.

I absolutely love traveling and I am absolutely thrilled to be feeling so much better to be able to do this on my own after having to depend on someone for a while. However, I am reminded of my illness each time I leave my home by the number of medicines I have to pack in order to be able to enjoy my travels. It is sad that packing my medications takes me twice as long than actually packing my clothes.

The first thing  we have to keep in mind when we travel, especially if going across various time zones, is the time changes when we are trying to keep up with our medication schedule. I find it a lot easier to go west than east. What I do is I continue to take my medicines as scheduled through out the trip and when I arrive I switch to that time zone and then proceed to take my medications on the same schedule (meaning every 6 hours and so on) – however, we must be aware of the time it has actually passed ..make sure you maintain the same hours between dosage so if you just took a medicine and arrived and now is time to take another medicine because it is noon for instance don’t double the dose wait til next dosing time ..but if you took medicine 5 hours ago and now new time zone indicates that you will have to wait another 3 hours but you know you take your meds every 6 hours take the medicine within the hour and adjust schedule… Do not suffer …and always keep medicines handy in your personal belongings and within your immediate reach like in a purse and carry water with you to facilitate intake of pills. I always keep my medications in my purse in a pill  box. Within this box, I also carry prn medications..in other words medications I don’t take on a daily basis but might need especially when traveling or sitting for a long period of time such as nausea medications, pain meds- like Tylenol & Motrin, migraine pills, and muscle relaxants.

Try to get seating with extra leg room and do stretch exercises  while sitting every hour…stretch your neck, legs, back, and feet. You can do small circular motions of neck and limbs including hands and feet for five minutes…walk about if you can. Also, if you tend to swell, like I, do when sitting you might consider wearing Ted hose or support stockings to avoid deep vein thrombosis (DVT’s) as well as improving circulation and decreasing edema.  Conversely, don’t wear tight socks that only go to your ankle- this will only worsen swelling rather use diabetic socks.

Since it is hard to take diuretics when traveling to decrease swelling, we must try to eat naturally diuretic foods like cucumber, lemons, tomatoes, and drink plenty of water especially if you are going to be out on the sun -need double amount of fluids. Drinking lots of water can actually help flush  all the toxins out and is the most effective diuretic. Another way to eliminate fluid build up in your body naturally is to drink cranberry juice, or add cucumber  or lemon wedges to your drinking water..of course any caffeinated drink will help to get rid of fluids but these will only dehydrate you in the end so not as healthy and do not recommend if traveling  for long distances. Another food which has lots of natural diuretic effect is oats. Go ahead and have an oatmeal bowel before traveling or in the mornings while your traveling, not only will this help get excess fluids but will promote better digestion.

Drinking plenty of fluids also helps to improve digestion and decrease constipation which also makes us feel bloated and causes swelling. Because we sit so long when traveling, the natural peristalsis of our bowels decreases even further. Now compound that with medication intake  side effects and PD itself and we are one miserable uncomfortable person with bloating, gas, increase nausea and poor absorption of our medications making them less reliable when we need them the most. I recommend taking ‘gas- X‘ or some equivalent..try to eat light like yogurts and take a probiotic capsule to stimulate  proper digestion since I have found it extremely hard to take laxatives when traveling especially if have a packed schedule.

In flight or on your trip you can also drink Sprite, ginger ale (this also aids with Gi upset and nausea, plus ginger is a good diuretic). Eat dry fruits  and crackers ..I like  to carry with me ‘thin addictives‘ they make a great snack, easy & convenient to carry plus they have dry  fruit and nuts to give you energy. If you are completely bloated and feeling constipated do a light liquid diet the first day  when you arrive at your destination. Although, you will certainly need a nap after you arrive, if possible you should continue your exercise routine there- sometimes hard to do if are speaking or are sight- seeing, good thing is that usually sight seeing entails a lot of walking so you will have plenty of exercise). but don’t neglect your sleep..of course the sleep may be a bit messed up. in order to avoid jet lag carry melatonin 6mg – 1-2 tabs a night.  when you are on vacation especially if at a tropical island you will be tempted as I have to do as the locals do and enjoy some nice alcoholic beverages with a little umbrella. however, we must be mindful of our alcohol intake for several reasons.

1)  initially it can make you sleepy after a few hours it becomes a stimulant disrupting your sleep wake cycle further and making you more lethargic and fatigue.

2) it is extremely dehydrating.

3) can worsen REM behavior

4) can interfere with your medications

5) increases swelling

When you get to destination and en route eat plenty of vegetables like carrots, asparagus, tomatoes, beets and celery which also are natural diuretics. ( I emphasize the diuretics because all of the Mao inhibitors,  along with the amantadine and dopamine agonist cause a lot of fluid retention especially in us women). The above foods are also healthy and can cause some slimming effect especially oat consumption. Did not our mothers tell us we are what we eat? Seems like there is a lot of truth behind this saying…Even before trip should avoid salty foods and no high fatty meals in transit especially if crossing several time zones.

I have learned these perils the hard way  making me look like a 9 month pregnant woman while traveling because I am unable to take my Linzess, & my diuretic pills because I am on the go and don’t want to have an accident or be detained every few minutes looking for a bathroom worst sometimes is hard to keep a eating schedule as I would at home  one thing we must always remember is that WHEN we eat is as important for us living with PD as WHAT we eat. so next time you are packing your suitcase getting ready for a travel adventure keep some of these points in mind to avoid the perils and focus on the FUN & Joy of it all!

 

 

 

parkinson's disease, parkinsons health and beauty tips

Tips & Tricks: Traveling with Parkinson’s Disease: By Dr. De Leon

Spring break is fast approaching and many of us especially those of us with children look forward to this time of year to being able to travel as a family. Sometimes you even get to chaperone for fun on school excursions just as an excuse to see the world through their eyes! However, even though it now takes me longer to pack my medications than it does my actual clothes and toiletries, I still enjoy traveling whenever possible….( still have a million meds to pack- need a bigger bag just for this but could not do it with out my trusty world travel -diva bag!)
So, here a few tricks to make traveling a bit easier and not such an ordeal.
Of course, it takes more planning than it once did since traveling with PD is a lot more complex than if we did not have a chronic illness. Don’t be discouraged it can be done but don’t forget to keep in mind destination climate and time of year. We not only have to keep track of our meds but we also have to be conscientious of the temperature and other weather conditions in the areas of our destination because believe it or not extreme weather can make our symptoms worst as I am sure many of you already know.

General tips!

 Always carry a letter from your neurologist stating your diagnosis and medication list. This might avoid extra scrutiny or people thinking you are either drunk or mentally challenged.

 Always keep on hand your PD specialist phone number and how to reach after hours. Don’t forget the countries area code when calling if traveling outside of the US.

 Always keep your medications with you, that’s one piece of luggage you cannot afford to do without – trust me I know. Carry some extra in case you spill. I have a tendency to do this as many of you can relate, I am certain; also in case there are delays to your travel plans due to weather, illness, etc. Plus, carry a prescription and letter from your doctor in case you need or someone gives you hassle for carrying so many pills. I never had this problem but is best to be prepared just in case. Put your medicines in small plastic containers or bottles you can get from pharmacy or in a large pill box depending how long you will be away from home.Product DetailsProduct DetailsProduct DetailsProduct DetailsFashion Smart Pill and Vitamin Compact Travel Clutch Case (Fleur De Fash)

 Pace yourself, listen to your body. You know it better than anyone else. Try to keep routine and medications at same time – if traveling abroad, stay with the new time zone in keeping with medicine intake. Choose activities wisely and allow for down time. If planning on climbing Machu Picchu do at the end of trip so can recover at home and on plane on way back.

 Leave the ego at home. Fortunately, we now have so many tools at our disposal, please make use of them this includes folding canes with height adjustment, wheelchairs, laser canes, disposable undergarments, you name it. Don’t pay any heed to those staring who do not understand what we have to go through.laser-cane-parkinsons_tProduct DetailsU step walker with laser for foot placement

 Don’t underestimate the importance of a good travel companion especially if venturing out of comfort zone or internationally. A good friend or companion can Tips for traveling with friends... and staying friends.be a god send when you need an extra pair of legs or hands. Trust me, when I suddenly freeze because my back gives out from the rigidity of my axial muscles it is nice to have a plan ahead and a person to lean on to help walk with me to prevent falling and to retrieve my luggage is an absolute gift.

 Mentally notice all bathrooms especially when traveling internationally do not pass a good one since these are hard to find. Remember many charge to use the facilities as well as for the toilet paper. So carry your own toilet paper. Also most all older countries like Italy have only one bathroom for both sexes and toilets are really low with no toilet seats so a good companion not only will help to stand guard but can aid you in going to the bathroom.

1. Remember a lot of us have bladder issues so keep a mental note of location in case you have to hustle back but if don’t think can do this that’s what undergarments are for. There is an app to help locate restrooms but beware of international roaming fees.

 ESPECIALLY IF TRAVELING Outside of US or remote areas have your doctor give you prescriptions for Apomorphine in case need it ( make sure you know how to use and what to expect before using- the company now has 24hour hotline to assist),take sleeping pills, muscle relaxants, and pain meds like Vicodin. As well as anti-inflammatories in my experience a Tylenol plus a Motrin go along way for relieving most pain.

 When making reservations try using an agent that has dealt with booking trips for people with disabilities. Always purchase travel insurance best if you buy insurance from third party rather than travel agent or cruise ship. (AIG Travel Guard).

 Consider the climate of country where traveling- if during hot weather consider investing in a cooling vest. Consider Alaska in summer, Europe in fall, and Caribbean in winter.

 I also recommend a cruise, I am not a big fan of being in the middle of the ocean but a nice river cruise may just be what the doctor ordered. Smaller, easier to navigate has all the amenities at your disposal plus if you can tired or fatigued you can just go lay down. Plus, there is a doctor on board!

Don’t Forget to Have fun! In light of the fact that our Parkinson’s is progressive we want to enjoy life while we can so go on that trip you always wanted now rather than later. CARPE DIEM!!!

Bon Voyage!!!

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all rights reserved by Maria De leon MD