Whether for business or pleasure, travelling can be exciting but it is important to be prepared. The following tips will help ensure your trip goes as smoothly as possible.

Planning your trip

Let the CF team know about your travel plans. We will help prepare a travel letter. It will say that you have cystic fibrosis and list the medications and supplies you need to carry with you. Travel letters should be requested from the CF administrative staff by calling 416 864 5409 or e-mailing cfclinicbookings@smh.ca

If you are worried about becoming sick while you are away, we can provide prescriptions for antibiotics and the names of CF centres in the area(s) where you are travelling. Speak to the CF clinic nurse about this at 416 864 5409.

Medications

Ensure you have enough supply of all of your medications for the full length of your trip plus a few extra days.

Transport your medications safely. If travelling by air, bring all of your medications and equipment in carry-on baggage. Never put medications or equipment in checked luggage.

Contact your airline to notify them about medical devices, syringes, and liquid medications you may be bringing. You may need a doctor’s note in order to bring them on the plane.

Some medications are temperature-sensitive and require refrigeration. Bring these meds in an insulated bag or cooler. Ensure you have access to a fridge at your destination.

If you are travelling outside of Canada, make sure your medications are clearly labelled in original packaging. Every country has regulations about importing medication and some may require a doctor’s note. Be sure to check this in advance!

Certain medications and devices may be better suited to travel. For example, dry-powder inhalers are easier to transport and store than solutions and nebulizers. Check with your CF team if more portable options are suitable for you.

Equipment

Do not check your equipment. Always carry it on to make sure it will not be lost or damaged. Your medical equipment does not count against your carry-on allowance of one small carry-on bag and one personal item.

For medical devices such as compressors, BiPAP, or CPAP, voltages outside of North American may be different. Find out about the electricity voltage, frequency, and type of plugs at your destination.

  • In North America, the standard voltage is 110-120 V with a frequency of 60 Hz. In Europe, Australia and most of Asia and Africa, the standard voltage is 230 V and the frequency is 50 Hz. Generally, you cannot use North American compressors in other countries, regardless of adaptors or convertors. Speak to your Respiratory Therapist (RT) in clinic to discuss the best option for you.

Instead of bringing your own compressor, where possible you should buy or rent one once you have arrived at your destination. Prepare ahead of time by researching online or calling the local CF centre (if there is one) for advice

  • Travel compressors exist (e.g. PARI Trek) but some people report they can stop working after only a few uses, or they are unable to nebulize medications in the 30 min before the device automatically stops running to allow for cool down of the device. It then takes another 30 min for the device to start back up again.
  • Depending on what medications you take, the PARI eFlow nebulizer system, with the correct handset, may be a solution as it runs on 4 AA batteries. Speak to your Respiratory Therapist (RT) in clinic about this.

Remember to clean and disinfect your equipment after each treatment while travelling. Bacteria can be present, even in safe tap water, so make sure the water you are using is sterile.  Water can be sterilized by boiling it for 5 to 10 minutes.  Alternatively, you can use a microwave or electric steam sterilizer if you have access to these.

Oxygen

Oxygen levels in airplanes are lower than oxygen levels on land. This may pose a problem if you have low lung function. Speak with your doctor to determine whether it is safe for you to fly without extra oxygen.

If you need oxygen on your flight, or at your destination, make arrangements for oxygen rental before you book your vacation. Some airlines allow you to bring your own oxygen with appropriate documentation, while others require that you use their oxygen (fees may apply).

  • You can rent a portable oxygen concentrator (POC) from your home country. If oxygen is only needed for exertion and/or flying, a small pulse dose unit that goes up to 5 pulse dose may suffice. If oxygen is needed 24 hours per day, a larger POC may be required. Units that go up to 9 pulse dose and 3 litres per minute continuous flow are available. Battery time varies between units and with flowrate.
  • It is recommended that the airline be notified that you are intending to travel with oxygen at the time you make your reservation and once again 48 hours before your flight time. Check with each airline about their requirements.

Usually you will be required to do the following: 1) Provide a prescription for oxygen, 2) Alert the airline that you are flying with a POC that is Federal Aviation Administration (FAA)- approved, 3) Organize your oxygen at least 1 month in advance, or 4) Organize your oxygen up to 3 months in advance if testing is required.

Nutrition

Portable nutritious snacks can help you meet your energy needs when travelling. Nuts, dried fruit, trail mix, beef jerky, and granola bars are easy options. Look for a granola bar with at least 200 calories per serving (e.g. Clif Bar, Nature Valley Crunchy, Lara Bar)

When travelling to hot destinations, make sure you drink lots of fluid and eat salty foods to prevent dehydration. Carry a water bottle with you at all times and do not wait until you feel thirsty to drink.

Replace the salt that you are losing in your sweat through portable salty snacks such as chips, salted nuts and pretzels, beef jerky, and crackers. When eating out, salt your food liberally and consider adding cheese, pickles, or olives if it fits!

If you are eating out more often than usual, remember that many restaurant meals can be quite high in fat. Take additional enzymes to account for high fat meals. Speak to your dietitian if you have questions about enzyme dosing, or refer to the CF website: https://torontoadultcf.com/living-with-cf/nutrition/

Other Tips

  • It’s important that you are properly immunized before travelling to another country. Consult with a travel clinic or check this Government of Canada website for recommended vaccines: Travel vaccinations – Travel.gc.ca
  • Scuba diving can be extremely dangerous for people with CF, even those with mild lung disease, because the changes in pressure that come with diving can cause a lung collapse or pneumothorax. If you are considering scuba diving, discuss with your CF doctor before your trip. Snorkeling does NOT have the same risks and is safe to do.
  • For physiotherapy, ask the clinic physiotherapist for “hands free” options for Airway Clearance Therapy (ACT). This can be really handy if you’re travelling for a long time or have long layovers and do not have the luxury of a private space to perform ACT
  • If you have diabetes, you may need to adjust your long-acting insulin times if you are travelling overseas across 5 or more time zones. Travelling east will shorten your day so you may need to decrease your insulin, while traveling west lengthens your day and may require more insulin. To get an idea of how to adjust your insulin, check out this diabetes travel calculator: https://diabetestravel.sansum.org

 Plan ahead, be prepared, and have a great trip!