Is it possible for rheumatic patients to travel to exotic countries? What can’t you forget to pack? How and how much medicine to take? What if a child is going on a trip? How to protect yourself from sun damage?
During the summer season, trips or vacation getaways are frequent. However, something that seems trivial may not be for people who suffer a chronic disease, such a rheumatic and systemic autoimmune pathologies.That’s why from the Spanish Society of Rheumatology (SER) we have launched the following ten tips that can be very useful for patients and contribute to their vacation break:
In case you need medical assistance during a trip, whether related to rheumatological disease or not, it is important to have an updated report with the diagnosis and chronic treatments carried out. It would also be highly recommended that if it is a trip abroad, the report is translated.
In the case of children who go to camps or similar, it is important, in addition to keeping the report updated, that parents communicate directly with the monitors so that they know the degree of limitation for activities (if any), medication schedules , and the special care that the child may need and that are described in the rest of this Decalogue.
Patients must plan the days they go on vacation and the amount of medications to take. It is advisable to take a slightly higher amount than necessary in case there is a problem (especially painkillers in case you need to take more doses due to an outbreak), and it is also a good idea in case of traveling with check-in luggage To carry the medication with you to avoid losing doses in case of lost luggage.
If a patient plans to travel to areas that require special vaccinations (eg G. Yellow fever), they must notify the reference rheumatologist well in advance, since in the case of immunosuppressive treatments (methotrexate, leflunomide, biological drugs, etc. …) There are many vaccines whose administration is prohibited, and there are even countries that require a special document that explains why some vaccines cannot be administered (as they are mandatory for entry).
We usually associate flare-ups or the onset of gout with Christmas when we are exposed to foods high in uric acid and in large quantities. However, in summer these foods reappear: seafood, alcoholic beverages (also non-alcoholic beer), barbecues with red meat, etc. Therefore, gout patients must be careful in their diet.
Many patients receive methotrexate or subcutaneous biological treatments, and it is important that they know that they must be kept at a maximum temperature of 25º. Therefore, we must remind them that if they plan to travel they must control the temperature during the transfer and also when storing them upon arrival. If in doubt, they can be transported in a cooler with ice packs and then stored in a refrigerator and removed 30 minutes before administration.
Patients who have been diagnosed with antiphospholipid syndrome and who take long trips where they can barely move are at increased risk of thrombosis. Therefore, apart from the usual recommendations to stop every 2 hours and walk (if you are driving) or exercise your legs and walk down the hall (if you are flying), you should notify your rheumatologist if it is necessary to add a dose of heparin to prevent problems.
During the summer months, high temperatures, increased sunlight, and air conditioning are great enemies of Sjögren’s patients’ dry eye and mouth symptoms. It is important that you increase your administration of eye drops, avoid exposure to strong air conditioners as much as possible, and wear quality, oversized sunglasses that cover your eyes well.
Some medicines commonly used in rheumatology such a methotrexate or salazopyrin produce photosensitivity, which means that when exposed to the sun , skin rashes can appear. As a general rule, in patients with chronic rheumatological treatment it’s advisable to use total factor creams at least 30 minutes before going out, renewing them every few hours and avoiding direct sunbathing.
Algunas enfermedades como el lupus o la dermatomiositis pueden tener brotes no solo en la piel sino a otros niveles si estos pacientes se exponen al sol. Por eso es importante seguir de forma muy rigurosa las recomendaciones del punto previo y aumentar esta protección del sol con ropa que cubra más la piel, gorras, sombreros de ala ancha o incluso paraguas.
*Decalogue made with Dr. Cristina Macía collaboration, rheumatologist at Severo Ochoa Hospital in Leganés, Madrid.
Source: Spanish Rheumatology Foundation