Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system. It causes lesions that cause motor, sensory and cognitive disturbances. In the long term, these disorders can progress to an irreversible disability. Current treatments can reduce exacerbations and improve quality of life for patients but are still insufficient in efficacy to fight against the disease’s progression.
However, having Multiple Sclerosis does not mean that you cannot take holidays or travel. Today, you can travel just about anywhere, anytime, with a bit of preparation. At the same time, know your limits and try to avoid lengthy and physically exhausting journeys. Ideally, make stops during your journey to recover from stress and tiredness.
The Uhthoff Phenomenon
For many people with multiple sclerosis, heat causes a temporary worsening of symptoms (the Uhthoff phenomenon). If you have Multiple Sclerosis, you should therefore avoid saunas, hot baths, or other heat sources, and make use of plenty of cooling solutions. There are now for example cooling scarves that you can soak in water that will cool you down by evaporation. Choose your destination based on your reaction to the heat.
However, it is important to note that even if the heat exacerbates the symptoms of Multiple Sclerosis, it has no effect on the disease itself. A holiday in a hot country or a hot summer can affect your quality of life but will have no effect on the actual evolution of your disease. Heat and humidity do not further damage your nerve pathways and do not influence the prognosis of your illness. Moreover, this kind of symptom is usually temporary.
But in practice it is advisable for patients with Multiple Sclerosis to avoid prolonged physical effort, exposure to the sun, or taking a hot bath. If you feel tired, you need to rest and not to fight against the fatigue which usually disappears after a few moments of rest.
When traveling, if the weather is too hot, take a small lukewarm shower from time to time, try to keep the drapes closed so as not to raise the interior temperature, relax, sit and wait for it to rain, or for the temperature to fall…
Your travel agent
Tell your travel agent that you have multiple sclerosis and explain the special requirements that your trip might entails. In this way, a suitable route can be designed to better meet your needs. When booking, inform the company of any medical article (canes, walkers or wheelchairs) that you might take, and inform them if you need help for boarding, landing or during the flight.
Discuss your trip with Multiple Sclerosis with your doctor
Consult your doctor before planning your holiday. Discuss your itinerary with him and develop a plan for your medication, especially when traveling through different time zones. Ask your doctor what to do if you become ill while on holiday. You will perhaps need medical advice about the possible effects of this trip on your Multiple Sclerosis, or whether to take special precautions.
Talk to your pharmacy
Ask for a list of your medications (including generic names and dosages) from your pharmacist. Always bring a copy of this list with you.
Travel insurance and Multiple Sclerosis
Make sure you have comprehensive travel insurance to cover your trip and keep copies of your insurance documents with you in case of emergency. When traveling, the occurrence of an exacerbation of your multiple sclerosis symptoms does not always justify hospitalization or a medical repatriation. However, to be safe, take out a repatriation-insurance in the rare event of a severe relapse needing immediate support.
Multiple Sclerosis in a foreign language
Learn to say “I have multiple sclerosis” in the language or languages of the countries you visit in case you have a medical emergency or if you need to let people know that you suffer from this condition.
Your Multiple Sclerosis medication
Make sure you have enough medication to cover the entire duration of your trip. It also may be a good idea to double the amount of medication you need for your trip and put a set in your hand luggage and a spare set in the luggage of your travel companion (if possible). This way you will have a back-up if you happen to lose some of your medications on the trip or if your suitcase gets lost. Keep your medicines in a correctly labelled container (as issued by your pharmacist) and keep your medication at the right temperature (between 2-8° C). Lifeina has developed a range of solutions for the safe transport of your multiple sclerosis medications.
Needle boxes
In addition to your medication, you will need a secure box to throw away your used needles. These boxes are usually available for free at your pharmacy. Talk to your pharmacy or your doctor about this.
Vaccinations and Multiple Sclerosis
Be sure to get the necessary vaccinations at least four weeks before your departure to allow time to deal with possible side effects. International law makes certain vaccinations mandatory for different destinations. Even in less exotic areas, it is important that all your vaccinations be up to date, especially with regards to tetanus vaccination (always recommended, even when you do not travel or as a precaution when conducting recreational activities such as gardening).
Depending on the destination, some vaccines are mandatory. Many studies have analysed the link between multiple sclerosis and vaccinations. To date, these studies demonstrate that there is no increased risk after vaccination for the patient with Multiple Sclerosis, regardless of the vaccine.
Prescriptions
Ask your doctor to give you a prescription in English because English is the most widely accepted international language.
Travel certificate
Download a travel certificate and have it filled by your doctor. This certificate says that you have Multiple Sclerosis and you should not be separated from your medicine, and that this medicine should be stored at a temperature between 2-8° C. You can download this certificate for free on the Lifeina website.
(EHIC) European Health Insurance Card
If you’re traveling in Europe, this card will entitle you to free or inexpensive health care in most countries. The EHIC card is free and is available on the National Health Insurance website (https://assure.ameli.fr/ ).
Assistance
Always inform your airline or your travel agent when you book if you require assistance during the trip.
Copies of your prescriptions
Make copies of your prescriptions and keep them in your hand luggage in case customs or airport security ask you about any medicines you are carrying.
Your Multiple Sclerosis medication
If possible, divide your medications and supplies in half and put one half in your hand luggage and the other half in the luggage of your travel companion. This way, even if you lose one of your bags, you will have emergency supplies. Most importantly, make sure you have some of your medications in your carry-on. Take supplies and additional medication in case of loss or theft. Keep your medication at the right temperature (between 2-8°C).
Generally, medication for Multiple Sclerosis can also be stored at room temperature (between 15 and 25° C) for a period not exceeding one week (check the instructions). However, it is important not to exceed the temperature of 25°C, because beyond this temperature they will lose potency relatively quickly. For this reason, MedActiv has also developed the EasyBag Classic, which maintains medications between 16 and 25° C for up to 4 days without electricity.
Customs
• Inform the security personnel that you have Multiple Sclerosis and that you are carrying medical supplies
• Your medication must have a prescription label in your name
• All medications must bear the manufacturer’s label
Security scanners used during recording will not damage your medicine. However, if your luggage is in the X-rays machine for longer than normal, or if the luggage is X-rayed several times, your medication may lose some of its potency.
Where to put your Multiple Sclerosis medication on the plane
Generally, the luggage storage areas in planes are pressurized and maintained at a constant temperature of about 5°C. This is a standard for most airlines. It is not a problem for you to put your medicine in the luggage hold. However, if you make an unusual journey (for example through the Russian tundra with a former military aircraft Russian), you should know that the luggage area will probably be non-pressurized and will sometimes be at a sub-zero temperature that could freeze your medication.
Traveling by plane
Be sure to give yourself some extra time before your flight because you will be traveling with syringes and that your screening for security might take a bit longer than usual. Generally, it is recommended to never separate yourself from your medication and, if possible, to carry it in your hand luggage, because if your medication is in your main luggage and your suitcase is lost, it may ruin your vacation. The weight of the transport bag in which you carry your medicines is not usually included in the authorized limit for the hand luggage.
Traveling by car
As for air travel, it is important to keep your medication in your hand luggage so that they’ll be easily accessible.
You might need a rental car, even if you have reduced mobility. Call the rental company ahead of time to see if they have cars capable of transporting your mobility aids (wheelchairs, walkers, etc). There are rental cars equipped with special equipment for people with disabilities, such as manual controls (for people who cannot use their legs to push the pedals). Most of these services are free, but you usually need to book them in advance. If the heat is exacerbating your symptoms, choose a vehicle with air conditioning. You may also consider getting extra road insurance during the rental period (if you do not already have one).
Traveling by boat
Once you have chosen a cruise company, call to see if your needs can be taken care of, so that you can access public places and shore excursions. Whether it is using a wheelchair, needing air conditioning, or a cool place to keep your medicines, the staff on a cruise company will be happy to help you. However, it always helps to make arrangements in advance. Find out if it you need a note from your doctor or a medical clearance. Choose a new cruise ship, which will probably be more spacious and more accessible to people with disabilities.
Seasickness can ruin the most beautiful cruises. Before leaving, ask your doctor or pharmacist about getting medication for seasickness, and ask if you can safely use them with your other medicines.
Hiking
A vacation in the great outdoors is often the most fun but remember the cardinal rule: do not go camping or go hiking alone. Tell someone where you are going and when you expect to return so that you can be found in the case of an emergency.
During the trip
Always keep a copy of your prescription and your medical certificate giving details of your treatment with you, so that no doubt can be issued on the need to travel with these drugs.
Transporting your multiple sclerosis medications
MedActiv and Lifeina have developed a range of solutions to always keep your Multiple Sclerosis medicines at the right temperature. These solutions are divided in two major technologies, which are cooler bags and mini fridges.
EasyBag
The EasyBag keeps medicines cool for 5 days without electricity. The EasyBag kits use gel crystals that cool down medication when in contact with water. To activate the EasyBag simply immerse it in water for 40 seconds. The crystals in the panels of the EasyBag turn into a gel that stays cool for three to five days (depending on the ambient temperature) based on an evaporation process that will keep your medication at a temperature between 16 and 25°C (up to an ambient temperature of 38 ° C). Generally, medications for multiple sclerosis can be kept for a week at a temperature between 16 and 25°C.
iCool
The iCool bags use a new generation of chemical ice packs that do not sweat and have a longer thawing point than traditional ice packs. The iCool bags can keep medication between 2 and 8°C for up to 36 hours, depending on the model chosen. They also include separate compartments for transporting your accessories. Available under both the MedActiv (iCool) and the Lifeina (LifeinaBag) brands, these bags are the perfect companion for longer trips.
LifeinaBox
LifeinaBox is the world’s smallest intelligent fridge for the safe transport of fragile medications. Connected to an application that monitors the temperature of your medication, and with a built-in 6-hour battery, LifeinaBox is a perfect solution to keep your multiple sclerosis medication between 2 to 8°C at the hotel or in the car.
Nifty little tricks
• Avoid sudden temperature changes
• Stay on the move, but be cool…
• Be active in the cooler times of the day and take breaks when it gets warmer
• Try to move as much as possible when it is cool
• Take regular cool showers
• If you have a fever, treat it as quickly as possible
• Avoid hot baths and saunas
• Check before you travel that your hotel room has air conditioning
• For environmental reasons, more and more hotels are using coded cards to open the doors of their rooms and these cards are also often used as a switch to turn on and off the electricity in the room. This means that when you leave your hotel room, you take your card with you and turn off all the electricity in your room (including the little bar fridge where you keep your medications cool). To work around this problem, just use any old plastic card (a gym membership card, business card, etc.) to switch on the power in your room. Leave it permanently in the room so that the electricity stays on.
• If you need to freeze the ice packs of your travel bag before leaving the hotel, the refrigerators in the hotel rooms are generally not of a very good quality and will not completely freeze your ice packs. So instead of using the bar fridge in your room, go down to the hotel bar and ask the helpful staff to freeze them for you. After all, they always need ice in bars for making gin tonics and therefore have high quality freezers.
