For those people who suffer with any type of lung condition they may have difficulties when travelling by air. This is due to the reduced air pressure in the aircraft cabins as well as the lack of mobility for long periods of time. Air pressure in an aircraft cabin is lower than air pressure at ground level and feels like being at 6000 to 8000 feet on a mountain. At high altitudes blood oxygen levels fall in everyone, and some people may feel a little breathless. In most people this has no health effect, but if you already have low blood oxygen levels because of your lung condition, then the extra dip that happens while you are in the plane can cause breathlessness and discomfort for you.
As long as you meet a minimal fitness criteria agreed with your doctor then it is still possible to fly, even if you require constant oxygen therapy.
Before departure :
If you are able to walk 100 metres on ground level without needing oxygen, at a steady pace without feeling breathless or needing to stop, then you are not likely to be troubled by the reduced pressure in aircraft cabins.
If you cannot do this then you will need to talk to your doctor about whether you should travel by air. You may need to have some breathing tests to show if a fall in your blood oxygen level is likely to be a problem to you while travelling.
You should also check your travel insurance policy to make sure you are fully covered for any medical costs that may arise in connection with your lung condition. It is important that your travel medical insurance includes the cost of return by air ambulance if you were to become too ill to return on a commercial flight.
Many policies will not cover you for costs from your lung condition unless you have a written note from your doctor that he or she feels you are fit to fly.
Oxygen and air travel :
If tests show that your usual blood oxygen levels are so low that air travel may be a problem for you, you may still be able to travel by air, if oxygen is provided for you. Airlines can arrange extra oxygen, but remember that most will charge for providing oxygen. Different airlines have different charges; check with each one before you arrange your flight. Don’t trust to luck that planes will have oxygen on board. They carry emergency supplies but not enough for several hours.
You will also need permission from the airline to take on board and use any electrical equipment you need for your treatment. Equipment must be battery driven, and you will not be allowed to use it during take off or landing. Using an inhaler with a spacer is just as effective as using a nebuliser.
You may find it easier to organise your oxygen needs via a company that can arrange oxygen for both the plane and the entirety of the holiday, just in case you need oxygen throughout your trip or if you just want to arrange to have a ‘back-up’ supply just in case. It’s easier to have dealings with just one company rather than multiple, especially if you’re travelling to more than one place during your trip.
Essential Tips from the NHS website to remember before flying:
1. Ask your doctor well in advance for a letter to take in your hand luggage with details of your condition and medication.
2. Be sure to take your inhalers in your carry-on bags. One of the most common problems is that people pack their inhalers in the luggage that goes into the hold.
3. If you get breathless when walking, make sure you have help at airports. Distances to departure gates can be long. Disabled assistance at airports can be arranged before you travel.
4. When you are in the aeroplane try to move about every hour or so and exercise your legs. Sitting for too long can lead to blood clots in the legs.
5. Drink plenty of water and non-alcoholic drinks during the flight.
6. Remember the golden rule: If in doubt about travelling, check with your doctor.
There is a myth that if you are on oxygen therapy then your life is effectively over and that it is too restrictive and complicated to go away on holiday. This is not necessarily the case and for most sufferers the world is your oyster. Always check with your doctor first to ensure you are fit enough to travel and ask your doctor to write a letter stating this just in case you need it.
All you need to do is prepare and plan the holiday well and ensure that you consider some factors when planning your trip:
• Climate: many people with lung conditions prefer warm climates that have salty air. Lower oxygen levels at higher altitudes can make breathing difficulties worse.
• Terrain: whether your destination is flat or on a hill could affect your ability to get around comfortably.
• Wheelchair access.
• Transport availability.
• Special needs such as oxygen treatment.
• Plan in advance: if you leave things to the last minute, you could forget something crucial. Think about how far you can walk, how many stairs you can manage, access to toilets and what transport you can use.
• Be realistic: places you liked in the past may not be suitable now. Pick something you and your carer can cope with physically.
• Shop around: different companies have different policies for people with lung conditions, so find the best deal for you. Many travel agents offer holidays for people with special requirements.
• Ask questions: travel firms are used to dealing with special requirements. They should be able to answer all of your queries and concerns.
You should ensure that you and your carer have full travel insurance before going away to avoid huge medical bills if you are taken ill during your trip. Look into this first as it may be expensive and you may need a specialist provider depending on your health. Check that it covers all aspects of your medical condition and that you declare everything accurately to them otherwise it may not be valid, leaving you with a huge bill.
Keep your documents safe with you while you travel in case you need them suddenly in an emergency.
The European Health Insurance Card (EHIC) entitles you to reduced cost – sometimes free – medical treatment if you fall ill when travelling in Europe.
Accommodation in the UK is divided into four mobility categories:
• Category One – suitable for people able to climb a flight of stairs that have extra fittings to aid balance.
• Category Two – suitable for someone who needs a wheelchair some of the time but can manage a maximum of three steps.
• Category Three – suitable for people who depend on a wheelchair but who can transfer unaided to and from the wheelchair in a seated position.
• Category Four – suitable for a person who depends on the use of a wheelchair and needs help from a carer or a mechanical hoist to transfer to and from the wheelchair.
Each category has its own logo, which is displayed by accommodation providers that have been assessed. Make sure you choose accommodation that best fits of requirements.
Other countries have different systems so just make sure you ask your travel agent about how to choose your accommodation abroad.
Several coach companies are working towards making their vehicles accessible for people with disabilities. Many coaches now feature kneeling suspension, which makes boarding and alighting easier. Most on-board toilet facilities are now level with the coach seating.
Some companies allow you to bring on board your own oxygen supply and will carry some types of collapsible battery-powered wheelchairs.
Different train companies have different policies regarding people with disabilities, so plan your route in advance and find out which companies’ trains you need.
Many ferry companies have lifts, toilets and wheelchair facilities; some can supply wheelchairs at terminals. A few have special cabins for disabled people and/or offer discounts. Check before you book, especially if you need oxygen.
Camping and caravanning
The Camping and Caravanning Club has three stages of accessibility for camping and caravan sites. So you just need to check that the site is appropriate for your needs.
• No accessible facilities;
• Accessible to people who can move around a little, but not wheelchair accessible; and
• Fully accessible including shower blocks and facilities.
Holidaying With Oxygen
Oxygen for travel in the UK is provided by the NHS. You just need to let your usual oxygen provider know the details of your holiday, including the dates you are going and returning and where you will be staying, and they will arrange everything for you.
You should first get permission to store oxygen cylinders and equipment from the owner of the place where you are staying.
Oxygen suppliers in the UK will only provide oxygen for travel and stays within the UK. If you are travelling abroad then there are many overseas oxygen providers that can fulfil your oxygen requirements and if you are travelling by plane then you need to ensure your airline’s oxygen policy and whether you need to complete any additional documentation for them.
Flying with a lung condition
Many people believe their lung condition will prevent them from flying, especially if they need oxygen but this is not necessarily true. First, ask your doctor whether you can travel by plane and whether you will need any additional oxygen on the plane.
Then contact individual airlines to discuss your requirements and to find out what their policy is for carrying and using oxygen on planes.
If you are planning a long-haul flight and use a continuous positive airway pressure (CPAP) machine to treat the sleep disorder obstructive sleep apnoea (OSA), you should consider whether you might need to use your machine during the flight.
Some airlines have restrictions on what machines are permitted for use on board and others may require you to fill in a form before you travel.
When you contact the airline, find out what assistance is available at the airport as well as on the plane and check:
• the airline’s policy on carrying and using oxygen and medical devices such as CPAP machines;
• the exact length of the flight, and whether delays are likely;
• the facilities available at the outgoing and incoming airports. These might include assistance to get you from the airport lounge to the departure gate and on to the plane, the use of wheelchairs, and whether oxygen is available at the airport; and
• how you should confirm your fitness to fly.
If you are on medication then you will need a letter from your doctor confirming that you need the medication, and you should also keep a list of all the medication and doses you take in case you need to get more during your stay. List the proper names, keep all medication in its original packaging and keep it with you in your hand luggage. A doctor’s letter is required for liquid medicines exceeding 100 millilitres that are taken into the aircraft cabin. When given medication abroad, check whether it can be brought back into the UK. If you are in any doubt, declare the medication at customs.
Preparation is the key. Plan your trip in advance, think through everything you need, ask as many questions as you can of as many people as possible, then decide what’s best for you.
References: http://www.blf.org.uk and http://www.cancerresearchuk.org