Be Very Prepared: Tips for International Jet Setters

Having just completed an eventful trip to the USA, Posy thought it might be helpful to pass on a few helpful tips for traveling internationally with Parkinson's disease (PD).

7 months in advance

• Check passport expiration date
• Get visas (if required) and travel insurance
• Stay on top of foreign health rules
• Book vaccines if appropriate - be prepared for rules to change during your trip and take a mask

3 weeks in advance

• Check all paperwork (online or hard copies)
• Get cash - whatever the exchange rate, get some foreign currency now as you may need to tip
• Order an extra month’s worth of medications just in case you get stuck
• Check and re-check you have the medication all sorted
• Have a list of your medical information, prescriptions, and allergies in case you are unwell or need to justify a request
• Book assistance for each leg of the trip

Posy had been dreading making this trip. Her left foot had been so painful that she was worried about sprinting the long distances to get across the airports (Heathrow is bad enough, but Atlanta takes the biscuit!) However, inspired by the advice of other PD sufferers on this site, Posy had asked the airline in advance for assistance. Remember: You have an actual, diagnosed condition.

Instead of feeling wobbly while waiting in long queues at check-in, security or immigration/passport control, or trying to puff her way through a painful half-marathon, Posy was transported to the gate on a cart, or in a wheelchair (embarrassing, but helpful) and she was allowed to jump the queue wherever she went. Posy felt less of a feeble burden and more of a provider of perks!

During the trip, Posy kept a couple of days’ worth of medication immediately on hand, and the spares ready to place in her carry-on bag. Before your trip, practice saying: "I must not be separated from my hand luggage containing my pills, therefore I need early boarding."

A few days ahead

• Work out a schedule for taking your PD meds
• Set a timer (rather than the usual alarms) for each dose

Bear in mind that you will have to function for 24 hours and cope with changing time zones. In Posy’s case, she set a timer for every 3.5 hours for each dose of her levodopa. She had started her day at 3 AM, so, she replaced the previous night’s fourth dose with an early bedtime (extended-release) dose.

This dose of levodopa, taken at 8 PM the previous night, kept her going until 7:30 AM. This enabled Posy to complete the 30-hour journey with only 2 extra doses of regular levodopa throughout the long journey.

The day before

• Fill the car’s tank with gas to avoid delays
• Load the luggage in the trunk the day before

The night before

• Lay out your clothes and accessories
• Set multiple alarms
• Write a list of anything to remember for the morning

Knowing how difficult the morning could be, Posy prepared absolutely everything the night before, so that she would just have to shower and get ready. She laid out her clothes, including socks (Do you really fancy having bare feet on the well-traversed floor while passing through security!) her exact jewelry, including the gold chain with disc declaring a tiny, list of her allergies. Chances are, you will not sleep, anyway, but Posy sets multiple alarms.

Travel day

• Start Early
• Allow extra time for problems
• Re-check your travel route for road closures
• Keep calm
• Enjoy the adventure

There are a million reasons not to be late and the stress is simply not worth the extra half hour in bed. Be aware that you may feel a little anxious, fragile, and over-sensitive on the big day! Having taken no morning pills, Posy was not 100 percent. All was going fine, until the front door closed, plunging Posy into complete and utter blackness. The joys of living in a rural area of outstanding natural beauty are countered by a few practical drawbacks.

Streetlamps are verboten as they would spoil the beautiful clarity of the starry sky. This morning, however, the rain and mist had shrouded the stars and moon, and, for a moment, Posy felt unexpectedly and completely blind! It was actually rather horrifying not to be able to see anything around her. Fumbling for her mobile phone Posy, who can juggle only 2 to 3 items at a time, nearly dropped everything else! Finally, she located it and jabbed frantically at the torch app button, just as her patient husband came to her rescue.

The 90-minute drive to Heathrow airport was not too bad. However, the signs to the relevant parking lot were rather confusing, challenging Posy and her husband to remain courteous! Posy and her husband, by now enjoying doing something different, waited patiently as 2 or 3 frustratingly empty shuttle busses drove tantalizingly by. No matter, there was a nice shelter with seats. Everything was super clean and they had arrived with plenty of time to spare, so why fuss?

Stepping out of your comfort zone

It’s so rewarding to step out of your comfort zone, occasionally. Posy realized what a homebody she was becoming! The night before the trip, her husband had joked, "We’re getting too old for this!" Now Posy is determined to be more optimistic. Organization and attitude are key factors. Maybe she will try sky-diving, hang-gliding, take up a new hobby, or learn a new language.