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Travel should be fun, but if impairments keep you from achieving that, you should try to make it as carefree as possible. Nobody can plan for an accident or sudden illness while traveling, but if you have a pre-existing health condition, you can still enjoy your trip, especially if you do some planning ahead. When it's an allergy that bothers you, or something as demanding as diabetes, for instance, you should consult your doctor and consider looking into some of the resources mentioned below. With many health conditions, it matters not whether you are at home or traveling -- you need to take the same care wherever you are. In cases where you have dietary restrictions you need to plan ahead for every contingency. Be prepared, in other words.

Allergies & Diabetes

Eating on the airplane can be chancy, the current joke being that the term "airline food" is itself an oxymoron. But if eating at regular intervals is important, as in the case of diabetes, or what you eat is crucial, as for people with allergies, there can be problems. You might need to warn others of your condition, for instance, or you might not be able to communicate because you lack the local language skills. So, how to communicate?

Emergency cards are the answer, and are great to have on hand. You can make your own or get them from a company such as SelectWisely (www.selectwisely.com), which offers travel translation cards for medical emergencies, including allergy situations or for diabetes. You keep the card in your pocket or wallet. The Diabetes Emergency card can come in handy in countries where you don't speak the language, and SelectWisely has it in 24 major languages and dialects (Spanish, Chinese, German, Czech, Hebrew, Nepali and more).

Allergy emergency cards from SelectWisely come in 15 standard languages and cover over 40 different foods (nuts, peanuts, wheat, milk, shellfish, eggs, strawberries, corn, soy, etc.). Cards cover allergies as well as announce that you are lactose intolerant, must have gluten-free meals, or eat only vegetarian food. An allergy card reads, for instance, "No peanuts!" with a photo of a peanut and the international sign (a red diagonal stripe) for "no" across the nut on one side, as well as "I am allergic to peanuts" and "Does this food contain peanuts?" on the other, in the appropriate foreign language and in English. You order one card, you always get two, so you have a spare. The prices range from $4.50 to $9.50.

Flying with Allergies

Though some passengers with allergies are more sensitive to allergens than others, it's better to fly airlines that don't serve peanut snacks when you can, such as American, Delta Shuttle, Northwest, United and US Airways. Internationally, Aer Lingus and British Air also do not serve peanuts. Some airlines, if you make a request with plenty of advance notice, will not serve peanuts on your flight even if they normally do so. To be sure, I suggest you book on the phone, so you can talk to an airline rep. In any case, no airline can guarantee a peanut-free zone, as other passengers may choose to bring their own goobers, for instance.

For all allergy conditions, you should consult your allergist, bring your own food, reconfirm your allergy status at every chance, and if traveling with a contact-sensitive child, wipe down the seats, arm rests, tray table and window area with a handy wipe. And if you are subject to possible anaphylactic reaction (swelling of the throat, etc.) or other possible life-threatening reactions, be sure to carry epinephrine with you. A reliable form is the Epi-Pen, available by prescription.

Because of my allergy to peanuts, I bring my own food on board any flight I take, though I do avail myself of plain food such as fruit or cheese, and packaged food with ingredient labels such as yogurt, certain snacks and other items I feel I can trust. (Once, though, I was nearly done in by an advertised "peanut-free" meal, which, despite the label, contained a sauce loaded with peanut oil. Fortunately, I had my epinephrine syringe and other medications with me and was able to contain the swelling in my throat until we landed at my destination.)

Telemedicine Aloft

Medical emergencies aboard the plane are always frightening, whether the underlying condition is pre-existing or not, but may become less so in the future, thanks to telemedicine devices such as Tempus, introduced recently on Virgin Atlantic, bmi (British Midlands) and Emirates airlines. Using satellite technology, the onboard telephone system transmits medical information such as pulse rate, temperature and blood pressure readings (also pulse oximeter, capnometer and ECG/EKG apron results) as well as video images to medical experts at the MedAire Center in Phoenix. Ground-based doctors there can then diagnose the problem and advice the crew on the next course of action, allowing the crew to use their medical training to assist the passenger in trouble. The system also allows the crew to contact your own doctor or a specialist if necessary, the creators of Tempus say.

If you have a complaint about an airline involving your allergy or medical condition, you can file a complaint at http://airconsumer.ost.dot.gov/forms.htm. This applies only to domestic flights or international flights to or from the United States.

Oxygen

You can't bring your own oxygen on board, but if you need it, contact your airline well in advance of flying and they will have extra canisters for you. (They have emergency canisters, as well.)

Security at the Airport

Current TSA regulations permit such allergy-related equipment as Epi-pens and medical items for diabetes such as "all diabetes related medication, equipment and supplies." I recommend getting a letter from your doctor attesting to your need for such items in case the screener you meet might not be fully aware of the TSA regulations. I also have in my carry-on the TSA printout from its website, just in case. Senior travelers should remember that Medicare does not provide coverage for hospital or medical costs outside the USA, and take out trip coverage with that in mind. More info is available at http://seniorhealth.about.com.

Resources

If you're planning a trip abroad, a good source of information about staying in good health is IAMAT, the International Association for Medical Assistance to Travellers (www.iamat.org), a not-for-profit charity that I have long been associated with as a volunteer. IAMAT provides, free of charge, a directory of English-speaking doctors around the world, from Algeria to Zimbabwe, with over 35 clinics in China, for instance. If you can donate to their cause, you can also ask for a sampling of their many publications, which include charts showing where it is safe to drink the water, eat ice cream, etc. and which shots are needed and where. Through its worldwide network of doctors and other medical personnel, IAMAT often has more reliable information on health issues than the World Health Organization, since WHO relies on its member governments for information, and some governments don't always tell the whole truth about embarrassing medical problems (think SARS, for instance) right up front.

Allergy sufferers may wish to join the Food Allergy & Anaphylaxis Network (FAAN) (www.foodallergy.org), a font of good information. The Centers for Disease Control & Prevention (www.cdc.gov/travel) has a lot of health-related travel information. Lastly, the World Health Organization (www.who.int/ith/en) has a good section on pre-existing medical conditions and special needs.

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