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Traveling Abroad..need advice

Hello Everyone!

I am traveling in December to Pakistan for the first time and I'm wondering if anyone knows how prepared I should be.  I'm not a severe asthmatic, I only take my inhaler as needed such as exercise or if I'm around animals.  But when I am around animals or pollutant I get asthma really really bad.  I had to have breathing treatments as well as go on prednisone. Should I wear a dust mask? Bring my nebulizer? Prednisone? I just don't know what to expect and my worry is that I'll have an attack while I'm there. I'll be in the Islamabad area as well as Lahore. 

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Comments 11

  • Kathy P

    Hi DaisyZ and welcome to the community.

    I have not been to that area of the world, but I do travel a lot. Here is what I do:

    • Check in with my doc to . I often will enact my "sick plan" with includes bumping/adding daily controller meds preemptively. For instance, when I travel to see my family, I know I'll be around cats which are a big trigger for me. So my doc has recommended that I bump up to a higher dose on my preventative inhaler in anticipation of that.
    • Refill all my meds – this includes having an extra quick-relieve inhaler, prednisone to take along just in case, etc. Make sure all meds are in their original packaging and all prescriptions have the Rx label from the pharmacy. I make sure I pack the boxes from my inhalers as "proof." Sometimes, I request an extra label from the pharmacy and put it on the mediation itself (I do this epinephrine autoinjectors and I've wrapped the label around inhalers too).

    Personally, if you can manage it, I'd pack the nebulizer. Be sure that it will work on the electrical system in the country you are visiting. My neb will work with multiple voltages and currents, so I just have to make sure I have a plug adapter. But do check the electrical specifications of your device.

    If you are taking the neb, you'll also need to take the meds…. Be sure to pack them in their own 1 quart plastic zippered bag and include the prescription label. I usually flatten the box and stick it in. There is no limit on prescription meds, but you still need to take them out through TSA security (and check about the return trip).

    I would probably also take masks. There are different type and some are more effective at filtering allergens than others. Is there a type of mask you already use? I use industrial filter masks when I clean like an N95. Some of our members use that to protect themselves from irritants and allergens.

  • Melanie Carver

    Hi, 

    It's been a long time since I traveled internationally, and I've never travelled to Pakistan, so I can't give you location-specific advice…

    Here is a helpful guide for Traveling with Asthma and Allergies:

    You might want to start with booking an appointment with your physician so you can talk about your upcoming travels and how to prepare. Are you on a daily controller medicine? (e.g. Flovent, Advair, Pulmicort, QVAR, etc.)

    I do think you should pack all of your treatment and prevention tools. If you have the original box for the nebulizer, that will help. Pack all of your medicines in their original packaging. Also get new refills to take extra medicine with you (in your carryon luggage).

    I'll be interested in hearing how your trip goes! Maybe you can share photos of your travels with us? Other photos from community members can be found here:  

  • K8sMom2002

    Hi, DaisyZ, and happy travels! 

    to what Kathy P and Melanie have said.

    One thing that I might remind you is that other countries may have far different air quality rules than, say, the US. When I traveled to China in the early 2000s, I was amazed at the amount of haze and pollution that was present. Luckily back then, my asthma was not an issue. But I will say that many of our babies (we went with a group of about 14 couples to adopt babies from China) had bronchitis and other lung issues, and my daughter was later diagnosed with asthma. I do have to wonder if the air quality was part of the problem. 

    It appears that Pakistan has a website for their in English, and it has some information about air quality. They say this:

    According to a recent study, average air pollution in big cities is about 4 times higher than the World Health Organization (WHO) limits.

    I don't know whether they were referring to big cities the world over or big cities in Pakistan. 

    What part of Pakistan will you be traveling to? Here's a for Pakistan … I'm thinking you can zoom in on the map and get some idea. However, I would warn you that weather patterns can change, which might mean that the air quality would be better or worse than you see. 

    Another possibility … you might reach out to the and ask for their advice and input. Embassies usually publicize travel warnings and advice on their website, and I do see the .

    Embassies and consulates are great resources for information about services — medical and otherwise — in a country because they have American staff who live and work there and who have helped out other tourists and American citizens as well. 

  • DaisyZ
    Kathy P posted:

    Hi DaisyZ and welcome to the community.

    I have not been to that area of the world, but I do travel a lot. Here is what I do:

    • Check in with my doc to . I often will enact my "sick plan" with includes bumping/adding daily controller meds preemptively. For instance, when I travel to see my family, I know I'll be around cats which are a big trigger for me. So my doc has recommended that I bump up to a higher dose on my preventative inhaler in anticipation of that.
    • Refill all my meds – this includes having an extra quick-relieve inhaler, prednisone to take along just in case, etc. Make sure all meds are in their original packaging and all prescriptions have the Rx label from the pharmacy. I make sure I pack the boxes from my inhalers as "proof." Sometimes, I request an extra label from the pharmacy and put it on the mediation itself (I do this epinephrine autoinjectors and I've wrapped the label around inhalers too).

    Personally, if you can manage it, I'd pack the nebulizer. Be sure that it will work on the electrical system in the country you are visiting. My neb will work with multiple voltages and currents, so I just have to make sure I have a plug adapter. But do check the electrical specifications of your device.

    If you are taking the neb, you'll also need to take the meds…. Be sure to pack them in their own 1 quart plastic zippered bag and include the prescription label. I usually flatten the box and stick it in. There is no limit on prescription meds, but you still need to take them out through TSA security (and check about the return trip).

    I would probably also take masks. There are different type and some are more effective at filtering allergens than others. Is there a type of mask you already use? I use industrial filter masks when I clean like an N95. Some of our members use that to protect themselves from irritants and allergens.

    Thank you Kathy. I have never traveled outside of the US so I never thought about the electrical, that's great advice. I also never thought about taking the boxes with me.  Also, I don't use any masks currently but I will be buying them before I travel. I truly thank you for taking the time to reply to my post. Blessings to you. 

  • DaisyZ
    Melanie Carver posted:

    Hi, 

    It's been a long time since I traveled internationally, and I've never travelled to Pakistan, so I can't give you location-specific advice…

    Here is a helpful guide for Traveling with Asthma and Allergies:

    You might want to start with booking an appointment with your physician so you can talk about your upcoming travels and how to prepare. Are you on a daily controller medicine? (e.g. Flovent, Advair, Pulmicort, QVAR, etc.)

    I do think you should pack all of your treatment and prevention tools. If you have the original box for the nebulizer, that will help. Pack all of your medicines in their original packaging. Also get new refills to take extra medicine with you (in your carryon luggage).

    I'll be interested in hearing how your trip goes! Maybe you can share photos of your travels with us? Other photos from community members can be found here:  

    Melanie,

    I appreciate you taking the time to reply to my post. I will check out the links you provided and I will let you all know how I fare (with pics )

    Take Care!

  • DaisyZ
    K8sMom2002 posted:

    Hi, DaisyZ, and happy travels! 

    to what Kathy P and Melanie have said.

    One thing that I might remind you is that other countries may have far different air quality rules than, say, the US. When I traveled to China in the early 2000s, I was amazed at the amount of haze and pollution that was present. Luckily back then, my asthma was not an issue. But I will say that many of our babies (we went with a group of about 14 couples to adopt babies from China) had bronchitis and other lung issues, and my daughter was later diagnosed with asthma. I do have to wonder if the air quality was part of the problem. 

    It appears that Pakistan has a website for their in English, and it has some information about air quality. They say this:

    According to a recent study, average air pollution in big cities is about 4 times higher than the World Health Organization (WHO) limits.

    I don't know whether they were referring to big cities the world over or big cities in Pakistan. 

    What part of Pakistan will you be traveling to? Here's a for Pakistan … I'm thinking you can zoom in on the map and get some idea. However, I would warn you that weather patterns can change, which might mean that the air quality would be better or worse than you see. 

    Another possibility … you might reach out to the and ask for their advice and input. Embassies usually publicize travel warnings and advice on their website, and I do see the .

    Embassies and consulates are great resources for information about services — medical and otherwise — in a country because they have American staff who live and work there and who have helped out other tourists and American citizens as well. 

    K8sMom2002,

    I appreciate you taking the time to reply to my post.  Thanks for providing links, I will definitely do my research and you have given me a starting point. I am traveling to the capital Islamabad, that's where my in-laws live and is less polluted than any other cities in Pakistan due to their strict laws, Rickshaws are not allowed here, but they would like to take me to Lahore for shopping, but I hear it is more polluted than Islamabad.  I'll also be going in December which will be nice because it won't be too hot. 

    Thanks again for the advice! Blessings to you and your family. 

  • K8sMom2002

    It sounds like a great trip, and that's great that you will be going to a less polluted city. December ought to be a nice time to travel. 

    Maybe you can pick a day that is a good clear day for your trip to Lahore. I'm looking forward to hearing more about your plans and your pictures!

  • Jen

    Hi Daisy,

    Welcome to AAFA's asthma support forum.    I think it's great that you're doing your research months in advance.  I think it would be worthwhile talking to your doctor about your upcoming trip.  They should be able to give you some good advice about what medicine you need to take with you, etc.

  • Kathy P

    A couple more things I thought of:

    • Check your insurance plan and figure out the process for a medical emergency. If you have a bad flare or get a respiratory infection, you'll need to see a doc there. How does your insurance billing work? Most times when I've had to go to the ER or whatever abroad, I've had to pay the bill in full and submit things to insurance when I got home. Check that they even will cover it. You may need to purchase extra insurance for the trip.
    • This may not be as important since you will be with "locals," but how do you get emergency medical help? Here, I'm used to being able to go to an Urgent Care type place to avoid the ER, but I've found that those don't exist in other countries (and if you ask they have no idea what you are talking about and send you on a wild goose chase while you are in pain from a broken wrist )
  • Jen

    @DaisyZ Have you had a chance to talk to your doctor about the trip?