Travel Tips for Heart Patients

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Travel Tips for Heart Patients Compiled by Dr. Deepali Tukaye, MBBS. PhD, Division of Cardiology, The Ohio State University Ross Heart Hospital for Mended Hearts Before making any solid plans please discuss safety and feasibility with your cardiologist. This is especially true if you are taking a long trip, will be experiencing significant changes in altitudes and have required oxygen in the past. When is it safe to travel after a heart event? How long to wait: Heart attack with no complications recommend 2 weeks Heart attack with complications at least 2 weeks if stable Angioplasty/Stent 1 week Permanent pacemaker/intra cardiac defibrillator few days; 2 weeks if complications Open heart surgery minimum 6 weeks; wait longer if pulmonary (lung) complications occurred during the event Don t fly if you are symptomatic from your underlying disease Please talk to your cardiologist for your specific case.

Prepare for your trip: Make sure you are well rested before your trip and get plenty of sleep while you travel. If you ll be walking a lot on your getaway, start a walking program before you leave and wear the most comfortable travel shoes you can find. If you are on a special diet at home, follow your diet (as much as possible) on your trip. If you have heart failure, eating too much salt can bring on symptoms. Avoid salty snacks on the plane and during the trip; bring low-salt snacks with you. Plan for medication supplies: Check to see if you have enough doses of your medications well before you leave home. Bring enough with you for your trip plus a few extra days. Keep your medications with you in the carry-on luggage. Don't leave them in your checked-in luggage. Organize your medications before you leave home. Place a week's supply in a pill organizer to help you stick to your routine. Carry a small water bottle with you in case you need to take your medications while traveling (its allowed at the airport if it s within the limit). Bring along snacks if your medications must be taken with food. For international travel, contact the travel agent or embassy of the country you plan to visit for medication policies during travel (what is permitted, how to carry medication). Best to carry prescriptions of your medication with you OR a doctor s note stating your necessity, especially if you are using controlled/uncommon medication during international travel. Carry a list of all you medication and place a list in each big luggage piece you carry and on you cellphone. It would be best to sort out the list based on disease, e.g.: Medication I use for my heart disease; Medication I use for diabetes etc.

Compile a travel kit: The kit should contain some first aid supplies and basic medication for unanticipated emergencies. Consider stocking you kit with following medication, a lot of which are available OTC. Anti-pyretic for fever Anti-diarrheal for diarrhea Pain medication - acetaminophen or NSAID (avoid NSAID if you have heart failure or coronary artery disease) Anti-allergy First aid supplies Sub lingual (below the tongue) nitroglycerine if you have history of heart vessel blockages or chest pain due to low blood flow to the heart Specific preparations for international travel or small towns/cities: Availability of nearest specialized care; have the contact information of that place on your cell phone or medication list. Contact embassy for pre-travel medication/vaccines. High altitude/scuba diving check with your cardiologist for recommendations. Identify contact numbers and web site addresses for pacemaker/icd manufacturers and local representatives in the destination country if traveling abroad.

Medical history that you should carry: EKG - last Copy of latest ECHO/imaging report (may be a 1-2 line summary of Ejection fraction, status of the valves and any significant findings) Details of Device/ Stents Blood group Allergies Current medication know major interactions (talk to your physician) Medical history chronology Potential complications to anticipate talk to your doctor You can carry this information on your cell phone using a health app (lot of free health apps are available). Emergency services can access this information without unlocking your phone. OR prepare a health history card. The card below is a sample from the internet (no copyright infringement intended, material was on web for public access)

Blood clot prevention during long distance travel: Walk around frequently Stand up for a couple minutes every hour and shake your legs. If driving, take frequent walk breaks. Select an aisle seat Drink plenty fluids; limit coffee and alcohol caution with heart failure (don t drink too much fluid, know your symptoms for increased fluid) Do regular seated exercises, if you cannot standup or walk that involve contraction of your ankle, calf, thigh and butt muscles. https://www.youtube.com/watch?v=tl4d5tizijc If you are at high risk for blood clots, talk to your doctor if you need temporary blood thinners to cover your travel time

Medical Insurance: It is strongly recommended to get additional travel medical insurance especially for international travel. Talk to your travel agent. Determine the kind of insurance you want/need. At the airport/station: Do not over exert. Use bags with wheels/trollies/transportation services. Anticipate and request assistance this is not the time to suck it up. If you have a pacemaker/icd /linq/stent it is ok to pass through metal detector/body scanner do not linger near it. Step away as soon as possible. No evidence full body scanners interfere with devices. If you become symptomatic at high altitude or in air: Request crew assistance right away. You may require oxygen. If you have needed oxygen on and off in the past, talk to your doctor before travelling if you need to carry oxygen with you in these situations. If you have CP, take sublingual nitroglycerine. Talk to your physicians before you undertake your adventure for immediate management of anticipated emergencies.

Basic life support save a life! Learn basic CPR and use of AED (Automatic External Defibrillator). If you see someone go down: http://www.webmd.com/first-aid/tc/dealing-with-emergencies-rescue-breathing-and-cpr 1 st check pulse for 10 seconds or less, if no pulse is felt Call 911 (if you are alone) or request someone to call 911. Also request someone to check if an AED is available nearby and bring it. Check pulse in one of the large arteries of the neck (carotid). Start chest compressions at a rate of 100 compressions per minute (follow the tune of Bee Gees song, Stayin' Alive. Not only must compressions must be fast, they should be two inches deep and they mustn't stop till help arrives). Get the strong people in the group to do the chest compressions if there are other people around. Familiarize yourself with the use of AED. Use it if one is available. If CPR is need for a long time, provide 2 breaths for every 30 chest compressions Some useful links for basic CPR: https://www.youtube.com/watch?v=o9t25smyz3a https://www.youtube.com/watch?v=r8iu3mtblho https://www.youtube.com/watch?v=vzsq-88ibak https://www.youtube.com/watch?v=zrvfvtolkrm Wish you a fun and safe travel!