Traveling With Immune Deficiencies: Some Advice

Editor's note: This article was written in November 2019, before the COVID-19 pandemic. Please remember to follow CDC and local guidelines regarding travel during the pandemic.

So, it’s been over two weeks since Sue and I returned from Europe. Leading up to the trip, we were very concerned, due to continuing very low red and white counts. I had been taken off my Revlimid maintenance a few weeks earlier to allow them to bounce back a little. It wasn’t happening as it should. Although potential MDS was on my oncologist’s mind, just not getting pneumonia for the third time this year was about the only thing on my mind... and Sue’s.

But, even with this concern paired with my chronic back pain, we made the leap to go...yelling, “No Control-Alt-Delete this time”. Actually, it was a little more profane than that, but you know what I mean.

Mission accomplished

Now that the trip is complete and I’ve moved past the incubation period for most illnesses, I’m a little more confident suggesting things to try to help you stay “healthy" during your trips. These suggestions are especially important on extended trips where planes, trains, and subways are involved.

Before I move forward though, I probably ought to state my disclaimers. First, most of these suggestions you all will probably say are “common sense”. That is true, but even though they are, we all sometimes fail to practice what we know, so please take these as well-intentioned reminders.

Second, I know we are all different in how blood cancer impacts us physically and mentally. I know that many of you cannot travel, so this article may not apply... now. There is no way I could have made this trip 12 months ago, so please keep the faith.

 Suggestions and recommendations

Purchase an emergency medical policy and work closely with their customer services to get listings of recommended hospitals in the cities and countries you are traveling to. Also, get on the CDC site to learn what you can about those places. Going in with eyes wide open and a “plan B” will give you a great confidence boost.

Take plenty of face masks with you and wear them wherever you will be in close quarters with a lot of people. It’s a pain in the a**, but very important. These places include all public transportation, very crowded airports, train stations, etc. Also, very crowded museums, indoor tours, and shops. I know “very crowded” is a subjective term, so you will have choices to make. My suggestion is to be a little conservative in those choices.

There will also be crowded places, where you will just have to de-mask, like at immigration and airport check-in. Again, a pain, but sometimes necessary. My biggest challenge was with restaurants. Wearing a mask while eating became so inconvenient because I had to pull it down and up every time I took a bite. I really wasn’t getting any protection in that scenario, so I decided that during the remainder of the trip, I’d just take mask off when eating or drinking.

Know you will get strange looks, but try to get past it. I created a game to play with my masks that helped me. Look for my article titled “Maskeuraid” to get more detail.

Take a lot of antibacterial hand wipes and hand gel. Wipe your hands often, with either. When you get into a plane seat, wipe down trays, armrests, and touchpad TV screens. In your hotel rooms, re-clean drink glasses before you use them. wipe down desks, tv channel changers, doorknobs, or anything else other guests may have touched. I also don’t use the coffee makers.

In restaurants wipe your hands down both before and after meals. Also, wash hands before eating, if facilities are available. Wipe your hands regularly and randomly during the day. You will be touching things like handrails and door handles all the time. Wash hands with soap and water wherever you can. Keep your hands away from your eyes, nose, and mouth as much as possible. Get an extra napkin at restaurants to lay your utensils on, to keep them off the table. Drink bottled water whenever feasible, even if you are told tap water is safe.

Safe over sorry these days

Keep your ears open. If someone near you is coughing or sneezing a lot and you can move away, do so. When you can’t move away, put on your scary mask. If you are on an elevator, hold your breath until you are almost passed out. (Just kidding. I was testing to see if you were paying attention.)

Don’t have a letdown on your way home. Just because you are healthy on that last plane flight doesn’t mean you can’t catch something.

I’m pretty sure you’re now thinking how very OCD I am, but believe me, a lot of this stuff is easy to do and takes no time at all. During the trip, I was constantly trying to convince myself that certain situations didn’t warrant being careful. When this happened, all I had to do was think about the two weeks I’d already spent in the hospital with pneumonia because I was previously lax. If that didn't work, Sue was sure to remind me. Her two favorite phrases on the trip were "Did you wash your hands?" and "Why don't you just ask for directions?" That’s all it took.

That’s about it for now. I’ll talk about dealing with my back and chronic pain in my next article.

Until then... safe travels.