Medical Travel Tips: Chronic Fatigue Syndrome/ME
Dr Ruth Handford's Tips for travelling with Chronic Fatigue Syndrome or ME
Chronic Fatigue Syndrome (CFS) is a long term medical condition which can cause a wide range of symptoms that can fluctuate in severity. There is lots of debate and disagreement about what to call this syndrome – CFS is one name for it, others are Myalgic Encephalopathy (ME) and Post Viral Fatigue Syndrome.
The types of symptoms caused by Chronic Fatigue Syndrome or ME can vary from patient to patient, and from day to day. Women are more commonly affected than men, and onset can be in childhood.
Sufferers usually experience extreme fatigue, and may have other symptoms such as palpitations, headaches, trouble concentrating, memory problems, muscle aches and pains, sore glands, and dizziness.
Because the symptoms of Chronic Fatigue Syndrome or ME are so variable, it is important to think about what triggers a deterioration in your own symptoms. For some people it is changes in temperature, increased activity, concurrent illness, or alcohol. Think about what affects you before you go on holiday, to try to minimise the symptoms whilst away and enjoy your trip.
Choosing a destination
Consider how long you want to travel for – or are able to travel for – before choosing a destination. A long haul journey may be acceptable to you if you know you can sleep on a plane, but it may be preferable for you to have a shorter journey that does not affect your daily routine too much.
Also bear in mind the climate when choosing where to go. For some people with CFS, keeping warm can be a problem, and a trip to a chilly location may exacerbate symptoms. Likewise, humidity and heat can be draining, and worsen symptoms like palpitations and fatigue. Make sure you are prepared for these environments, with measures such as appropriate clothing, a handheld fan, and by choosing air-conditioned accommodation.
The type of accommodation you choose is also important. Check out how long your transfer is from the airport if you are flying to your destination. A long trip on a coach after getting off a plane can be hugely stressful. If you can, arrange private transfers in advance, or choose accommodation near the airport.
Also look in to the surroundings of your accommodation – will you need to walk to restaurants and attractions? Is the area hilly? Are there lifts or will you need to climb stairs? You can request rooms on the ground floor if stairs are a problem, but you will need to do this in advance. Is the location busy, and noisy at night? Sleeping problems are often worse when we are away from our usual environment anyway, but add in a local nightclub next door to your hotel and sleep may be impossible!
All of these issues are avoidable – with some thought and research. Review websites can be a useful source of local information – and check the reviewer travelled at a similar time of year to you as well.
Mode of travel
Also bear in mind how you would like to get to your destination. You may find that travelling by car is preferable, allowing flexibility with stopping and breaking the journey. This control is lost when using a train or coach. However, taking away the stress of driving can be invaluable.
Consider whether your flight is direct or has a lay over. You may prefer to break a long flight with a stop somewhere else, or for some this could be more exhausting and potentially spoil the start of the holiday. Bear in mind that when flying, you may have a long journey to the airport, and you have to arrive early. Consider your flight times and work out when you would need to be setting off. Sometimes staying at a hotel at the airport the night before can be invaluable in getting your trip off to a good start.
Make sure you arrange any assistance required prior to arriving at the airport. If you are likely to need help boarding, or assistance moving around the airport, arrange this in advance.
Cruising is an increasingly popular way to take a holiday. It is worth considering as a way to take some stress out of travel, catering, and to give you some flexibility with how active you want to be day to day.
Jetlag
Travelling across timezones can be tricky to adjust to, and can make anyone feel quite unwell – mostly due to upsetting our sleep patterns. Useful measures to minimise this are to make sure you plan a couple of quiet days at the start of your trip, so as to allow flexibility with your sleep and meals.
Try to time your flights so you arrive at your destination during the day – natural light is important and can help you adjust more quickly to local time. Avoid alcohol before and during your flight too, as this will make you sleepy, dehydrate you, and disturb your sleep too. Try to avoid using sleeping pills to sleep, or caffeine to stay awake – this will only prolong your jet lag and delay your adjustment to local schedules. Instead, drink plenty of water to help your circulation and improve your quality of sleep.
Try to get some gentle exercise on arrival – just a short walk can help release endorphins which will improve your adjustment in timezones. Take a short nap if you need to, but try to get up again afterwards and go to bed at the usual time in the evening.
Medication advice
If you take regular prescribed medication, make sure you travel with it in its original packaging. Take a copy of your repeat medication list with your from your GP, in case you need anything whilst you are away. If you are packing medication in your suitcase, ensure you have a few days’ supply in your hand luggage too, just in case your case is mislaid in transit. Some strong painkillers are ‘controlled drugs’, and some are even illegal in some countries. Check with a travel clinic or your pharmacist if you are unsure. If you do need to take these medications, make sure you have a letter from your GP to authorise you travelling with them.
Stock up with simple pharmacy medications prior to travelling too – some paracetamol, rehydration sachets, and mosquito repellent can be vital when overseas.
Food and drink
Make sure you eat food that has been cooked properly – a tummy bug can cause a rapid deterioration in CFS symptoms for some people. Avoid street foods, ice, and stick to peelable fruits. Make sure you drink plenty of bottled water, especially if you are in a hot environment. Dehydration can be a big cause of fatigue and lethargy, which will worsen CFS symptoms.
Try to keep alcohol consumption to recommended safe levels. Alcohol will dehydrate you, and seriously impairs the quality of sleep you will get. Both of these things will worsen CFS symptoms.
Exercise and activity
Keeping active is important, but try to plan ahead just how active your travels will require you to be. A sudden increase in your daily activity could cause a decline in your CFS symptoms. Pace yourself – take breaks, stop for rest regularly, and plan in relaxation days when you are not expecting to do as much. Use your holiday as an opportunity to make the most of treats like massage, hot tubs, and saunas. These can help with muscle pains and contribute to better sleep.
Vaccinations
Visit your local travel clinic at least 8 weeks prior to travel to check whether you require any immunisations. It is important, and sometimes compulsory, to be fully immunised if advised. This includes anti-malarial treatment, which sometimes needs to be commenced well in advance of travel. Protecting yourself from infections is vital, as recovery from disease can be extremely prolonged when you also have CFS.
Patients with CFS are usually experts in their own condition – with good awareness of what can trigger a worsening in symptoms and what helps them feel well. Circumstances can be different when travelling, and it is important to think through your trip prior to travel to try to maximise your chance of having an enjoyable break.
Travel insurance cover for Chronic Fatigue Syndrome or ME
Make sure you have travel insurance in place to cover any unexpected emergency medical treatment whilst you are away. You will need to declare your CFS/ME as well as any other existing medical conditions you may have to ensure you are fully covered.
Always consult your own doctor before travelling
These travel tips are intended to provide general information to those with Chronic Fatigue Syndrome (CFS) or ME. They do not replace a visit to your doctor . If you are planning a holiday you should consult your doctor to ensure that you are fit to travel and discuss any specific health requirements you may have.
About Dr Ruth Handford
Dr Ruth Handford is a GP with over 10 years' experience of working in both hospital and primary care. She is particularly interested in caring for the elderly in the community, child health, and family planning. Ruth lives and works in a rural community, and is kept very busy by her job and young family.
Important Information: These travel tips are intended to provide general information to those with Chronic Fatigue Syndrome (CFS) or ME. They do not replace a visit to your doctor . If you are planning a holiday you should consult your doctor to ensure that you are fit to travel and discuss any specific health requirements you may have.
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