For the 16 million Americans with chronic obstructive pulmonary disease (COPD), travel can be as anxiety-provoking as it is life-affirming.
The fatigue, chest tightness, congestion, and difficulty breathing that come with the chronic bronchitis or emphysema behind COPD can make the thought of travel seem overwhelming. There are so many questions: How would I handle a long flight? What do I need to bring? And how would I make my overall itinerary manageable?
[time-brightcove not-tgx=”true”]COPD may require a lot more planning, pulmonologists say, but for the majority of patients without the most severe lung disease—even those on oxygen—it’s certainly doable.
Here are the considerations doctors and COPD patients say you’ll need to keep in mind before you hit the road and while you’re away.
The first step is making an appointment with your pulmonologist to discuss the conditions at your destination, including altitude, air quality, and weather, as well as what you plan to do there.
“Our biggest concern is always the altitude,” says Dr. Roberto Swazo, a pulmonologist with Orlando Health Medical Group. “If you struggle at baseline, you are going to have a harder time at altitude than anywhere else.”
Traveling by plane will also mean a lower concentration of oxygen when you reach altitude, which could be challenging for those who struggle with blood oxygen levels.
If you’re on oxygen already, your doctor can perform a high-altitude simulation test to determine if you’re fit to fly, and how much oxygen you will need to take with you. The procedure involves breathing a mix of oxygen and nitrogen that mimics the reduced oxygen environment of an airplane cabin, while monitoring your blood oxygen saturation and heart rate. If your doctor is unsure if you’ll need a prescription to travel with oxygen to make it through the flight, they can order a test to justify the prescription.
From there, you can determine what kind of oxygen concentrator you need for your flight and how many battery packs you require. You’ll have to procure any airline, train, or cruise documentation needed, as well as prescriptions for equipment or meds you need take with you. And plan for when you reach your destination.“We want to make sure you know where the nearest pharmacy is, and that you know where to go in an emergency,” Swazo adds.
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It’s also important that you make these plans well in advance of your trip, Swazo says, so you have plenty of time to rent any equipment you need and notify your airline, cruise line, or hotel.
Remember to get an updated COVID-19 booster a month before your flight, and make sure you have your RSV inoculation. If it’s a fall or winter trip, get a flu shot before you go. Your doctor can lay out an action plan for the steps to take in case you don’t feel well, with zones of green, yellow, and red, outlining what to do for each level of symptom severity. In this plan, you’ll take actions and use the medications and therapies specific to each zone, with red being emergency medical treatment.
You’ll need to have your equipment and meds always within reach, including in your carry-on baggage on the plane. For those not prescribed oxygen, that might be as simple as making sure you have your rescue inhaler and all prescription and over-the-counter meds in your bag to control any symptoms. Those with more compromised lung function will need to bring supplemental oxygen along with medications. Swazo says that for his patients who have flare-ups at least a couple of times a year, he also prescribes steroids and antibiotics to take on their trips as a precaution. But be judicious with the drugs.
“The instructions are clear: Don’t take it unless you need to,” he says. If there is a flare-up, he wants his patients to call him to make sure he can adjust dosing as needed. These medications should be brought in their original container with the prescription label on it, even if you usually use a weekly pill box.
Keep a list of these medications with you in a travel folder, along with your oxygen prescription, and any letters from your healthcare provider, including your fit-to-fly report, your emergency contacts, and contact information for the airline, train, or cruise line on which you are traveling, advises the COPD Foundation. While this information might be on your smartphone on the MyChart app, you want to have it handy if there’s no cell service or WiFi, or if your battery dies.
If you’re traveling out of state or out of the country, review your health plan’s coverage and buy additional temporary medical coverage or trip cancellation insurance you think you might need. If you can, consider having a friend, family member, or spouse travel with you—someone who understands your needs and can provide help when required.
“I automatically know when I’m starting to get sick,” says Lisa Hall, 55, of Minnesota, who struggled with asthma for decades, before being diagnosed with COPD in 2005. “It feels stuffy, I get warm, and I have to sit there and take in deeper breaths and blow out longer.”
While she doesn’t travel with oxygen, Hall says her mom knows when she needs help and will say, “‘Lisa, take a deep breath.’ She notices when my breathing is getting shallower.”
Start your trip planning by working with a local oxygen supplier to ensure you not only have enough supplies to bring with you, but will have what you need at your destination. Most oxygen suppliers are part of a network and can make arrangements for you to have oxygen delivered to your hotel or other accommodation. Plan on doing this at least two weeks in advance of your trip. It’s also a good idea to ask for the contact information of the person your local supplier spoke to, so you can call and confirm a day or two before you travel that your equipment will be there when you arrive.
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If you’re staying in a hotel, make sure they know about any equipment that is to be delivered, and let them know to allow an employee to sign for it, and not to forget to have it brought to your room by the time you check-in.
“That is not a surprise you want, when you roll into your hotel room at 10 p.m.,” says Dr. Steven Davis, associate professor at the Burnett School of Medicine at Texas Christian University.
If you are taking to the skies, remember that airlines do not allow oxygen tanks on flights and do not routinely supply oxygen, although they have it for emergencies, Davis adds.
You’ll need to take a portable oxygen concentrator (POC) that is aviation-approved as well as back-up batteries and an airline form that your health care provider filled out. Make sure you call the airline no later than 72 hours in advance of your flight to notify them of your condition. The general rule for battery life is to make sure you have enough to last from the time you take off until the time you land, plus an additional 50%. You will need more still to accommodate any layovers or delays.
The good news is that your medical supplies, such as nebulizers, concentrators, and batteries do not count against your carry-on limit so you can take what you need on board, stashing it either under the seat or in an overhead bin.
Tom Krueger, a 70-year-old traveler from Wisconsin who uses oxygen tanks at home to deal with his emphysema, said he was pleased with how well his portable oxygen concentrator worked on his flight, after testing it first on the ground.“It actually worked out better for me than using my tanks on the trip,” he says.
Krueger also requests wheelchair assistance to eliminate the long walk to his gate, and ease him through security, so he is not stressed and out of breath before the plane takes off. It also allows him to board first so he can get his luggage stowed and equipment in the right place before other people get on.
“A lot of this is swallowing that big chunk of pride and recognizing your limitations,” Krueger says. “Don’t be shy to ask for help.”
Keep in mind that not every mode of travel is equal. Traina are easier than trains, for example. You can bring oxygen tanks and concentrators on Amtrak, as long as you call to reserve a spot for your equipment. You must have enough oxygen or battery life for your concentrator to go at least four hours without a charge, and the total weight of tanks may not exceed 120 pounds.
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Car trips won’t require as much planning, but you will need to have enough tanks to last throughout your trip, and know where you can have empty tanks exchanged for new ones at your destination. Take your stationary concentrator to use at night, and any additional tubing, electrical outlet extenders or other supplies. Also remember to keep your phone charged up for emergencies.
Cruises are a great way for travelers with COPD to see the world. Most large cruise lines allow passengers to travel with oxygen, as long as your medical documentation is approved and you call special services a month or more before the cruise to get oxygen delivered to the ship.
Once you’re at your destination, don’t push yourself too hard. Take an Uber or rent a scooter, so you can enjoy yourself without getting short of breath. And don’t feel like you need to keep up with travelers without lung disease. If you’re sightseeing and feel unwell, arrange a time and place to meet and just enjoy the street scene from a local café.
Krueger took in the stunning glacier views from the deck of his Alaska cruise and saw the ship’s stage shows, while his wife and her friends did the more taxing excursions. The trip was such a success he and his wife are considering a future trip to Florida in the winter.
“I think there is a lot of benefit both physically and mentally to travel,” unless your COPD is really severe, Davis says. It’s such a confidence booster, he believes, knowing you can make it to family events, or cross off a bucket-list trip that you’ll always remember. “We do whatever we can to facilitate getting people to where they need to go.”
