The impact of heat
I am currently fit and healthy, and about to spend two weeks in the United States meeting my partner’s family. It will be a time to remember.
But MS has the potential to get in the way during my first visits to Phoenix, Arizona and St Louis, Missouri.
Many people with MS have a degree of heat sensitivity, and experience suggests that I am particularly sensitive to changes in temperature. Lets face it, I’m the girl who almost passed out in a hot bath in Berlin and on a crowded tram in Melbourne because my system shuts down when I heat up too quickly.
As of right now, Phoenix is 43°C (that is 110°F). That is a good 8°C more than I have let myself go anywhere since the tram incident.
With MS, anything could happen. And so I am taking what precautions I can.
My emergency guide to travelling with MS
Nothing in my emergency kit is going to stop me from having a relapse or an exacerbation, particularly if I overheat. But if my healths takes a dive, these things might help.
My little red kit includes:
- My disease modifying drug of choice, Gilenya. I have enough for the duration, as well as a few stashed away in different bags in the event that I lose some. Given the heart rate complications of the drug, Gilenya is not something that I can miss.
- A letter from my neurologist. Gilenya costs around $62,500USD per annum in the United States, and it is not something to lightly carry through customs (although it is significantly less fraught than travelling with injectable MS therapies). This letter is also going to help if I end up in the hospital (for MS, or due to some other random event).
- Travel insurance for MS. For the first time, my annual insurance now includes a premium for MS related issues. God knows if this will actually be effective, but I’d be an idiot not to have it.
- My Medic Alert bracelet. I don’t wear this normally, it is for emergency use only. But if I were to become sick or disoriented (like that time in an airport I missed my flight), I can wave this around (or more likely, my partner can wave it around as I may not be moving my arm at that point) to receive help.
- Just-in-case Prednisone. If I have a relapse, the thought of seeing yet another neurologist when in a distressed state is not appealing. Depending on what my symptoms are and whether I am mobile, I will just get on a plane and head back to Melbourne to see my neurologist – an option far cheaper than the medical system in the United States. But in the meantime, or in the event that I do see a neurologist and don’t like his treatment advice (as happened in Sydney), I can start the Prednisone myself.
- Relevant contact details. I have the business cards of my neurologist and MS nurse, and they are also loaded into my phone and that of my partner.
- Additional incidental drugs. For those one off occurrences and to address a variety random MS symptoms.
- Hand sanitisers and wound disinfectant. I – and just about everyone who travels – always carry hand sanitisers anyway, but now they take on a particular importance. My immune system is compromised due to the Gilenya, and any inflammation or sickness can trigger an exacerbation of my symptoms.
- Vitamins. Strictly speaking, these aren’t for an emergency. But I take them every day, they are part of my health routine, and they are coming with me.
And of course, there is good old common sense. I will not go into direct sunlight. I will stay hydrated. I will not attempt to climb Camelback Mountain in Phoenix (and I will regret every moment not doing so). I will conserve my energy.
And I will damn well enjoy myself.
Post script: I do not advocate anyone with MS randomly treating themselves with Prednisone if they feel unwell. My neurologist gave me the script to use in case of a genuine emergency where on the spot and/or effective treatment was not available. Hopefully, I never use it and I end up carrying the script around until it is out of date.