Tag Archives: Travel

Traveling with Chronic Illness: Q&A with Dr. Bradley Connor

Posted on by Charlie

A consultant to the CDC and a gastroenterologist specializing in gastroenterology and tropical medicine, Dr. Bradley A. Connor has been counseling travelers for more than 30 years. Community asked Dr. Connor for his tips on traveling with chronic illness.

Bradley A. Connor, M.D., Medical Director, The New York Center for Travel and Tropical Medicine, Clinical Professor of Medicine, Weill Medical College of Cornell University.

Bradley A. Connor, M.D., Medical Director, The New York Center for Travel and Tropical Medicine, Clinical Professor of Medicine, Weill Medical College of Cornell University.

What do you think is important for those with chronic illness to know about travel?
The ability of people with chronic illness to travel has probably never been better than it is now. The ease of travel has developed to the point where people are going to more and more exotic places because there are physicians and health professionals who specialize in health issues related to travel. Those with chronic disease can feel confident at least knowing what the risks are and taking steps to prevent them.

What are some general tips for those traveling with chronic illness?
• Before you embark on travel—it could be domestic travel, travel to Europe, or a more adventurous type of trip, like a safari in Africa, or travel to Asia—check with your doctor who takes care of your chronic disease and make sure it’s his or her opinion that you’re fit to travel and that your condition is in a stable place.

• If you’re traveling to an exotic destination, avail yourself of travel medicine specialists who know the specific health risks. In some cases, either your own physician or a travel medicine physician might find a physician at your destination to refer you to should your illness become active when you travel.

• Preplanning is absolutely necessary. Make sure that your medications are up to date, and that you have more than enough medication for the trip. If your trip is for two weeks, take four weeks’ worth of medication. We’ve had patients who were stuck in Europe in 2010 when the clouds of volcanic ash from Iceland delayed flights. Be a little bit over-prepared.

• Take your medication, in the original, labeled container, in your carry-on luggage, never in your checked bags.

• If you need to, consult with a travel medicine specialist if you’re going to a place with a destination-specific illness.

Molokai sea cliffs, Hawaii. Photo: Hawaii Tourism Authority (HTA)/Tor Johnson.

Molokai sea cliffs, Hawaii. Photo: Hawaii Tourism Authority (HTA)/Tor Johnson.

• Have an emergency plan in place. What happens if your illness becomes active? What are you going to do? That could be something as simple as an email to your doctor; it could be having a doctor then referred to you at the destination.

• Post-travel, is there anything likely that you’ve picked up on the trip that may impact your illness? What are your doctor’s assessments?

What should travelers with chronic illness know about health insurance?
Check whether you do have health coverage overseas. In many cases you don’t. It’s a good idea to investigate what types of policies you can obtain for your travel in case you need to access medical care.

Some might want to consider medical evacuation services. It’s not for every traveler, but sometimes it’s less expensive to contract with a company like Global Rescue or International SOS in the eventuality that you have to be evacuated back home, or somewhere you can get good medical care. The cost of a policy for a short trip is usually fairly reasonable.

Some medications that are legal here are illegal in other countries. Do these issues come up for travelers with chronic illness?
Those issues do come up. There are certain countries, where certain medications (in some instance, even non-prescription medications) are not permitted into the country. Now, having said that, I don’t know of any instance where a traveler with a prescription medication with a physician’s letter has been denied entrance to the country, or has had their medication confiscated.

But, I think it’s something you at least need to consider. Bring a letter from your physician in case you’re questioned about your medication.

In some countries, if you have a physician there who is prepared to give you the medication or prescribe it there, that’s another way around it. But that takes a lot of effort.

The other issue, which is very important, is that the world is plagued with counterfeit medications. Beware of counterfeit medications sold in other countries. If you see a drug that sells for $10,000 here selling somewhere else for $400, be careful. People should take more than enough medication and not plan on buying medication overseas.

What are some of the precautions those who are planning to go on cruises should take?
One thing they can do is to check out the medical backup at the various cruise lines. Everyone is interested in keeping passengers healthy. Some do a better job than others. There are a few cruise lines that have put a lot of effort into having excellent physicians onboard, and having excellent medical directors.

With the norovirus outbreaks that you see on cruise ships, it’s not that there’s a lapse of hygiene with the cruise lines, it’s just that you have a lot of people together, and people are coming onboard with illness. Take the usual, frequent precautions for hand hygiene, like washing with soap and hot water and using hand sanitizers, and make sure the medical back up is there. Do the research.

What are some considerations when traveling with oxygen?
• If you plan on flying, ask your doctor whether you can tolerate the reduced air pressure on a plane and if you’ll need an additional oxygen supply during the flight.

• Check with your airline well in advance of travel about regulations and methods for permitting supplemental oxygen, including the need to carry a prescription for your portable oxygen compressor, whether it’s an approved device, and whether the airline charges for providing supplemental oxygen.

• If you’re on supplemental oxygen, make sure you have an adequate supply and that you have extra batteries for your POC in your carry-on luggage.

• If you’re going to a destination with high altitude, it’s important to let your physician know. Discuss with your doctor what effects altitude might have on your illness and on the delivery of oxygen.

Le Train Bleu, restaurant Gare de Lyon, Paris. © Paris Tourist Office. Photo by Amelie Dupont.

Le Train Bleu, restaurant Gare de Lyon, Paris. © Paris Tourist Office. Photo by Amelie Dupont.

What would you say to those with chronic illness who want to travel, but are afraid?
With proper planning, some of the perceived restrictions of traveling don’t have to be. Use your doctor as a partner. Use specialists in travel medicine if need be. Have an escape plan in place if you get sick. Don’t leave anything to chance.

If you’re new to traveling with chronic illness, take an easy trip first. See that you can do it. Then, maybe for your next trip, you can be a little more adventurous.

Done the right way, with a lot of preplanning, you don’t have to fear travel. If you’re suffering with a chronic illness, travel can be very enlightening and it can be uplifting psychologically.

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Accessible Travel: Washington, D.C.

Posted on by Charlie

Washington, D.C., one of the nation’s most accessible cities, is also one of the most popular for tourism. We’ve highlighted some of D.C.’s top attractions, hotels and restaurants, as well as travel tips for visitors with special needs, and accessible vacation destinations in neighboring Virginia.

National Mall skyline at dusk.

National Mall skyline at dusk. Photo by Destination DC.

GETTING THERE AND AROUND
About a sixth of the U.S. population—more than 48 million people—lives within a five-hour drive of Washington, D.C. Its three airports, Reagan National, Dulles and BWI, offer accessible ground transportation, including lift-equipped buses, and Reagan National has a wheelchair-accessible walkway to the Metro station. Amtrak serves D.C.’s Union Station, one of the Metro’s hubs.

D.C. Metro rail system

D.C. Metro rail system. Photo by Destination DC.

Metro
The D.C. Metro system serves 86 stations in D.C., Virginia and Maryland. The Washington Metro Disability I.D. Card entitles riders to discount fares on the Metro and to Baltimore on MARC. The card must be purchased three to four weeks in advance and cannot be purchased at kiosks. For more information go to www.wmata.com/accessibility/metrorail.cfm

Parking and Taxis
On every D.C. block with government parking meters, there are two dedicated ADA meters, and the National Mall has dedicated drop-off zones. Consider saving money on hotel parking or time searching for parking by using Union Station’s public parking garage, which connects to the station via elevators. It’s open 24/7 and costs $22 for 12 to 24 hours, while hotel parking can easily be twice that. You can take the Metro from Union Station, and if you’re staying on Capitol Hill, a number of hotels, including the Hyatt Regency and Hotel George, are within a few blocks. Two companies offer wheelchair-accessible taxis in D.C. You can call or reserve a taxi online at:

Royal Taxi: 202-398-0500;
www.dctaxionline.com

Yellow Paratransit: 202-544-1212;
www.orderyellowcab.com (Select Add Special Options dropdown menu.) You can also install the mobile app, Taxi Magic, at http://taximagic.com/en_US

Hotels
Hyatt Regency Washington on Capitol Hill
400 New Jersey Avenue, N.W.
202-737-1234
The Hyatt Regency Washington features 23 ADA-compliant rooms, some of which have roll-in showers. Other accessible features include front door alerting devices and the hotel’s restaurants, lounge, fitness center and indoor pool. The hotel is three blocks from Union Station, and near many of the Smithsonian museums and the National Mall. For more information go to http://washingtonregency.hyatt.com/en/hotel/our-hotel/accessibilty.html

Hotel George
15 E Street, N.W.
Hotel: 202-347-4200
Reservations: 800-546-7866
www.hotelgeorge.com
One block from Union Station, presidential-themed, pet-friendly Hotel George features accessible guest rooms (some with roll-in showers), gym, meeting space and business center. Just off the lobby, the hotel’s excellent and accessible Bistro Bis serves modern
French bistro fare.

Hotel George lobby

Hotel George lobby. Photo by Isaac Maiselman.

Restaurants
Carmine’s
425 7th St., N.W.
202-737-7770
www.carminesnyc.com/locations/washington-dc
This spacious, easy-to-navigate Italian restaurant near the National Mall and Newseum serves super-hearty family-style portions designed to serve four to six people. Carmine’s is a good option for those in wheelchairs, with food allergies like gluten intolerance, and groups and families.

Carmine's

Carmine’s. Photo courtesy of Carmine’s.

Equinox
818 Connecticut Avenue, N.W.
202-331-8118
http://equinoxrestaurant.com
President Obama and the First Lady have dined at this accessible, contemporary power spot near the White House. The menu focuses on seasonal, locally-sourced ingredients, with gluten-free and vegan options.

Smithsonian's National Museum of the American Indian

Smithsonian’s National Museum of the American Indian. Photo © 2004 Judy Davis/Hoachlander Davis Photography for Smithsonian.

Attractions
The Smithsonian Institution
Museums and Galleries
The Smithsonian Institution’s 17 D.C.-area museums and galleries, including the Air and Space Museum, the African Art Museum, the American Indian Museum, and the National Zoo, are free and offer free manual wheelchair loans on a first-come, first-served basis. For more information, go to www.si.edu/Visit/VisitorsWithDisabilities

D.C. SUMMER TRAVEL TIP
If you’re planning on enjoying one of D.C.’s many outdoor festivals, remember that the city can be very hot in the summer. Make sure to have an umbrella for shade and plenty of water to prevent dehydration. For more information on accessibility in Washington, D.C., go to http://washington.org/DC-information/washington-dc-disability-information

QUICK TRIPS FROM D.C.
Williamsburg, Virginia
Williamsburg, Virginia, 150 miles south of D.C., draws visitors with its Revolutionary War-themed tours, activities and architecture, much of which is accessible. (Williamsburg’s Amtrak station has an accessible platform.) Nearby Busch Gardens theme park is accessible, with wheelchair rentals for a fee. For more information, go to www.colonialwilliamsburg.com/plan/accessibility.

Hotel
The Fife and Drum Inn
441 Prince George Street
Williamsburg, Virginia
1-888-838-1783
www.fifeanddruminn.com
Williamsburg offers dozens of modern, accessible hotels, but if you want to stick with the colonial theme, the Fife and Drum Inn is just two blocks from the Amtrak station in Williamsburg’s historic section. The inn’s Drummers Cottage is wheelchair-accessible and sleeps up to six.

Virginia Beach
Boasting the world’s longest pleasure beach, Virginia Beach is a popular family destination 208 miles south of D.C. and 62 miles south of Williamsburg. Although peak seasons can be extremely crowded, a three-mile-long concrete boardwalk, flat, wide sidewalks and spacious curb cuts make Virginia Beach easy to navigate by wheelchair or scooter.

Grommet Island

Grommet Island. Photo by Virginia Beach CVB.

At the Virginia Beach boardwalk and 2nd Street, Grommet Island is the country’s first beach playground designed for children and adults of all physical capabilities, and is completely accessible. The playground has drawn visitors from all over the country, with 15,000 square feet of ramps and decking, soft play areas and sculptures, accessible play equipment, a shaded play area, picnic areas, and beach wheelchairs. For more information go to www.grommetisland.org.

Catering to children and adults with special needs, 70-acre Camp Grom is scheduled to open in Virginia Beach in spring 2016 as an accessible state-of-the-art beach-style adventure camp emphasizing rehabilitation through recreation.

Camp Grom activities will accommodate a range of abilities and will include wheelchair-accessible adventure trails, cable wakeboarding on a man-made lake, indoor boogie boarding, and ziplining. It will also feature a rehab pool and a wave simulator. For more information go to www.jtwalk.org/grom-camp.asp

—Eva Leonard

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Accessible Travel: Travel Therapy

Posted on by Charlie

Those with chronic conditions and limited mobility have more options than ever before for accessible travel. Eva Leonard talks to travelers with special needs and accessible travel experts about important considerations when planning a trip.

Canoe Coming into shore, Waikiki, Oahu, Hawaii.
Canoe coming into shore, Waikiki, Oahu, Hawaii. Photo by Hawaii Tourism Authority (HTA)/Tor Johnson

“Part of my job is to make vacation travel possible,” says Royal Caribbean International Manager, Access Compliance, Ron Pettit. “Many people with disabilities don’t think about traveling or taking a vacation as an option.

“They have challenges in everyday life; getting out of bed, getting out of the house, going to school, to work, going shopping, and going to the doctor. So sometimes, when they think of all their daily challenges, they think, ‘Oh my goodness—I don’t think I could go on a cruise.’

“Some folks are born with a disability, so they’ve learned how to adapt all along. But a lot of people have acquired a disability with age, or a medical issue, so they have to rethink and learn things all over again.”

Fear of the unknown can be a factor in deterring those with chronic illness from traveling, says Pettit, who has worked for the past 25 years to improve travel for the disabled, first for 17 years at Northwest Airlines, where he served as program manager for customers with disabilities, then joining Royal Caribbean in 2006.

“It’s those personal issues. ‘How do I go to the bathroom? How do I know about oxygen? How do I do these things?’ Because, while they have learned to adapt at home, or maybe when going out a little bit, the thought of going onto an airplane, or going onto a ship seems a little daunting. They ask, ‘How would I ever do this with my new limitations?’”

But many with disabilities are traveling. The U.S. Census reports that more than 38 million Americans live with disabilities, and, according to a 2005 study by the Open Doors Organization and the Travel Industry Association of America, U.S. adults with disabilities or reduced mobility spend around $13.6 billion on travel every year.

With the world’s population now at 7 billion, about ten percent require barrier-free and easily accessible facilities. “Global estimates [of people with disabilities] range from 600 million to 900 million,” says Lilian Muller, President of the European Network for Accessible Tourism.

To meet rising demand, accessible and barrier-free travel options have grown dramatically over the last two decades. Whether you opt for a leisurely Caribbean cruise, a scenic train ride through the Canadian Rockies, or something more distant and action-packed, careful research, planning and preparation can help you decide which getaway is best for you and allow you to fully enjoy the mood-boosting, stress-reducing rewards of travel.

BEFORE YOU GO
Before you start planning your trip, check with your doctor to assess what you can do, and, depending on the type of trip you plan to take, consider working with a travel agent who understands your needs. Says Pettit, “The more information you can share about your ability and needs, the better.”

Make arrangements well in advance for wheelchair, scooter, and medical device and supply accessibility and rental. Says traveler Tracy Schutt, “Since being on oxygen 24/7, traveling has become challenging, but not impossible. Making trips to Jacksonville, Florida, to visit family requires preplanning with my home care company to have oxygen supplies waiting when I get there.”

Another traveler with pulmonary hypertension suggests sending IV medication and supplies ahead by overnight service and arranging for an oxygen concentrator, so that all are in place on arrival.

Traveler Milli Washock advises, “Have a sheet handy with all pertinent medical information, medication, supplies and emergency contacts. Being on [intravenous infusion] therapy and oxygen, I have written on top [in big, bold letters], ‘Do Not Stop Pump.’ And, she adds, for devices that must be charged or plugged in, “When traveling to a foreign country, be sure to have the proper electrical adapters.”

It’s also important to get as much information as possible in advance about the availability of services you might need en route and at your destination. For example, find out what airline, hotel, rail, or cruise staff can assist you with when traveling, and if there is a medical facility specializing in your condition at your destination. If you’re planning a cruise, ask what types of onboard medical services are available, and if there is a fee.

Scandic Hotels height-adjustable bed.
Scandic Hotels height-adjustable bed.

HOTELS, RESORTS, AND THEME PARKS
Travel writer Candy Harrington has been covering accessible travel for the past 16 years and has authored books on the topic, including, Barrier-Free Travel; A Nuts and Bolts Guide for Wheelers and Slow Walkers. She also writes the barrier-free travel blog www.BarrierFreeTravels.com.

Harrington advises travelers with special needs to be very specific about their needs and ask detailed questions when booking a hotel room.

“First and foremost,” she emphasizes, “you have to understand that there are many types of accessible rooms, so you have to ask for an accessible room with the features you need. Don’t just ask for an accessible or an ‘ADA-compliant’ room.

“If you need a roll-in shower, specify that, because all accessible rooms do not have roll-in showers—some have tub/shower combinations. If you need the toilet grab bars on a specific side, you need to specify that too.

“And if bed height is an issue for you, inquire about that also. Bed height is not covered under the Americans with Disabilities Act (ADA), and you could very well end up with a 32-inch-high bed, which would make transfers very challenging.

“Don’t assume that the accessible hotel room is going to have the exact same features that your own home has, because in most cases, it won’t. Ask a lot of questions to make sure you get the access features you need.”

Some hotels are more accessible than others, and good indicators of their commitment can often be found online. Benchmark Resorts & Hotels comprises 13 properties across the United States, and the company’s website promotes Benchmark’s commitment to ADA compliance, with detailed accessibility information for each property.

Benchmark’s Turtle Bay resort on Oahu’s North Shore features 15 ADA-compliant guest rooms and one ADA-compliant cottage. Other accessible features include the resort’s swimming pools, hot tubs, fitness center, spa, restaurants, lounges, and a wide-open door-less gateway entrance.

Magnus Berglund: Accessibility Director, Scandic Hotels
Magnus Berglund: Accessibility Director, Scandic Hotels. Photo by Karl Gabor for Scandic Hotels.

Stockholm-based Scandic Hotels, with nearly 230 properties throughout Northern Europe, has won awards for its hotels’ accessible features, such as a minimum of two cane holders attached to the front desk, carpet-free meeting rooms and height-adjustable beds. In consultation with disability organizations, hotel guests, and team members, Scandic Hotels drew up an accessibility standard in 2003 that works as a checklist and template for the hotels. The standard has grown over the years, and today it contains 110 checkpoints to follow. Eighty-one of these points are mandatory for all hotels, and for new hotels, all points must be considered.

Community spoke with Magnus Berglund, Scandic’s accessibility director, about his work with Scandic and how his service dog, Dixi, helps him throughout the day.

How did you first become involved with Scandic Hotels?
It started about ten years ago, when I was a cook at Scandic Hotels. Due to a muscle disease, I was on sick leave for five years. When I was able to start work again, I contacted my former employer, with my ideas on how the hotel chain could increase accessibility and use accessibility to gain competitive advantage. In 2003, I was appointed disability ambassador for Scandic Hotels.

What is a typical day like for you as Scandic’s director of accessibility?
I work with all departments at head office, on everything from new hotels to renovations. I consult with Scandic’s hotel designers on accessibility, and I’m also involved with employee education within Scandic. I travel a lot, often several times a week, when I visit any of our hotels or when I’m invited as a speaker around the world.

Dixi is a service dog that helps me with everything from getting my clothes to the bed in the morning to picking up things that I drop. She also carries my computer bag when I’m flying, and she follows me on all my trips. Basically, she follows me everywhere I go in my daily work, at the office, at conferences, when I’m invited as a speaker, and so on.

What are some of Scandic Hotels’ smart design features?
A really smart design feature is our cane holder at the reception desk. We also have our vibrating alarm clock that the guest puts under the pillow, so if you’re hearing-impaired, the clock will wake you up so you “hear” the fire alarm. We also have special bread for breakfast for guests who have gluten or lactose intolerance.

What are some of the barriers that travelers with disabilities encounter most often when they travel?
I think it’s extremely different [depending on] what kinds of special needs people have. The big challenge is to get the right information.

For more information on Scandic Hotels, go to www.scandichotels.com/Always-at-Scandic/Special-needs

 

A video on Turtle Bay’s website features paraplegic surfer Jess Billauer, founder of the Life Rolls on Foundation, dedicated to improving the quality of life for young people affected by spinal cord injury, as he easily wheels through the resort, surfs with an adaptive electric surfboard and describes the independence that accessibility brings.

ADA-compliant pool, Benchmark's Turtle Bay Resort, Oahu, Hawaii.
ADA-compliant pool, Benchmark’s Turtle Bay Resort, Oahu, Hawaii. Photo courtesy of Benchmark Hotels & Resorts.

“We do everything possible to make sure everything is accessible,” says Gary Harnist, vice president of construction and design for Benchmark. “ADA guest rooms at Turtle Bay have automatic doors. The peepholes are lower. Bathrooms have roll-in showers, and shower, temperature and lighting controls are at a reachable height. We want to make sure the balconies are accessible, so we have sliding glass doors and ramps.”

Harnist advises, “Ask questions before you arrive. Let us know what your needs are. Many times we’ve sent staff members to the store to buy a lower shower seat, or called a rental company to get the kind of wheelchair a guest needs to insure that their stay is perfect.” For more information about Benchmark Resorts & Hotels, go to www.benchmarkresortsandhotels.com/about/social_responsibility/ada_accessibility_compliance

Roll-in shower, Benchmark's Costa d'Este Beach Resort, Vero Beach, Florida.
Roll-in shower, Benchmark’s Costa d’Este Beach Resort, Vero Beach, Florida. Photo courtesy of Benchmark Hotels & Resorts.

As with hotels and resorts, when planning a trip to a theme park, checking in advance for clarity on accessibility and disability policies can be a good idea. Walt Disney World and Disneyland Resorts made headlines in October when it replaced its Guest Assistance Card (GAS) program with a Disability Access Service Card (DAS).

A Disney Parks blog post by Thomas Smith, social media director, Disney Parks, explains that guests with disabilities can now “request a DAS at Guest Relations and receive a return time for attractions based on the current wait time.” Prior to the change, which Smith said was prompted by abuse of the program, guests with disabilities had been able to go directly to the front of the lines for Disney attractions.

For more information on Walt Disney World and Disneyland Resorts, go to http://disneyparks.disney.go.com

CRUISES
A recent study by the Open Doors Organization and the U.S. Travel Association found that 12 percent of Americans with disabilities have taken a cruise in the last five years.

“Cruises are great for people who need to move slowly and take their time. You can be as active as you want and do everything, or you can do as little as you want, have a nice spot in the lounge and watch the sea,” says Royal Caribbean’s Pettit. “We’ve designed our cruise ships to be very accessible, so there are elevators, ramps, and platform lifts. We have options all over the ship for guests with limited mobility.”

Travel agents can be helpful in sorting out accessible cruise options. Says Pettit, “If you’ve never cruised before, you don’t know the questions to ask, and that’s why we recommend using a travel agent.

“There are travel agents who specialize in accessible cruises and in specific conditions. Some specialize in dialysis cruises, autism cruises, deaf cruises, blind cruises, and disability in general, and not just group cruises. They deal with individuals or families. They specialize, may have the disability themselves, and know the questions to ask. They can help walk you through making an informed decision about the right cruise line and cruise for you.”

Says traveler Milli Washock, “A few years ago, I went on a weekend cruise, with a wheelchair, room air concentrator, oxygen tanks, a portable concentrator and a BIPAP, and did quite well. The cruise line, Carnival, went out of their way to bring me [my oxygen] tanks wherever I was and made sure everything was taken care of in the cabin and with shows and dining. They even had distilled bottled water. We had a great time.”

Oasis of the Seas
The Oasis of the Seas, Labadee, Haiti. Photo courtesy of Royal Caribbean.

For those cruising for the first time, Washock suggests, “Book a room with open air, a window and/or a balcony, and liberally use hand sanitizer everywhere.”

Says Pettit, “Oxygen has changed over the years. What works well for a lot of people now is the new portable oxygen concentrator, what I call’ the magic box.’ It takes ambient air and turns it into breathable oxygen on demand.

“This works well for many people who require oxygen therapy. It may not work for everyone. Some people need continuous air flow. They may need a flow rate that’s higher than what the portable concentrators can give. But for many, many people, portable oxygen concentrators have been revolutionary.

“Portable oxygen concentrators allow passengers to use the same equipment in the plane, on the ground, and on the cruise ships. We have power outlets in our staterooms, so passengers can charge overnight, and they can bring extra batteries as well.

“Technology and the ability of our staff to assist our guests go a long way to help [those with special needs] think about cruising as a possibility. We provide our staff with sensitivity training and technical training, primarily for wheelchair assistance and assisting guests on and off the ship. That’s the number one request that we get.

“We provide training about different types of disabilities and how to communicate with different types of guests. We focus primarily on people with mobility, hearing, and visual disabilities, but we do talk about guests with cognitive or developmental disabilities.

“From an identification perspective, there’s always the question of dignity in providing too much information. The more information we have, the more we can assist you. If we don’t understand your condition, we may provide inappropriate support. If we know ahead of time, it makes things easier.”

Royal Caribbean's Quantum of the Seas accessible balcony stateroom.
Royal Caribbean’s Quantum of the Seas accessible balcony stateroom. Photo courtesy of Royal Carribean.

In February, Royal Caribbean was the first cruise line to be named as autism-friendly by Autism on the Seas, a agency that develops cruise vacation services for those with children with special needs.

Says Pettit, “Our products and services are accessible for guests with autism and other developmental disabilities. We have priority check in, boarding, departure, and special dietary offerings like gluten-free items. We offer modifications to our youth program onboard, like dropping down an age group if the child would be more comfortable, based on ability.

“We offer autism-friendly movies: The sound is not so loud, the lighting is a little bit lighter, and the kids are encouraged to get up and walk around during the movies. We added a social story to help families dealing with autism prepare for their cruise. Often children with autism need a little structure and preparation, [so we let them know that] when you get to the ship, this is what you’re going to see and this is what you’re going to do, so they can prepare. And really, it’s about the entire family and not just children. Many of our features are used by teens and adults with autism.

“Everybody is different. Their needs are going to be different. We can work with our guests and our travel agents to see if we can help accommodate that need. A lot of our business continues to be booked through travel agents. For many people, it’s their first time, or they may have special needs. You may need a little additional help from an expert. It makes for a much better cruise experience.”

Royal Caribbean’s Access Department is a resource center for guests and travel agents. Staff can answer questions about accommodations for guests with disabilities and can be reached at 866-592-7225 (phone); 954-628-9708 (local); 954-628-9622 (fax) or email special_needs@rccl.com. Or for more information, go to www.RoyalCaribbean.com/AccessibleSeas

WHERE TO CRUISE
Pettit says that cruises that involve the United States are often preferable for those in wheelchairs or those who need to move slowly. “Alaska, Hawaii, New England, and Western Pacific coastal cruises are all great options, simply because they involve U.S. ports of call, and, generally, when you’re within the U.S., you have a much better sense of accessibility.

“There are curb cuts. There are accessible restrooms and facilities. Whenever you get outside of the U.S., while there are accessibility regulations in place, they may not always meet the same level as in the U.S.”

“The Caribbean has mixed levels of accessibility. We’ve seen progress over the years in many of our ports of call. People tend to gravitate to the Eastern Caribbean itineraries more because more of the ports of call are docked—that means you can roll on and roll off the ship with ease. When you get to the Western Caribbean, you have more ports that are tender,” says Pettit.

“We sail to more than 300 ports of call around the world, and about one third of those ports are tender. What that means is that our ships cannot dock at a pier. They have to anchor in the harbor, and so we transfer guests onto a smaller vessel, usually called a tender. They take that tender to the port and get off there. That process may pose some challenges for guests in wheelchairs and those who have difficulty walking.

“Our larger ships, like Oasis of the Seas and Allure of the Seas, are great ships for guests in wheelchairs and those with difficulty walking, because they never have to tender. They always dock.”

Royal Caribbean Allure at Port Everglades.
Royal Caribbean Allure at Port Everglades. Photo courtesy of Royal Caribbean.

Bob Curley, Caribbean travel expert for About.com, notes that the U.S. Virgin Islands must comply with the ADA and that “Barbados has also made a pretty concerted effort to be compliant, as have Aruba and St. Maarten. Every cruise port in Jamaica is a non-tender port, and St. Thomas also has a dock.”

Says Pettit, “Europe is becoming increasingly accessible, although it’s mixed. A lot of our ships sail there in the summer. There are cobblestone streets, and there may not always be curb cuts. The buildings are older, so they might not always have the wider doors and accessible restrooms. It does require that our guests and our travel agents research the different ports of call to see which ones are more suited than others.

“The Mediterranean is increasingly becoming more accessible, and the more northern and the western you go, it gets more accessible. When you look at bigger ports, especially those that have hosted the Olympics, because they hold the Paralympics, they have increased accessibility over the years.

“Athens and Barcelona are recent examples, so they may have more accessible taxis and motor coaches and overall facilities for people in wheelchairs. You go to some of the smaller ports, like Santorini, and the island ports, and there are mixed levels of accessibility.

“The challenge we get with different ports of call is usually with accessible vehicles; if a guest has some ability, or a caregiver who can assist them into a regular taxi, or they can go up a few steps into the motor coach, more options become available.”

To improve accessibility for guests with more limited mobility, Pettit says that, in Europe, Royal Caribbean has created Easy Tours—a modified version of the cruise line’s panoramic city tours.

“It’s a narrated ride throughout the city on a bus, with a couple of opportunities to get off to look around. These have a motor coach with a lift, or, more often in Europe, a van with a ramp in the back. These are in about 80 ports and are a great option for guests in wheelchairs or scooters, who have limited capability.”

RAIL TRAVEL
Rail travel has its advantages for those with chronic conditions and medical devices, and train trips throughout the U.S. and Canada can be a good place to start.

Says traveler Milli Washock, “I always used to find a plug at the gate [at the airport] for last-minute charging, but I don’t fly anymore. Traveling [domestically] by train is easier in that there is a plug by every seat. It takes longer, but you have a bigger selection on dining and with movies if you plug in your laptop or device.”

With input from disability advocacy organizations, over the past five years, Amtrak has made accessibility improvements at more than 200 stations. All Amtrak trains have accessible seating and restrooms, and all long-distance trains have accessible bedrooms. Amtrak also offers a discount to passengers with disabilities and their companions.

For more information, go to www.amtrak.com/accessible-travel-services.

Other countries have also made recent improvements in rail travel accessibility. Australia, for example, offers a host of services and special deals to meet the needs of travelers with disabilities, including accessible services in most of its trains. For more information, go to www.australiaforall.com

But accessible international rail travel might be even closer than you think. “We are more accessible than flying or taking the bus,” says Jacques Gagnon, senior manager, media and community relations for Via Rail Canada, Canada’s national passenger rail service.

“When you take Via Rail, you can enjoy traveling while looking out the window and seeing scenic portraits of cities, prairies, and the Rockies, while being comforted by having a quiet time.

(Top) Indian Pacific train journey across Australia. (Left) Via Rail Canada, Toronto-Vancouver route. (Bottom) Via Rail Canada, Montreal-Halifax route. (Right) Via Rail Canada, Montreal-Halifax route.
(Top) Indian Pacific train journey across Australia. Photo © Great Southern Rail. (Left) Via Rail Canada, Toronto-Vancouver route. (Bottom) Via Rail Canada, Montreal-Halifax route. (Right) Via Rail Canada, Montreal-Halifax route. Via Rail photos by Bianca Courtemanche.

“It’s spacious. We have invested in making cars accessible, roomy, and user-friendly for people with limited mobility and special conditions. We also cater to gluten-free and other special dietary needs, with advance notice.

“Canadian laws and regulations provide ample services for people with limited mobility. It’s part of the fabric of Canada to provide accessibility to its citizens and to travelers.

“At various stations we have lifts to allow people with wheelchairs to board the train. We have a dedicated area where the person will anchor his or her wheelchair safely.

“We also allow someone, or a service animal, to accompany that person and ride at no additional cost. We ask to receive 24-hour, or ideally, 48-hour advance notice that someone with a specific condition will be boarding the train so the attendants can recognize and attend to their needs.”

For those interested in viewing gorgeous vistas while riding the rails, Gagnon says, “There are two long-haul routes—one is The Ocean—a 22-hour journey from Montreal to Halifax. The train travels along shorelines of the Atlantic Ocean and has a panoramic car.

“The other one is The Canadian, between Toronto and Vancouver, through the Canadian Rockies and the prairies. It‘s a very scenic three-and-a-half-day journey. The track goes across terrain where there are no highways and roads. It’s very unique—even in the summer time, the Rockies are covered with snow. It’s a very elevated, beautiful terrain, with views of the Pacific Ocean.” For more information on Via Rail, go to https://www.viarail.ca/en/travel-info/special-needs/accessibility

AIR TRAVEL
Getting as much information as possible and alerting the airline to your needs in advance, as well as allowing time for delays, are critical when traveling by air. Be sure to factor in potential traffic issues, lengthy distances between gates, crowds, long lines and flight delays when connecting. And don’t be hesitant to ask for assistance, such as wheelchairs or electric carts, experienced travelers advise.

One flyer says, “My husband has Huntington’s disease, and for him, we found going on the plane with assistance has given him more time to get to his seat without people pushing and being impatient. Also, we request wheelchair assistance at all airports.

“If you’ve ever been to Jamaica, Miami, or Atlanta airports, then you know it’s like walking a mile from one point to another. Imagine if you only have half an hour to get from one gate to the other. Always ask for assistance when needed. Most of the people who work at airports are only to happy to help.”

Traveler Keti Galanos says, “Panic attacks are commonplace for those of us afflicted. I am at the near norm readings for PAH, yet will take medication for the next year. I request a wheelchair, as I cannot run between gates in the airport, and I always panic and am out of breath.”

Traveler Cheryl Kneal recalls, “I traveled to Chicago from Orlando over Christmas. I had my portable oxygen concentrator and had the airline take me to the gate for departure, and then, when we arrived, to where I was picked up, to conserve energy.”

Kneal adds that, to deal with stress and panic attacks about running out of oxygen, she meditated frequently during the two-hour flight.

For those with limited mobility, addressing needs step-by-step ahead of time is key to alleviating stress and making travel as hassle-free as possible. When making your airline reservation, let the agent know if you’ll be traveling with a wheelchair or scooter, if you’ll need one at the airport, and if you’ll need to transfer to one of the airline’s aisle wheelchairs (a narrow wheelchair designed to fit aircraft aisles) to help you board or deplane. Also ask if you can use the aisle wheelchair during the flight to get to the bathroom.

Ask to keep your wheelchair until you get to the gate, check it there, and have it returned to you at the gate on arrival. (Depending on the type of wheelchair you have and space available, it will either be stored in the cabin or in the baggage hold during the flight.)

Flight attendants can help passengers use the aisle wheelchair to get to the restroom, but not in the restroom, and many onboard restrooms are not wheelchair accessible. Flight attendants are also not required to lift or carry passengers. Some fliers with limited mobility limit fluid intake before and during a flight to prevent the need to use the restroom, however doing so can present the risk of dehydration and other medical problems.

Flying can also be unpredictable. Air traffic and weather delays can mean the plane is stuck on the runway before takeoff or circling for an extra hour before landing. If you have limited mobility, it might be advisable to consider flying with someone who can help you in the restroom, or catheterization, rather than limiting fluids.

AIRPORT SECURITY
Candy Harrington advises those who have concerns about navigating airport security in wheelchairs and with medication and medical devices to check the TSA guidelines beforehand.

“Although the TSA is exempt from the ADA and the ACAA, they have developed specific guidelines for dealing with disabled passengers. They list these guidelines on their website, so it’s a good idea to familiarize yourself with them, so you will know what to expect.”

Traveler Ruth Cozad says that she was pleasantly surprised with her TSA experience. “We went to Hawaii with both oxygen and CPAP machines and had an amazing trip. Going through security was my big worry, and it went so smoothly.” For more information on TSA guidelines, go to www.tsa.gov/traveler-information/travelers-disabilities-and-medical-conditions or call the TSA Cares hotline at 855-787-2227 with any access-related questions prior to travel.

DRIVING
For some travelers with chronic conditions, especially those traveling with oxygen, driving can provide the most stress-free journey, and help them slowly ease into travel. Taking short trips from one central location can also help to conserve energy and get the most out of a trip.

Cozad suggests, “My advice would be to stay in one location and take day trips, instead of moving each day. We often take driving trips that last several weeks, and those are easy enough, with my husband unloading and reloading oxygen and CPAP equipment, plus our luggage.”

Milli Washock says, “A lot of people are using the Inogen One portable oxygen device, and it’s nice to go on a plane or a ship. I find it great for long-distance auto travel.”

A potential problem, though, says Washock, is that the device does not have a HEPA filter. She recalls that once, while she was dining out, “a man was smoking a cigar in the nearby bar, and suddenly I was ‘smoking a cigar’ and could not breathe.”

In this case, Washock found that traveling by car had benefits. “Thankfully, I had an oxygen E tank in the car and did not have to permanently abandon my dinner, but it gave me something to think about.”

Despite such challenges, Washock says, “It is good to travel if you can. Just because our bodies do not cooperate the way we want does not mean our brains and lives have to shut down. And, she notes, travel, no matter the distance, can be enhanced by state of mind. “Take it slowly, and enjoy the world around you, whether traveling to your porch or across the world. Each day is a new day.”

 

See Part 2 of our accessible travel story, highlighting some of Washington, D.C.’s top accessible attractions!

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Away We Go!

Posted on by CVCinfo

Living does not end with a lung disease diagnosis.
Life begins with a new challenge.
Meet that challenge.
Be active in understanding your disease,
your rights, your treatment.
Learn all about it with a caregiver or a friend.

Look forward! Make plans! Find a new hobby.
Learn a new game.
Keep in touch with friends, neighbors and family.
And then travel with your oxygen!!

-Sea Puffers

As the first official heat wave of The Summer of 2012 takes the country into it’s grips, youmay start thinking it’s time for a vacation. How about a trip to the Caribbean, Europe, The Pacific Northwest, The Panama Canal or Hawaii? These destinations are among the many hotspots of Sea Puffers Pulmonary Cruises and Vacations. The amazing and unique difference between Sea Puffers and other travel groups is the fact that this organization provides trips and cruises for people who use supplementary oxygen. Onboard a Sea Puffers excursion, guests will find Respiratory Therapists to aid and assist them while they get much needed relaxation time.

Sea Puffers was formed in 2003 by Pam MacKenzie and Celeste Belyea. Pam’s background is in the travel industry; she has been working as an independent agent for over fifteen years. Celeste holds a degree in respiratory therapy from the State University of New York Upstate Medical Center in Syracuse, NY, as well as a nursing degree from Broome Community College in Binghamton, NY. Celeste is founder and editor of The Pulmonary Paper, a not-for-profit organization that provides a newsletter for pulmonary patients and is distributed worldwide.

During the cruises, the organization schedules group gathering times. During thesemeetings, attendees can discuss coping with special needs, hobbies, family and caregivers. Families are also welcome on these excursions and at the same rate as the Sea Puffers. The Respiratory Therapists keep an eye on oxygen saturation levels, and hold seminars about news and ideas pertaining to pulmonary health. Often, a traveler’s insurance will cover the expense of the oxygen and equipment needed for their vacation.

An administrator from the Breathing Better Living Well website said the following: “One of the people in our pulmonary rehab program went on a Sea Puffers Cruise and had a wonderful time! He and his wife could not say enough good things about it. His pulmonary function could be considered very low but they were still able to enjoy something they would not have otherwise even thought about doing. They went to Greece.”

Here at CVC, we love that organizations such as Sea Puffers exist. As they say, living does not end with a lung disease diagnosis. So friends, where will you be going?

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Taking Your Disease on Vacation

Posted on by CVCinfo

Bizarre travel plans are dancing lessons from God.” Kurt Vonnegut

As most of us get ready for the upcoming holidays, we prepare to load up the car and visit with relatives.  For many, the process of travelling involves the planning of what clothes to pack, games to keep the children occupied, and the special fruitcake for Uncle Ernest.

For some, a holiday excursion takes a little more planning.

The first step would be to see your doctor.  Is your condition such that travel would or would not be advisable?  You’ll want to seriously evaluate your health before you hit the road.  You’ll also want to make sure that any medications or treatments that you receive on a regular basis are up to date.  If exposure to groups of people is a high-risk situation with your illness you’ll want to talk to your doctor about vaccines for the flu or other viruses.

You need to plan for your destination.  Is it urban or rural?  What sorts of activities are planned?  How long will you plan on staying?  These are all questions to be answered before you head over the river.  If your host is in a rural area, you’ll need to do a little research to find out what sorts of medical facilities are available.  If you are in a crisis, the last thing that you want to be doing is thumbing through the phone book trying to find the nearest emergency care facility.  The facility that you’ve chosen should be up-to-date on your specific disease.

In planning for activities and the length of your stay you’ll need to think about the medications that you’ll be taking with you.  Don’t run out of your essential medications on day six of a seven-day trek!  A daily routine that requires supplemental oxygen will be exaggerated by holiday sightseeing.  Might be a good time to stock up on the O2!

Supplemental oxygen is also a heavy consideration if you’re travelling by air.  Contact your airline to alert them to your needs and make your condition known upon arrival to the airport and upon boarding your airplane.  Most associations recommend against air travel for people fighting respiratory or heart diseases.  They also warn of the increased risk of blood clotting during extended flights.  Also talk to your airline about any mobility issues that you may have, and find out what sorts of assistance or accommodations they can make for you.

Your flight may be crowded, so the same concerns about other sick people and crowded conditions still apply.  Remarkable as it may sound, airlines have also been known to separate people from their luggage.  Essential medications or documentation will want to stay with you, not buried in the cargo hold for that unexpected trip to Kalamazoo.

As carefully as you’ve packed your medicines, you’ll want some important documents.  You should have a list of your medications, along with their generic names, should you be stuck out of town without what you need.  It is often helpful to have something from your doctor outlining your condition and what you’re prescribed.  You don’t necessarily need your entire file, as that would probably mean another checked bag, but the basics are a good idea.  We did see one company that would put your file on a flash-drive that any doctor could pop into a computer and know who you were.  If this sounds like too much information to travel with, find out what the holiday protocol is for the doctor’s office.  Who can you call on Christmas Eve?

You’ve done a great deal of planning to do some travelling this holiday, but have you spoken to your host?  The folks that you’re going to be seeing should know up front what to expect.  Don’t feel uncomfortable about sharing your condition and it will save them the awkward feeling of having planned something inappropriate.

Once you’ve gotten to your destination, HAVE FUN!  See some friends and family, and share in some good tidings.  Relax, keep up with your body’s rhythm for sleeping and eating, and enjoy.  When you get back, share with your doctor anything unusual that you experienced during your trip, and show him your post-holiday smile!

The Centers for Disease Control has a tremendous list of links for every possible travel/medical situation.  It also has current advisories for overseas travel and outbreak alerts.

We’ll chat after the holidays when we can welcome you home.

No one realizes how beautiful it is to travel until he comes home and rests his head on
his old, familiar pillow.” Lin Yutang

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