Traveling with Allergies

by Robin Bayley

Those of you with allergies to food and airborne allergens may have given up on travel due to the risks, obstacles and discomfort frequently associated with it. However, if you start small with short vacations to places where they speak your own language and take some precautions, you may soon gain the confidence to become a world traveler.

Some of the challenges allergic people face regarding overnight accommodation are:

• Difficulty identifying accommodation with cooking facilities
• Higher cost of accommodation with cooking facilities
• Highly scented cleaning products and poor ventilation in rooms
• Difficulty in avoiding pet dander
• Moldy air conditioners and ducting
• Dust mites in bedding

Some of the challenges relating to air travel include:

• Having pets allowed into the airplane cabin
• Sharing the air with highly scented people on airplanes
• Having to walk through duty-free store areas (with highly scented environment) in order to gain access to airplanes
• Lack of facilities to warm up meals in airports and airplanes
• Snacks containing common allergens such nuts and sesames served on flights
• Luggage restrictions and waiver forms that challenge the right to carry food in coolers and do not recognize the need to carry food as a medical necessity

Inclusive package deals and even day activities can discriminate in that services cannot be disaggregated (i.e., meals included), and the allergic individual subsidizes the others.

Overcoming these challenges and barriers takes effort. Planning and advance preparation are key. However, enjoying the benefits of travel are usually worth it. In addition, once you have prepared for one trip, future trips take less work.

The tips below apply to both business and personal travel. They have been compiled by a highly allergic individual who travels a good deal. They may not address all the requirements of every allergic individual. They assume that the allergic individual will not eat in restaurants, or that information from other sources on how to deal with allergies in restaurants will apply whether the restaurant is at home or abroad.

The purpose of the tips for traveling with allergies is to suggest to allergic individuals how they can experience the world of travel without experiencing asthma problems or allergic reactions, while being prepared to survive them, should they arise.

Tip #1 - Self-cater

• Take charge of your food intake by doing your own cooking. This avoids risks in areas of the world where you may not speak the language or know how to reach emergency services.
• You can self-cater by renting accommodation with cooking facilities, or take your cooking equipment with you.
• When traveling by car, or luggage considerations allow, take a small hot plate, camp stove and/or microwave and a set of camp pots and utensils so you can cook if you do not have kitchen facilities in your accommodation. If it is good weather, you can cook and eat enjoyable meals at picnic tables in parks, often with unsurpassed scenery.
• Bringing your own pots and cooking utensils also prevents cross-contamination from your accommodation's cooking equipment if you get a kitchen, or can save the extra cost of getting a room with kitchenette.
• Another useful and compact piece of equipment is an immersion water heater. This plugs into an electrical outlet and has a probe that heats up to boil water, allowing you to make hot beverages or re-hydrate commercial or your own dried soups or other meals. You can even use it to boil eggs. Make sure you also take an unbreakable vessel to put it in, although a hotel coffee pot may do. You can find them in travel accessory stores. Remember to take an adaptor for foreign countries.
• Depending on your particular allergies or asthma triggers, carry your own:
  • Anti-allergen pillow cover (if you do so, create a fool-proof way to remember it when you move on)
  • Toiletries, including hand soap, for the hotel room
  • Food for travel time (allowing extra for delays)
  • Small quantities of food preparation basics like flavorings and spices (e.g., salt & pepper, sugar, garlic powder, mixed herbs) in little screw-top containers available in camping equipment and travel stores
  • Unscented laundry detergent
  • Medications & prescriptions
• Don't rely on airline food. Bring your own in a soft-sided carry-on cooler or an insulated lunch kit.
• Bring some of the foods that may be difficult to find elsewhere, and bring supplies for the first day's meals - especially breakfast.
• Bring some cleaning supplies like cloths imbedded with dish soap and re-sealable cleaning wipes. These are seldom available in kitchens with dishwashers.
• Take advantage of grocery services offered at some suites hotels by faxing a list in advance or your arrival, specifying the brands you know and not to substitute if something is not available (if its alternative is likely to be an allergen).
• Put all the equipment you are likely to use through the dishwasher on your arrival. Items like can openers may have been used to open tuna or cans of nuts and not been washed. Coffee makers may have been only rinsed out after brewing flavoured coffees which could contain nuts or other allergens.

Tip #2 - Help your travel services providers help you.

• Let the airline, rental car agency or hotel know you have allergies, what your allergens are, and what you require. This is a service industry. Staff are accustomed to dealing with special requests.
• Things you might ask for in your accommodation:
  • a HEPA filter air cleaning appliance to be set up in your room
  • no down bedding
  • non-scented cleaning products
  • no smoking and no pets room
  • kitchen or efficiency suite
  • dishwasher
  • extra cleaning for the kitchen - e.g., wiping cupboard knobs
• A dishwasher is important. You don't want to spend your whole vacation cooking and washing dishes. Also, if there isn't one, you may find that dishes and cooking equipment is not absolutely clean and has allergens on it.

Tip # 3 - Consider non-traditional accommodation

• There are more full-service suites hotels with kitchens available now then ever before. Find a chain you like and stick with it.
• Some long-term stay properties (furnished apartments) designed for business people will allow shorter stays, especially in seasons when business travel is down - e.g., summer. You may have to pay a special cleaning fee, but it may be worth it for the space and comfort of an apartment.
• Try camping instead of a traditional hotel/motel vacation. This may only be an option for driving vacations, due to the equipment involved.
• If you are flying, rent an RV at your destination. While expensive, RVs may be an economical option for families.
• Vacation home rentals can provide all the comforts of home. Many have minimum weekly stays, but some have flexibility. They are easy to find on the internet. Type in your destination and "vacation home rentals".
• Many of these non-traditional accommodations they often have washer/dryers, you can wash bedding and towels with unscented detergent. Packing light on the clothing and washing it while away can give you the extra room you need in your luggage for other allergy-related equipment or cooking supplies.

Tip #4 - When booking, ask questions and ask for written confirmation

• When making special requests, explain the reason. People may take health issues more seriously than personal preferences.
• A fully equipped kitchen is in the eye of the beholder. Ask specific questions about what appliances and equipment is in the property. Ask for a list. If you want an oven, don't count on it being there. You could arrive to find a one-burner hotplate. Ask about the size of a refrigerator, or you could be challenged to fit the contents of your cooler into a bar fridge.
• If the property will not send you confirmation, note what they told you would be included and send them a confirmation, with a way of contacting you if your understanding is not correct. While this may not ensure that you get everything they said they would provide, it gives you recourse.

Tip #5 - Be prepared for things to go wrong

• Ensure that you have adequate medical travel insurance if you go out of province or country, as the cost of treatment, even outside your home province or territory can derail a vacation budget. Make sure that you list your allergies or asthma as a pre-existing condition, or you risk having a claim disallowed. Most general insurance agencies carry travel insurance, and it is more reasonable than you might think.
• When things go wrong, be polite, assertive and be able to provide documentation. For instance, if you made it clear that you required a fully functioning kitchen when you reserved and you arrive to find a vital piece missing or not functioning, have your registration request or confirmation that indicates that this will be provided. You may even find that you get an upgrade if you are assertive yet civil.
• Have with you the name of the person you spoke to or dealt with in making your special arrangements.
• Carry a note from your doctor (with the doctor's contact information) that indicates the necessity for you to carry emergency medication such as an Epipen and your own food (or whatever is appropriate) in case you are challenged at an airport or customs and excise.
• Have extra medications with you, in different locations, in case one bag goes missing.
• Have prescriptions for your medications with you. Remember that in some countries, non-sedating daily or fast-acting, high-dosage antihistamines and Epipens require prescriptions.

Tip #6 - Prepare to be exposed to allergens during air travel

• The last place you want a reaction is at 30,000 feet over remote terrain. While flight crews may have emergency equipment, they are not authorized to use it all (e.g., Epipens).
• When flying, make sure medications are in your carry-on luggage because you may need them on the flight. This also avoids losing life-saving medication if your check-in luggage is lost.
• If you are traveling alone, let a person sitting near you know of your condition and show them your Epipen or other equipment and where it is located. Ask if they are willing to use it.
• You can ask to be re-seated if you are near a person with an allergen like strong perfume. Airlines are not obligated, but they will often try to accommodate you.
• Let the airline or rental car agency know you have allergies and what you require. (However, use caution with airlines, as they may deny you boarding if you tell them you are allergic to pets and a person with a pet arrives at the gate.)
• Get the contact name and number of someone within the airline who can help you if you face difficulties at the airport or when you check in.
• Discuss with your physician whether you should ingest anti-histamines prior to boarding airplanes, keeping the dosage up during long flights. If the timing allows, ingest it before going through to your gate, in case you are exposed to allergens in the duty-free shopping area.
• Counteract the effects of the antihistamine with consumption of water. Flight attendants will refill wide-mouthed water bottles if you ask. Be careful though. You don't want them touching your bottle if they have been touching allergens.
• Have extra food with you in case of delays (and do not rely on being able to heat it up). Also have some basic survival food that may be prepared for you in case you are in a long-term delay or an accident.
• Remember to ensure that you do not touch your eyes, mouth or nose with hands that might have become contaminated from the traces of seafood, nuts or other allergens left on the armrest or other surfaces by previous passengers. Consider wearing lightweight gloves to remind you.

Travel widens people's horizons and offers a break from the stresses of everyday life. For those with allergies and asthma, travel can present challenges and stresses. However, the rewards of travel and the opportunity to experience what others consider the normal, pleasant experiences of life make the work and pre-planning worth the effort.

from Allergy & Asthma News, Issue 3 2005