Traveling for COPD Patients From Oxygen to Medications, Everything People with COPD Need

Taking a trip is stressful for anyone, let alone someone with chronic obstructive pulmonary disease (COPD). Difficulty breathing can pose a number of problems – from carting around oxygen to dodging allergens and sick travelers. But with the right supplies and precautions, you can still have a “bon voyage”... When Bonnie Chakravorty travels, she packs items all travelers need, such as tiny toiletries and several changes of clothes and shoes. But she also totes a few extra ones others don’t: a portable oxygen concentrator, respirator, medications and more. That’s because the 59-year-old Nashville resident has chronic obstructive pulmonary disease (COPD). Sometimes she needs supplemental oxygen to treat COPD symptoms, such as shortness of breath. But that hasn't stopped her from hitting the road for work and pleasure. “It’s a hassle, but not too bad,” says Chakravorty, a public health professor at Tennessee State University. “It’s almost like traveling with a dog or cat. You have to make [arrangements] ahead with the airlines, for instance.” Traveling can be more challenging for COPD patients because they often have extra needs and restrictions and must tote supplemental oxygen tanks (filled with compressed oxygen) or concentrators (which concentrate the oxygen found in surrounding air). And certain destinations can make breathing more difficult. COPD refers to a family of diseases that includes emphysema, a disease that destroys the air sacs in the lungs, and chronic bronchitis (usually defined as lasting more than three months), which leads to inflammation and eventual scarring of the bronchial tubes. But COPD patients don’t have to be homebound – as long as they seek advice before they travel. “Most people with COPD, even those who use oxygen, can travel, but should contact their doctor first,” says Norman Edelman, M.D., chief medical officer of the American Lung Association. “Have your ducks lined up and know what you’re doing,” Chakravorty agrees. Whether by sea, air or ground, here are some tips for traveling with COPD. 1. See your doctor Before your trip, discuss travel plans with your doctor to get an honest assessment of your abilities and needs on the road, Edelman recommends. For example, ask whether you’ll need supplemental oxygen, particularly if you’re flying. 2. Get vaccinations Make sure immunizations are up to date and get a flu shot (influenza vaccine) and pneumococcal conjugate (PCV13) vaccine to protect against pneumonia, suggests Brian W. Carlin, M.D., a pulmonologist and chairman of the COPD Alliance, which provides clinicians and patients with information about COPD. “You’re more likely to catch influenza when traveling, especially if you’re in a closed compartment in a plane, train or car for a long period,” says Michael Zimring, M.D., director of Travel Medicine at Mercy Medical Center in Baltimore. COPD patients are also more susceptible to pneumonia, an inflammation of the lungs, which can result in unexpected hospital stays. 3. Check out your equipment Have your doctor test the equipment, such as compressors and oxygen concentrators, that you’ll be using while traveling, to prevent possible malfunctions and breakdowns. Also, get a concentrator before your trip to determine if you can handle it on your own or will need assistance to get to the plane, advises Carlin. “It can be cumbersome along with your purse and other carry-ons,” Carlin warns. Portable, battery-operated concentrators about the size of a laptop and weighing 15-20 pounds are available. (The Federal Aviation Administration requires COPD patients to carry battery power for 150% of your scheduled flight time.) 4. Discuss your destination Tell your doctor where you’re going, advises Carlin. That’s key if you’re going to a high-altitude place, such as Denver, Phoenix and Las Vegas, because high altitude can trigger shortness of breath, or hypoxemia (low blood oxygen), he says. The air is thinner and oxygen concentrations are lower at high altitudes, and even COPD patients who don’t use compressors at home may need supplemental oxygen supply in those cities, Carlin says. “People think of it when flying, but may not think it’s as significant when they go to a higher altitude,” Carlin says. “Then, suddenly you’re sleepy and your blood oxygen levels are out of whack.” At high altitudes, exercise a little lighter than normal or use supplemental oxygen when you exercise, says Carlin. 5. Prepare for weather Check weather reports and avoid smoggy regions or seasons, which are particularly a problem in places like Los Angeles, Pittsburgh and Phoenix. “Smog is irritating to people with COPD, so maybe you shouldn’t go to those areas in summer,” Edelman says. On car trips, use air conditioning and keep windows closed, especially in smoggy conditions and traffic jams, where exhaust can cause lung irritation, Carlin suggests. 6. Make plans with the airline COPD patients can’t use their own oxygen compressors (gas in tanks or liquid oxygen) on planes, but airlines allow FAA-approved battery-operated portable oxygen concentrators (POCs). To use a concentrator, you must show medical necessity and get permission from the carrier, typically at least 48 hours before your flight. Rules vary by carrier and are subject to change, so call the airline’s help desk a few weeks before your trip. Ask the airline representative what you need to do to get oxygen aboard the plane, Carlin advises. 7. Arrive at the airport early “The worst thing [for COPD patients] is having to rush through a huge, crowded airport,” says Edelman. Some carriers require patients with oxygen to check in at least an hour before a flight. 8. Use the special screening line Your biggest need for oxygen may actually be at the airport, walking around, going through screenings or trying to catch a plane, says Zimring, author of Healthy Travel: Don’t Travel Without It (Basic Health Publications). The Transportation Security Agency (TSA) allows supplemental oxygen and other respiratory-related equipment and devices, such as respirators and nebulizers, through airport security checkpoints. But you will have to get into a special-needs screening line. Often called “family lanes,” these are available at every checkpoint and should be marked with signs. To stay connected to oxygen during the TSA screening, you must have a doctor’s note showing medical necessity. If you normally use an oxygen compressor, the TSA allows you to stay connected to it until you get to the gate. You’ll have to switch to a concentrator on the plane. You’ll also need to make arrangements for someone to pick up the compressor equipment from you at the gate. That person will need a gate pass, which also needs to be arranged at least 48 hours in advance through the airline. The same process applies if you have someone with an oxygen supply meet you at your destination or at a layover airport. Oxygen rules for international carriers vary, so it's extra important to check in advance. 9. Contact the cruise line before sailing If you are cruising and using supplemental oxygen, tell the cruise company you have COPD at least 4-6 weeks before departure. Cruise lines require a letter from your doctor, which should include a brief medical history and a current oxygen prescription. You’ll have to make advance arrangements to use oxygen tanks and have them delivered to the ship by a medical supplier. Even if you don’t need supplemental oxygen, have a brief medical history available to show the shipboard doctor if an emergency arises at sea. 10. Make train and bus arrangements before your trip Amtrak allows portable oxygen equipment (bottled oxygen and concentrators) that doesn’t rely solely on onboard electrical power. But you need to make a reservation and tell the railroad that you plan to use oxygen at least 12 hours before your trip. Bus companies typically allow use of portable oxygen equipment, but check with the line before your departure. For example, some companies limit the number of canisters allowed onboard. If you’re traveling internationally, check with the bus or rail line because policies vary. 11. Map out medical suppliers along your route Using compressed air tanks? On long car trips, plot places to purchase extra tanks along your route in case you have a malfunction or run out. Your medical supplier may have branches you can visit. 12. Avoid COPD triggers in hotels Triggers for lung irritation are the same on the road as at home. That’s why you should request non-smoking rooms and floors, Edelman suggests. Third-hand smoke can be irritating to the lungs, he says. If allergens are a COPD trigger, request an “allergen-free” room, which some hotel chains, such as Hilton, offer. It means extra steps have been taken to reduce dust and other allergens, such as wood flooring, shades and hypoallergenic linens. As of early next year, most cruise ships will ban smoking in all cabins, though some lines still allow smoking on cabin balconies. Check with the cruise line about their policies. 13. Pack essentials Whether traveling by plane, boat, car, bus or train, experts advise that you take these items: Extra supplies of your medications in case you get delayed or stranded. Copies of all prescriptions in case you need a refill or luggage is lost. Put it in your carry-on luggage. Names of local doctors or hospitals at your destination where you can seek help if needed. Also include a list of phone numbers for your insurance company and health-care providers (e.g., doctor and respiratory therapist). A written note from your doctor detailing your medication and oxygen needs with a brief description of your condition. You may need this at the airport if you’re taking an oxygen concentrator. All medications, including inhalers, nebulizers or bronchodilators, in your carry-on in case of delays or lost luggage. Hand sanitizer, either wipes or gel (3.4 ounces or less to meet TSA requirements), in your carry-on. “If you’re in an airplane where there are probably other people [who are] sick, someone may have coughed and touched the door handle,” Carlin says. “Be aware of that and wash your hands.” 14. Stay home if you’re sick It’s a good rule for all travelers, “but COPD patients should think twice about” traveling when sick, Carlin advises. That’s because people with COPD are more susceptible to respiratory infections. 15. Move your body On long plane, train or road trips, “you don't need to get up and stretch your legs because of COPD, but because of deep vein thrombosis,” a condition in which clots form in veins, Zimring says. “You must move your legs to avoid clots,” he advises. For more expert advice and information, visit our COPD Health Center. How Much Do You Know About COPD? Chronic obstructive pulmonary disease (COPD) is on the rise, according to the National Institutes of Health. More than 12 million people in the U.S. are currently diagnosed with it, and another 12 million may have it but don’t know.