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March 5, 2008 > Have Oxygen, Will Travel

Have Oxygen, Will Travel

Traveling With Oxygen for Lung Disease Patients Requires Preparation

For patients living with lung disease, air travel can be tricky. And for those whose lung condition requires them to use oxygen at sea level, flying for an extended period of time - say to the East Coast or abroad to see relatives - at 35,000 feet will almost certainly require oxygen. For those with particular lung and cardiac conditions this type of journey takes time and preparation for a variety of reasons, according to Washington Hospital's Pulmonary Rehabilitation Program Coordinator Margaret Chaika, RCP.
"Air travel for patients with COPD is getting to be a big issue," Chaika says. "Pulmonary patients are traveling a lot more these days, and to make sure it is a safe journey for them, patients need to be prepared well in advance of their trip."
Those with a moderate to severe classification of lung disease will likely require oxygen on a trip lasting more than a couple of hours. And that's not all. For patients considering even a car trip to a popular destination such as Reno, they need to remember that they will have to function at high altitude during their stay.
"Lung diseases such as chronic bronchitis, emphysema and pulmonary fibrosis are characterized by obstruction to airflow that interferes with normal breathing," Chaika explains. "Traveling by airplane exposes people to decreased air pressure and lower than normal oxygen levels. For most people, these changes are not noticeable. However, for patients with certain underlying lung disease, small atmospheric changes can have significant and potentially severe effects."
Patients with both lung disease and/or a cardiac condition, such as an arrhythmia, are much more likely to be affected by a decrease in available oxygen, either on a plane or at a higher altitude location. They are also more susceptible to communicable diseases, such as the common cold, pneumonia or the flu, especially when traveling in close quarters such as an airplane cabin because underlying health factors often weaken their immune systems.
For patients planning to fly, Chaika highly recommends making an appointment with their physician well in advance of the trip - even before purchasing tickets. She adds that another consideration for pulmonary patients is the hefty cost they may incur to travel with oxygen on a commercial jet.
"The guidelines state that for any flight longer than two hours, you should probably have a high altitude study before traveling," she says. "An airline can only accommodate so many passengers on a plane with oxygen and each airline has different requirements. You have to check ahead of time with the airline. If you try to do it all two weeks in advance, that gives you little time to try to complete the appropriate blood work, testing and to visit your physician. Planning three months ahead of time is ideal, because you must remember that some tickets are nonrefundable."
Chaika also suggests patients carry a list of their medications and ask their physician for a letter of introduction that provides treating physicians with a patient's medical background and any other pertinent information. That way, if there is an emergency and you are far from home, the local medical personnel will be able to treat you appropriately.
Many times, Chaika herself will put together a medical history summary for patients, which might include their demographics, regular physician's contact information, list of medications, a copy of their pulmonary function test, recent chest X-rays and EKG results. She says it has come in handy for her own patients when they have found themselves being admitted to the Emergency Room in a hospital thousands of miles from home.
Other ways to make air travel safer and more pleasant for patients, according to Chaika, include:
* Arranging to travel with a companion that can assist you.
* If you have to connect planes, make sure there is a wheelchair available to meet you - but nonstop flights are even better because you don't have to deplane.
* Stay hydrated when traveling. Drink water, not alcohol, and avoid caffeinated drinks.
* Do leg lifts and ankle rotations to keep circulation going.
* Avoid salty foods; pack a healthy snack if the airline will not be serving food.
* Bring hand sanitizer with you.
* Carry a letter of introduction from your physician summarizing your medical history for medical personnel.
* Have a warm beverage to heat the air and introduce moisture, which can improve breathing.
* Be aware of how dirty items are when traveling by plane. Try not to touch objects such as blankets and pillows. Bring your own if you can.
* Wash your hands often.
* Make sure you have your flu shot and pneumonia vaccine before traveling.
* Never pack your medications in your luggage - always keep them on your person in case of emergencies.
Having an arterial blood gas (ABG) test before traveling can help your physician identify the concentrations of carbon dioxide and oxygen present in your blood and can help determine whether or not you need oxygen when traveling. Chaika notes that patients must have written consent from their physician to travel with oxygen.
Because all airlines have different restrictions and requirements for patients traveling with oxygen, Chaika stresses that patients should contact the airline they are thinking of traveling with and asking for information before booking their travel arrangements.
To find various airlines' policies regarding in-flight oxygen use and equipment, visit the Airline Oxygen Council of American's Web site at for a list. When you call an airline, be sure to ask if they have a special services office, medical department, or a help desk to assist you in arranging for in-flight oxygen.
"Even the best laid plans for traveling can run into emergency, so be prepared," Chaika says. "Planning in advance might save you time, money and hardship."
To learn more about Washington Hospital's Pulmonary Rehabilitation Program, visit, click on "Services & Programs" and select "Pulmonary Rehabilitation" from the drop-down menu.

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