Chronic kidney disease affects millions of Canadians. With medical advances, kidney transplantation is now considered to be the standard of care for treatment of many of those patients.
Canadian rates of success for transplantation are very good with long term success in patients in all age categories. Many of these patients go on to resume most or all of their normal daily activities, including international travel.
There are some important tips for patients travelling with suppressed immune systems, such as kidney transplant patients.
The first, and most important, is to have a fulsome discussion with your transplant medical team to ensure that you are cleared for travel. Your medical team is the best source of information and it is key to keep them involved in any travel decisions you make.
When meeting with your medical team, you may want to discuss the following with them:
1. Effect of Anti-Rejection Medications on Travel. Many kidney transplant patients will be required to take anti-rejection medications (immunosuppressants) which decrease the body’s immune response to a foreign substance in the body. Because the transplanted kidney is a foreign object, the immunosuppressants are designed to prevent its rejection. However, the immunosuppressants may also increase your risk of having other infections so it is important to keep this in mind when travelling.
2. Timing of travel. Kidney transplant patients need to have routine blood work and check-ups to ensure the transplanted kidney is functioning, and that the medications required to ensure the success of the transplant are not causing other side-effects like high blood pressure, infections etc. Therefore it is important to understand when you will need to return for follow up care when planning your travel schedule.
3. Vaccines. Discuss with your kidney transplant team whether there are any vaccines recommended for your destination and whether these can be given safely to people with weakened immune systems. If your team agrees that a vaccine is recommended, your physicians may recommend blood tests to ensure that the vaccine is effective, or whether additional precautions are necessary. In some cases, they may recommend choosing another travel destination.
4. Medicines. Make sure to have more than enough medication with you (at least an extra week of medication) should there be any travel delay. Take the medicine with you in their original bottles and make sure they are all in your carry on luggage in case your checked luggage is lost or delayed.
5. Effect of Time Change on Medication. Post-transplant medication may be time sensitive which means you should take it at roughly the same time every day. If you are travelling to a destination with a time-change, make sure you talk to your doctor about when to take your medication on your travel days, and on your arrival. You do not want to miss a dose, or to double-up on a dose, due to a time change.
6. Food and Water. People with weakened immune systems can be prone to traveller’s diarrhea and other illnesses. It is important that you follow medical advice for eating and drinking safely. In addition to all medical advice, it is wise to always wash your hands and preferably also use hand sanitizer. Exercise caution when eating local food to avoid food borne illnesses. It is best to avoid eating raw fruits or vegetables. Water borne illnesses can be very prevalent, especially in developing countries. Drinking bottled water, and using it for teeth brushing etc., is a start, but is is also important to avoid wet serving dishes, cups, and utensils.
7. Quality Health Care. Check out the Health Care available in your local destination. It is best to travel to destinations with a robust health care system that will be able to treat you should any complications arise while travelling.
8. Quality Travel Insurance. Make sure your travel insurance covers you for EVERYTHING. Many health insurance providers in Canada have stability periods or exclusions. This can mean that if any of your medications or health status have changed, you will not be covered. Make sure you get coverage from ClearCompare.ca which does not have any stability period requirements or exclusions. ClearCompare.ca provides policies from top insurance companies including Manulife and AIG Travel Guard. They regularly cover patients who have successfully received a Kidney Transplant, allowing their customers to travel with peace of mind that should they have any complications while travelling, they will be covered.
9. Emergency Contacts. Keep a list of all of your medications and emergency contacts with you at all times, including the names and numbers of your medical team in Canada. Check with your team as to whether you should be wearing a Medical Alert bracelet.
10. Sunscreen. Bring high quality sunscreen and wear it! Some transplant medications can make patients more susceptible to the sun and since travellers often seek out sunny locations, this is especially important to remember when travelling.
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