Foreign Travel with RA

In December 2019, I was invited to speak at the International Diabetes Federation (IDF) biannual meeting. I was invited to speak in January 2019 and, between January and December, I worked extremely hard on my presentation to get it just so. As far as the presentation was concerned, I was ready for the event and, yes, more than a little nervous. I wanted to be sure I did a good job. I believe I did and, for that, I am grateful.

Stepping up to the challenge

In addition to the presentation, I also prepared for travel. This adventure required that I travel to South Korea and stay for seven days. It was the first time I have ever traveled to South Korea and I found the trip to be challenging but also exciting.

Even in the best of circumstances, the trip itself was challenging. But when one adds in rheumatoid arthritis, ankylosing spondylitis, and diabetes, it was more than challenging. Yet, the opportunity to speak at a conference of this magnitude and to travel on mostly someone else’s dime was too good to pass up.

6 tips for foreign travel with chronic illness

Since that time, COVID-19 has gripped the world and foreign travel has gotten more difficult. Here are my six tips for foreign travel with chronic illness, with tip one dealing with COIVD-19 - thankfully, something I did not have to deal with.

1. Where are you going?

Know where you are going (this includes all border stops) well before you leave. The world is full of advisories and restrictions. COVID-19 is a major issue, but so is violence and weather. For US citizens, you can check most of these alerts at the United States Department of State Travel site. I know what you are thinking: "Hey I am an American and I will do what I want when I want to." Well, not so fast.

Various countries around the world are restricting US visitations. Usually, if you cannot enter a country, you will be stopped before you get on the airplane, ship, or train. Still, that is a terrible time to find out you cannot go. Even countries you might be able to visit may have quarantine restrictions that make entrance impossible. For instance, if a country requires a fourteen-day quarantine and your trip lasts 7 days, there is little reason in going forward. If such a disparity exists, be prepared to hear about it, with special emphasis on not allowing you to go in the first place.

If COVID-19 restrictions had been in place in December 2019 as they are now, I would not have traveled to South Korea since it is currently listed by the U.S. State Department as having a stage 3 of 4 alert or reconsider travel. In the future, if you check this link, the status might have changed.

2. Take your medications

Oh, what a pain. I travel with 14 different medications, plus two types of insulin, insulin pump supplies, methotrexate, and several dozen back up syringes. I am a walking pharmacy and I hate it. But as convenient as it might seem to leave part of the medications at home, I buckled in and took the complete show on the road. Oh, goodness, what a mess.

I had to plan that, if any of my hardware (pump supplies, syringes, etc.) failed, I would be in serious trouble 14 hours away from home. So I packed what I needed and two backups. This is my typical routine for hardware. But when I was dragging that stuff through the third airport of the day, I thought, "Oh I wish I could have left the excess material at home." As it turned out, it was good I did not. My pump failed the day before I came home, and I had to resort to my backup material to make it home.

And on the subject of medications, the Food and Drug Administration, Transportation Security Administration, and the United States Department of State advised that I should take my prescriptions in their original containers/vials. I was worried that if I did not comply, that someone could confiscate my mobile pharmacy.

No one at three border points ever looked or concerned themselves with the medications. But just as sure as I would have divided them into individual packets and not had the prescription information, someone would have wanted it. I am glad I decided to comply since it just gave me some security of knowing that part would be alright.

3. Minimize border crossings

I know this sounds like common sense, but in my case, there were no US to Busan, South Korea, flights available. No matter what I did, I had to stop in Japan for a connection. While I never technically entered Japan, I was still subjected to screening before I was able to get to my gate for the flight to South Korea.

This taught me a valuable lesson if I ever travel internationally again. Namely, do not do that third country stop if you can avoid it. If I were to do it again, I would ask to change my itinerary so I could fly to Seoul and then take a regional airline to Busan. The reason is that there are direct US flights to Seoul, and the additional border crossing and screening adds stress and significant delay to the trip. See tip one.

4. Sleep

There are various thoughts about sleeping and international travel. One school of thought is to hit the ground running at your new destination - go with the new time zone. So if it is time to sleep, do that; if it is the middle of the day, keep going until the new bedtime.

I arrived at 2:00 AM so I took the next sleep option. It would not have mattered if it were 2:00 AM or 2:00 PM, I was going to bed. I was exhausted after 20 hours of travel and there was no way I was going to stay awake. I hit the room and hit the bed in almost the same motion. I do not recall removing my pants but, when I woke up, they were on the floor. I assume there are no pants monsters in South Korea that snuck into my room and took off without my knowledge.

5. Take the methotrexate

Oh, I struggled with this one. I am usually ill at least one-half day after I take methotrexate. And who wants to do that when in a foreign country? Not me for sure. But I did it because it helped me keep a schedule similar to my normal schedule and who wants to risk more joint pain while going through airports?

6. Have fun

Remember the reason you went. I did not accomplish everything I had hoped. I did not do much sightseeing except to walk around a large shopping mall and a fantastic food court. I tried at least one new food each day while I was in South Korea, and I worked on using chopsticks (I used them exclusively for two meals each day and yes, it was not pretty).

But I had a good presentation and I enjoyed myself. I have to remember that I could go back if seeing and experiencing more of South Korea is important. I need not have done it all on one trip. By conserving energy, I had a good time and accomplished my purpose while there.

I enjoyed South Korea

I hope someday you get the chance to experience South Korea. Its people and the city of Busan were amazing. It was well worth the trip and yes if asked, I would... well, decline. I had a blast, but the trip took a toll on me that I would not repeat. But I would never absolutely dismiss a chance to see a country for the first time on someone else’s dime.

Weighing the risks and benefits of another trip to Asia

So if someone asked me to attend and speak again in another country, I would weigh the benefits and risks and make another decision, weighing Sheryl’s considered opinion of course. So, while I would not go back to South Korea, I would not reject foreign travel altogether. So the biannual meeting in Thailand in 2021? If I were invited to speak once again, I would have to - well, let's not prejudge. Getting to Busan took some persuasion from Sheryl. So Thailand? Let's cross that bridge if we get to it.

Note: The International Diabetes Federation provided my airfare and hotel in exchange for my participation at the meeting. My opinions and comments are my own. This blog posting was not a requirement of participation.