Multiple Sclerosis (MS) is the most common disabling disease of the central nervous system in young adults — right when they’re in their prime years to travel and experience the world. Although MS comes with challenges when it comes to travel, with careful planning, you can avoid most complications and enjoy the trip.
Traveling with MS brings forth a unique set of challenges.
Most potential problems while traveling with MS can be avoided with careful planning and preparation.
Discuss possible issues with your clinician before traveling.
Living with MS brings unique challenges, such as possible triggers and managing a medication regimen. In addition, traveling brings further unique challenges to the mix.
MS Medications when traveling
A recent study demonstrated that about 30% of MS patients took more than five medications daily, including controlled substances. Traveling with these types of prescription medication can bring on unique challenges. For example, always stock up on your medications. Keep them in your carry-on bag — not a checked-in bag — to ensure they travel with you to your final destination.
Furthermore, ensure you carry a copy of your prescriptions with you. Also, if traveling internationally, familiarize yourself with customs regulations beforehand, as some medications may be illegal in some areas. For example, Adderall, a commonly controlled prescription medication in the US, is strictly outlawed in Japan, which has led to countless Americans being detained at the border.
Mobility & temperature
As multiple sclerosis is associated with limitations in mobility, it is of utmost importance to know your limitations and to ask for assistance at the airport.
Additionally, heat and humidity are common triggers in MS. Therefore, if you’re traveling to a warmer climate, double-check the weather and availability of air conditioning. In many areas outside of the US, air conditioning is not as common or not available. Therefore, it may be prudent to have a backup plan if the heat becomes unbearable. For example, ask for ice on the plane or carry towels that you can wet to keep you cooler.
Vaccinations & prophylaxis
As multiple sclerosis is immune-mediated, some medications that alter the course of the disease, i.e., disease-modifying therapies (DMDs) can be considered immunosuppressive. You should thus check with your physician on your susceptibility to infections and check if you’re immunosuppressed. For example, your physician may recommend further immunizations depending on your risk and travel plans, as well as possible prophylaxis against malaria if you’re traveling to a malaria-endemic area.
If you are immunosuppressed, you may also be at increased risk from complications of SARS-CoV-2, aka COVID-19. Therefore, you should discuss any concerns with your physician. for example, whether pre-exposure prophylaxis with monoclonal antibodies is appropriate. In addition, they may recommend wearing a tight-fitting, high-quality mask such as a KN95 or N95 when in crowded enclosed spaces such as an aircraft, not only for protection from SARS-CoV-2 but also from other viruses such as influenza or bacteria such as tuberculosis.
Food and water
If you’re traveling to a third-world country, it is always a good idea to be careful with eating specific foods and drinking water. For example, remember to practice appropriate hand hygiene to prevent fecal-oral diseases and drink bottled water. Additionally, try to avoid eating unpasteurized milk and other dairy products, as well as street food from vendors that you’re not comfortable with. Finally, make sure your fruits/vegetables are thoroughly washed before consumption.
If traveling to an area with ticks, mosquitoes, or similar disease vectors, make sure you take appropriate precautions by applying tick/bug repellant or minimizing skin exposure. Doing so will minimize the risks of contracting a disease and, thus, MS exacerbation.
Swimming in freshwater is relatively risky when compared to chlorinated pool water or the open ocean. Thus, try to minimize rafting and similar freshwater activities and stick to properly maintained pools or salt water. Furthermore, walking barefoot on a beach can also be risky due to hookworms and, therefore, should be avoided.
Finally, if driving in a foreign country, take the utmost care. Driving in the context of MS comes with its unique challenges, and driving in a country where you’re not familiar with the local rules of the road, may lead to an increased risk of accidents. Remember that motor vehicle accidents are the number one cause of death in travelers.