Travel and RA While travelling and taking holidays is second nature for many people with rheumatoid arthritis, for others at the more severe end of the scale, the thought of travelling may cause frustration, stress and additional arthritic pain. However, with careful planning, preparation and advance knowledge, you can overcome obstacles and make your holiday stress-free and far more enjoyable. There are many sources of help and support for people with RA who find travel difficult. Planning ahead Ideally don’t plan a trip during a time of year when you are likely to have flare-up. If you are flying, travel during off-peak times to avoid standing in long queues. Mid-week is often a better time than at the weekends. Try to schedule some time to rest when you arrive at your final destination. Consider adding an extra day to relax on your holiday. If going to a long-haul destination, try to break your travel time with a stop-over for a day and perhaps an additional night. If you are concerned about travelling for the first time with arthritis, try taking a shorter break at first and ask someone to come along with you in case you need assistance. Get advice from your doctor Some arthritis medications suppress your immune systems, so ask your doctor about the kinds of diseases you might encounter in certain countries. There may be vaccinations required that you may not be able to receive if you are on medication for your rheumatoid arthritis. If moving across time zones, you may need to adjust the times of your medications. This is especially important with steroids, which have to be administered at certain intervals throughout the day. Speak to your doctor to determine how to best address this timing issue. Also, make sure your travel insurance company is aware of your condition before you go away. The most exhausting period of a holiday is often the part when you are moving from one place to another. Below are a few planning tips to make travelling by plane, car and train easier. By plane Try to book a direct or non-stop flight Reserve seats ahead and make requests for any special needs Allow extra time to get to and through the airport Request an airport wheelchair if you have difficulty walking. It’s a long way to some of those departure gates! Some airlines in Dublin Airport provide wheelchair assistance as part of their passenger handling service. Other airlines outsource this service to Greencaps Limited, which should be booked in advance (01-814 4633). Do range of motion exercises during the flight. Raise your arms and move your hands and fingers at least once an hour. If driving to the airport, make sure you pre-arrange your parking. Short- and long-term parking for disabled passengers is available at Dublin Airport and can be booked in advance (Tel: 01-814 4828). If you are bringing prescription medicine, you should bring the prescription with you to show security staff. More information on travelling by plane with a disability can be found on the UK Disabled Persons Transport Advisory Committee (DPTAC) website (www.dptac.gov.uk). By train Make reservations early and request special assistance if needed. Inquire whether train personnel will be able to offer assistance. If you are travelling within Ireland, make sure you advise Iarnrod Eireann (www.irishrail.ie), of your traveling plans (destination, time of train, nature of disability etc.) where you need to be assisted on or off the train. Iarnrod Eireann produces a guide for rail travellers, including DART users, entitled ‘Guide for Mobility Impaired Passengers’. It is available free of charge in all stations. By car Use a neck pillow to rest your neck so it does not get stiff. If you are renting a car, ask for the following features: automatic drive power steering and tilted steering wheel wide-angled rear view mirrors four-door car with light-weight doors cushioned seats and back support Keep medications, maps, emergency kit, and first aid kit in the car. Stop to stretch every couple of hours and make sure you have enough leg-room. If driving your own car, customise your car to suit your needs. Contact the Disabled Drivers Association of Ireland (DDAI) for advice. This is located in Claremorris, Co.Mayo. (Phone: 094 9364266 or 094 9364054) Apply for an EU parking card from the DDAI (www.ddai.ie) The DDAI also offers a residential three-week intensive training course for any person with a physical disability (Tel: 094-9364054/094-9364266). You may be entitled to a mobility grant to adapt your car. Contact www.citizensinformation.ie for advice. Choosing a destination Be realistic when choosing a holiday destination. Consider the distance of the holiday destination from your home. How long will it take to get there? Is the airport far from the resort or city to which you are travelling? Be practical and decide ahead what you think your body will be able to manage. Try to pace yourself and not plan to many activities during the day. Be sure to take plenty of rest breaks. When packing, try to use lightweight luggage with wheels and/or shoulder straps to make it easier to transport. Make sure you carry with you anything that might help if you experience a ‘flare-up’: special pillows, travel sized heat and cold packs or assistive devices (reachers for picking up items etc.). It is also useful to take a list of all your medication with you in case it needs to be replaced while you are away. Also, make sure you place your medication in your hand luggage if you are flying. When choosing your hotel, it is important that you ask questions about accessibility (eg. walking distance to pool and lobby, amount of stairs, location of lifts, hand rails in baths and showers, elevated toilet seats, levers instead of round knobs for doors). When booking your room, request a location close to the lift and on a lower level in case there is a problem. Make sure you let reception know if you have any mobility issues, especially if you are traveling on your own. If available, ask for an in-room refrigerator so that you can store your medication. Getting advice before you go In Ireland, there are many organisations that can people with mobility issues plan their holiday. For example, there is excellent travel advice and safety tips on the Assist Ireland website (www.assistireland.ie). With some research and forward planning you can have an enjoyable and carefree holiday. Commuting There are also organisations in Ireland that offer guidance on commuting to your workplace. Check out the Dept of Social and Family Affairs (Free Travel) website at http://www.welfare.ie (Tel: 01 704 3000, LoCall: 1890 500 000) and the Travel Assistance Scheme of Dublin Bus (Tel:01 703 3204 or e-mail:email@example.com).