Travel

Checklist: 10 steps for a safe and relaxing vacation

1. Visit your doctor to discuss your trip (risks, vaccinations, precautionary measures).
2. Clarify medical care options at your destination.
3. Take out an international travel health insurance policy and clarify coverage of costs in the case of possible treatment.
4. Pack a sufficient supply of anticoagulant medications.
5. Organize a list of emergency telephone numbers at the holiday destination.
6. Pack necessities in your hand luggage (anticoagulants and other medications, medical alert tag or ID, health insurance documents, physician’s letter and monitoring device and accessories).
7. Wear comfortable clothing when travelling and remember compression stockings, sufficient liquids and regular movement, which are recommended for thrombosis patients.
8. Find out the location of the nearest doctor at your holiday destination.
9. If you have a self-testing device, monitor your INR value more frequently when travelling than at home. If your INR changes suddenly (either an increase or decrease), try to have this checked via a blood test at a local hospital.
10. The same rules apply to the consumption of alcohol while on holiday as they do when at home.

Enjoy a relaxing vacation and discover the world!

Doctor’s advice: Travel and anticoagulation

Dr. Sucker, medical specialist for transfusion medicine and internal medicine, has dedicated experience in the treatment of patients with anticoagulants. Here, he answers some frequently asked questions about travelling while on anticoagulants.

Travel and anticoagulation — a healthy match?

Absolutely. But before you embark upon a trip, there are a few things that you should discuss with your doctor. For instance:

• Are there concerns regarding the climate?
• If necessary, will I be able to get proper medical treatment in an emergency?
• Is travel prophylaxis necessary?

Also, keep in mind that some vaccinations and preventive medications, such as anti-malaria medicines, can influence blood clotting.

What should I always take with me?

Be sure to take your anticoagulants, and all other medications, with you in sufficient amounts. Add to that the medical alert tag or ID and the most recent letter from your doctor. An absolute must for patients who self-test their coagulation is the monitoring device, along with any necessary accessories. And none of this should be packed in your checked luggage — always make sure that you have it close at hand in your carry-on luggage. That way you’ll have everything you need, even if you have travel delays or lost luggage.

Is there a direct connection between travelling and blood coagulation?

The answer here is maybe. Take for example food and climate: they certainly have an impact. Then again, many people pursue different interests while on vacation — some are active and engage in more sport activities, while others take it easy in every available beach chair or hammock. If more or less activity is a change from your normal lifestyle, travel may have an effect on blood coagulation — but not necessarily. Please be sure to contact your doctor with any questions as you plan upcoming trips.

Should patients check their coagulation rate more frequently when travelling?

One of the benefits of self-testing is the ability to test from anywhere, anytime, including while travelling. Studies have shown that patients who regularly self-test have better control of their treatment,^1-4 a better quality of life,² and are less likely to suffer a stroke^5-7 than if they visited the clinic for testing. For this reason, please continue to self-test your coagulation rate based on your prescribed schedule while travelling. For coagulation self-testers, a simple fingerstick and 60-second test give you the independence to enjoy your holiday and normal daily activities, while providing the same reassurance of knowing your INR value that you would get in the anticoagulation clinic.⁸ Patients also learn how their bodies react to the changes that can happen on a trip. In the case of extreme fluctuations in INR, please always consult with a doctor at your travel destination.

Do you have any other travel-related advice that you would like to share?

By all means enjoy your trip! A change of scenery is extremely important to be able to truly relax. This includes travellers who take anticoagulants. They may have to put a little extra effort into preparing for their trip, but it’s their ticket to an enjoyable and relaxing vacation.

1 Gardiner et al. J Clin Pathol. 2009;62:168–171.
2 Matchar et al. N Engl J Med. 2010;363:1608–1620.
3 NICE diagnostics guidance [DG14]. Accessed August 2016. Available at: www.nice.org.uk/guidance/DG14.
4 Ryan et al. J Thromb Haemost. 2009;7:1284–1290.
5 Heneghan et al. Lancet. 2006;367:404–411.
6 Heneghan et al. Lancet. 2012;379:322–334.
7 Wigle et al. Am Fam Physician. 2013;87:556–566.
8 Burgwinkle et al. Managed Care. 2008;17:1–8.

4 tips for travelling while on anticoagulation

1. Luggage can get lost

Always pack medical necessities in your carry-on luggage, including your anticoagulants and other medications, CoaguChek operator manual and your health insurance documents.

2. Hand luggage

If you are a self-tester, you should carry your measuring device, test strips and any related documents such as insurance card or custom declaration in your hand luggage.

3. Impact-resistant bag

Put all equipment in an impact-resistant bag and take a medical certificate with you on board, which confirms the medical requirements.

4. Time difference

Remember to take the potential time difference into consideration and adjust the intake of your medicine accordingly. This particularly applies to oral anticoagulants.