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Heart failure

Travelling, holidays and trips away from home

Holidays and trips away from home may not be straightforward for people with heart failure. Many of those we talked to were worried that they might be taken ill or were anxious about managing their medication (especially diuretics) on long journeys.

Many people had chosen to take organised day trips or short holidays. Some found that coach trips were better for them than travelling by car, and several went on organised holidays where all the arrangements, including carrying luggage, were part of the package. A man who had been on an organised trip to Scotland said it was a wonderful experience because he had never expected to travel again.

 

Holidays were a problem for him, but now he goes on organized coach trips.

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Age at interview: 82
Sex: Male
Age at diagnosis: 72
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Holidays were a problem, I don't think I went on holiday for two years after my major illness, we had arranged that, the year I was ill, we had arranged to go to Fort William, Scotland, and we had to cancel that. And then I don't think we went away for two years.  And then we started to go away on one of these coach holidays. And all we have to do is get a taxi to take us from here to the bus station, they take the luggage and we don't see it again until it comes to our bedroom, and this is what we do and this is very enjoyable, to be able to do that. And I think it's wonderful to be able to do that. I mean last year we went to the north of Scotland to Ullapool and we went to Ireland, who would ever have thought that I could ever do that! 

Others had taken to travelling with groups or clubs or went on holiday with their children who did the driving and looked after them. Some had given up active holidays like camping and caravanning, and a woman said she and her husband now stayed in hotels with lifts. Several people said they always asked for ground floor rooms and a few said they notified hotels about their heart condition.

 

She only stays in hotels with lifts and chooses less active holidays than before.

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Age at interview: 65
Sex: Female
Age at diagnosis: 59
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Well no I, if we go on holiday I've got to pick a holiday where there isn't a lot of activity in it, so now it's more or less just laze around by the pool. Or we go a short walk or we'll go on bus trips so that there is, we see everything but we don't have to do the walking. 

So in a way you have to plan your holiday?

Oh yes, yes very, we do have to plan our holidays to see, we have to certainly make sure that it's not too active. I mean neither of us are getting any younger and we like to get away - we used to have a caravan but we've had to do away with the caravan because I couldn't help to do, pull it about or put the awning up or anything like that, it was just too much.

When you do, you always read the brochure and you try to find out from somebody else if they've been there, what it is like, if there is a lot of climbing or if there's, because a lot of the hotels don't have lifts, and if there was a lot of stairs I couldn't manage, I couldn't manage to go. 

 

 

The bustle of airports or getting to and from holiday destinations put some people off travelling and holidays. One man said that just being at an airport could made him feel tense, and someone else who had taken up cruise holidays since being widowed said he wasn't sure how much longer he could manage to get himself and his luggage from Scotland to Dover.

 

Says he will keep going on cruises as long as he can despite his breathlessness.

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Age at interview: 74
Sex: Male
Age at diagnosis: 73
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I don't know how long I can, the last cruise I went on I had to stagger down to Dover and I went down by night bus and I nearly killed myself with it. But this time it's out of Leith and back into Leith and next year, would you believe, if I'm still alive, that's Dover again but I'm going to fly down to Gatwick and do it all differently. But I'm just wondering how long I can in fact cruise. You know you can't do it forever and the old puffiness and breathing, etc, it makes it look as if, you know the termination is not going to be so very long. But still, I'm going to enjoy while I can and let's see how it goes.  

Travel arrangements sometimes needed to be carefully thought about in advance. One man was dismayed that his insurance company refused him medical cover because of his heart failure because it stopped him going to see his daughter in the US. Someone else whose luggage (containing his medication) was lost en route to Canada was surprised that he could not get a local doctor to prescribe replacement medication. (He now travels with medication and a list of contact numbers in his hand luggage).

 

He has been refused medical insurance for travel to America because of heart failure.

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Age at interview: 59
Sex: Male
Age at diagnosis: 58
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Or [pause] perhaps more important has been the fact that I can't get travel health insurance at the moment. (I think somebody should help... help us look into this.) So... my wife's going over to see my daughter in America in a fortnight's time but I, I won't go because I wouldn't run the risk of being in America without adequate health insurance, travel insurance... I was insured through the BMA scheme - British Medical Association scheme - but they have told me that they will not insure me under any circumstances at present. 

I believe I have some cover through my Visa [card] but I'm really not sure when one is asked questions by the by the Visa company people whether if one really had a big claim in America let's say, whether they would consider that you were covered or not. But ordinary insurance such as you go to buy from the bank or building society or travel, travel agency, if you're honest and say what you're on, and what in my case has happened to me, then there is a point blank refusal to give you cover.  

So your world's shrunk a bit, your opportunities? 

'One time I was sort of momentarily a bit tearful was when having been promised by the BMA travel people that if I fulfilled certain criteria - periods of time following surgery and so on - then I would be covered, was to ring up and be told, 'Well we've changed the rules and we won't cover you under any circumstances,' that's when I felt my world had come in on me rather.  

 

Describes how he managed without medication after his luggage was misdirected on holiday.

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Age at interview: 35
Sex: Male
Age at diagnosis: 35
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Of course when you travel it's a bit of a nuisance because you have to take all sorts of medications with you. When we went for two weeks holiday out to Egypt I had a whole bag like this full of medications. And I remember two years ago we travelled, me and my wife, we weren't married then, we went to Canada and the bag went to Austria [laughs]. We arrived in Toronto and my medication, my little bag of medication were in my suitcase and it was this big. And I called my insurance company here in the UK and said "Listen I need my medications, get me in touch with my doctor, I don't have any, any contact details to anyone because they're all in the, in the suitcase." And they said "We can't do anything just try and see a local doctor." I went to see a local doctor and he said "I can't give you anything, I just can't, just can't prescribe you with anything." I said "Listen I've got a heart disease," you know I showed him my scar, you know the scar, the operation scar, "And I have to take these medications," and it was, it took them think five days to get me the suitcase, the suitcase. It went to Austria instead of Toronto, I don't know why, for some reason. And those five days I didn't do anything because you know I didn't have the medication and I didn't do any, any activities, any physical activities, not even walking you know because I was a bit concerned that anything can happen without having medications around you. All that I could buy from the local chemist  was aspirins because you don't need prescriptions to buy them [laughs].

A few people who had been taken ill on holiday said they had found it traumatic. A woman who had needed emergency treatment on two holidays in England said that she and her husband decided that for the time being going away from home was not worth the risk. Others had decided not to go abroad on holiday because they felt safer staying at home.

 

Prefers not to be away from home in case she's taken ill.

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Age at interview: 59
Sex: Female
Age at diagnosis: 55
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It's actually made a great difference to our travelling, the illness. We were never great at going, we've never been one for going on holiday going abroad because we have birds and dogs and fish and, until recently, rabbits. When we did go our sons actually looked after them but now they've both moved away, it's much more difficult. So we'd never go away for more than a week in the past and I suppose over the last 4 years never more than a couple of days or even less than that'

So it's actually made us very worried about being away and even going to conferences or courses, I actually went on a conference once and actually became ill there and had to be brought home. So now I can't go out to a conference where you have to stay overnight. My mentor is now, one of great mentors in nursing older people, is now Professor of Nursing in Northern Ireland and asks me over frequently, to perhaps share my experiences of person-centred caring and you know, individual care for people, and I can't go because I just can't take the risk of being away.  

Being away from home, being away from my husband, being away from my local GP, being away from local consultants and from my local hospital - I'm just, we're just... my husband possibly more than me, much too scared! We've actually talked about moving house, we'd actually like to move down towards the South Coast but it's not just moving away from our family, it's moving away from all our support links!  

 

Explains why she prefers to stay at home rather than take holidays abroad.

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Age at interview: 63
Sex: Female
Age at diagnosis: 61
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We'd been to Turkey twice a year for the last 6 or 7 years or, if not, holidays abroad.  But the moment I was diagnosed, a year gone Christmas, I just don't feel like going anywhere in case I'm poorly when I'm there or in case you need' I know some of the places abroad are excellent but it's just in your own home you can be poorly and you feel as it you're a bit better being at home. But I think if you're abroad and you're poorly, you feel worse to start with. Well that's my opinion, anyway. 

Several people had flown long distances since having heart failure, for example a woman who had travelled on her own to the US said that the airline had looked after her very well. On the other hand others wondered whether long flights were advisable, and a woman said doctors had told her not to take any flight lasting longer than 4 hours.

 

She was well looked after by airline staff when she flew to America. (Video and audio clips in...

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Age at interview: 84
Sex: Female
Age at diagnosis: 82
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(This interview was conducted in Punjabi and the transcript translated into English.)

After that I went to America. I discussed it with the doctor and told him that I'd really like to go, my son and grandchildren are there, and when my son learnt I was in hospital he kept on phoning because he was very worried too and wanted to visit me. He asked if he should come over but I said, 'No, don't you come over, there's no need. I'll come to America by myself. From this side I'll be very well looked after.' The nurses were told everything and the flight attendants and they really looked after me. 

Did a nurse go with you? 

No, no, there were only the airline people, their staff took care of me. So I got to America and my family had me checked out by a doctor there. And the doctor said that I was taking the correct medications and that I would have to take them for the rest of my life. I told him that with the medications I do seem to be a lot better. And in America I generally stayed in the house, I carried on taking the medicines and I stayed there a month, just less than a month. And I came back here because there my healthcare was extremely expensive and so I didn't want to stay. I wasn't registered there either, nothing, it was all done privately by my son. 

 

 

When travelling abroad, people fitted with a medical device are advised to avoid walking through security arches because these scanners contain a magnetic component which will set off the alarm. Instead, people should inform airport security about their ICD and show their ICD identification card. The person will then be hand searched. If during a search a hand-held scanner is used, the wand should not be held over the ICD/CRT as it can disable the medical device. 

In Europe, North America and Australasia, people with ICD devices can find hospitals in major towns and cities with ICD facilities. If travelling elsewhere and unsure of care facilities available, people can ask for advice at their regular ICD clinic before travel. If the person needs medical care when abroad, the UK hospitals can send relevant medical details to the hospital that is providing medical care. [From Patient Information Factsheet, Implantable cardioverter defibrillator, University Hospital Southampton, NHS Foundation Trust. December 2011.] 

At present, the remote monitoring terminals may not work in all countries outside the UK, so people who have their medical device checked via tele-monitoring and want to take the remote monitoring device on holiday should seek advice from their regular ICD clinic before they go. Similarly if they want to stop it while on holiday abroad they should get advice from their ICD clinic.
 

Bruce says that when going abroad he asks his ICD nurse about where to go on the internet for information about ICD clinics abroad.

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Age at interview: 76
Sex: Male
Age at diagnosis: 63
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Oh and another thing about having the ICD it is possible to obtain information when you are going on holiday where the specialist clinics are that can deal with my particular device. 

ICDs?

Yes. And I will be ringing the specialist nurse shortly because, if I can’t find it on the website because she has told me the route to find it on the website [ha] and I can, I am going to Spain and Portugal for a holiday and I will be able to find out where the specialist centres are near where we are going to be so that if I have a problem, you know, I’ll have a sheet of paper that I can give to the doctor, the, anybody who is dealing with me and say, ‘Look this is where my device is, can be dealt with’. And they can phone up and get advice.

Ok 

So that and in this country obviously I’d refer them to the specialist hospital I deal with and I’m sure that every A&E in the country knows where their nearest ICD centre is.
 

When holidaying abroad Bruce finds the process of telemonitoring cumbersome and feels that he can do without it for just two weeks.

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Age at interview: 76
Sex: Male
Age at diagnosis: 63
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And what happens with your monitor when you go abroad? Do you take it with you? Do you plug it into a phone?

No I don’t, no I don’t bother. I could but then I’d have to register to a new phone number and quite honestly, you know, for two weeks at a time I’ll take my chances.

Ok.

Yeah I mean if, if it was giving a lot of problems then I might have to resort to taking it with me and setting it, but when you are on a coach tour staying in a different hotel every couple of nights it’s going to be an awful lot of work and I’m not that confident that I’d get it all set up properly before I moved on somewhere else.

 
For more information about travelling with a heart condition see our resources.


 

Last reviewed April 2016.
Last updated April 2016.

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