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| The following information aims to reassure and advise all ostomates that travelling short or long distances can be relaxing and enjoyable. |
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| There is no reason why having a stoma should stop you from travelling anywhere in the world. Many people, particularly soon after the operation, associate problems which lead to stress with even the shortest journey. Fear of not having clean facilities available when required, running out of or misplacing appliances or even not sleeping in your bedroom where everything is familiar, can be a worry. The best way to overcome these concerns is to plan ahead. If all possible disasters have been catered for, there should be nothing to worry about. No matter where, when or how you make a journey—be prepared. |
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| The following gives general guidelines to advise on things that should be considered before a journey is started. Of course everyone's requirements are specific to their needs and will depend on their particular preferences. However, general advice will help make preparation for holidays and journeys a lot easier. |
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| Click on the following links to go straight to a subject you would like to know more about. |
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| General Tips & Advice |
| Appliances |
| Pre-travel Advice |
| Accommodation Abroad |
| Food and Drink |
| Fashion |
| Extra Support |
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| GENERAL TIPS & ADVICE |
- If you are going away for a long period of time and are travelling by air with a lot of supplies, your luggage weight allowance (20 kilos per person in most cases) may be a problem. Some airlines may offer special overweight allowances for medical supplies. Check with the airline when making your booking.
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- Remember that IATA (International Air Transport Association) regulations forbid passengers to take dangerous items on board an aircraft, such as ether meths which could cause flash fire. It is the passenger's responsibility, if in doubt, to check with the airline. Your travel agent, pharmacist or ostomy equipment supplier can usually advise you of items that are on the prohibited list.
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- During a long haul flight remember that a queue for the toilets will develop after a meal and that food trolleys can block the gangway to toilets for a period of time, so beat the rush and go before food starts being served.
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- Your hand luggage will be inspected at the security baggage check before boarding an aircraft. Remember to pre cut your flanges or pouches prior to checking your main baggage as your scissors will be confiscated by airport security. If you have any drugs with you, have your doctor prepare a card explaining that they are medical supplies. Some countries do not allow certain drugs, such as codeine, to cross their borders, so check before taking drugs abroad. You may be frisked when leaving the terminal to board the aircraft, so be prepared to explain about your ostomy.
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- Travelling by car should present no problems. Obviously your car seat belt should be comfortable. It should sit across your hip bone and pelvis, not your abdomen and stoma. If you feel you need to give your stoma extra protection from the belt strap there are inexpensive, commercially available devices for making seat belts more comfortable. An extension bracket can be fitted which lowers the angle at which the belt crosses the body.
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- While staying in foreign accommodation, if you feel that your appliances are not safe, speak to the management and ask to have the bulk of your supplies locked away in a secure place.
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- Always check the suitability of the water supply. If in doubt, use bottled water for drinking and brushing teeth.
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| Tips & advice for Ileostomates |
- Due to the nature of the ileostomy appliance, leakages may occur during the night. It is a good idea to take along a plastic mattress cover or sheet so that in the event of a leak during the night the mattress does not get damaged.
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- Non-ileostomates are often more prone to "Travellers Trots" or "Montezuma's Revenge" because these bugs act mainly on the colon. However, ileostomates should take extra care as acute diarrhoea can lead to dehydration through loss of fluid.
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| Tips & advice for Colostomates |
- A change in air pressure in an aeroplane cabin can create wind for anybody, but it can be a particular problem for colostomates. So avoid obvious things like gassy drinks, eating too quickly or anything which causes you to swallow air. There are appliances that are especially fitted with flatus filters. A small hole in the top of the pouch allows air to escape through the filter which absorbs any odours while releasing the trapped wind.
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- If you are making a journey of a day or more's duration, it is a good idea to either eat something which you know will constipate you for a day or two or obtain tablets from your doctor. This will reduce worries of having to change your appliance while en-route.
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- Irrigation, a technique of administering an enema through the stoma, empties the bowel at a scheduled time convenient to you. It should then prevent stoma activity between irrigations. This can be very helpful when travelling or on holiday. Irrigation is a complicated process however, which can only be carried out by colostomates who have their stoma in the lower part of their colon. You will need to get detailed instruction from your Stomal Therapy Nurse well in advance of your holiday on how to irrigate and it is important that you do nothing without professional guidance and advice. An important point is to check if the country's water supply is suitable for irrigation. Contaminated water introduced into the stoma may cause infection.
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| Tips & advice for Urostomates |
- For urostomates who are worried about having embarrassing accidents while away from home and for peace of mind, take a plastic mattress cover so that in the even of a leak during the night the mattress will not get damaged.
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- In hot climates dehydration can be a problem which may lead to the development of a urinary infection. It is important that you drink plenty of fluids to keep up your usual urine production in order to 'flush' out your system. See a doctor if you begin to feel ill, as a urinary infection may be developing. Carefully keep up your usual skin care around the stoma, especially in hot climates.
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- Take an overnight drainage bag or leg bag with you when travelling. This will be useful when travelling on an overnight journey to extend periods between pouch emptying. Be sure that if you should fall asleep, however, you have made arrangements to ensure no accidents can occur.
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| APPLIANCES |
| Supplies and hand luggage |
| With a prepared travel check list, packing equipment and appliances should be easy. In general it is advisable to keep most of your supplies together as hand luggage so that it remains with you at all times and is in easy reach. Particularly when travelling by air, when luggage has been known to go missing, it is wise to keep hold of the essentials. It is much easier to replace clothes than ostomy equipment. However, in case your hand luggage is misplaced, extra supplies should also be kept in your suitcase or travelling companions luggage as a precaution. A separate small travel kit containing items needed for a change of appliance should be kept close at hand to make visits to the toilet simple and discreet. |
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| Storage of appliances |
| Storage of appliances is also important. They should not be allowed to get too warm while in transit. When travelling by car, especially in warm and humid climates, do not keep supplies in the boot or glove compartment which are often the hottest places in warm weather. |
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| "I have found, especially when on a camping holiday, that in order to keep m y appliances at a constant temperature, I keep them in a picnic cool box or bag. The adhesive seals remain in perfect condition and all my supplies are kept in one place within easy reach whenever I need them." Angela Cooke, National Secretary of the Urostomy Association. |
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| Most manufacturers provide guidelines for storage of ostomy equipment which are especially useful when staying in hot climate locations. Generally, when abroad, bathrooms are often the coolest place and as long as they are not too steamy are probably the best place to keep your appliances. |
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| Disposal |
| Disposal of used ostomy pouches while abroad will not be difficult if you make proper preparations. Before changing your pouch, check that the washbasin is not in a separate room from the toilet and that a means to dispose of the pouch is at hand. In your travel kit make sure you have toilet paper to wrap up the used pouch, plastic carrier bags to dispose of them at a convenient place and time and carry cleansing wipes to clean up any accidental mess. Don't be embarrassed to go into hotels or restaurants to use their facilities as they are more likely to be clean and have washbasins and sanitary bins available. |
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| Some manufacturers supply self-seal polythene disposal envelopes in which used pouches can be wrapped for easy disposal. Alternatively, nappy disposal bags are very handy and come pleasantly scented or freezer bags, available in convenient sizes with ties to close them, make disposal of used appliances simple and discreet. |
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| PRE-TRAVEL ADVICE |
| It is only natural that you feel a little apprehensive about travelling for the first time after your operation. It makes sense therefore, to start with short trips away from home to build up your confidence. Once reassured that you equipment stays secure during normal day-to-day activities you can start to venture further afield. |
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| Preparation for Your Holiday or Journey |
| Before starting off on any journey - whether it be a weekend break to your local seaside town or a month's holiday in the Far East - plan ahead. A few days or even weeks before departure, prepare a checklist of things to take with you at your leisure. Go through your daily routine of pouch changes to help remind yourself exactly what you use and need such as pouches, flanges, skin protective wipes, disposal bags and so on. Don't forget to take along different sized pouches to cater for sporting activities when a smaller one may be necessary or for long journeys when a bigger pouch may be needed as pouch changes may have to be delayed. |
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| Calculate the number of pouch changes you normally need to make and then double it to make sure you have plenty of appliances at hand. You never know what may happen, your return journey may be delayed, some appliances may go missing or the changes in climate and environment may mean more pouch changes are needed than usual. Having extra supplies can only add to your peace of mind. |
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| Travel Documents |
| When travelling abroad it is wise to check you have all the necessary travel documents well in advance. The usual paperwork such as passport, tickets, visas etc. will be a matter of course. However other documents may come in handy. A travel certificate available from your surgeon or a referral letter from your Stomal Therapy Nurse will help explain what your appliances and medications are for, thereby avoiding embarrassing questions at custom checks. |
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| Travel Insurance is essential as it covers loss of luggage and money as well as cancellation of holidays. Carefully check any exclusions such as age limits or pre-existing medical conditions. If you are in any doubt about whether you are fully covered or not by your policy contact either your Insurance Broker or Travel Agent for advice. |
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| If you are travelling within the EC (and some other countries) there are reciprocal agreements which entitle you to free emergency treatment if required. To claim you must carry your MediCare Card with you. You may still have to pay if your travel insurance does not cover you. |
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| Finally, familiarise yourself with the procedure for obtaining medical aid abroad and have emergency contacts available as a precaution. Chances are you won't need them, but it is best to be prepared for anything. The various Ostomy Association can give you contacts of suppliers abroad. |
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| Last Minute Arrangements |
| Many ostomates may be tempted to reduce the flow from their stomas while travelling by changing their regular eating or drinking routine. In general it is advisable not to vary your normal routine or usual eating habits. However, some people find a complete change of their equipment before departure will give maximum security and confidence from the possibility of leaks. |
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| "As a Urostomate, I have found it advisable to change my appliance three or four hours before departure to give time for it to settle down and ensure it is working satisfactory." Fiona Solman, Urostomate. |
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| ACCOMODATION ABROAD |
| An area that often causes a lot of concern is that of foreign accommodation. At home everything needed is at hand and total privacy ensures nothing embarrassing can happen. Fear that all this will change when away frequently keeps people from staying with friends and family or going away on holiday. So often this fear is totally unfounded. With good forward planning you should have everything you need neatly packed in your travel kit. Most hotels now have en-suite bathrooms so that pouch changes can be made easily, in private and at your leisure, at a time convenient to you. If you are still concerned then check when making a booking that you have private bathroom facilities adjoining your room. When staying with friends or family who may not be aware of your special needs, try to use the bathroom out of rush periods if at all possible or explain briefly about your operation—family and friends are sure to understand. |
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| FOOD AND DRINK |
| While abroad, general advice on food and drink is the same for anyone. Common sense precautions, such as avoiding the local drinking water, eating foods that have been well cooked or come from a reliable source and being aware of the possibility of becoming dehydrated in hot climates apply to everyone regardless of whether they have an ostomy or not. |
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| However, a change of water, climate or food can upset your bowels so be prepared. Diarrhoea medications are available without a prescription over the counter from your local chemist and if taken at the first signs of diarrhoea, will usually nip the problem in the bud. |
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| Diarrhoea, particularly if accompanied by a fever and vomiting, may also lead to a shortage of salt in the body. The difficulty is knowing how much salt needs replacing. Normally one level teaspoon of salt a day is all you need, but if your 'output' is doubled then salt needs to be doubled. Don't take salt on its own, always add it to your food or take commercial salt solutions or tablets which are available from your chemist. |
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| Dehydration |
| In hot climates, as chances of dehydrating are increased, ostomates are recommended to drink more fluids (preferably water). A sign of being dehydrated is the production of less urine than usual. Special rehydrating solutions such as Gastrolyte can be useful for severe cases of dehydration and are available from most chemists. Provided you have diarrhoea medication with you and you take care of what you eat and drink you can enjoy the local delights, but be sensible and avoid excesses. Remember also—too much alcohol will accelerate dehydration as well as give you a hangover in the morning so don't overdo it. |
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| FASHION |
| When away on holiday, the main objective is to relax and enjoy yourself. Part of this is to be able to wear what you like. As you know there are very few restrictions on what you can wear, however, be careful with especially tight clothing that may restrict the flow of your body waste into your appliance. |
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| Swimwear is possibly the only exception to the 'wear what you like' rule. How brief swimming trunks or bikinis can be depends on the position of your stoma, but there is no reason why you should not take to the water. People tend to be very self-conscious, especially of the way we look, but how often do we notice other people around us? Some make the mistake of believing everyone will immediately turn to their stoma and stare, in truth most will not even notice the colour of your costume, let alone what may lie beneath it. If you are worried, wear a bold-patterned swimming costume which will distract the eye and camouflage any bulges that may be caused by your appliance or otherwise! |
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| If you can't find a swimsuit that you like, there are a number of special suppliers of swimwear who make swimming costumes to suit particular needs. |
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| EXTRA SUPPORT |
| Having a stoma is a major operation which should not be underestimated. The first few weeks or even months following the operation may be difficult as you adjust gradually. However, once fully recovered and settled at home, returning to the lifestyle enjoyed before the operation should be no problem. |
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| As long as you have no complications and your doctor has no objection, you can enjoy any kind of sporting activity. Even violent contact sports such as rugby, karate or kung fu and sports such as bowls and aerobics, which involve a lot of bending, have been taken up. |
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| If you would like to talk to someone about a particular sport, contact your local Ostomy Association. They may be able to put you in touch with someone who currently enjoys your sport and who can give you some practical advice. |
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