anticoagulation and travel to foreign and developing countries

[Leah]

Hello. As things have evolved, it looks like surgery will be this year but not this month, probably early fall. (No emergency but it's time.) I'm taking the tissue vs. mechanical decision far more seriously now. At 57 I'm in that "gray area."

I'd like to know what kinds of experiences, cautions, prohibitions, and difficulties people on warfarin have had concerning travel, particularly non-luxury travel to places like India, Southeast Asia, etc. Does the perspective that warfarin is basically an inconvenience but not a life-stopper apply if you stray outside of a medical capitol where interventions are not available should anything go wrong? Are there any impediments to home testing while you're traveling? You get the idea. I will also discuss this with the medical folks but would like to know your real experience. Thank you.

 

[catwoman]

Leah:

If you intend to travel outside your country of residence, you might want to consider getting coverage through MedicAlert. Seems that it offers optional coverage for something like Medi-vac charges should it be required.

I am a cat show judge. Many of my fellow judges judge overseas and some have had medical emergencies that landed them in hospitals. We have some insurance coverage through our registry association, but it's not enough to cover charges if I broke my arm, let's say, & had to have surgery. Some judges have additional coverage (riders on their home policies or through another means) for this. That's what I would do if I went overseas -- regardless if I were on warfarin or not.
I definitely would travel with my INRatio monitor and with all my medical history and records scanned into a flash/jump drive.

I wouldn't let my being on warfarin keep me from traveling.

 

[RobThatsMe]

Hi Leah,

I travel internationally often. If I am out of the USA for more than 2 weeks at a time, I take my Protime home testing unit with me. I have never had any issues using it, or getting it through the airport. Same applies to the testing supplies that I use with the unit.

That being said, here are some personal comments that I would highly recommend.

1. Always, Always, Always.. take enough of your daily medications with you in your carry-on luggage. I take 2 week emergency supply, in my packpack, and my normal weekly supply containers, or monthly supply in my checked luggage. Just this last trip, they lost my luggage for 4 days. I didn't know during that time if they would find it or not. I at least felt safe, knowing that I had my emergency supply in my carry-on back pack!

2. IMPORTANT. IF you take your home testing unit with you, be sure to check it for what type of current it will take. If it only takes 110V, then mearly using a "Plug" converter will not work. For example. My unit is a 110 V. The current in Germany and Europe is 220V. So, if I use only a plug converter to plug my unit into the wall plug here, then 220 V will go into my unit. It will blow-up the unit, or hopefully just the power pack.. I know first hand because this happened to me on one of my earlier trips. WHAT YOU WILL NEED is a POWER TRANSFORMER. It will convert for example, 220V down to 110V. The Transformer plugs into the wall, and you plug your home testing unit into the transformer. ps.... You may also need a converter plug so that your transformer plug can adapt to fit into the wall plug.

3. Try and reserach facilities that will be able to assist you in the areas you travel in case of emergency. Do they speak English? is there a doctor that you can obtain as a reference from a recommendation? Did you know that in most cases, your doctor in the USA cannot just fax a copy of a prescription to you in the country you are in. It would be a useless piece of paper. You would need to see a local doctor, and they would have to write you a prescription locally. In my case through the company I work for, I am registered with an international health organazation to help in case of emergencies. It is called "International SOS". I do not know if they offer services for individuals, but you can check. Their website is www.internationalsos.com If you are travelly on business you may want to ask your corporate HR if they offer this service.

Hope this helps some. Please let me know if I can provide any other info.

Rob

 

[aussie girl]

Hi Leah,

I would just like to echo everything that Rob said and also add that when I travel I also take my prescriptions with me and a letter from my doctor stating that the medication is needed on a daily basis. The other thing I do is work out the time I need to take my tablets if we are travelling to different time zones ( I take a 24 hour watch and leave it set to my home time ). Hope this helps

Mary

 

[Valve-Viking]

I have been doing extensive travelling in the Far East, both for
business and leisure, I think you have been given some good advice
already. I´d like to add that before I got my selftest monitor, I used
to test my INR locally and in hospitals in Vietnam, Thailand etc, it was
really fast, safe and efficient and an alternative to not bringing your
own monitor, in case you do not have one. I think I paid something
like 10:- Usd for a test in Thailand and it took me half an hour to
get the result.

Apart from the good advice already given, please consider the diet is
different, there´s a lot of fresh nice vegetables ni SE Asia that you do
not know much about or the level of vitamin K for that matter. So
while I am travelling to I try to self-test every 3-4 days.

The thing to look out for, is if you get an upset stomach or diarrea.
It will shoot up your INR most of the time. Obviously it is hard to
control, but it is better to play it safe try to have your meals in places
that seems nice and clean. I think the best is to eat what they locals
do as it is much fresher then your typical Western food.

But overall, I find it rather easy and hassle-free to travel after the last
five years as a "valver" - you adopt a thinking and lifestyle that adopts
to the situation without too much of worries or issues.

/Martin

 

[ThomasAw]

I just had an AVR at the Heart Institute in Kuala Lumpur, Malaysia in February 2008.

There is no problem in testing your INR in Malaysia. Most government clinics/hospitals will do it.

The problem may be the food. I think you should eat food serve in fast food outlets, clean restrautrants & hotels. Try not to eat food from hawkers.

I am planning to visit USA maybe next year. My worry is the food consumption will be different & I will have to change my warfarin dose accordingly.

Thanks

 

[ALCapshaw2]

One word of caution about putting pills in your checked baggage in the USA:

My previous PCP told me that all the vitamins and medications were taken from the luggage (probably as an overzealous "security" measure.

 

[ThomasAw]

One word of caution about putting pills in your checked baggage in the USA:

My previous PCP told me that all the vitamins and medications were taken from the luggage (probably as an overzealous "security" measure.

I see. Thanks for the hint. I will know what to do if I visit the USA next year.

Thanks

 

[RobThatsMe]

Hi,

I have never had my medications taken from either my carry-on or mu luggage when traveling within the USA or out and then back into the USA.
I travel extensively, and carry alot of medications and vitamins with me.

Perhaps someone stole the medicine, looking for drugs. That would not surprise me. But they cannot take your medicine from checked luggage.

If you have more than the allowed amount of liquids however, in your carry-on, then that could be an issue and you would most likley have to check that.

Rob

 

[Susan BAV]

International travel with prescription medications?

International travel with prescription medications?

Regarding prescription medications, I've read it is important to be able to prove that you actually have a personal prescription for whatever RX meds you may have with you, when you travel internationally.

So, perhaps for someone who, for travel, rearranges their medications in one of those weekly or monthly boxes, this may appear as an inordinate amount of unidentifiable pills, to a member of the security personnel.

It's important to be able to prove that the medications you have with you have been prescribed to you. So, while it's not the most convenient thing to do, it's important to also have your original RX boxes/bottles with you in your carry-on luggage when you travel internationally. Possibly a doctor's note for emergency refills would also be a good idea to take with you while traveling.

 

[aussie girl]

We travelled to the USA Cuba and Mexico in march this year, I carried my weekly pill dispenser in my handbag and another weeks supply in my carry on luggage and then had about six weeks supply in my check in luggage. We entered and left the USA twice during this trip and I was never questioned about my medicines.

Mary

 

[RobThatsMe]

Hi,

I travel every 2 weeks back and forth from Nashville to Detroit, then on the Frankfurt,Germany.

I take 2 and sometimes 3 weekly pill dispensers, plus a baggie and another bottle each containing 2 weeks emergency supply just in case my luggage gets stolen, or due to some other reason,that causes me to have an extended stay overseas. I have been doing this for 3 years and have "never" ever had an issue with my medications and airport sercurity. That applies to both the USA and Europe.

They Home Land Security Rules do say to carry the original bottles, but I do not, too many bottles. I figure I will just show them my scare if asked, and also my mechanical valves ID card.

That being said... there is always that old saying... "Never say Never"

Probably jsut jinxed myself..


Rob

 

[Susan BAV]

I've never had them look twice at my bag of prescriptions either. But I could be "up a creek" if they were taken away (if I couldn't prove they were mine) and I've read isolated news stories where it has happened (although I wondered if it was also a loophole to profile certain travelers).

 

[DuchessBear]

I don't travel as much as RobThatsMe, but I've done a fair amount, both domestic and international.

I never take my prescription bottles with me when I travel. Instead I parcel out my pills into daily packets -- you can get small (about 2" x 3") plastic bags at the pharmacy and put labels on them for Monday, Tuesday, etc.

But I do take the extra pill bottle labels/receipts that are attached to the bag the pharmacy puts the pills in. (My mail order pharmacy has similar labels/receipts.) It's a lot easier to take a few small pieces of paper than those big bottles. Also, I take a couple of photocopies of those labels.

Like RobThatsMe, I always take enough extra medication to last at least a week in case of emergency.

Do not put any medications in checked baggage. Carry them ALL with you. If you have liquids over the limit, you are supposed to be able to take them in carry-on if you have proof of prescription. From the TSA web site www.tsa.gov:

Medications, baby formula and food, breast milk, and juice are allowed in reasonable quantities exceeding three ounces and are not required to be in the zip-top bag. Declare these items for inspection at the checkpoint.​

If I take my home tester with me, I take copies of the prescription for that, as well.

TSA has never questioned any of my medical "stuff", but I hope these precautions will be adequate if they ever do question me.

 

[Susan BAV]

Perhaps what I posted here earlier isn't the current info?

Perhaps what I posted here earlier isn't the current info?

Here's a link to the TSA site, in regard to medical conditions, with further information and links:

http://www.tsa.gov/travelers/airtravel/specialneeds/editorial_1059.shtm