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holiday

Question
My daughter has a friend with CF. They are going on vaccation to Barcelona.
What should her friend do to organize that flight?
R.L.
Answer
Air travel is certainly possible for CF patients but good preparation is necessary and will depend on the disease severity. Most young patients with CF are fit to fly but it is important that the friend of your daughter discusses this with the treating physician so that she can prepare the travel appropriately.

In general we can state the following about travelling for patients with CF. The disease severity varies from mild to very severe and the health status of an individual patient can at times change rapidly. Travelling should thus been done in a time of stability, when the treatment is stable and after the patient has consulted his doctor. During air travel one is exposed to a lower atmospheric pressure (cabine pressure) and thus lower oxygen tension. For healthy people or people with mild/moderate lung disease this does not hold any risk because they are able to compensate for the lower oxygen pressure during travel. But patients with severe lung disease or patients who are already hypoxic before travel can experience problems during a flight. To evaluate the risk for an individual patient, the physician will determine lung function and also the oxygen concentration in the blood at rest and during exercise. The doctor may ask for a flight simulation test and will advise the patient. In general patients with an FEV1 above 55 to 60% (specific lung function test) should not worry. It’s very unlikely that they will need extra oxygen during the flight. Patients with advanced lung disease who need oxygen daily should prepare their travel carefully. Patients have to make sure oxygen is available during the flight. Until departure and at arrival oxygen should be supplied by a company specialized in oxygen delivery (patients can rent portable devices). The patient should always check with his flight company what their specific policy is. There’s usually a cost involved.

There is a third practical aspect. Patients with CF have a complex treatment that should not be discontinued. Drugs and equipment such as aerosols, syringes, etc. should travel with the patient. Moreover we advise that these should be taken on as carry-on luggage so that they will not get lost. Usually a letter of the treating physician is necessary to alow the patient to do so. Some medication needs cold storage. Patient should check the voltage in the country of destination and take an adapter along if needed. Patients with CF need chest physiotherapy and in case they need the help of a physiotherapist they should make arrangements beforehand. Lastly preparing for travel means checking whether you need extra vaccinations.
If travel abroad is well prepared problems can be avoided.

Kind regards
Dr. A. Malfroot
14.03.2013