| THIS MONTH: HOW TO KEEP YOUR BLADDER, BOWELS AND SKIN HAPPY WHEN YOU TRAVEL | | |
When I took my first international trip as a wheelchair user, flying solo from Seattle to London as a college freshman, less than two years removed from my C7 spinal cord injury, I had no idea what I was doing. During the nine-hour flight I sat on my wheelchair cushion, which saved my coccyx, but because it was so tall, left me unstable and uncomfortable. I still had a foley, but I didn’t know how I’d empty a leg bag. So I didn’t drink anything but a neat whiskey on the plane, hoping it’d dry me out. It worked, but by the time I got to Europe, I felt like a mummy.
Since that first trip, I’ve visited 23 countries on four continents via all manner of transport — from airlines, to road trips, high-speed (and slow-speed) trains, ferries, Tuk-Tuks, long-distances buses and touring handcycles. Staying healthy while traveling means getting creative with maintaining your body’s most finicky systems — bowel, bladder and skin — under less-than-ideal conditions. | |
Drying yourself out is an option that many people rely on because airline bathrooms are so impossible to use. If you do choose to dehydrate yourself for a flight, there are better options than whiskey. When I was traveling frequently for wheelchair rugby, I’d put two electrolyte tabs in about 12-16 ounces of water and drink that about two hours before a flight, making sure to cath as close to boarding the plane as possible. There’s mixed advice about whether sodium and electrolytes make you pee more or less, but I found that the Nuun high-sodium electrolyte tabs helped me hold onto my fluids, and I was much less likely to have to pee during the flight.
Even when you plan carefully, there are times you just have to go. In his column “Airline Bladder Management,” Bob Vogel, a T10 para, suggests asking your urologist about an indwelling Foley and leg bag just for the flight. Bring an empty disposable bottle in your carryon that you can empty a leg bag into. Jeremy Hannaford, a wheelchair rugby player, brings a blanket to drape over himself so he can self-cath. “It helps other passengers mind their business while you handle yours,” he says in “Five Pro Tips for Flying with a Power Wheelchair.”
If you intentionally dehydrate yourself for travel, you need to be just as intentional about rehydration. I now will start rehydrating myself while I’m still on the flight, getting a water the last time the drink cart comes around, knowing that it won’t usually work its way through my system by the time I land. Joanne Smith, a certified nutritionist and wheelchair user, recommends drinking 500ml of water as soon as you land. The quicker you can get yourself rehydrated, the less likely you are to deal with UTIs, constipation, fatigue, low blood pressure and other consequences of dehydration. | |
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| The author’s road trip kit keeps him awake and hydrated without having to find a bathroom every hour. | |
| All these tips work for buses, cars, and any other form of transit you can’t immediately access a bathroom. As I explain in “Six Tips for Long Haul Road Trips as a Wheelchair User,” I combine a water bladder with a DIY closed system catheter so I can stay hydrated and pee without having to constantly pull over when I’m driving more than a couple of hours. | |
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How to maintain bowel regularity and avoid accidents is the other issue that dominates travel planning as a wheelchair user. As I wrote in “Stir-Frying My Pants,” “Hoisting myself up into a tuktuk, getting piggybacked from one boat to another or up the stone steps of a 12th century Cambodian temple can feel like an adventure. But there is nothing remotely enjoyable about rushing to find a toilet you can use before something bad happens.”
Smith wrote an excellent guide, “Tips to Maintain Bowel Regularity with SCI When You Travel.” Her number one piece of advice:
“No matter your destination, stick to your regular bowel-management routine as much as possible. Bowels love routine, but if you suddenly adopt a Mediterranean lifestyle and start eating dinner close to midnight, sleep in, and switch your routine from morning to midday, your bowels might go rogue.” | |
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| Creativity is often required to stay regular while traveling. | |
Sometimes, though, you have to enjoy the good life while you can. Ian Ruder, a power wheelchair user and C5 quad, started using digestive enzymes to help keep his gut happy while traveling and eating richer than normal foods. "The science seemed a little murky, but after a number of recommendations, I figured trying enzymes was worth it," he says. "I can't prove they work, but I've probably used them for 75-100 rich, or hard to digest meals – the kind that would give me indigestion, gas or bowel problems – and not once have I had any of those issues."
Bob Vogel wrote in “Avoiding Montezuma’s Revenge,” that 20-50% of international travelers experience traveler’s diarrhea, and it’s a bigger issue for people with SCI “mainly because we can’t feel it coming.” His rule of thumb is that “if it’s not boiled, well-cooked or peeled,” don’t eat it. Also, if you can’t drink the tap water where you’re visiting, avoid ice, and brush your teeth with bottled water. Wherever you’re traveling, it’s always a good idea to have a bottle of Imodium in your carry on.
“Traveling With and Without a Caregiver” details how different people manage travel when they need help with daily tasks, like bowel programs. Some people bring a caregiver, and for others that’s too restrictive. Shawn Fluke, a C5-6 quad, posts an ad in his destination on Care.com two or three weeks before a trip and interviews applicants by phone. | |
Nutrition Tip
“To help ward off altitude-induced constipation and potential stomach upset from unfamiliar bacteria, two to three days before I leave on vacation, I double up on my daily probiotics.”
— Joanne Smith, certified nutritionist, from her article “ Tips to Maintain Bowel Regularity with SCI When You Travel” | | | |
I no longer sit on my everyday cushion when I fly, but for any flight or drive longer than a couple of hours I’ll typically transfer onto a low profile cushion. A ROHO Adaptor Pad is small and lightweight enough to fit in a carryon as a secondary travel cushion, but unlike other ROHOs, the cells don’t connect to each other, which is good because if you pop a cell it doesn’t deflate the whole cushion, but not so good in that you can’t let pressure out when it overinflates at 30,000 feet. I now travel with a simple, inexpensive gel cushion. It fits in a laptop sleeve, you can’t pop it, and it works just fine on a shower bench or tub floor.
The other part of protecting your skin is managing the awkward transfers that inevitably accompany travel. Vogel puts an Adaptor pad on the aisle chair before he transfers onto it. If you can’t self-transfer, getting from A to B may feel like a crapshoot, but remember you’re still in control. Tell the people transferring you how to do it safely, and don’t let them start lifting unless they’re doing it correctly.
Staying healthy while traveling is like any other part of disability life. It can be frustrating, exhausting, uncomfortable … and extremely rewarding.
Happy travels, and please let us know of any tips we’ve missed by replying to this email. If we get some good ones, we’ll use them on social media. | | |
