12 Tips For Traveling with POTS

Questions about travel pop up a lot and I can certainly understand why traveling with POTS is a battle. When flying you face problems such as security lines, standing to get off the plane, change in pressure, change in elevation, and a lot of walking. Driving doesn’t offer a wonderful alternative to flying. Often driving includes sitting in the same position, limited food, and drink options, or motion sickness. Often the combination of these factors leads to a lot of POTS patients avoiding travel. If you do decide to travel I offer up the things that have made traveling bearable for me:

1. Keep All Medications Near You
This applies to traveling by car, boat, plane, or by sled dog. Anytime you travel you should pack a bag that you are going to keep close to you. This bag should stay right below your feet so you are ready for anything that may arise.

Travel creates stress on our bodies and sometimes some of your most rare symptoms or an abnormal presentation of your symptoms will pop up. For example, on a flight to Arizona I decided not to bring migraine medication on the plane. I didn’t have an aura or the beginning of a migraine and it was a short flight so I thought I would be fine. Usually, my migraine onset is very gradual. Change in elevation and pressure, as well as possibly stress, triggered a migraine immediately and suddenly. The entire flight was miserable and I had trouble making my connecting flight.Therefore, I advise you take into account that your body may not react “normally” (like it’s ever normal) and be completely prepared.

2. Hydrate
I know you feel like you are listening to a broken record with everyone telling you to hydrate; this time it is even more important. Airplane cabins are kept extremely dry. This leads to dehydration and is why drinking extra water is especially important. When I have a flight I try to drink 1 liter of water before security. Then, immediately after security I buy another liter for the plane. I try to finish it before the flight attendant comes around for drinks and order another water. So you get the picture- drink a lot of water. Surprisingly, you may not find yourself peeing more often as the body retains water due to dehydration.
I know on car trips it can be tempting to skip the water so you aren’t constantly having to stop to pee. It is absolutely not worth it. You may get where you are going more quickly, but you will feel so terrible you won’t be able to enjoy it. In addition getting up and walking every couple hours is better for you in general. So keep up the hydration- no excuses!

3. Nausea Tips
I am often nauseous even without motion sickness so nausea is a real problem when I travel. Sometimes Zofran and Promethazine are the only things that touch my nausea, but there are some other solutions that you don’t need a prescription for.

I was skeptical about acupressure being helpful for nausea (haven’t found many scientific articles on it), but it either is effective or generates a profound placebo effect. Acupressure is when you put pressure on a part of your body for different effects. Applying pressure at the inside of your wrist right between two ligaments for a few minutes is definitely worth trying as there are essentially no severe side effects. If nothing else it may help distract you from your nausea.

I recently tried GinGins and they were strange, but I felt like they actually did help. Ginger is said to settle the stomach (which is why ginger ale is a common home remedy for nausea) and these candies are essentially ginger in a more manageable amount- well compared to eating raw ginger. I found no scientific evidence to support this claim.

Peppermint is also said to help settle stomachs. I found no scientific evidence to support this claim. If you like chewing gum on a plane I suggest peppermint gum. Otherwise, I would suggest peppermint candies with real peppermint and not too much sugar.

Cold is one of the things that helps me the most with nausea. Taking off a layer, pointing the tiny AC at my face, and sucking on ice all help me be less nauseous. I order ice water to sip on if I am extremely nauseous and it helps me not be sick.

4. Consider Using Assisted Mobility Devices
It took me a while to feel comfortable using a wheelchair at the airport; it helps so incredibly much.  All you do is go to your airlines desk to check in (where you check baggage) and tell them you need a wheelchair. If you have your own wheelchair just tell them you need assistance at the same desk. Then they often have you wait and someone comes and gets you. I look healthy and have never been asked why I need the chair, which is a common problem with POTS. They wheel you past the security line, you stand for a second in the body scanner, then sit back down. Even though you do skip the security line I don’t recommend planning on it and showing up later. Often many people need help with wheelchairs and you have to wait for someone to help you for quite a while.
If you have your own wheelchair you can keep it with you until the gate and gate check it. Unlike literally every single other thing with airlines, checking a wheelchair is free. Traveling is also easier if you get a lightweight wheelchair.

Wheelchairs aren’t boring and lame- look at this guy!

5. Compression Tights
Compression tights can be hot and unattractive, but don’t have to be. Try Rejuva Health or these are the ones I wear. They are so comfy and come in cute bright colors so my tights look more like a fashion statement and less like an old lady in medical wear (although some of those grannies rock it).

Compression tights help with blood pooling from sitting in the car or on a plane too long. On a plane, the cabin pressure is lower which may exacerbate POTS symptoms. After all, even healthy people feel worn out after long flights. The pressure put on your legs by the tights really does help me with POTS symptoms. Compression tights also help prevent blood clots when sitting for long periods during flights or long road trips- two birds one stone.

6. Small meals with a lot of extra salt
Pushing salt is usually important on normal days, but when you are flying it is even more important. I try and get something salty both before my flight and during. I usually choose trail mix, pretzels, or salted nuts. Eating a lot of salt earlier in the day and even the day before you travel may help. Keep your salt up after your flight too.

It is best to keep up your salt through eating many small meals. Small meals keep you from becoming nauseous. When you eat a large meal blood can move into your abdomen and worsen your POTS symptoms.

7. Buffer Days
Buffer days are an absolute must have for traveling with a chronic illness. What I mean by buffer days is that I schedule at least one day before and after travel just for rest. Travel is hard and if I don’t give my body the rest it needs whatever I’m traveling for ends up being a disaster.

ready to party

8. Preboard Flights
If you tell your airline you cannot stand they will give you a preboarding pass. That way you are the first person on the plane and minimize time standing. So far I’ve had no problems with airline employees not treating me with respect despite my illness being invisible.

9. Choose Your Seats
Some airlines (Southwest is all I know for sure) don’t assign seats. If you can use an airline that doesn’t assign seats it is amazingly helpful. I always sit in the very front row so I can get off the plane and don’t have to stand waiting for people.

No matter what your means of travel, sit in front or where motion sickness will be the least awful whenever you have a chance. This especially helps me on road trips and my friends and family are nice enough to let me always sit “shotgun.” If your friends and family are less helpful tell them sitting in the back will likely result in you puking in their car. They change their minds pretty fast.

10. Be Ready For Weird Temperatures
I made this mistake at the Dysautonomia Conference. I was really ready for warm temperatures, after all Washington DC is much warmer than Denver. Well, what I didn’t prepare for was the air conditioning being so cold to make up for the heat outdoors. I had to go to Target just to buy warmer clothes. A lot of times those of us with Dysautonomia don’t respond to temperatures correctly so having backups for any temperature is essential.

11. Insurance for Flights & Flexible Plans 
Planning in advance with a chronic illness can be challenging. I always pay more for insurance and the ability to cancel flights, hotels, car rentals, etc. I can’t know how I will feel that day until the day of; this has saved me a lot of stress.

12. Put Your Feet Up When You Can
Put your feet up whenever it is possible. This is difficult to do on an airplane unless you are in the first row, but you can put your feet up before you board and after. This will help minimize blood pooling and help your POTS symptoms.

On road trips it its much easier to put your feet up as long as you aren’t driving. Be forewarned that sitting with your feet up in the front seat of the car may make car crashes more dangerous. If you are worried about this put your feet up in the backseat instead of the front where the airbag is.

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