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Travel
Having a child with a heart condition does not necessarily prevent you enjoying a holiday away from home or even abroad, but it is important to spend some time planning. If you plan in advance to cover any medical, safety and mobility aspects hopefully you should be able to enjoy a fun, relaxing holiday.
Ability To Travel
Remember that all children's health needs are different and each will have different requirements, so before booking a holiday you will need to seek advice from your cardiologist or liaison team to check that your child is able to fly or undertake a long journey in a car or by coach for instance.
You may need to take a completed ‘fit to travel’ form or a certificate from your doctor. In some cases the travel agents will arrange for this to be completed.
Where To Go
Having found out your child's medical limitations from your cardiac team, you will have a better idea of suitable holiday destinations. You might also like to think about the following things when planning your trip.
Where is the nearest hospital? Many cardiologists advise against small island holidays because of the distance from medical care. You will want to be able to seek medical care for your child as quickly as possible in the event of an emergency.
Temperature. Consider if your child is able to cope with very hot or very cold weather. Check the hotel facilities.
Are there fridges in the rooms for medication? Are upstairs rooms accessible by lift? Is there disabled parking?
How will you get to your destination and how long will the travelling take?
Travel Insurance
Once you have had the ok to travel and decided on your destination, it is very important that you have adequate travel insurance when travelling abroad.
It is advisable to call a few different companies; you can try specialist insurance companies that deal with pre-existing medical conditions, although many high street insurers are also able to insure people with congenital heart conditions. Call a few to get the best policy and price for yourself.
Please remember that you MUST declare your child's heart condition and treatments in full otherwise the policy will be void. You must ensure that the policy fully covers your whole family: please declare your child's condition as some companies take on new policies without asking medical questions. Check that the insurance will fly a sick child home with an accompanying parent. Don't let yourself be persuaded to take out a policy which excludes medical cover for your child, even if they have been well recently. It is better to have a holiday knowing that all eventualities are covered.
If you are travelling to countries outside the European Economic Area (EEA), especially to countries such as the USA who operate a private medical system, if you are not adequately insured, you may end up paying for any care.
An insurance company may ask you to speak to their Medical Screening Line. It will be easier if you have all your child's details to hand as they will most likely want to know where you are travelling to, dates of travel, your child's date of birth, details of your child's condition, medication, symptoms, any treatment, and whether they are currently on a waiting list. Most systems only want yes or no answers - it isn't a DLA application! Tricuspid Atresia takes you to questions about acquired valve disease, so you are better to state that your child has congenital heart disease.
Your insurance company may ask for a letter from your child's cardiologist confirming that your child is fit to travel.
Please ensure that you take a copy of your insurance policy and any contact numbers on holiday with you.
LHM has a list of insurance companies although we cannot recommend any. To view the list click here.
If you have travel insurance with your bank account or if you have medical insurance with a company such as HSA, you may also like to check to see if you can get travel insurance for your child.
If you are travelling to a European Economic Area (EEA) country or Switzerland you can obtain a European Health Insurance Card (EHIC) which will entitle you to reduced cost, sometimes free medical treatment if necessary whilst you are in this country. The card is normally valid for 3 - 5 years. This is not a substitute for travel insurance as it will not cover cancellation of a holiday or the cost of transfer back to the UK.
You can get an EHIC by applying on-line at
www.ehic.org.uk or
www.dh.gov.uk/travellers or by calling
0845 606 2030 or picking up a form from a Post Office. Once eligibility to receive it has been verified, an application will be processed and you should receive your EHIC within 10 working days.
Some Examples of Medical Screening Questions
Initial screening questions are about:
- Whether your child takes prescribed medication.
- Whether he or she has been a registered in or out patient in the last two years.
- Whether he or she is on a waiting list.
- Whether he or she has a diagnosis of a terminal illness.
Questions specific to congenital heart disease may include:
- Has the condition been fully corrected?
- Does the affected person’s skin, lips or fingers ever become blue?
- Is the affected person currently growing at a normal rate?
- Does the affected person become breathless unusually easily?
- Does the affected person ever collapse?
Oxygen
For some children oxygen is helpful during a high altitude flight. If your cardiologist advises travelling with oxygen in case your child may need it or if he/she advises that they will need it for the duration of a flight, you will need to discuss this with the airline you are going to travel with before you book as they all have different regulations and costs. You will need to check what their policy is on taking oxygen and whether there is a cost involved also whether you need to complete a form or get a doctor's certificate confirming your child is fit to fly. If you have booked through a travel agent, they may be able to do this for you.
If your child is on oxygen at home, you should ask the Home Oxygen Service how to go about arranging oxygen for the journey and your holiday stay.
Medications
Ensure that you have enough medication for the whole trip and take extra in case of accidents such as broken bottles or travel delays.
It may be a good idea to pack any medicines where possible in your hand luggage, in case of lost luggage.
All medications must be kept in their original packaging.
You may wish to obtain a letter from your doctor to say that your child needs the medication and a list of all medications, (proper name not just the trade name), in case you need to replace any or have difficulty going through customs.
Some liquids are allowed in your hand luggage, although there is a limit on the quantity. You can carry small amounts of liquids in separate containers, each no greater than 100ml. They must be taken to the airport in a single, re-sealable, transparent plastic bag, which does not exceed 1 litre, so about 20cm by 20cm. Contents must fit comfortably and the bag must be sealed. The bag must be presented separately at the airport security point.
Essential medicines for the period of the trip may be permitted in larger quantities above the 100ml limit, but will be subject to authentification. Passengers must have obtained prior agreement of the airline and the departure airport, and must also take along supporting documentation from a doctor.
If your child is on Warfarin, make sure you take your Coaguchek machine and an adapter. Please remember that the machines and the strips are sensitive, so avoid exposing them to temperature extremes. Ensure that you take plenty of strips and try to make sure that your accommodation has a fridge for storing them. If you are staying at a hotel you will need to check guidelines about storing medicines in the hotel fridge. Transporting the strips in an empty thermos flask protects them from sudden temperature changes.
Make sure that you take the contact details of the people who manage your child's anti-coagulation, so that you can get advice if needed.
Dehydration
If you are holidaying in the summer or in a hot country be aware that some children find the heat very tiring and they dehydrate very quickly. This can happen even more quickly if they catch a stomach bug. Remember that dehydration can affect the blood’s coagulation and therefore affect the dose of Warfarin that it is safe to give.
Ask your doctor for a rehydration solution to take with you that is safe for your child.
Infections
If your child is prone to infections you may wish to ask the doctor to give you antibiotics to take away with you.
Pacemakers
It is fine for children to travel with a pacemaker but it can be affected by the security scanners at the airport and may set off alarms. Make sure that you have the pacemaker card with you and stop your child moving through the scanner.
The security staff are used to travellers with pacemakers.
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