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Travel advice

Planning your holiday

If you are planning your first trip, it is only natural that you may be feeling apprehensive about travelling for the first time following your operation. It makes sense, therefore, to start with short trips away from home to build up your confidence. Once reassured, and as your confidence builds, you can start to venture further afield. Note: if you have recently had surgery, check with your consultant or GP prior to booking your holiday to ensure you are able to travel. You must seek medical approval for the trip if you have been in hospital during the last 6 months.

Plan ahead

• Make a checklist of equipment you need to take with you
• Go through your daily routine to remind yourself of exactly what you use
• Calculate the number of pouches you would normally need for the days of your holiday - and double it, with a few extras! The change in climate and environment may mean more pouch changes are needed
• Having extra supplies can only add to your peace of mind Note for colostomists: if you have a colostomy and normally wear a closed pouch, a few drainable pouches may be useful to take with you. Whether you are travelling abroad or at home, you can catch a tummy bug. Draining a pouch can be much more convenient if the stool is loose, and reduces the frequency of pouch changes and possibility of sore skin.
• It may be useful to take with you different size pouches for different activities. Most companies make a range of different size pouches. You may want a larger capacity pouch for a long flight, or a smaller pouch for swimming. Ask your stoma nurse for advice
• In general, it is advisable to keep most of your supplies in your hand luggage so that it remains with you at all times and is within easy reach. However, in case your hand luggage is misplaced, extra supplies should be kept in your suitcase or companion's luggage as a precaution
• If travelling abroad, contact your stoma care nurse for details of a stoma care nurse in the country you are visiting. If staying in the UK, contact your stoma care nurse who may be able to give you contact details of a local stoma care nurse in the area you will be staying in.
• A separate small travel kit containing items needed for a change of appliance should be kept close at hand to make visits to the toilet simple and discreet

Travel insurance

When you have decided on your destination, you must ensure you have adequate holiday insurance cover. Before insurers agree to provide cover, you will have to go through the insurer's screening process. This may involve completing a medical questionnaire or perhaps a telephone call with a medical advisor. You must disclose any medical history, surgery and any pre-existing conditions.

• Shop around for insurance cover
• Contact ostomy associations (Colostomy Association, Ileostomy Association or Urostomy Association): they may have names of reputable insurance companies If travelling to Europe, it is essential to have a new European Health Insurance Card (EHIC), which replaces the old E111 form. (Phone EHIC scheme on 0845 606 2030, pick up an application form from the Post Office, or see the web site www.ehic.org.uk.) The card entitles you to free, or reduced cost, medical treatment in most European Countries. This is recommended as well as travel insurance.

Outbound journey

Remember that the IATA (International Air Transport Association) regulations forbid passengers to take dangerous items on board an aircraft, and restrictions apply to carrying liquids on board. Check with your airline a few weeks before departure. Scissors should be packed in hold luggage. When you check in at the airport, make sure you arrive early so you are at the front of the queue. This way, you can request an aisle seat near the toilet. You may also be able to request this in advance with your travel agent. Air travel can make some people a bit ‘windy’. It is a good idea to avoid foods which you know may cause excessive wind; have frequent small meals for 24 hours prior to flying; and try to avoid spiced or fatty foods and fizzy drinks. Your hand luggage may be searched at the airport. If you are unable to speak the language, you can obtain travel cards which are printed in several European languages and explain the reason why you are carrying your equipment and about your condition.

Contact Salts Healthcare or your Stoma Care Nurse, who will supply one. If you are travelling by road, try to plan your journey breaks around places that have adequate toilet facilities. Most roadside cafes, restaurants, service stations and hotels have toilet facilities. Do not be afraid to ask if you need to use them.

If travelling in the UK, you can obtain a Radar key for access to disabled toilets. Contact your Stoma Care Nurse for information.

Food and drink

When abroad, the general advice on food and drink is the same for anyone:

• Be wary of the water supply in some countries
• Use bottled water or boiled water, including when cleaning your teeth and your stoma
• Avoid food that has been standing for long periods
• Don't have ice cubes in drinks
• Wash salads and fruit before eating them

Tummy upsets

A change in climate, water or food can upset your bowels, so be prepared. As a precaution for diarrhoea, it is advisable to take with you, Loperamide (Imodium) which slows down the bowel's activity; and sachets of rehydration powder (Dioralyte or Rehydrate) which easily dissolves in water to replace lost body salts and reduces the risk of dehydration. Note for ileostomists: if you have an ileostomy, Imodium capsules will not be absorbed adequately as they are designed to be absorbed in the large bowel. ‘Imodium Melts’, which you place on your tongue, or ‘Imodium Elixir’, which is obtainable on prescription from your GP, will be utilised better. All of these medications are available on prescription or over the counter from the pharmacist or local supermarket. Always read the instructions very carefully before taking these medications. If your symptoms do not settle after 24 hours, seek medical advice.

Fluids

Drink plenty of fluids. In hot, humid countries, we perspire much more and need to replace lost body fluids. This applies to all the family. Make sure you have plenty of fluid stops and always carry a bottle of water. Isotonic sports drinks such as Lucozade Sport or equivalent are excellent for combating dehydration. Allow them to go flat first, to reduce wind.

Symptoms of dehydration are:

• Thirst
• Headache
• Weakness
• Small amounts of concentrated urine
• ‘Light-headedness’
• …or any combination of these symptoms

If you experience dehydration, you can make up a simple oral rehydration solution as follows:

• 6 level teaspoons of sugar
• 1 level teaspoon of salt
• Half teaspoon of sodium bicarbonate
• Mix with 1 litre of tap water (bottled water if abroad)
• Palatability may be improved by mixing with a small amount of fruit juice or squash

This solution should be drunk over 24 hours. Seek medical advice if symptoms persist. Remember, also, that too much alcohol will accelerate dehydration as well as giving you a hangover in the morning - so don't overdo it!