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Hitting the road (or air or sea) with hydrocephalus
Hitting the road (or air or sea) with hydrocephalus
Erin Garde, published 30.10.22
Planning a trip in the near future? Whether it’s a vacation, a business trip, or just a quick getaway, many of our members might be ready to pack their bags and set off on an adventure. Before you make arrangements for your home and pets, it’s important to consider a few travel tips related to hydrocephalus to ensure a smooth and enjoyable journey.
TRAVEL INSURANCE - IT'S COMPLICATED
TRAVEL INSURANCE - IT'S COMPLICATED
This is practically the number one question our members ask us when planning to jet off somewhere: Do I need travel insurance? And if I do, which company will (charge me lots of money) cover my trip?
Fair question we say, as unexpected trips to hospital for accidents or shunt failure can cost big $$ quickly. So, here’s the thing: if your trip is within Australia you are almost completely covered for any health related mishaps while on holiday. You can present yourself to any public hospital ED Australia wide and be treated free of charge. If you have private health insurance, your coverage works at the same level Australia wide too. There are some exceptions to this: Sometimes ambulance cover is tricky if you’re visiting a different State or Territory to where you live. Our advice is to look into it before you go, and check your private health insurance coverage for inclusions and exclusions when away from home.
In other good news, Australia has reciprocal health care agreements with a number of countries overseas. This means that urgent medical care is covered, or at least subsidised, for treatment that can’t wait until you get back to Australia. It is up to each country what they will cover or subsidise. More information about overseas countries Australia has agreements with and what care it provides can be found at www.smartraveller.gov.au/before-you-go/health/reciprocal-health
Finally, let’s do it: What travel insurance companies have covered our members when travelling overseas? Well, depending on your individual circumstances and your current health status, there are a few companies around that cover pre-existing medical conditions under certain circumstances. One we found is Cover More Travel Insurance (www.covermore.com.au) and the other is Insure and Go (www.insureandgo.com.au). There may well be others; the best way to find out is to obtain a quote from a range of insurance providers. Finally, please note that while we have identified these two companies to give you somewhere to start, the Hydrocephalus Support Association does not endorse, support, or recommend any individual travel insurance companies.
RIGHT, I'M READY - WHAT'S NEXT?
Now that you’ve got the insurance sorted out, there are a few other things that might be useful for you to think about so that your trip away is a success.
HOT TIP #1 - KNOW YOUR SIGNS
What happens to you when your shunt or ETV malfunctions? When do you know that something is wrong, and it’s likely your shunt or ETV? Everyone is different when it comes to experiencing complications related to hydrocephalus, so it’s really important you know what happens for you so that you can get help as soon as possible. If you’re travelling with friends or family, you might find it useful to have a conversation with them before you go about what shunt or ETV failure looks like for you. If you’re not comfortable doing that, or travelling alone, what about writing it down so that you can show the team when you go to a medical facility for help.
Finally, the Hydrocephalus Association in the USA also has a handy app where you can store documents such as these in one place without taking up too much room in your suitcase. The HydroAssist® app (www.hydroassoc.org/hydroassist/) is free and can be downloaded from the Apple App Store or Google Play direct to your device.
HOT TIP #2 - GET YOUR DOCUMENTS AND MEDICATIONS TOGETHER
This is something that EVERYONE with a medical condition should do before travelling, not just the folk in our hydro community. Before you go, build a collection of documents that might be useful if you have to seek medical help while you’re away. This might include a medical alert card (available from the HSA) or bracelet identifying that you have hydrocephalus; copies of your most recent scans to show what your brain, shunt or ETV and ventricles look like when you’re well; details of the brand of shunt and it’s current settings (in the case of a programmable shunt); and a letter from your doctor about the current management of your hydrocephalus and any medications you are taking.
Then, make sure you have enough of the medication you take on a regular basis for the duration of your trip and some spare, just in case you are delayed returning back to Australia. Do be mindful, however, some overseas countries have different rules and restrictions for some medications than Australia does, particularly around bringing in codeine or oxycodone based painkillers or cold and flu medicine containing pseudoephedrine, for example. You can usually find this information on each country’s consular website.
HOT TOP #3 - RESEARCH YOUR DESTINATION
Preparation is the key to success here, particularly when it comes to getting help in the unlikely event something goes wrong while you are away. Research the medical facilities at each of your destinations, and know where your nearest hospital or doctor is so you can get there quickly. Many travel insurance companies also provide support for people who don’t speak the local language, with lists of hospitals and doctors that speak English. Check your policy for more information.
Hot tip #4: Airport security, body scanners and metal detectors
Many people in our community who have programmable shunts feel nervous about going through metal detectors and body scanners because they worry the magnetic field emitted might change the setting of their shunt. This is understandable, because it would ruin your holiday before it even started if it did happen!
The most recent advice from the Hydrocephalus Association Medical Advisory Board states:
“There is no reported incident of airport security procedures causing a change in an adjustable (programmable) valve setting and it is safe to walk-through metal detectors. Generally speaking, most valves on the market need magnets around 100 gauss, right on top of the valve, to move the mechanism. It is important to keep in mind, for magnetic fields, distance matters. It is stronger when magnets are closer and weakens as they are apart (within centimeters).” (Hydrocephalus Association Medical Advisory Board, 2022).
If you are still concerned, or have prior experience with your shunt settings changing after going through airport security, we suggest you discuss it with your neurosurgeon before you go. That way you can make an informed decision before the departure gate!
HOT TIP #5 - FLYING WITH HYDROCEPHALUS
Some members of our community are also concerned about flying, because they are worried about the effect the air pressure of the cabin might have on the functioning of their shunt. Fair enough too, we say, because who would want to have a pressure headache on a long flight?
We had a dig around in the literature about this topic, and the take home message is that people with shunts are no more at risk, per se, of developing headaches related to pressure than are people who don’t have hydrocephalus or don’t have a shunt (Hydrocephalus Association Medical Advisory Board, 2022; Presti, Weil & Ragheb, 2015).
That’s not to say it won’t happen, though. Our hydro community has lots of stories about people who are sensitive to barometric changes or changes in altitude. Unfortunately, there’s no way to know for sure before you go. That’s why preparation is the key: If you experience regular headaches or are sensitive to changes in barometric pressure or altitude, make sure you have access to your medication during the flight; and sure you know where to go for help once the plane lands.
HOT TIP #6 - LOOKING AFTER YOURSELF WHILE YOU'RE AWAY
Please remember to look after yourself while you are away too. Rest when you need to; eat good food; stay hydrated and take your medications as usual. These are all common sense things you can do to make sure your time away on holiday is the best it can be!
Finally, and most of all, just have fun. Also, feel free to send us some photos and stories of your experiences travelling with hydrocephalus to feature in the newsletter (to news@hydrocephalus.org.au). We want to hear from you!
REFERENCES
Australian Government, Department of Foreign Affairs and Trade. (2019). Reciprocal health care agreements. www.smartraveller.gov.au/before-you-go/health/reciprocal-health
Hydrocephalus Association. (2022). Traveling with hydrocephalus factsheet. www.hydroassoc.org/traveling-with-hydrocephalus/
Hydrocephalus Association. (2022). HydroAssist® app. www.hydroassoc.org/hydroassist/
Hydrocephalus Association Medical Advisory Board. (2022). Airport security procedures and hydrocephalus. www.hydroassoc.org/traveling-with-hydrocephalus/
Lo Presti, A., Weil, A. G., & Ragheb, J. (2015). Letters to the Editor: Flying with a shunt. Journal of Neurosurgery: Pediatrics PED, 15(2), 223-224. https://thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/15/2/article-p223.xml
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