Jürgen Zender, Munich, February 27.02.2022, XNUMX 

Where should the journey go, what do we want or need to take with us.

Questions and answers that occasionally give even healthy people a headache. For people with Parkinson's disease, however, the checklist is significantly longer and is not repeated nearly as often as the checklist for healthy people. Because the progressive disease creates a new challenge with every trip.

I don't drive a car anymore, but even the position in the passenger seat, sometimes sitting for hours on end, challenges my rigor to the worst. I can't stand sitting for long periods of time at all Essen I am very sensitive and I need my regular afternoon nap. If even one of these parameters changes, I can actually check off the day. Do I have enough medication with me? If necessary, can I get medication at my destination? But fortunately, you can avoid many problems through clever travel preparation.

On the website https://www.fit-for-travel.de/ -travel.de/ an interesting article about the travel preparations for the risk group Parkinson's patients was published these days, which I don't want to withhold from you.

Source: © GSK group of companies, all rights reserved, fit for travel.de

Parkinson's disease is not in itself a reason not to travel. Nevertheless, a few basic rules must be observed so that the trip promises the desired relaxation and does not end in stress and severe health problems. The travel destination should be adapted to the severity of the disease, ie the more advanced the disease is, the more “exotic travel destinations” should be avoided. Stressful situations can make the symptoms worse.

planning before the trip

It is advantageous to research medical care facilities in the travel country before the trip, which can help in an emergency. Light and breathable clothing (preferably made of natural fibers) should be taken to warm countries. A hat to protect you from direct sunlight is also suitable. Some tour operators offer travel concessions for Parkinson's patients (especially for air and train travel), which can be requested and organized in advance. Since the movement sequences are usually slowed down and stressful situations can also affect mobility (e.g. "freezing"), a generous amount of time should be provided for travel planning. In the case of advanced disease, it is advisable to travel with an escort.

carrying medication

Sufficient medication should be carried for the travel time. It is safest to carry an “emergency ration” in case the return journey is unexpectedly delayed. Especially when traveling by air and for border crossings, it is important to have the medicines you are carrying certified by a doctor. The certificate should ideally be in English, so that Parkinson's patients with chronic medication can identify themselves if necessary. When traveling abroad, it can be advantageous to carry a list of the international drug names with you. Before the trip, you should discuss with the doctor what to do in the event of an emergency or if the symptoms worsen. During the trip, various factors can lead to fluctuations in the effect of the medication (on-off phenomenon), which should be discussed with the doctor in advance. Travel sickness medications containing metoclopramide should be avoided, as this active ingredient can contribute to a worsening of Parkinson's symptoms. Alternatively, drops with the active ingredient domperidone can be used as a medicine against nausea.

climate and heat

The disease can lead to thermoregulation disorders. Warm and tropical temperatures can therefore lead to worsening of the symptoms of the disease. If symptoms such as hyperkinesia (pathological increase in muscle movements with partly involuntary movements) or tremor (typical “tremor”) already exist, the increased muscle work and reduced sweat production can cause the body temperature to rise and lead to what is known as hyperthermia (“overheating”) . To prevent the body from overheating, physical options such as cold compresses, sun hats, ice packs, etc. can be used. Since the symptoms can worsen considerably in the case of hyperthermia, a brief hospital admission may be helpful until the body has stabilized again. In the case of hyperthermia (“overheating” of the body), the intake of anticholinergic drugs and amantadine should be avoided, as this reduces the sweat secretion of the body and thus promotes overheating. Regular and sufficient fluid intake is essential. In warm, tropical countries in particular, the body has an increased need for fluids, ie at least 3 liters of fluid should generally be consumed per day. The physical activities are to be adapted to the outside temperatures of the travel destination and physical overexertion is to be avoided. Quiet times, especially during the strong midday heat, are useful, it is not for nothing that warm countries have the “siesta.”

Particular dangers in Parkinson's disease

In Parkinson's disease, reduced heat tolerance and disturbances in heat regulation can lead to circulatory problems that can lead to a sudden drop in blood pressure. Severe dizziness and "blacking out before the eyes" can be the first harbingers of a circulatory collapse. Therefore, travel to countries with extremely high temperatures or large temperature differences, especially in connection with high humidity, should be avoided. There is also an increased risk due to the increased tendency to fall in Parkinson's disease. Strenuous mountain and trekking tours should therefore be avoided, as the restriction of the holding and righting reflexes promotes a tendency to fall and falls can occur without warning. Affected persons should therefore stay away from busy roads, impassable terrain, etc. or only go there when accompanied. It should be noted that changes in diet, stress, traveler's diarrhea, etc. can lead to reduced absorption of the drug and consequently to a weakened effect. Upset stomach and intestines can lead to reduced absorption of the medication (restricted absorption). This in turn has the consequence that only a reduced effect of the drug is possible and, as a result, the symptoms can worsen. Careful food and drinking water hygiene is therefore essential to reduce the risk of gastrointestinal irritation or traveler's diarrhea. How to behave in such cases should be discussed in advance with the doctor treating you.

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