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Archive for the ‘International Travel’ Category

I haven’t even left California yet and I’ve already screwed up. Awesome.

Checked my e-tickets two days ago and discovered that for reasons lost to the mists of post-menopausal memory, I booked us on a 7am flight out of San Francisco.

Which means we need to get to the airport no later than 5am. Crap.

Much furious consultation with my spouse ensued. We decided to get a motel room at a place near the airport that offers free shuttle service, plus a well-lit place to park a car for the 10 days we’ll be gone.

Of course the problem isn’t confined to the California end of the trip. We arrive in Dublin at 6:55am. Which means that we’ve got ~9 hours to kill before our room in Dublin City Centre opens up.

I can’t manage sightseeing after a transcontinental+transatlantic flight. My body absolutely will not tolerate that kind of nonsense.

The answer is yet another airport motel room. I emailed customer service at the Radisson Blu Dublin Airport and discovered that they’re set up to deal with situations like this in a couple of ways. They’ve got what they call Day Rooms that are available from 9am-5pm, or they’ll let a weary traveler rent a room overnight and check in very late (like, say, early the following morning), then check out at 3pm for no extra charge.

I went with option B, which will allow me to stagger/roll out of Customs and Passport Control straight to the free shuttle, straight to my motel room to collapse in an insensible heap.

While I haven’t yet stayed in their motel, so far I’m quite happy with the Radisson Blu customer service folks. They’ve followed up with me and seem intent on making sure I’m taken care of.

The morals of this story:

1. Pay attention to your flight bookings, and try to make your departure and arrival times work for you rather than against you.

2. Flexibility and good problem-solving skills are key for traveling with pain. Be willing to change your plans to make yourself more comfortable.

3. Money helps. A lot.

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Next week I’m off to Ireland. I’ve never been to Ireland before, so everything will be new and different and shiny.

Here’s how I’ve planned around my pain so far.

Flying out

I’ll do all the right stuff to make the long flight more tolerable, including:

  • Get to the airport ~3 hours before my flight leaves.
  • Use the wheelchair service
  • Bring my own food
  • Bring my neck pillow
  • Do in-seat stretching exercises
  • Get up every hour and walk the length of the cabin and back at least once
  • Stay hydrated
  • Relax when disembarking–the prize for the “race” to the baggage carousel is to wait 20-30 minutes for the luggage to appear, and I don’t want to win that prize

Hotels

All my hotel rooms are booked. Because I’m traveling on my parents’ budget rather than my own, they are nice hotels. Which means working elevators, other people carrying the bags, soft comfy beds, bathtubs, and room service. It’s not politically correct to say so, but rubbing money on the pain really does help.

On the ground transport

In Dublin, we’ll be walking and taking public transit. Because it’s a big touristy city, I know I can catch cabs if I need them. I also know that if I’m having an iffy day, I won’t stray too far from the hotel.

We’re hiring a car and driver for the longer hauls and our time out beyond Dublin. The ‘cars’ will actually be minivans, which means I’ll have a place to lie down if I need it.

Meds

I’ll be refilling all my prescriptions before I leave. None of my current meds are restricted in the EU. All meds will still be in my carry-on, in their original (labeled) bottles.

Ireland is a civilized country that sells codeine-based painkillers over the counter in pharmacies. I will likely take advantage of said civility.

Money

I’ll be getting in touch with my bank early next week to inform them of the trip. These days, you want to do that, so they don’t suspend your account (for suspected fraud) when you suddenly start making charges in another country.

Yup, that’s a lot of planning. But every practical thing I take care of at home makes it easier for me to relax and enjoy

 

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Moon California & prescriptions

Meds I have traveled with. Yes, I keep them in their bottles with labels like that.

There’s no central place on the Internet or on paper that lists which prescription and non-prescription medications are legal and illegal by country. Which makes international travel with meds…a little nerve-racking. I’ve heard and read the horror stories of tourists with legal opiate prescriptions being detained and imprisoned in the United Arab Emirates (UAE)/Dubai.

So I decided to create a list here. It’s woefully incomplete, but it’s better than anything else I’ve found. But what you’ve really got to do is contact the embassy of

IMPORTANT SAFETY TIP: This list does NOT substitute for contacting the embassy of the countries you’re visiting and getting the latest legal information from them about traveling with medications. I take NO legal responsibility for anyone traveling with medications of any kind.

Oh, and if you’re stupid enough to travel carrying illegal drugs (which includes medical marijuana, pretty much worldwide) you’re so totally on your own. Be aware that if you’re caught with illegal drugs in another country, your passport will get you precisely squat in the way of legal protection.

United States

Painkillers with codeine are prescription-0nly items in the USA. If you’re from Canada, the U.K., or another country that sells codeine OTC, be aware that you will NOT find your meds OTC in the U.S. You’re permitted to carry these pills, but you’ll want to have your passport with you any time you’ve got your pills on your person as it is NOT legal for US citizens to carry OTC codeine.

United Arab Emirates/Dubai

All narcotic painkillers (that is, anything with codeine or oxycodone or any other opiate derivative or synthetic opioid) are banned in the UAE. To carry a prescription opioid into the UAE, you’ve got to carry a doctor’s letter and prescription information, both of which must be notarized and registered both with your home country’s State Department and the UAE consulate.* If this sounds like way too much work, I’d consider thinking about whether you really need or want to travel to Dubai or elsewhere in the UAE.

While I’ve seen plenty of individual reports online of travelers who have not been searched or questioned about their meds when they’ve entered the UAE, here at TWP I recommend NOT just hoping that you’ll get lucky. ‘Cause in this case, UNlucky = years in a foreign prison. Don’t go there.

State Department info on UAE’s alcohol and drug laws….

* I haven’t been able to verify this statement.

China

You’ll need to carry your prescription meds in their original bottles with labels AND have copies of the original prescriptions available to show Chinese authorities if asked. Yes, that’s a lot more liberal than many of the other countries on this list. Live and learn.

Japan

Cosmopolitan though it is, Japan’s policy on “importing” drugs and medication is draconian. Japan’s got restrictions on OTCs that contain pseudoephedrine and codeine. They’re not fond of people who try to mail or Fedex in their meds either–if you need to mail yourself meds, be sure to get a Yakkan-Syoumei certificate from the Japanese Ministry of Health, Labor, and Welfare.

You need to get permission IN ADVANCE from the Japanese Consulate to bring prescription opiates, psychotropics, injectables and syringes (including insulin). Your prescription and a doctor’s note are NOT enough.

If you get caught with a banned medication and no documentation for it, Japanese customs or police can detain you for several weeks. You can be convicted of a drug offense in Japan based only on a urine or blood test.

Seriously, if you’re traveling to Japan, contact the Japanese Embassy in your home country and learn whether your meds are allowed and what documentation you need to carry them–and do this weeks before you leave home.

State Department info on Japan’s drug laws

Mexico

You can hand carry your meds into Mexico legally, though they advise that you have your prescription info with you. (Which you should always do anyhow.) Mexico does permit visitors to ship personal-use medications into Mexico provided that you do some paperwork beforehand. For a fee, you can go through a broker to get your paperwork expedited. Check the link to the State Department for more info about that.

You’ll find a lot of “pharmacies” selling antibiotics, pseudo-Viagra, and who-knows-what-all…especially in heavily traveled tourist areas. Buy from these places at your own SERIOUS risk. TWP recommendation: don’t buy “medications” from “pharmacies” at Mexico’s tourist traps. You don’t know what’s in them.

State Department info on Mexico

Thailand

You can bring up to 30 days worth of medication to Thailand.

Be aware that if you get caught in a drug sting at a club or party, you’ll be arrested if your urine tests positive for drugs. So if you’re taking prescription opioids, consider avoiding the club & rave scene. Yes, I know that’s the main reason lots of people go to Thailand, especially Bangkok. But please consider the ramifications of ending up in a Thai prison, and just go to Burning Man or an ecstatic dance weekend if you’ve really got to do the rave thing.

State department info on Thailand

That’s it for now. I’ll add Parts 2, 3, etc. as I have time to do the research for y’all. Which brings up the question…What countries would you like info about medication/drug laws for?

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Hey y’all, guess what? Somebody out there cares enough about disabled travelers to survey us!

http://www.surveymonkey.com/s/P7F59J5

Please take a few minutes to take this survey. It’d be great to see travelers with hidden disabilities well-represented in this effort.

Best of all, it’s clear that somebody out there thinks that disabled travelers have enough money and desire to travel internationally. And they want to market to us effectively. That’s so awesome! This is how we’ll get better travel experiences worldwide–by getting the travel service industry to realize that we have money and we want to spend it on travel.

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pills_sparktography

Writer’s Note: I committed this epic cautionary tale several years ago, before I started this blog. But it remains my personal reminder of why I must always, ALWAYS think and plan before I walk out of my door and hit the road. I repost it in the hopes that you’ll learn from my mistakes and not end up wandering the streets of a foreign city in a foggy half-delirium. ‘Cause it’s not safe to do that.

In my own defense, I was pretty distracted before this trip–my marriage was in the process of imploding, I’d just been informed that I was about to be laid off, and I was about to go into my second surgery. Yeah, that year just sucked.

I

think what I like best about Toronto is the fact that no one attacked me while I was walking its streets in a bleary haze of leftward* SNRI withdrawal.

Well, that and the food. The food was awfully good in TO. And the number of live theaters, and the recycling bins in all the cute little city parks, and the lake, and… Actually, I loved Toronto even after I got my medication disaster straightened out.

So what happened?

A series of blunders that added one upon the other to create a situation in which I missed 3 doses of Cymbalta (an SNRI) in a row.

Blunder #1: Booking a red-eye flight.

I’d never recommend this special little corner of travel hell to any of my readers, so it’s a mystery as to why I inflicted it upon myself. (Actually it’s not. It was a budget-based decision, and a bad one. Not to self: Pay more and fly during the day. Always.)

Blunder #2: Not adjusting my med schedule before I left.

A couple of days before I left, I should have shifted my med times by about two hours so that I could take my pills before I left home for the airport. This would have been an easy thing to do. Now I start shifting my pill-taking times before I take a trip through a wide band of time zones.

Blunder #3: Not just taking the stupid pill before I left the house.

SNRIs aren’t all that time sensitive. I could have just taken my Cymbalta before I left for the airport.

Blunder #4: Not planning to take my non-narcotic meds on the plane or in the airport.

I always put a bunch of meds in my purse anyhow–it would have been easy to think “Gee, I need to take my Cymbalta twice a day. I could put some in my purse and take it at the end of the flight in the morning.” But I didn’t. So the Cymbalta wasn’t anywhere I’d see it (triggering a memory that I needed to take it) while I was in transit.

Blunder #5: Flat-out forgetting to take my meds when I got to the hotel.

I was exhausted, in pain, and (oh the irony) starting to withdraw from the Cymbalta. I got to the hotel and promptly collapsed into bed, and the thought of taking meds never even crossed what was left of my mind.

 

I am a professional. Do not try this at home. Or on the road. Ever. By blundering like this, I put myself at  real and serious risk of harm. In addition to the dizziness, confusion, headache, and lethargy I put myself through, I could have had a seizure. Seizures can cause brain damage. Brain damage probably won’t improve my pain.

I seem to have learned my lesson–I’m much, much more careful about planning my medication schedule when I travel now, and I’ve had no repeats of Total Medication Fail. Hooray for learning without horrible personal consequences!

* Whenever I or the pharmacy have done something stupid and I miss doses of key meds, my visual sense shifts to the left. I don’t know how else to describe the sensation.
Photo (c) sparktography on flickr

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Prague

This is Prague, apparently. Couldn't prove it by me, sadly.

Once upon a time, I was young and healthy and pain-free. Like many college students, I took a couple of quarters to “study” abroad. I went to Paris, and used the locale as a base from which to travel much of Western Europe. Over the Christmas break, I shouldered a pack lent to me by a 6-and-a-half-foot tall guy and spent 6 weeks banging from city to city, country to country. Just like healthy people do every day. Just the way the magazines and websites describe as ideal and fabulous and amazing.

Interesting facts to know and share: About four weeks into that trip, my brain overloaded completely. I’d seen so many cathedrals, ruins, museums, etc etc ad infinitum, that I just couldn’t take anything more in. So I forgot things. Like Prague.

I forgot the arguably most beautiful city in all of Europe. I spent three days touring in Prague, and I remember none of it. Not a single building. Not the view of the river (I hear there’s a river in Prague). Nothing at all.

That’s such a huge bummer. I’ve got a few snapshots I don’t remember taking of buildings I can’t name, and that’s the sum and total of the gain I got from visiting Prague. For that, I might as well have stayed home.

So what does any of this have to do with traveling with pain?

It means that the way I travel with pain now–slowly and selectively–is actually be a better way to travel altogether. The Slow Food movement is all the rage right now. I think I’d like to jump on board something like a Slow Travel movement.

So what does my Slow Travel movement look like?

  • Don’t sightsee right off a plane, ever
    Instead I leave the terminal, check in to my accommodations, grab a meal and a good night’s sleep. That way I’ll be fresh and rested and relaxed, and get far more information, enlightenment, and fun out of the sights I see.
  • Pick a pretty hotel, or a hotel with a pretty view.
    If I’ve got a hotel that’s right on the beach, or halfway up the mountain, or overlooking the city skyline, or inside a famous historic building, I don’t have to leave it to start my sightseeing. I can (and do) enjoy a new and wonderful view from the comfort of my bed.
  • Don’t plot a list of ten things I must see every single day. Or any day.
    Instead, I choose one place I really want to go for the day. And I keep a couple of other possible destinations in mind, in case I have extra energy or my first choice doesn’t work out. Then I spend almost a whole day focused on that one place/attraction
  • Rest early and rest often.
    If I’m tired and I need a nap…I go back to my hotel and I take a nap. Yes, I miss things by resting when I need rest. Things like collapsing on public sidewalks.
  • Enjoy eating regularly.
    I take advantage of B&B breakfasts, shop at local farmer’s markets for fresh fruit to snack on, ask locals for recommendation for good restaurants that mere mortals can afford. And I take my time over my meals–I sit and enjoy the atmosphere in the dining room rather than bolting my food so as to rush off to the next item on some checklist.
  • Take a day off the sightseeing.
    Yes, really. On trips longer than five days, I often take a whole day “off.”  Even in Europe, I’ll kick back in my hotel room (enjoying the view, the history, etc.) and meander around the hotel property at some point.

When I travel this way, I don’t forget whole cities. Nope, I don’t see everything. Not anywhere I go. But because I’m spending more time and energy on what I do see, I get more out of it. And remember it afterward.

 

Photo (c) ♀Μøỳαл_Bгεлл♂_BACK_FROM_PRAGUE

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Arno River Florence

The Arno River in Florence, photo (c) Eustaquio Santimano

Almost 10 years ago I traveled to France and Italy with my ex-husband and Andrew & Catherine–long-time friends who have traveled with me many times to many places over the years. Andrew has severe Crohn’s Disease. Catherine has moderate to severe asthma. This was my last big trip before I got sick myself. (Wow. I’d never really thought about that before.)

France was great. We did Paris for a week, then Nice for the weekend. We ate great food, drank cheap wine, gaped in awe at Gothic cathedrals and strolled sandy beaches bordering the glorious azure sea.

Then we boarded the train for Italy. It all went south from there. (Ha ha.)

I got us the top two floors of the renovated medieval castle tower in the Tuscan countryside, in the “village” of Stigliano. As a bunch of medieval history nuts, we were utterly thrilled by the idea of staying in a genuine 14th century tower. And it was great! Except that just like in medieval times, the tower had no elevator–only steep stairs up to the 3rd and 4th floors. Also apropos of a medieval town, Stigliano had no grocery stores. It had a restaurant…which shut down permanently about 4 days before we arrived. And unlike a medieval town, Stigliano had no pubs, no taverns, and no market days with food sold in the town square. Over the five days I spent in Tuscany, I lost five pounds. We did manage to take in some sights, to tour in Florence and to explore the slightly bigger neighboring town of Rosia. But the next time I travel to Italy, I’m doing pretty much everything differently.

Using the zillion mistakes I made as the Official Trip Planner as a base, here’s what I’ll do next time I venture into Italia:

* Work with a disability-friendly Italian tour company

Look what I found when I was researching for this post:

Accessible Italian Holiday

Neat! Drool-worthy resort hotel-spas with hydrotherapy pools and super-suites. Expensive as all get-out, but if I ever gather up the money I am *so* staying at some of these places. I expect that they’ll do all they can not just to minimize my pain during the trip, but to help me with long-term wellness.

* Check the Italian bank holiday calendar when planning the trip

Almost everything in Italy grinds to a halt on national holidays–public transit, restaurants, grocery stores, etc.

This gets somewhat less true the bigger the Italian town you’re staying in. In the biggest cities you’ll probably be able to find a place to grab a bite, and the subways will have limited service. But even if you’re planning to be in Milano or Roma for Italian Independence Day, you’d be wise to know in advance that the holiday is coming. Stock up on food and coffee for that day, and make plans that don’t require public transportation.

* Stick to the major cities of Italy 

I don’t want to drive in Italy–Italian roads scare me enough just as a taxi passenger. What can I say? I’m a wuss.Rome's famed Spanish Steps, photo (c) Eustaquio Santimano

But I want to eat and to get around. That means I need to stick with the big cities, and Italy’s got plenty of gorgeous metropolises to choose from. Florence, Venice, Milan, Bologna, Pisa, Rome, and Naples all have cosmopolitan services, including restaurants open late and reliable public transit (well, sort of). You’ll also find reasonable access to transportation and services in good-sized towns like Siena, Parma, Verona, Pescaro, and Brindisi.

If you want to spend serious time out in the picturesque Italian countryside…take a bus tour, or find a travel companion who will drive a rental car. Period.

* Research food options and availability

In the big cities of Italy, food availability isn’t a major big deal. Restaurants stay open late at night and plenty of trattorias serve on Sundays and holidays. Hotels serve breakfast to guests as part of the room rate.

Though corner markets aren’t as prolific in Italian cities as they are in France, enough of them exist to make shopping for snacks a doable deal–so long as you don’t need it during the afternoon siesta, on Monday mornings, on Thursday evenings, on Sundays, or on bank holidays.

But in the tiny little towns, it’s worse than that. There may be only one restaurant, only one multi-function shop selling any food, or nothing at all. That one eatery in the village will probably have limited hours; the grocery store will probably be closed every afternoon for siesta as well as shut tight all day Sunday. Nothing remotely resembling a 24-hour supermarket exists anywhere in rural Italy.

Think through your food needs thoroughly before you get on the plane or the train. If necessary, bring packaged food with you so that you’ll have emergency backup supplies. On our first night in Stigliano, we made do with powdered Ensure, applesauce, and tasteless crackers. Plus a bottle of Limoncello donated by a group of Australian travelers we’d met in town. It wasn’t much, it wasn’t tasty, but it got us through the night.

* Rent or buy a cell phone

This Rick Steves article does a good job of describing the different options for cell (mobile) phones in EU countries, including Italy.

My major point of difference from Rick’s advice: DO get a cell phone that functions in Italy, even if you’ll only be there for a couple of days. Traveling with pain isn’t the same as traveling healthy–relying on pay phones and hotel phones doesn’t work well at all for travelers with pain or disability. When I need a phone, I need a phone. I don’t need to spend spoons buying a phone card, then hunting up a pay phone that works, or getting back to my hotel to use my room phone (which may not exist if I’m staying in a budget hotel).

* Preload the cell phone with the phone numbers of cab companies that cover every place you plan to visit

A taxi is a quick, easy way to bail out of any number of pain-inducing situations. They’re not cheap, but they’ve saved me from intense pain (and collapsing on the sidewalk in a foreign country) more times than I can count.

* Learn a few useful phrases in Italian

Things like: “Where is the nearest bathroom?” “Do you sell bottled water here?” and  “Can you please call me an ambulance?” You know, the usual stuff. This little chart includes useful phrases.

In fact, the more I know of the language of the country I’m visiting, the easier it is for me to deal with my pain. It’s also more fun when I can eavesdrop on conversations on public transit and read signs in museums. Rick Steves sells a full-fledged Italian phrase book, if you want to get further into the language.

Portofino Italy by soa2002

The Italian coast town of Portofino, photo (c) soa2002

* Avoid arriving or departing Italy on Sunday

We purchased tickets (in France) for a Sunday trip from Nice to Siena.  The times on the tickets flat-out lied to us, and we found ourselves sitting for hours on a drafty platform while the train’s engineer had a smoke break, a newspaper break, then shut down the locomotive and walked away. His explanation? “It’s Sunday.”

Italy is a Roman Catholic country. (Har har.) That means that public transit service on Sundays is minimal at best, nonexistent at worst, incomprehensibly off-schedule always.

* Know that you cannot depend on public bus service

My early research claimed that a bus line ran past our little mountain town, serving other local villages and running on into the more cosmopolitan Siena on a daily basis. I made the tragic mistake of believing this to be true.

I never saw a single bus on the road past Stigliano. When we walked 4 km into the tabac in Rosia to buy bus tickets, the sales clerks had never even heard of the bus route we were talking about. They started searching under counters for literature to try to figure out what I was talking about. I gave up.

* Italian breakfast breads taste terrible

Even though we had nothing to eat for breakfast but the packaged breads, we couldn’t manage to choke ’em down. Which pretty much left us with the espresso. Zippy!

* When hiking, remember that in Europe the topographical maps use meters, not feet

Not one of the four people in our party realized this before we embarked on a hike with a 1000 elevation change. 1000 meters, that is. We figured this out at the summit of the mountain, while gasping for breath and rationing sips from our single 1-litre bottle of water.

By that point in our trip, we were all giddy from lack of food. That’s my story and I’m sticking to it.

 

Have you been to Italy with your pain? If so, what tips would you give to a first-time visitor to Italia that I haven’t thought of? If you want to go to Italy, what else do you think you need information about before you go?

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