When you have asthma, planning ahead is the key to enjoying a successful holiday, wherever your destination. As asthma varies from person to person, holiday plans need to be flexible.

General tips
Work out how many tablets and inhalers you need to last for the holiday, plus a few extra days to be on the safe side. Also consider medicines that you do not use every day, such as steroid tablets. Anyone over the age of five may be advised to take a peak flow meter.

Talk to your doctor. They will be able to advise you on a treatment plan. You may also be given a short course of steroid tablets with instructions on how to use them in an emergency.

If you are going abroad, keep a list of the medicines you have or may need. You will find that brand names vary from country to country. Therefore, a pharmacy in Spain may have no idea which medicine you are referring to. As well as the brand name, it is a good idea to know the ingredient name of the medication ie. what is in it. A translation into the language of the country to which you are travelling is of course the ideal.

When you reach your destination, find out how to get medical help. Ask the holiday representative or hotel staff:
Where the nearest telephone is (with someone to translate a call if necessary). If you have a mobile phone this makes life a lot easier.
The telephone number of an ambulance or doctor
The location of the nearest hospital A&E department

Nebulisers
If you have a nebuliser and are going abroad, check what voltage the country uses so that you can establish if it will work there. Contact the nebuliser manufacturer if you are unsure. Most likely, you will need an adaptor.

Some airlines provide nebulisers if given advance notice. Other airlines may be difficult about even letting you use your own. Check with the airline before you book.

If there is a problem, ask your doctor about using an aerosol inhaler with a spacer. In an emergency, you can always use a disposable coffee cup as a mask by making a hole in the bottom to fit over the inhaler mouthpiece. Then take 15 – 25 puffs of reliever at 10-second intervals.

Otherwise, hand pump nebulisers or ones with rechargeable batteries are available.

Medical pack
You should take your usual reliever and preventer medicines, some spare prescriptions, your asthma management plan and a peak flow meter.

For emergencies, you should have:
An aerosol reliever inhaler (usually blue)
Plastic or foam coffee cup
Steroid tablets
Emergency action plan, as discussed with your doctor

When and where to go on holiday
As asthma varies so much from person to person, there is no ‘best destination’ as such. The most useful thing you can do is work out what triggers your asthma and if possible, how you can avoid those triggers. It may help to think back over the places you have been in the past. Was your asthma particularly bad in any one place? Find out about climate and pollution. The internet is an invaluable source of this information and a good travel agent may also be useful.

Trigger factors
Remember that regular preventer treatment can help to avoid most problems. You’re your preventer regularly before and during your holiday, increasing it temporarily if the doctor advises this. In the meantime, here are some tips on avoiding particular triggers while on holiday:

Pollen: Different people are sensitive to different pollens. Grass pollen is a common asthma trigger and there are high levels of this from May to the end of July. Visiting areas with little grass or those south of the Equator during our summer months may help.
Mould: Autumn is the worst time for people affected by mould spores.
Animals: Check that your hotel/accommodation does not allow pets, as this trigger can stay in the air for several weeks.
Exercise: You only need to avoid exercise if you have severe asthma. However you do need to be very fit if you are going on a vigorous holiday, such as mountaineering. Short bursts of activity and using a reliever inhaler before exercise can help. Water sports with warm, moist air suit many people.
House dust mite: Make sure that the place you are staying in is thoroughly cleaned before you arrive and ask about synthetic pillows and duvets. (Some people may choose to bring their own synthetic pillow and mattress cover with them.) The house dust mite does not live above the snowline on mountains. In some countries, such as Finland and Switzerland, special low-dust rooms can be booked. Check with their tourist information offices.
Damp: Houses that are damp or near rivers may have more mould and house dust mites than others.
Air pollution: Air pollution can be bad in some cities and countries. Check with the travel agent when booking.
Cigarette smoke: Unless holidaying in Ireland, where smoking is now banned in workplaces including pubs and restaurants, smoke can be hard to avoid in public places.
Weather: When abroad, you are better off in warm weather, but not intense heat – dry places may be dusty. High humidity (warm, damp air) can be a problem for some, but not others. Similarly some people enjoy breezy areas, while for others, this sets off their asthma. Again, check with your travel agent what weather is to be expected.

Types of holiday

Camping and caravanning
Camping brings you especially close to pollen, dust from crops and possibly animals. On the other hand, you may find a lower amount of house dust mites than you would on other types of holiday (although caravans need to be thoroughly cleaned out before and after use).

If you are using a tent, make sure it has a sewn-in ground sheet. Watch out for campfire smoke and cold air on a misty morning, as both may trigger your asthma. Always keep bedding clean and well-aired.

Cruises
While they are expensive, cruises do keep you away from pollen and pets. Also most cruise ships are well equipped for medical care (check before booking).

Winter holidays
Some people prefer crisp, cold weather, while for others, this type of weather exacerbates their condition. Those with exercise-induced asthma will often find that cold air brings on their symptoms. The good news is that house dust mites do not live above the snowline.

Skiing can be strenuous and in the event of an emergency, it can be difficult to get help in remote areas.

Air travel
Flying times to many destinations are short and the chances of having an attack on
a plane are low. However it is wise to take your medicines on board as hand luggage in case your suitcases are lost or stolen. While planes do carry oxygen, they do not always have many medicines on board.

If you are allergic to perfume, let the cabin crew know so that they avoid using perfume testers near you.

Medical expenses abroad
Anyone travelling abroad needs to consider the cost of medical care as it may be expensive. As an Irish resident, you are entitled to get healthcare throughout the EU, as well as Iceland, Liechtenstein, Norway and Switzerland, if you become ill or are injured while on a temporary stay there, i.e. a holiday.

Before June 1, 2004, you would have required a special form for this, such as the E111 or E128, from your local health board. However these paper forms have now been replaced by the European Health Insurance Card. One card is needed for each individual or member of the family.

The card is similar in size to a credit card and is valid for two years, so people do not have to reapply every time they travel.

Remember the card should never replace travel insurance. It only covers you for necessary treatment in public hospitals. If you want to be treated privately or if your illness/injury requires treatment in a private facility, you will be charged in full unless you have the adequate travel insurance.

Also remember the card only applies to the EU and other listed countries. For more information, click on http://www.ehic.ie

Ask your travel agent about the best insurance option – it is now possible to buy travel insurance for a year. If you travel frequently this is much cheaper than doing it on a trip-by-trip basis. It also covers travel that people sometimes overlook in terms of insurance eg. a weekend trip to Paris or London.

For more information, contact the Asthma Society of Ireland on freephone, 1850 44 54 64.

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