Holidays and Meds and Nebs

Ok so here is a question for you all!

I go every now and again to Greece to visit my family (i grew up there) and stay for long periods of time- usually around 3 weeks.

Now i dont consider my asthma to be that bad (on early stages of step 3 treatment) and have never had a hospital admission. HOWEVER i have had a lot of NEAR hospital experiences, but thankfully nothing more than that.

My question is:

When i go to greece again, how should i prepare? The problem is i go to a VERY small island and for some very strange reason hardly ANYONE in greece suffers from asthma- especially adult onset. if i were to need help like an ambulance for example, there isnt one. in fact there is nothing.

just to show you what i mean and so that you can get a clear picture, go to google maps and type in Antiparos, greece and look at the map. its a small island. now if i need help, THE ONLY HELP AVAILABLE APART FROM GP is a helicopter that comes from ATHENS (the capital) and picks you up and takes you back to athens to a hospital.

So.... would it be worth telling my GP about this and sorting out some sort of asthma plan? (dont have one at the moment). Never been on pred, but maybe should get some ""just in case"" ? and last but not least, when i am down there should i maybe have a Neb as home just in case?? i know that i dont need one while in the UK but if i need one on the island, then who is responsible to give me one- my GP here or the local greek doctor??

sorry for the long post everyone! looking forward to your opinions! :)

Lizzie xxx

18 Replies

  • I would definitely talk to GP about an Asthma Action Plan, not only for here but abroad too. As far as the nebuliser to take with you, what I would say is, ask what the best course of action would be there, but I really would doubt (after looking at your profile AND taking in to account that I am not a doctor nor can or should I assess people over the internet) that you would get a neb.

    I was told when I got mine that my doctor would only give me the nebules, as to the compressors, I had to arrange those for myself.

    I do worry here because you seem to be working yourself up about your asthma, maybe it could be a case of too much information being a bad thing. I think your best bet is to get an action plan, follow it to the letter, and play anything else by ear because the more you worry and work yourself up about being overly prepared, the chances are you will cause an attack by stress. Have done it and its not fun.

    Hope you have a good holiday

  • I agree with 1_Winged_Angel, you really should have an action plan, it might be the case that you end up having two, one for home and one taking into account the remoteness of the Greek Island. I guess there's no harm in asking, but I too doubt that your doctor will recommend a neb, but may give you a volumatic spacer and a standard MDI if you don't already have one. I suspect that in an emergency situation the local doctor would be called to treat you until the helicopter arrived to take you to hospital, perhaps your family who live there can confirm this for you? Try not to worry about it too much, once you have your action plan I'm sure you'll be fine.

  • When I was first diagnosed and my treatment was stepped up to 3 I was scared and thought it was getting worse but it settled down after a bit. Hopefully yours will too.

    It's good to be prepared though, so discussing your fears with your GP would be sensible - wherever you're going.

    Also, is there a chance you'll be away from your normal triggers and feel better anyway? I always feel better by the sea or in a hot dry climate.

    Hope you get things sorted.

  • Hey Lizzie,

    A few years ago I went backpacking around New Zealand, Australia, Thailand and Cambodia, and as you can imagine I was pretty isolated some of those times. I did go prepared though, and went with 2x 5 day course of prednisolone incase I flared and my GP prescribed me plenty of meds to keep me going. As for a nebuliser, they are seriously reluctant about giving them out these days. It gives people a false sense of security, and like the others, looking at your profile and stuff (bearing in mind I'm no dr, I wish) I can't see your GP giving you one. A trick many of us have learnt is to use our inhalers and spacers to our advantage. If you take 10 puffs of your inhalers, through a spacer (don't do it all at once as much as it may seem tempting) it does the same job as a nebuliser. All a compressor driven neb really is, is a really high dose of salbutamol inhaler. Or Bricanyl, but you get the idea.

    An idea would be to go to your GP and explain your concerns to him/her. As Greece is in the EU, if you should get into trouble you shouldn't have any problems getting emergency help.

    If you wanna ask me anything else, feel free to PM me :)

    Vicky x

  • Hi Lizzie

    I am with the others and doubt very much if your dr would allow you to have a neb, you have no experience of being bad abroad and might be worrying about it too much.

    I have a neb which I use for hols but that was only allowed after years of being resuced and very close to death a few times, beleive me if you think greece is remote try the Maldives! when the hospital on the main island which is an hour by speed boat away is not even staffed and then your compaion has to go an get the meds from the pharmacy then its a issue! luckily I survived that one! (things might of changed now as that was my honeymoon 15 years ago - lets hope so!) lol, also we go to a log cabin which is 30 mins drive out of the forrest to even get a phone signal, which is mainly why we like it there as you can get away from it all, but take my neb with me and use it on the drive to ring 999, but I am only given a set amount of vials and to get more have to go and see gp to explain when and how I used them etc as we both agreed not to put them on repeat so I did not rely on them.

    Just be prepared, I take 3 lots of everyting, my plan, my translation cards which tells people what to do etc and then ive done all I can.

    Try and have a chat with gp though to ease your worries


  • thank you everyone for your long replies, i really appreciate your advice!

    I will definitely chat to my GP about all this. I guess i do worry alot, but i am sure you can understand why! my not so serious asthma, is so much more serious in a remote place- as it is with all of us i am sure! anyways i will calm down lol and take it up with GP about asthma plan. i might leave it for now as i am not going abroad again till september, but will definitely get it sorted by then! :)

    Lizzie xxx

    P.S. keep your replies coming, i love to hear from you all! :) <3

  • It is alright to worry and be cautious, Asthma is dangerous and can be lethal when it goes off. Hope you get a plan with GP soon


  • Hi Lizzie,

    Whilst it's obviously important to have a plan of what to do in an emergency, I would echo the others in the importance of not getting too anxious. If you're worried, I think you should investigate exactly what support the doctors (GPs) on the island can give, and at what times (e.g. is one available 24 hrs?). They are likely to be able to nebulise you, give O2, (and probably able to give IV drugs if necessary), and probably deal very well with keeping people well enough to not need hospital, given their location. My experience of dealing with doctors in incredibly remote locations is that they're brilliant at not panicking, and very resourceful with what they've got.

    Speak to your GP. Taking a pred course with you sounds like a reasonable request, and your GP may be able to put your mind at rest. Having said that, you could always see the local GP on the island if you start deteriorating enough to take your first pred course.

    If you're still worried, feel free to PM me. I spend extended periods in remote regions of developing countries, and have developed various strategies for keeping myself safe and happy. If you've got GPs close by, and the possibility of helicopter evacuation, I reckon you're in a pretty good place.

    My basic tips would be to write down the generic (e.g. Salbutamol not 'Ventolin') names of your meds, incase you need to see a doctor abroad, as they can use different brand names. If you're in a remote location you should seek help sooner rather than later. Take double the med supply you may need - a bag may go AWOL/volcanic ash may erupt delaying your return/you may need to take more meds than at home etc etc. I often travel with 3 months of meds in hand luggage and another 4 months in hold luggage - and have never been stopped in airports. Carry your spacer in hand luggage. If you dont qualify for free local health care, make sure you have decent insurance (you must declare that you're asthmatic).

    Once you're organised, and have a plan, you can relax and enjoy the sun!

  • i just booked today to go to Rome, italy in june :) something to aim for...

    told flight company easijet, booked accom separatley, that i have brittle asthma, and they said thats fine and i dun neet a 'fitness to fly' dr note certificate etc....

    will be well prepared with meds etc... and have EU adaptor plug for my home nebs...

    where do i get portable neb? i have googled where nearest hospital is and luckily am travelling wiv my best friend who is a consultant + i am a nurse myself :)

    as for travel insurance, i bought an annual coverage one- worldwide - last oct, which cost an arm + leg once i mentioned ITU admissions etc... only i am more severe, on more meds now etc... so will need to contact them and no doubt will have to pay even more, if they will even cover me now... ??

    otherwise need a morgage for medical bills if nellie comes to Rome....


  • Snowygirl, I brought portable neb Omron MicroAIR from Evergreen - found Evergreen on the Internet, brilliant service and much cheaper than our local chemist (think about £70 as opposed to over £100 in chemist).

  • I also have the omron micro air and its fab!

    I tend to pick hols that give away free insurance, so far every year james villas have if you book early then just pay the extra for the un-insured part of the brittle asthma which last year was only £10.50, it works out much cheaper that way!

  • ur very lucky only paying 10.50 crikeys!

    for my annual worldwide, declaring my brittle asthma, i paid 350 quid :S


  • if you go with the co's free insurance you never have to pay much, that was last year and I had 7 admissions with 2 ITU, give it a try...

  • thanks snowy, i will give that a try..

    similiarly last year - 1 ITU, 3 HDU, 4 ward admissions and numerous day admisions...

    this year, 2 HDU so far and 1 ward admission - in past 2 weeks! as well as few day trips hosp...

    whats the websit or contact details ?

  • each year we have just booked with James Villas, and if you book early they give you free insurance, then you contact Mondial who run the ins and you can do it on-line, answer a few questions and they give you a cost you have to top up the policy by, for me it seems to work out the best, not done it for this year yet as too early, but dont suppose its changed much since last year.


  • thanks snowy.

    just booked with easyjet.... so travel insurance is with someone else as covered still for the annual till sept.

    cant believe it was so expensive - 350 quid :S but it does cover me for worldwide, multiple etc...

    but defo need to find cheaper before renewal especially as condition deteriorated and change of meds etc...

    will have a look at james villa.

    x x

  • I have been stuck on a remote Greek island in trouble with severe asthma and it really isn't fun. My regular rescue treatment simply wasnt enough. You will probably find though that most rural Greek medical centers have at least a nebuliser. I was grounded from flying home and the Greek doctors when I eventually got to one were very attentive. They suggested that I get my own nebuliser which my English Consultant did agree was a good idea for this instance.

    I also go hill walking in very remote areas so for this very reason I always take enough of my regular meds, an ultrasonic nebuliser (which I bought myself) with plenty of nebs (on prescription), prednisolone emergency cover and always keep my face covered during the flight where I frequently pick up upper respiratiory infections. If I know I am going somewhere very remote I also take antibiotic cover for URT infections, just in case. Your doctor may not agree to that though. Talk it through with your asthma nurse or consultant. I found them to be really helpful.

    Don't stress just be prepared, know your body and enjoy the holiday.

  • anyone ever have problems in- flight ?

    my asthma wasnt as bad last time i flew, but concerned this time now re: air pressure in the cabin etc... will i need oxygen ? do i need to ask for assistance ?

    i tol the airline i was brittle asthmatic, but they said 'oh, thats fine, we dont need a fitness to fly certificate' but i am concerned by them being so blasey.

    i will have my nebuliser with me, but its mains operated , and of course air compressor, not oxygen!

    i dont fancy flying gatwick -> rome -> hospital !!!

    x x x

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