travel in developing world

[TULIPFLOWER]

has anyone travelled in the developing world while being on methotrexate.

I intend to go to Mexico and Costa Rica

[Mmrr]

I haven't travelled much since my diagnosis of RA, but was travelling independently in South America and Galapagos a few years beforehand and became quite ill, passing blood. I took myself to the local hospital in Galapagos who diagnosed amoebic dysentery.

A metronidazole IV drip was administered immediately, after 6 hrs I went back to my accommodation, feeling so much better. I was up and running again within 48 hrs. An excellent service, no cost and they didn't take my insurance details, all free. I did insist on a fresh IV needle and giving set (there were a few used ones lying around on work surfaces, I was concerned they would be reused).

It is a 5 year training for nurses in several South American countries, they are well educated. Personally I did not see a Dr, all diagnosis and treatment was undertaken by the nurses.

My nurse, Paul, didn't know much about Scotland other than he loved 'The Red Hot Chilli Pipers' (not peppers). We had a great chat, with his English being a whole lot better than my Spanish.

[Gnarli]

I think you need to ask your GP, a healthcare professional or rheumy. Medical thinking is changing all the time and none of us here is medically qualified to advise

[helixhelix]

People in Mexico and Costa Rica have RA too…..

If you are planning on travelling independently, using all local facilities and transport, then I would take a well stocked first aid kit. However if staying in more westernised hotels, and with private transport, then you should have access to good health facilities. Costa Rica reportedly has very good health care.

[kristapb99]

I am from the US and take both methotrexate and Enbrel. I have no hesitation traveling to either Mexico or Costa Rica healthwise, both counties have modern medical facilities and in fact are utilized by people in the US who can't afford healthcare (like knee replacements) as they are much less expensive. But of course, the most reliable and educated answer would come from your GP or other health professional.

[MJSlide1958 in reply to kristapb99]

How do you transport your Enbrel when you travel? Is it easy to take on flight and then to your destination fridge?

[kristapb99 in reply to MJSlide1958]

Enbrel can be kept at room temps for up to 14 days, so for shorter trips, I just bring one or two injectors with me on the plane, in my carry-on. For longer trips, I have brought it in a zipper casw with an icepack, and refrigerated it when I reached my destination. I recently purchased and used a cooler made specifically for medication that can run either plugged into a USB port or a battery pack purchased separately. It seemed to work well.

[MJSlide1958 in reply to kristapb99]

Thanks very much. Which Cooler with USB port/battery pack did you get and from where? Sounds perfect for travel. Thanks

[kristapb99 in reply to MJSlide1958]

I bought it from Amazon (US):

4ALLFAMILY AUTO Shut Off USB TSA Medication Cooler Travel Case Keeps Fridge Temp 36F-46F + Biogel Ice Pack |Perfect Medical Cooler Diabetes Insulin Eye Drop Arthritis (Blue)

also bought this battery:

INIU Portable Charger, USB C Slimmest Triple 3A High-Speed 10000mAh Phone Power Bank, Flashlight External Battery Pack

[MJSlide1958 in reply to kristapb99]

Thanks very much.

[Hidden]

Staysure or Allclear do travel insurance for people with current medical conditions. One is cheaper than the other but can’t remember which 😂. There are a few others listed on Money Saving Expert (Martin Lewis). Have a lovely time!

[Celticdancer]

From what people are saying about the healthcare being good, I would be more worried about the violence and crime rates especially in Mexico where there are lots of drug cartels. Have your wits about you and make sure you have good travel insurance that covers all your medical conditions as some people seem to think that it won't happen to them but anything could happen at any time. I've travelled the world on my own and have always taken precautions and good travel insurance. You could also wear a money belt under your clothes and be careful using ATM's as card skimmers might be used.

[MJSlide1958 in reply to Celticdancer]

Hi, Which insurance cover is good for travelling with an illness like RA? I have heard it is quite expensive for a single travel.

[Hidden in reply to MJSlide1958]

See my post above ..

[Celticdancer in reply to MJSlide1958]

I used to have a travel insurance package with my bank account and I paid so much each month for it which also included mobile phone insurance and gadget insurance so it wasn't bad as I regularly went abroad. I think quite a few of the major banks still do travel insurance packages with their bank accounts but make sure you get the worldwide travel insurance and that you tell the medical screening team about all your health conditions. Don't hide anything otherwise you could invalidate your insurance. I have never been refused insurance when I told them I have arthritis. They didn't have a problem with it. I travelled some years ago with methotrexate tablets and I didn't have a problem going through airports as long as you declare any medication you have if they ask for it on any forms. If your bank doesn't offer travel packages then you could try the well known travel insurance providers as they generally have a better reputation than the less well known ones. I can't recommend one travel insurance provider that is better than another as I've been fortunate I've never had to claim on my travel insurance but I've always travelled with insurance.Read lots of reviews on websites like trustpilot and that will help you decide as I always read reviews of different insurance companies before I insure my car etc. I didn't have a choice which travel insurance company my bank used and I can't remember which one it was. You can also use the comparison websites to find the best value but I personally think it's better to pay more for better quality insurance as I find the less well known providers might be cheaper but they might have more conditions and less cover when you check the small print. Also the comparison websites might give you a cheap price but do you have to have the fitness and health of an Olympic athlete for them to cover you?

It might work out cheaper to buy a multi trip insurance especially if you plan on going abroad several times in the same year. My bank account travel insurance was a multi trip insurance. Also double check how long the insurance covers you for and you have full cover for the entirety of your trip as I've read some tourists have had an accident after their insurance expired.

[MJSlide1958 in reply to Celticdancer]

Thank you so much, you are so kind with all the advice. All taken on board too. Thanks very much for your time. Good luck

[Hidden in reply to Celticdancer]

Loads around Cancun, so giving there a wide berth for a while..

[Celticdancer in reply to Hidden]

One of my relatives went to Cancun recently and they weren't impressed. Alot of poverty and crime.

[Hidden in reply to Celticdancer]

That’s terrible. We can avoid it, but it must be awful for people who live there. I went to Mexico years ago (1987) and was shocked at the poverty. That was just over the border from California. Such a shame. Hope your relative was ok.

[StormySeas]

Yes, I've travelled in Mexico and Peru whilst on MTX. Obviously you'll have comprehensive travel insurance so the other question is how rural you'll be going, and if it's really off the beaten track.

I assume you'd take all the usual precautions any traveller would take re water and food. I'd make sure you have a list of acceptable antibiotics for someone on MTX , so if you do get ill you know what you can take.

If I was going very rural I'd make sure I had a first aid kit with me with sterile needles just to be on the safe side, but other than that I wouldn't worry too much. If you're insured and in a city you'll find good health facilities. Hope you have a great time!

[CagneysMum]

My last holiday adventure a few months before lock down in 2019 was to Argentina/Brazil/Uruguay and at the time I was on methotrexate and hydroxychloroquin (have since added a biologic). We wanted to go into rainforest so I worked with my NHS rheumatologist well in advance to temporarily cease my methotrexate for 4-5 weeks in order to have a yellow fever vaccine. Weeks 1-3 of stopping MTX were ok but weeks 4-5 were tough and I needed steroids (prednisolone) and naproxen to help me get back on track. Had all the usual (non live) vaccines pre holiday (all ok) and went armed with walking sticks, plenty of naproxen supplies and (emergency just in case of flare up) prednisolone tablets from my rheumatologist. Didn’t need the steroids but I did lean on my naproxen and sticks quite a lot due to the amount of walking we did and the uneven terrain. My blood (liver) results were quite raised when I got home (probably due to increased use of naproxen whilst away) but after 2-3 weeks of normal living and drinking lots of water, I retested and they had returned to normal. Holiday of a lifetime and memories for ever, wouldn’t change a thing 👍👍

If you want to do it plan..plan…plan, calculate any risk factors and get advice and support from your medical team.

[TULIPFLOWER in reply to CagneysMum]

Thnk you. This is really helpful advice. I will not go of the beaten track so dont think I will take the Yellow fever vaccination. I have a net on me and have different anti musquito treatments with Deet in it. Will indeed get a list of anti biotica I can have. The idea of coming off MTX scares me. I feel so good on MTX.

[CagneysMum in reply to TULIPFLOWER]

That sounds very sensible 👍

[AgedCrone in reply to TULIPFLOWER]

If you think about it….Costa del Sol or the Great Barrier Reef…..whether you have a RA crisis or the sniffles…the people who will point you in the right direction,& decide what level of qualified medical treatment you are covered for will be your travel insurance company.

They have local people on the ground who are invaluable in a medical emergency.

Never listen to the local who tells you “You can trust me-I’m a Doctor.”

[----54]

Please accept my apologies if I’m misinterpreting your question in any way. In the States we have travel clinics staffed with doctors and other healthcare professionals, and I found such a clinic to be very helpful before traveling to a developing country. (I was new to riskier travel and even learning to only choose fruit I could peel was very helpful!) The clinic helped get me the right vaccines at the right times and provided prescriptions in case I got sick overseas. I also had good travel insurance that included the cost of medical evacuation if needed. The or a pharmacist might be able to make sure that you have the right medication and/or information in terms of drug interactions.

Having a list of your medications and medical conditions on your person might be a good idea in case of an emergency, especially if something happens, and you are unable to communicate. I also deal with food allergies and try to travel with a note in a relevant language/s about my allergies for dining out. In the States, patients can subscribe to a service like Medic Alert, which will provide an ID bracelet, necklace, or other wearable with a telephone number for emergency and healthcare personnel to call. Medic Alert can store your doctors’ contact information and important healthcare information. It is possible to order a special tag with a number that overseas callers can use.

If it’s any use for staying safer during the COVID-19 pandemic, in addition to a good mask with a silicone outer brace to fit the mask, I like wearing goggles hidden under big sunglasses if I’ll be stuck waiting with others in enclosed spaces.

I hope that you have a wonderful time with ‘magical’ and enchanting experiences and return safely with memories that feed your spirit for a lifetime.

[Happy5]

Hello pre Covid restrictions I traveled to East Malaysia to avoid UK winters.I'm on MTX injections, so I bought a small bag to put mine in usually 12 to cover

the 3 months I'm away. I would let the airline know ahead of time will be bringing them.

You should have some sort of card explaining you're a MTX patient and have them.

Ask the flight attendant to put the bag safely with their items to keep cool, and protected from bags crushing them. They must not go in the hold where they would freeze.

I never had problems with security, airlines of custom checks .

Bon voyage

[AgedCrone in reply to Happy5]

PLEASE…..Do NOT ask the flight attendant to put anything vital to your well-being in an aircraft fridge.The fully stocked fridges are wheeled on & off aircraft at various destinations & your vital injection could be on it’s way in the opposite direction to you! Get a clinical cool bag to suit your needs & keep it in your cabin baggage.

[Happy5 in reply to AgedCrone]

Agree I never do I only ask to have it put in overhead area I can see but is not being squashed by others as they put their luggage in.

[AgedCrone]

Your best bet is to search out a travel insurance company who specialise in policies for people with previously diagnosed medical conditions. Don’t be tempted by cut price insurance…

Both Mexico & Costa Rica have good health facilities….but as a tourist it will all depend on the service your insurance company provides in the countries you visit.

In countries far away…..repatriation costs are especially important.I had to be repatriated with a broken leg….needing three seats….that could have been be very expensive. ..luckily my insco paid up.

[Jamarruk]

Go on holiday …..!!!

[Hidden]

One other thing I always do now, even in the UK, is to have a copy of a recent prescription list in my wallet.