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Inside MS

The doctor weighs in

The doctor weighs in

Barbara Giesser

What should I do if I have an exacerbation while traveling?.

The first thing to remember is what an exacerbation is. It’s a worsening of old symptoms or the appearance of new ones that lasts at least 24 hours. This is important because stress, heat, and/or fatigue (all of which easily happen while traveling) could cause a temporary symptom flare, which should clear by the next day. If symptoms persist, do you have signs of infection? new bladder symptoms? a fever? symptoms of flu or a cold? If there is an infection, have it treated. Your flare may be a pseudoexacerbation.

In the event of a true exacerbation, seek medical evaluation, preferably by a neurologist. However, if you have a predictable response to steroids and you’ll be traveling in an area where medical help might not be available, your physician may give you a prescription for a brief (1-2 weeks) supply of oral prednisone to take with you just in case.

I’m pecking my injectables in an insulated carry-on bag, but suppose I can’t freeze my Blue Ice?

Avonex, Betaseron, and Copaxone (before they are reconstituted) can stay at temperatures that don’t exceed 86 [degrees] for a total of 7 days. Ice can usually be obtained on airplanes, trains, and in hotels.

Remember to pack clean plastic bags for ice holders.

Do I need a note from my neurologist to get through airport security with my needles?

Some airports, particularly overseas, may have more stringent security standards. So, yes, it’s safest to have a doctor’s note certifying that you are on injectable prescription medication. Additionally, tours or cruise lines may require a “fitness to travel” letter from your doctor.

What do you recommend for diarrhea? motion sickness? or Third World travel?

Over-the-counter anti-diarrheals, such as Kaopectate, Pepto-Bismol, or Imodium, work well. The biggest problem from diarrhea is dehydration. If you are traveling in less-developed areas, it’s wise to pack some electrolyte-rich “sports” liquids. Persistent diarrhea, or diarrhea accompanied by fever or abdominal pain that lasts more than a day, needs medical evaluation. Over-the-counter Dramamine works for motion sickness, or your doctor may give you a prescription for Antivert (meclizine). The Centers for Disease Control posts vaccination recommendations for everywhere in the world. Ask your doctor to check their valuable Web site: .

Barbara Giesser, MD, is a clinical neurologist who has specialized in MS care for more than 20 years; she is chair of the editorial board of this magazine.

COPYRIGHT 2001 National Multiple Sclerosis Society

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