Holiday Arrangements Summary
Before you go:
- Order the ITP Support Association's Holiday insurance and Travel Guide, which includes advice on insurance, flying, avoiding malaria, medicines and vaccinations, It also includes insurance companies recommended by our members.
- If travelling to Europe get a European Health Insurance Card (EHIC) to entitle you to free or discounted healthcare in European countries.
- Discuss any required vaccinations with your doctor well in advance, bearing in mind that they are not effective within 3 months of certain drugs.
- Order medication well in advance, ensuring you have enough to last the holiday. Inform your holiday insurance company about your ITP, or you may find you are not covered in the event of a claim (they may require a doctor’s letter).
- Try to find out what ITP is called in the country you are going to, in case of an emergency. You may be able to obtain this from the country’s embassy.
- Find out what the equivalent of 999 is in the country you are visiting.
- Find out the locality of the doctor and hospital nearest to your accommodation.
Make copies of all important documents, such as passports, and leave the copies with a friend of relative. You may need the copy if your originals get stolen.
If you take prescribed medicine, take a copy of your prescription and doctor’s letter.
Is Air Travel Safe?
Risk of bleeding?
The question of safety in air travel is one that needs to be considered individually. It is generally considered that there is little risk of bleeding if the platelet count is greater than 30 unless there is a history of bleeding problems at this level. If the platelet count is below 20 there may be a greater risk, although this is not necessarily related to flying but to the condition of the patient. There is no clear correlation between a low platelet count and bleeding manifestations, so it is better to discuss this individually with the doctor who knows your symptoms.
The ITP Support Association’s medical advisors recommend that if the platelet count is around 30 or above and there are no bleeding problems, flying should present no additional risk. Some consultants express concern about their patients going on long-haul flights in pressurised cabins, but the Association’s medical advisors in the UK and US agree that they know of no evidence that there is any increased risk of bleeding relating to air travel.
The national ITP guidelines approved by the British Committee for Standards in Hæmatology (published in the British Journal of Hæmatology back in 2003 contained the following statement: ‘There is no evidence that air travel predisposes to bleeding in patients with ITP; there is no indication to treat the count prior to holidays other than to cover activities’ . There has been no change of advice issued since. However, if you are prone to nose or mouth bleeds that require medical intervention you should consider whether you could cope with this mid-air.
Deep vein thrombosis
The possibility of deep vein thrombosis on long-haul flights is now accepted as a recognised hazard for travellers. Extended periods sitting in a plane in cramped conditions (plus a spot of dehydration, booze and caffeine!) may encourage blood platelets to clump together in the veins to cause thrombosis. This is possible even with a low platelet count, and particularly with certain treatments.
Aspirin should always be avoided by thrombocytopenic patients, despite the advice to other passengers that it be taken when flying. Flexing toes, ankles and knees while seated, plus a periodic walk up and down the plane, will help to keep the blood moving during the flight. Drink plenty of water and avoid too much alcohol.