Erica and Matt Chua: Traveling with Allergies

I had only one goal for India: survive.  Hours after I wanted to be in a hospital, between gasps for air, I wondered if my goal of survival was too ambitious.  The trip between Agra and Varanasi started well enough.  We had reserved beds in an air conditioned sleeper car, complete with fresh linen that was Four Seasons compared to our crowded and sweaty, jail-like experience in General Seating.  Shortly after laying down to sleep though the ride took a turn for the worst: I was struggling to breathe.

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To put it gently, I have terrible allergies.  One could say I’m allergic to life, but that would be an understatement, I’m allergic to dead and inanimate objects as well. Luckily my allergies are manageable: avoid horses, animal pens, and untidy, pet infested homes.  If exposed to such situations my body floods my head with mucus, constricts my airways, and, in extreme circumstances, makes my whole body break itch.  Overall, my allergies can quickly create an uncomfortable situation.

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Only four times in my life have I actually considered that my body could suffocate itself.  The previous times I had access to medical attention.  This time I was out of bullets, I tried everything I was carrying to no avail; I needed medical attention and I needed it now. I didn’t know where the train was, where I could get help, or at what point barely breathing would become not breathing.  It was during this crises that I realized I was not carrying the right medicine to deal with such situations.

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As soon as LOCAVORista awoke she began peppering me with questions about my obvious issue.  I tried to ease her concerns, but it was hard to hide my condition.  The train was moving too slowly, minutes felt like hours and I wasn’t getting better.  Finally I admitted: I need to go to the hospital.

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After finally arriving in Varanasi and surviving past dozens of hotel touts we arranged a rickshaw to a private hospital.  I was quickly seated with a physician that had a US medical degree on the wall.  He was convinced I needed to spend a night in the hospital, have a chest x-ray, and get a cortisol shot.  Accepting that I would only spend a night in an Indian hospital if I were severely bleeding or unconscious, he finally wrote orders for me to receive nebulization. My 12 hour ordeal came to an end after 10 minutes on the magical machine.

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This situation made me reassess what I carry to fight my allergies.  Previously I carried an arsenal against allergies in general, but nothing to deal with an emergency.  Allergies are uncomfortable, but a breathing emergency can kill.  I didn’t worry about emergencies at home as medical treatments are always near; while traveling, help may not be available when it’s needed most.

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Due to this experience I re-evaluated what I’m carrying, specifically adding Prednisone for emergencies. This deals with my specific condition, for others though carrying an EPI-Pen may save their lives.  Below is a list of the things that I carry to deal with allergies and allergy-induced asthma. Obviously you should consult a specialized physician who knows your specific conditions before setting off.

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• Fexofenadine HCL (brandname Allegra or Telfast).  This is my stalwart against general allergies and available inexpensively, over-the-counter, globally.
• Diphenhydramine (brandname Benadryl).  This is the ultimate over-the-counter allergy stopper.  The problem is that it knocks me out, one to two pills of this over a 12 hour period and my allergies are gone; but I will be sleeping for that entire period.  When things go bad this clears my system.
• Albuterol Inhaler–PRESCRIPTION ONLY (brandname Ventolin).  This is an emergency inhaler that helps me breathe when allergies are overcoming me.
• Flovent Inhaler–PRESCRIPTION ONLY (no generic at this time).  This is a “daily use” corticosteroids inhaler that I use when I’ve been having extended breathing issues (multiple days).  I use it until I feel confident that whatever has been aggravating my allergies is gone.
• Prednisone-PRESCRIPTION ONLY. I was not carrying this at the time of my asthma attack on the Indian train, but should have been.  For an allergy induced asthma attack this is a literal lifesaver.  I won’t travel the third world without it again.

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Do you travel with medical conditions?  How do you deal with emergencies when you are far from professional assistance?