Cilla's Tips on Traveling with a Trach
The first trip we took with Clarice was when she was a one year old and we flew to upstate NY for my parent's 50th wedding anniversary. We have flown with Clarice at least once or twice a year since then and taken trips in the car and even on the auto train with her. So, these are my thoughts from 4 years and 4 months of experience...
First, we never went any long distance with Clarice without taking two portable suction machines. Clarice got "suction machine dependant" whenever she was sick and I didn't want to risk being stranded somewhere with a broken machine. Not only was it "insurance" to have that extra machine, it made things easier upon arrival. Whenever we set up Clarice's things at our destination, we would plug one machine in and have it charging and use the other machine wherever we went on day trips or around the house. If we had to take off in a hurry the next morning, we would take the machine that had been charging all prepared with a clean canister and tubing and could just grab up the one we had been using and close it up without having to clean it out until we got to the next place. We have always had two sets of canisters and tubing so that one could be in use and one could be soaking/drying anyway. This particularly helped on our auto train trip where there was no electricity on the train and we were on the train for about 18 hours! I never checked a suction machine in as cargo on the plane, but you could do that if you didn't have enough allowance for carry-on luggage (we usually had all six of us so we had enough alloted). By the way, don't forget the chargers for the machines and the plug for plugging it into the car (we always carried that plug and cord in the diaper bag).
One thing to note about going through airport security is that some security people get flustered by the strange equipment (like the suction machine and monitor). It helps to say you are travelling with electronic medical equipment so that when they run them through the scan they know more what they are looking at. Also, a couple of times we had to plug each device into outlets at the security place to show that our equipment was "live" electrical equipment. This can take some time, so you may need to allow for a little more time to go through security.
If you are going to a house, make sure that the outlets are for three-pronged devices! My parents live in an old house, and didn't have the outlets with the ground prong the first time we were getting ready to come. They had those outlets put into their living room before we came since that is where we slept with Clarice, and I bought some adapters for a couple of dollars at Home Depot so that I could bring the suction into the kitchen and plug it in.
I also always carried the monitor and nebulizer as carry-on luggage. Our med supply company didn't want the monitor checked into cargo,but I did do it on the way back from a trip once because we had so much stuff. I was afraid to do it on the way and have it get lost and then be without a monitor! I used a midsized light-weight bag from Lands' End that the monitor in it's cloth bag and the nebulizer could both fit in. I put the monitor inside a dishpan because I have been many places where the dishpan was invaluable (particularly at a hotel, where it is a pain to wash out suction equipment and dry it in a clean manner! The dishpan doesn't take up extra space, really, since the monitor is inside it. I also threw in a clean dishtowel so that I could use it to place on a counter or back into the dishpan to air dry things on.
For the Bunn/compressor/humidifier issue--we have never flown with one of those. We have either rented one ahead at the site we were going to, took it in the van, done without it if it was just for a day or so, or had one mailed ahead by our med supply company and then mailed it back. I finally "inherited one from a friend whose child got decannulated and we had that one mailed to upstate NY since that is the place we went the most and might need one at short notice if a family emergency came up (I have elderly parents and other elderly family members and always worried about having to go there on a short notice--thank goodness that never came up).
Two things that are easy to forget (I have forgotten them before and either remembered at the last minute or had to get some from a med supply company at our destination)--trach masks and trach drain bags! Clarice has her own little "cosmetic" bag and this is where we put her trach care items like the ointments, the q-tips, etc. I bought her a Lands' End double zip carry on bag (I don't work for Lands' End but I have nothing but praise for that company and how their luggage has helped out!) and this is what we used to carry on her medical supplies (the "disposable" items) I guess you could mail items ahead in advance if you had enough time. We also checked this back into cargo on the way back, usually, knowing that when we got back home we had extra supplies. I used a bunch of those heavy freezer bags with the plastic zips to organize the supplies. In those various bags were things like: humidivents, saline bullets, trachties, trach masks, neb bottles, drain bags, extra trachs, feeding tubing and syringes for bolus feeding, syringes for medication, a couple of DeLee suction devices in case of emergency being without the suction machine or electricity, neb kits, etc. I also included a pair of non-Latex heavy gloves for me to use to wash out her stuff because vinegar and soap really aggrevates my hand dermatitis.
I forgot to mention that I put the catheters in the carryon "disposable med supply" bag. As for how much of each item, I usually took twice as many as I would expect to normally use. For example, if I would usually use one catheter a day, for a week-long trip I would take 14 of them. That way if you contaminate one occasionally you still have plenty. By the end of the trip your bag is at least half-empty and you can pack other stuff in it. For the corrugated tubing, I always took two lengths of it, cut longer than I used for Clarice's toddler bed at home. If you are trying to run tubing up and over something at a hotel or some place you might need more. I usually took two large-volume neb bottles. If you have two suction machines with you you will already have a spare canister and tubing.
We used to rent oxygen to be delivered to wherever we went, but as Clarice got older and more stable we stopped doing that. It did make me feel better to have it there when Clarice was one and we were making our first trip to my parents, who live 30 miles away from any hospital, in rural upstate NY. We have never used O2 on Clarice except when she has been sick with pneumonia or something.
So, our pieces of carry-on luggage were: two suction machines, the bag with the nebulizer, dishpan, and monitor, the medical supply bag, and the diaper bag. The diaper bag was our regular "to go bag." One of the best things I ever did was to get a backpack diaper bag. For the first three years we had a regular diaper bag, albeit the deluxe version from Lands' End. I hated to spend money for another diaper bag but the backpack diaper bag I got from Lands End was worth it. In the diaper bag was the Ambu bag, a little bag we called "the trach kit" (which had the current size trach and the next size smaller all set up with ties on them, a couple of catheters, a couple of humidivents, a pair of bandage scissors,a small cloth first aid kit with bandaids and wipes, a spare trach guard,etc.) We also had a Passy-Muir valve. I carried the cell phone, a small camping towel (the kind that expand a lot when wet but don't take up much space), and a small flashlight with extra batteries. You MUST take a flashlight on trips. You never know where or when you will be if the electricity goes out, and you would have to suction in the dark! I have used the flashlight to suction Clarice in a movie theater, on the auto train so I wouldn't have to turn on the light and wake the other girls up, and I always stick the flashlight into the suction machine I am using at night for Clarice so that it is readily available. I am quite good at suctioning with a small flashlight held between my teeth, by the way, just one of the many new tricks I learned over the past four years!
Other invaluable items to have on hand are lots of zip baggies (we used them to hold trachs, the current catheter we were using to keep it clean, etc.) and some of the gallon size zip-lock bags. You can stick some of those in your diaper bag and use them to hold all sorts of wet stuff like wet feeding tubing, clothes, bibs, etc. If you are trying to tube feed a child in a car, plane, train, or wherever, they are handy to hold so that you can catch any spills into them. Clarice was on Enfamil with low iron, and on trips we used the powder as much as possible. If your child is on Pediasure or something else, you can take a couple of the small cans in the diaper bag, have a couple in checked through luggage or the carry on medical supply bag, and either buy more at your destination, ship it there earlier, or have someone there get it for you. I always had a medium bottle of bottled water in the side pocket of the diaper bag to use for flushing the tubing, rinsing out bottles, or whatever. We also found "Kao-lectrolyte" to be a great help. That is the powdered version of Pedialyte-type electrolyte stuff put out by the people that make Kaopectate. It comes in a box with four packets making 8 ounce bottles. If I didn't use that, I would make sure I had one of the 8 ounce plastic bottles of electrolyte stuff in the diaper bag. You can tube your child that to keep them from getting dehydrated while travelling and even if they are not a good traveller, it doesn't bother their stomach. When we travelled with Clarice we always had a hard time keeping her from getting constipated so we tubed her a lot more fruit and electrolyte solution than we would use at home. I used to bring at least one of the little 6 ounce cans of prune juice with me, or more.
I either had someone buy hydrogen peroxide, white vinegar, and distilled water for me at my destination, or bought it when I got there. If you are staying in a hotel, don't forget a roll of paper towels, a small bottle of dish detergent for washing things out (we used it with white vinegar for cleaning the suction machine, used it to wash bottles, etc.) You can now get those cool small boxes of paper towel, which would pack easily. If I was taking a couple days trip in the car, I used a small plastic shoebox without the cover to stand a small bottle of white vinegar, the detergent, and a roll of paper towel in. If you use a Passy-Muir, don't forget the soap you use to clean it with (we never did find the recommended "unscented" type of soap and always used Ivory or something like that so I would take a small bar in a plastic Gladware container with a top and just pour some water in and also use it to wash the trach ties).
You never know when you might have to go somewhere fast, so we started to call our carryon med supply bag our "hurricane bag." I always left it packed with about two weeks' worth of supplies. It came in handy to do that because whenever I was ready for a trip I could just pull it out, inventory it, and go. It also kept me from ever running out of any supplies at home. Some of you may remember that we had to leave for Georgia last year with less than 24 hours notice due to Hurricane Floyd, and I was greatful for that bag being most packed!
For medications, I always packed them in a heavy ziplock bag and put them in carry-on luggage. I can't tell you how MUCH that double zipper Lands' End bag used to hold and still met carry-on regulations! Don't forget bottles, sippy cups, the container(s) you use for suctioning water (we used four ounce baby bottles with caps and rings). An extra bottle in the diaper bag,with a cover, can be used to run the water into that you are using to clean the tubing if you can't wash it out right away. If your child is still an infant/small toddler and you don't know if you will always have a safe high chair (my mom's "ancient" high chair from when I was a baby didn't have the crotch strap on it any more) or somewhere to prop them up for feeding, I heartily recommend the "No Jo" brand thing you can buy that velcros, has a crotch, and you can use to safely hold your child in a chair of any kind. One of my friends who had a trached child gave me that tip.
Glenn and I always took turns doing the nursing care on trips. We either co-slept with Clarice in the bed next to us, or with Clarice on a mattress on the floor. We sometimes used one of those expandable mesh side rails to put on Clarice's side of the bed. Safety 1st makes one that collapses flat and down to a small enough size it easily fits flat into a large suitcase and takes up little space.
When you make your airline reservations, make sure the agent identifies your child as handicapped, needing a wheelchair. If they don't need a wheelchair, it doesn't matter. We never got much of any help with just saying we needed assistance. It seems like the airlines don't think you need help if you don't need a wheelchair. It is a pain to carry all the carry-on luggage, a car seat, etc. and deal with suctioning and other things at the same time. If someone showed up with the wheelchair we would just say we didn't need it but we n eeded help because of our child's trach. One time I had to ride in the wheelchair with Clarice on my lap as we navigated Atlanta's horrible airport! By the way, we especially had problems with Delta airlines, but other people have had different experiences. We always took Clarice's carseat on the plane since we would need it at both ends, and I didn't want Clarice's neck jerked around even if we just had a rough landing. Always felt safer with her in the seat, and she slept in it because she was used to it.
That's all for now, folks! Hope this helps someone.
Cilla in FL
