Moving Well When Traveling

05/01/2010

Know Your Limits

• Pace yourself and be sure to add plenty of rest stops throughout the day. Most of us do too much on the days we feel well only to suffer the next day. Use the rule of thirds to avoid this. Think about all that you want to do in one day. Reduce that by one third to be sure you have enough energy left at the end of the day and going into the next day (this is your vacation after all not work). Remember the more tired you are the more likely you are to become irritable, fall, experience off times or dyskinesia.
• Consider bringing or renting a wheelchair or walker with a seat if you have balance problems and easily tired.
• Begin or include exercises that focus on balance and stamina before you leave for your vacation. A physical therapist can help you design a program that is right for you.
• Know when you are at your best and plan activities around those times. For instance, if you fatigue at the end of day or experience end of dose wearing off then these times are not the best time to plan an active outing.
• Call ahead, talk with your tour guide or review your physical limitations with your travel guide before taking the trip or signing up for that special excursion.
• Schedule 'wiggle' room into your schedule or agenda. A schedule too busy to allow flexibility or spontaneous rest is not a formula for rest and relaxation but sounds more like life when not on vacation.

Refuel Your body and muscles need energy to keep you going.

• Eat small meals and snacks throughout the day instead of fewer heavier meals that can leave you bloated and sleepy (think after lunch sedation or Siesta).
• Focus on high energy foods that can keep you going throughout the day. High sugar foods may ‘pick you up’ in the short run but rob you of energy in the long run. Choose healthy snack foods such as fruit, nuts, yogurt, and oat bars to refuel instead of candy.
• Stay hydrated. You need more fluids to replenish what you lose when you perspire in the warmer months. People often drink less when they are distracted, more active, spend more time in the sun or find themselves away from home or hotel room. Dehydration can cause fatigue, irritability, lightheadedness, confusion, muscle cramps and weakness. Bring a water bottle or better yet a ‘fanny’ pack or other hydration pack so that you can carry it with you and keep your hands free.
• Make time for brief daytime rest, nap or meditation and be sure to schedule plenty of time to sleep.

Manage your movement symptoms

• Walking and balance. Pace yourself, stop, sit and rest. Avoid doing multiple tasks while walking such as carrying items, reading a map. You may find a cane or walking stick helpful. Consider renting or bringing a wheelchair for long distances so that you can keep up with the group and not miss out on anything. If you need a walker, make sure it has a seat for that impromptu rest.
• Ask about disability accompdations or if elevators are available.
• Ask for a hotel room or seated reservation on the ground floor or close to the exit.
• Freezing. Motor initiation or freezing can be a big problem and the cause of falls. Consider whether a wheelchair would be safest. Remember that crowded, highly stimulating environments and crowds can worsen freezing. You may wish to visit an attraction during slower hours of the day,
• Tremor. Tremor can worsen during fatigue, and stressful situations. Some people spend so much energy worrying about what other people will think if they see you tremoring. Don’t let tremor worry you or embarrass you. When you sit down to dinner with a group of people try telling them you have tremor and may be a little slower. This declaration sometimes removes the weighty feeling your self-consciousness you may have as you wonder if the group sees your tremor. Learn simple breathing or relaxation techniques to help you reduce the impact of these anxiety moments.
• Rigidity and Stiffness. Stay hydrated. Try to move hourly. If you can stand up and walk a few paces. If you are on a tour bus, car or plan stretch your muscles, and move your joints. If you are part of a tour group ask your leader if they will take a moment to remind the group to stretch at convenient intervals. Sit and stretch shows simple exercises you can do on a plane, train, car or bus.
• Slowness. Give yourself  t-i-m-e. Don’t expect to rush out the door at the last minute. Some people set their watch time or alarm 10 minutes early to ‘fool’ themselves into having extra time to get going in the morning, get to dinner or other activity on time.
• Dystonia. Dystonia with muscle cramping and pulling is sometimes worse with activity. Avoid doing too much at once. Gently stretch the muscle (i.e. gently neck movements, foot stretches). Avoid cold if it worsens spasm. Use gentle but not aggressive massage. Ask your doctor about treatment before you leave.

Mind your medicines

• Take your medicines on time. This is harder to do when you are busy, distracted and adhering to a different schedule. Use a pill box or watch with an alarm (examples are available at www.epill.com) to be sure you get your medicine at the right time.
• Talk to your doctor or health care provider about how to handle changes in time zone or schedule. Questions to ask include:
  • What do I do with my medicine dose if I get up earlier than usual, sleep in or stay up later?
  • Should I add a dose, skip a dose or change the timing of my medicine dose, if I lose or gain time due to change in time zones.

Author: Monique Giroux, MD