How to Travel When You Have COPD
患有 COPD 时如何旅行

For the 16 million Americans with chronic obstructive pulmonary disease (COPD), travel can be as anxiety-provoking as it is life-affirming. 
对于1600 万患有慢性阻塞性肺病 （COPD） 的美国人来说，旅行既可以肯定生活，也可以引起焦虑。

The fatigue, chest tightness, congestion, and difficulty breathing that come with the chronic bronchitis or emphysema behind COPD can make the thought of travel seem overwhelming. There are so many questions: How would I handle a long flight? What do I need to bring? And how would I make my overall itinerary manageable?
慢性阻塞性肺病 （COPD） 背后的慢性支气管炎或肺气肿带来的疲劳、胸闷、充血和呼吸困难会让旅行的想法看起来不知所措。有很多问题：我将如何处理长途飞行？我需要携带什么？我将如何使我的整体行程易于管理？

COPD may require a lot more planning, pulmonologists say, but for the majority of patients without the most severe lung disease—even those on oxygen—it’s certainly doable. 
肺科医生说，COPD 可能需要更多的计划，但对于大多数没有最严重肺部疾病的患者——即使是那些吸氧的患者——这肯定是可行的。

Here are the considerations doctors and COPD patients say you’ll need to keep in mind before you hit the road and while you’re away.
以下是医生和 COPD 患者表示，在上路之前和外出时需要牢记的注意事项。

Check-in with your doctor
与您的医生登记

The first step is making an appointment with your pulmonologist to discuss the conditions at your destination, including altitude, air quality, and weather, as well as what you plan to do there. 
第一步是与您的肺科医生预约，讨论您目的地的条件，包括海拔高度、空气质量和天气，以及您计划在那里做什么。

“Our biggest concern is always the altitude,” says Dr. Roberto Swazo, a pulmonologist with Orlando Health Medical Group. “If you struggle at baseline, you are going to have a harder time at altitude than anywhere else.” 
“我们最担心的永远是海拔高度，”奥兰多健康医疗集团的肺病学家罗伯托·斯瓦佐 （Roberto Swazo） 博士说。“如果你在基线上挣扎，那么你在高海拔地区的时间将比其他任何地方都更难。”

Traveling by plane will also mean a lower concentration of oxygen when you reach altitude, which could be challenging for those who struggle with blood oxygen levels.
乘飞机旅行也意味着当您到达海拔高度时氧气浓度较低，这对于与血氧水平作斗争的人来说可能具有挑战性。

If you’re on oxygen already, your doctor can perform a high-altitude simulation test to determine if you’re fit to fly, and how much oxygen you will need to take with you. The procedure involves breathing a mix of oxygen and nitrogen that mimics the reduced oxygen environment of an airplane cabin, while monitoring your blood oxygen saturation and heart rate. If your doctor is unsure if you’ll need a prescription to travel with oxygen to make it through the flight, they can order a test to justify the prescription. 
如果您已经在吸氧，医生可以进行高海拔模拟测试，以确定您是否适合飞行，以及需要携带多少氧气。该手术包括呼吸氧气和氮气的混合物，模拟飞机机舱的低氧环境，同时监测您的血氧饱和度和心率。如果您的医生不确定您是否需要处方才能携带氧气旅行以完成飞行，他们可以要求进行检测以证明处方的合理性。

From there, you can determine what kind of oxygen concentrator you need for your flight and how many battery packs you require. You’ll have to procure any airline, train, or cruise documentation needed, as well as prescriptions for equipment or meds you need take with you. And plan for when you reach your destination.“We want to make sure you know where the nearest pharmacy is, and that you know where to go in an emergency,” Swazo adds. 
从那里，您可以确定您的航班需要什么样的制氧机以及您需要多少电池组。您必须购买所需的任何航空公司、火车或游轮文件，以及您需要随身携带的设备或药物的处方。并计划何时到达目的地。我们希望确保您知道最近的药房在哪里，并且您知道在紧急情况下该去哪里，“Swazo 补充道。

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It’s also important that you make these plans well in advance of your trip, Swazo says, so you have plenty of time to rent any equipment you need and notify your airline, cruise line, or hotel.
Swazo 说，在旅行前尽早制定这些计划也很重要，这样您就有足够的时间租用您需要的任何设备并通知您的航空公司、邮轮公司或酒店。

Remember to get an updated COVID-19 booster a month before your flight, and make sure you have your RSV inoculation. If it’s a fall or winter trip, get a flu shot before you go. Your doctor can lay out an action plan for the steps to take in case you don’t feel well, with zones of green, yellow, and red, outlining what to do for each level of symptom severity. In this plan, you'll take actions and use the medications and therapies specific to each zone, with red being emergency medical treatment.
请记住在航班起飞前一个月获得更新的 COVID-19 加强针，并确保您接种了 RSV 疫苗。如果是秋季或冬季旅行，请在出发前接种流感疫苗。您的医生可以制定一个行动计划，以便在您感觉不舒服时采取的步骤，用绿色、黄色和红色的区域，概述针对每个级别的症状严重程度该怎么做。在此计划中，您将采取行动并使用特定于每个区域的药物和疗法，红色表示紧急医疗。

What to take with you 
随身携带的物品

You’ll need to have your equipment and meds always within reach, including in your carry-on baggage on the plane. For those not prescribed oxygen, that might be as simple as making sure you have your rescue inhaler and all prescription and over-the-counter meds in your bag to control any symptoms. Those with more compromised lung function will need to bring supplemental oxygen along with medications. Swazo says that for his patients who have flare-ups at least a couple of times a year, he also prescribes steroids and antibiotics to take on their trips as a precaution. But be judicious with the drugs.
您需要将设备和药品放在触手可及的地方，包括飞机上的随身行李中。对于那些没有处方氧气的人，这可能就像确保你的包里有救援吸入器和所有处方药和非处方药来控制任何症状一样简单。那些肺功能更受损的人需要携带补充氧气和药物。Swazo 说，对于每年至少发作几次的患者，作为预防措施，他还开了类固醇和抗生素，让他们在旅行时服用。但要谨慎使用药物。

“The instructions are clear: Don’t take it unless you need to,” he says. If there is a flare-up, he wants his patients to call him to make sure he can adjust dosing as needed. These medications should be brought in their original container with the prescription label on it, even if you usually use a weekly pill box.
“指示很明确：除非需要，否则不要服用，”他说。如果出现发作，他希望患者给他打电话，以确保他可以根据需要调整剂量。这些药物应放在带有处方标签的原始容器中，即使您通常使用每周一次的药盒。

Keep a list of these medications with you in a travel folder, along with your oxygen prescription, and any letters from your healthcare provider, including your fit-to-fly report, your emergency contacts, and contact information for the airline, train, or cruise line on which you are traveling, advises the COPD Foundation. While this information might be on your smartphone on the MyChart app, you want to have it handy if there’s no cell service or WiFi, or if your battery dies.
COPD 基金会建议，将这些药物的清单放在旅行文件夹中，以及您的氧气处方和来自您的医疗保健提供者的任何信件，包括您的适宜飞行报告、您的紧急联系人以及您乘坐的航空公司、火车或游轮的联系信息。虽然这些信息可能在您的智能手机上的 MyChart 应用程序上，但如果没有手机服务或 WiFi，或者您的电池没电了，您希望它方便使用。

If you’re traveling out of state or out of the country, review your health plan’s coverage and buy additional temporary medical coverage or trip cancellation insurance you think you might need. If you can, consider having a friend, family member, or spouse travel with you—someone who understands your needs and can provide help when required.
如果您要出州或出国旅行，请查看您的健康计划的承保范围，并购买您认为可能需要的额外临时医疗保险或行程取消保险。如果可以的话，可以考虑让朋友、家人或配偶与您同行，他们了解您的需求并可以在需要时提供帮助。

“I automatically know when I’m starting to get sick,” says Lisa Hall, 55, of Minnesota, who struggled with asthma for decades, before being diagnosed with COPD in 2005. “It feels stuffy, I get warm, and I have to sit there and take in deeper breaths and blow out longer.” 
“我自然而然地知道我什么时候开始生病，”明尼苏达州 55 岁的丽莎·霍尔 （Lisa Hall） 说，她在 2005 年被诊断出患有慢性阻塞性肺病之前，几十年来一直与哮喘作斗争。“感觉很闷，我很暖和，我必须坐在那里，深呼吸，吹气的时间更长。”

While she doesn’t travel with oxygen, Hall says her mom knows when she needs help and will say, “‘Lisa, take a deep breath.’ She notices when my breathing is getting shallower.”

Traveling with oxygen

Start your trip planning by working with a local oxygen supplier to ensure you not only have enough supplies to bring with you, but will have what you need at your destination. Most oxygen suppliers are part of a network and can make arrangements for you to have oxygen delivered to your hotel or other accommodation. Plan on doing this at least two weeks in advance of your trip. It’s also a good idea to ask for the contact information of the person your local supplier spoke to, so you can call and confirm a day or two before you travel that your equipment will be there when you arrive. 

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If you're staying in a hotel, make sure they know about any equipment that is to be delivered, and let them know to allow an employee to sign for it, and not to forget to have it brought to your room by the time you check-in.

“That is not a surprise you want, when you roll into your hotel room at 10 p.m.,” says Dr. Steven Davis, associate professor at the Burnett School of Medicine at Texas Christian University. 

Planes, trains, automobiles, and boats

If you are taking to the skies, remember that airlines do not allow oxygen tanks on flights and do not routinely supply oxygen, although they have it for emergencies, Davis adds.

You’ll need to take a portable oxygen concentrator (POC) that is aviation-approved as well as back-up batteries and an airline form that your health care provider filled out. Make sure you call the airline no later than 72 hours in advance of your flight to notify them of your condition. The general rule for battery life is to make sure you have enough to last from the time you take off until the time you land, plus an additional 50%. You will need more still to accommodate any layovers or delays.  

The good news is that your medical supplies, such as nebulizers, concentrators, and batteries do not count against your carry-on limit so you can take what you need on board, stashing it either under the seat or in an overhead bin. 

Tom Krueger, a 70-year-old traveler from Wisconsin who uses oxygen tanks at home to deal with his emphysema, said he was pleased with how well his portable oxygen concentrator worked on his flight, after testing it first on the ground.“It actually worked out better for me than using my tanks on the trip,” he says. 

Krueger also requests wheelchair assistance to eliminate the long walk to his gate, and ease him through security, so he is not stressed and out of breath before the plane takes off. It also allows him to board first so he can get his luggage stowed and equipment in the right place before other people get on.

“A lot of this is swallowing that big chunk of pride and recognizing your limitations,” Krueger says. “Don’t be shy to ask for help.” 

Keep in mind that not every mode of travel is equal. Traina are easier than trains, for example. You can bring oxygen tanks and concentrators on Amtrak, as long as you call to reserve a spot for your equipment. You must have enough oxygen or battery life for your concentrator to go at least four hours without a charge, and the total weight of tanks may not exceed 120 pounds.

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Car trips won’t require as much planning, but you will need to have enough tanks to last throughout your trip, and know where you can have empty tanks exchanged for new ones at your destination. Take your stationary concentrator to use at night, and any additional tubing, electrical outlet extenders or other supplies. Also remember to keep your phone charged up for emergencies.

Cruises are a great way for travelers with COPD to see the world. Most large cruise lines allow passengers to travel with oxygen, as long as your medical documentation is approved and you call special services a month or more before the cruise to get oxygen delivered to the ship.

Managing expectations 

Once you’re at your destination, don’t push yourself too hard. Take an Uber or rent a scooter, so you can enjoy yourself without getting short of breath. And don’t feel like you need to keep up with travelers without lung disease. If you’re sightseeing and feel unwell, arrange a time and place to meet and just enjoy the street scene from a local café. 

Krueger took in the stunning glacier views from the deck of his Alaska cruise and saw the ship’s stage shows, while his wife and her friends did the more taxing excursions. The trip was such a success he and his wife are considering a future trip to Florida in the winter.

“I think there is a lot of benefit both physically and mentally to travel,” unless your COPD is really severe, Davis says. It’s such a confidence booster, he believes, knowing you can make it to family events, or cross off a bucket-list trip that you’ll always remember. “We do whatever we can to facilitate getting people to where they need to go.”