Members' travel tips Our members share their top tips for managing Addison's so you can enjoy travel and holidays - even when the unexpected happens. Whether you plan a long weekend in the UK or a month-long trek through the Amazon, it’s important to plan how you will manage your Addison’s while away and to ensure you have prepared for all eventualities. Here, some of our members provide tips on managing their travel plans. Start your preparations well in advance of travel“We have done Greek holidays since my daughter was diagnosed. As the mother of a teenager with Addison’s, I did find it fairly worrying to be out of the UK for the first time, but all went well. I had a good supply of medication in hand luggage, not all in our main suitcase, and a medical bracelet with the international number on. We had a letter from her consultant explaining the need for an injection kit in hand luggage when going through the airport – although I tried to show to staff, they just waived us through. We also took a range of other medication: rehydration salts, anti-sickness medication (we use ondansetron melt tablets) and the usual medication for minor illness, such as antihistamine, paracetamol – we were like a walking pharmacy. The ADSHG website has free downloadable emergency letters translated into other languages on their website – absolutely brilliant idea! On arrival, I then mentally worked out how to call a doctor or hospital if needed and where they were located.”Helen Line up all the paperwork you might need“My GP wrote a short note on surgery paper saying that I have medical conditions that require me to carry medication, injection needles and syringes at all times, even when flying. The letter is signed and stamped, and I always carry my clinician information sheets too, along with a repeat prescription, and my latest blood results, in case of an emergency admission. I carry all in my hand luggage, and duplicate everything in my checked luggage. I was asked to justify the injection kits a few years ago, but now things are just waved through.”Jackie Take a copy of your repeat prescription - just in case“I would always advise carrying the tear off from an old prescription – I was away in Devon recently and managed to forget my desmopressin tablets. With the prescription with my name and address on it and a list of my repeats, it was easy to get an emergency supply from a chemist.”Rachael Have a spare set of medication in case you lose your main supply“My daughter is at sixth form college, and going on the film studies trip of a lifetime to Los Angeles. She has a dosage box with all the various tablets counted out for four times a day for a week, her own injection kit and a spare emergency injection kit with the teachers, a tub with extra packets and bottles of all her medication (in case the dosage box gets lost/dropped/goes wrong), extra travel insurance, medical bracelet, letter from the hospital and ADSHG emergency card.”Phoebe Take care not to let moisture/damp degrade your tablets in a cool bag“Your tablets can be damaged by moisture, condensation, strong heat and light. Cool bags are really designed to store liquid drugs and can rapidly degrade tablets through moisture penetration. Unless your tablets are in a bottle with an unbroken seal, there is a risk they will go crumbly through moisture damage inside a cool bag. Overheating over an extended time period will reduce the potency of medications more slowly and is also likely to make them go crumbly as a sign of degradation. If you can, store your tablets at your holiday accommodation and carry a small supply with you while you are out for the day.”Katherine Take precautions against infections specific to your destination“Remember to keep adequately hydrated when in warmer climes and to carry a bottle of water with you. However, bottled water is often low in sodium, so make sure you have some salty snacks and rehydration fluids/salts with you too. There are lots of diseases in tropical climes which are dangerous in themselves and much more so when you have Addison’s. Check out TravelHealthPro and Masta for free professional health advice and the Foreign and Commonwealth Office for general travel advice.”Andrew Make a note of the nearest hospital with an A & E unit - in case of accidents“On the last day of a holiday in Spain, I had a fight with the world’s smallest revolving door and a large suitcase – and lost. I ended up on my back on a marble floor and was so worried that I’d hurt my spine that it took a couple of minutes to register the pain in my newly broken wrist. My well-organised husband had prepared a list of hospitals in Granada so off we went following our trusty satnav which got us to the nearest hospital, but couldn’t help us to find the A&E department. Now we do things differently. In a few days we’ll fly to Greece and the satnav is already programmed – not only with every hospital in the various areas we’ll visit, but with the satellite co-ordinates that will lead us to the entrance of each emergency unit. Hopefully we won’t need to use them, but it’s comforting for both of us to know that when speed might be of the essence, we’ve done our homework. As a final safeguard, both my brother (who’s coming with us), husband and I have downloaded and watched the emergency injection videos via the ADSHG website. Here’s hoping we don’t need to use any of it!”Gill Be aware that clinical practices may be different to the UK“As someone with a house in rural Andalusia, the first thing I’d say is that in Spain they give 100mg of hydrocortisone by injection (in your bum) for pretty much anything you rock up at the medical centre with! So far I’ve taken friends with a random allergic rash, a spider bite and a snake bite, and on all three occasions they gave hydrocortisone by injection before anything else. On another occasion, our son fainted in the street – probably just heatstroke and dehydration – and they gave IV fluids until his blood pressure was normal. The time from him keeling over to being in hospital hooked up to fluids was less than 20 minutes – and this in a small farming town where no English is spoken. So, in terms of the two key treatments, hydrocortisone injection and fluids, we’ve found that getting those in a hospital in Spain is simpler than dragging them out of A&E in the UK. It’s also worth knowing that you can buy prednisolone over the counter in Spain – it’s very cheap.”Lindsey Be aware that ambulances may not carry hydrocortisoneAmbulance regulations in other parts of Europe will vary from the UK. Dutch ambulance vehicles are routinely equipped with injectable hydrocortisone, but Spanish regulations do not allow ambulance crew to administer injected hydrocortisone, and their vehicles do not carry it. Within the USA, the regulatory approach differs from state to state. This uncertainty reinforces the need to self-inject (or have a family member do it for you) before phoning for emergency medical assistance.