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Take a Break When dreaming about a holiday, our minds rarely wander beyond images of palm trees dancing in the breeze, blazing sun on our backs and a dazzling white beach leading to an azure sea. And why should they? But holiday dreams can turn to dust if you fail to consider the asthma factor. Although there is not much to stop you, fourteen year old Naomi Wright's scuba diving holiday in the Red Sea fell apart because her parents hadn't realised that dive schools abroad often impose restrictions on people with asthma. According to Dr Louise H Bethea, the key to taking asthma on the road without incident are planning, communication, and compliance. But this needn't cramp your style or spontaneity. Most situations you encounter on foreign shores will be familiar from home. With a little research and forward planning, you'll soon be on your way. When Libby Mitman's seven year old son Luke's asthma got bad from crop spraying in the UK countryside, his doctor suggested the best thing they could do was take him abroad as soon as possible. "We hopped on a flight to Greece the next day, and his asthma got much better." Where to go? Although the world may be your oyster, to get the best out of a holiday you need to choose one that will also suit your asthma. Triggers are a key pointer to the ideal destination. Prevention being better than cure, some places, seasons or situations are simply best avoided. Asthma triggers vary between individuals, but commonly include allergens such as tobacco smoke, house dust mites, pollen (particularly grass), mould, air pollution, food, furry or feathered friends to exercise, stress and cold air. If your asthma symptoms are worse for pollution, a major city in the height of summer wouldn't be the best choice. Think of your asthma as a sensitive gauge that may lead you to the world's most pristine places! However, if cold air is a trigger, Everest may be voted out. Asthma-friendly places Pollen free places include coastal resorts with an on shore breeze, or life on the ocean wave. Water sports and swimming while breathing lungfuls of warm, moist air suit most people with asthma. Mountain air has long been sought after for its health benefits. With fewer pollen-producing plants above the snow line, little air pollution, and no house-dust mites, mountain air can be good for your asthma. However, a mountain spa resort may be better than heading above 5000 feet if cold dry air, found at high altitudes, is a trigger. If exercise triggers your asthma, don't let it stop you, skiing in Switzerland or trekking in Transylvania. But build fitness levels slowly before going. Hotel rooms often contain large concentrations of dust mites and moulds. Ask for an allergy-proof room, and if there isn't one, the AAAAI suggest requesting a sunny, dry room away from indoor pools. DIY holidays If you're considering a self-catering holiday, although rustic is pretty in the brochure, it can mean dusty shutters, mouldy beds and dust mites. Farm cottages or Auntie Flo's may mean animal fur, dust from crops and fields of oil-seed rape. Make sure properties are aired before you arrive, and pet and smoke free, if this is likely to trigger asthma. If you use barrier covers on mattresses at home, and they aren't provided, consider bringing your own. Camping under the stars may sound romantic, but make sure you are not allergic to grass pollen, or asthma isn't triggered by smoke from campfires or drops in temperature. When to go Whether facing the thick, humid air of Bangkok or the hot dusty desert of Botswana, climate and season poses challenges to asthmatics. Most people think asthma is at its worst in Spring and Summer because of high allergen levels. Certainly, tropical, damp climates mean dust mites, airborne moulds and pollens, but winter brings it's own aggravations. Cold, damp climates, mean more indoor dust mites and moulds. But cold, dry air is also a common trigger, although a scarf over the face proves effective in warming air breathed in. Before you go Forewarned is forearmed so have a check-up before travelling. Your doctor will check your asthma is under control, suggest frequency and dosage of medication, and draw up a travel management plan. This may involve increasing your preventer medication several weeks before you leave, advice on how to modify medications should there be changes in your asthma, and emergency medication. What to take? "I always take an "asthma kit' with me," says Libby, "Including Luke's puffer, a nebuliser and a pack of steroid tablets, just in case. I find out where the nearest hospital is when I get there and then just forget about his asthma." Take medication in your hand luggage, in case cabin luggage is delayed or lost, and make sure medicines are clearly labelled, preferably in original containers. Take a large volume spacer with you, and a peak flow meter to give a regular indication of how well your asthma is being controlled, so you can be worry free. Travel health insurance "It's better to be safe than sorry' the maxim g"s, and this applies to medical insurance. Those travelling within the European Community are entitled to free medical treatment on the production of an E111 form (from post offices or the Health Literature Line (0800 555777)). However, many countries don't have a reciprocal health agreement with the UK - extra money spent on travel health insurance is well worth it for peace of mind. Tour operators, flight providers and travel agents are all able to advise on a suitable policy - just check the small print to make sure 'existing conditions' are included. Getting there The increase of non smoking flights have made life easier for asthmatics, but this d"sn't apply to all international flights. If there is a smoking section, check in early, and request a seat as far away from it as possible. Air quality is unlikely to be a problem in itself, just let air stewardesses know if you have an allergy to perfume. "We've never taken Luke on a long haul flight," says Libby. "We'd want to be able to get home quickly if anything happened." If you use a nebuliser, check whether the airline will provide one, or let you use yours, and the availability of supplementary oxygen if you have severe asthma, when you book. If travelling by car, air vehicles to get rid of the mites and moulds lurking in seats or carpets. Use air conditioning to avoid external allergens when travelling, and travel early morning or late evening when air quality is better. When you get there With well controlled asthma, you shouldn't have a problem on the piste or in the depths, as long as you prepare adequately. Active holidays such as mountaineering, parachute jumping or sky diving are fine. However, for those whose symptoms are triggered by cold air, exercise, and stress, sports and activities like scuba diving, climbing, hiking or skiing at high altitudes, can cause problems. Although many people with asthma dive without incident, many dive centres abroad pose restrictions, so check regulations before booking. Asthma travel plan It's easy to forget or put off taking medication when out of your routine, crossing different time zones and having a good time. This can put you at greater risk of developing symptoms of asthma. When you are away, continue to take your preventer inhaler regularly, which will help to avoid most problems. Keep medication with you at all times, including emergency measures. If you're doing exercise on holiday, warm up for 5-10 minutes then do a few short sprints, taking a couple of puffs of your reliever inhaler beforehand. Now all you need to do is relax and de-stress in paradise knowing that you and your asthma are on holiday. "So far, we've had no problems abroad," says Libby. "In fact, half the reason we take Luke is because it helps his asthma." Holiday check list
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