What is the guidance for safe travel?

What is some guidance for safe travel?

So I think when we're talking about, or at least when I talk to my patients about travel, we sort of talk about it in sort of two ways, right? You've got people who are getting on an airplane, especially a longer flight, and people who are just taking a road trip with their family and friends. And I think those are really two classes of travel that we should address differently.

If you're just going on a road trip, it's being smart about, you know, crowds, the usual stuff. Are the people you're going on your road trip with going to be smart about
crowds and that sort of thing. If you're going on vacation, you're going to go see something and see some people, right? We want you to be able to do this stuff. So there's going to be a larger concentration of folks. Hand hygiene when you're amongst these areas using hand sanitizer, just trying to stay clear of the bigger masses. But still enjoying the thing that you're doing.

Air travel is the bigger challenge. And I think it's always been challenging for our patients in ways that we don't always think about. So things like blood clots, we know that being up at altitude, especially for longer transatlantic flights, this sort of stuff that people are at higher risk. And so talking to your docs about should I be on aspirin, full dose aspirin, that sort of thing, what meds are you on at the time and does this interact? Okay, so fine.

But what about infections in this situation? I still wear masks on the airplane. I wear an N95 mask on the airplane. I think that that's a very reasonable thing to try to do. We know that the N95 masks are going to be better at protecting you, whereas maybe a standard surgical mask is you protecting others around you. So I think wearing that N95 mask, making sure it's fit well, it’s uncomfortable, I know, but it's something that we should probably be doing to protect ourselves and to protect others.

Good hand hygiene. I think this is the area where you may really do want to wipe down with some good bleach wipes or something like that, antibacterial wipes on the seats and the armrests and the tray table and stuff because although the airlines do their best to get these things cleaned, they're also doing their best to turn over that plane real fast and get you where you want to be on time. So you got to take it into your own hands a little bit. I think those are the big things. Unfortunately, in the new era where we know the people are packed in, there's no way that you're going to get on a flight that's not packed. So you're going to be sort of stuck with it as best you can. You know, protect yourself. I'm not sure you have to wear a whole body suit but as much as you can get the area clean around you and wear that N95 mask, I think that's probably the best- the best thing.

And this is where we get into kind of each individual person's what they do. Depending on where people go, I frequently send them with antibiotic prescription so that if they get an infection while they're abroad, or far away from clinic, from me, they can at least fill that and get moving with it. Or sometimes they'll just have the pills with them so that if they do get an upper respiratory tract infection, for example, it won't bloom into something more serious like pneumonia or a postviral pneumonia for them. I think that's little bit more controversial, that's sort of my practice.

We've been talking in our clinic about should we be sending peoplewith pills against COVID like PAXLOVID? I don't think we have any data to tell us what to do about this, but this is something that we do consider on a case by case basis, depending on where patients are going.

But I think in terms of safe travel, again, it's also making sure that your doc knows when and where you're going. Sometimes if you need a letter sort of explaining what your medical situation is and what your risks are, so that if you do have to interface with the medical community, wherever you're going, that you've got that additional information and that it's just on hand for you so that you don't have to worry about trying to, in a stressful situation, get in touchwith your primary docs office and then having them send over records.

So I think the purpose of treatment, treatment of myeloma is to keep our patients alive, but at the same time to maintain the quality of life and life must go on. So the recommendation is, yes, take caution. But I think travel nowadays with the advent of vaccination, with all the new drugs and COVID as well as policies with good handwashing, mask wearing distancing, it is reasonably safe nowadays to travel, certainly within the United States. I think it's reasonably safe to travel. I would certainly advise our patients with active myeloma to consider wearing N95 if they're getting to the airports and on the plane.