Travelling as a laryngectomee

Traveling as a laryngectomee can be challenging. The trip may expose the traveler to unfamiliar places away from their routine and comfortable settings. laryngectomees may need to care for their airways at unfamiliar locations. Traveling usually requires planning ahead so that essential supplies are available during the trip. It is important to continue to care for one’s airway and other medical issues while travelling.


Caring for the airway while flying on a commercial airline

Taking a flight (especially a long one) on a commercial airline presents several challenges.
Several factors can lead to deep vein thrombosis or DVT. These include insufficient hydration (due to low moisture in the cabin air at high altitude), lower oxygen pressure inside the plane, and the passenger’s immobility. These factors, when combined, can cause a blood clot in the legs that, when dislodged, can circulate through the blood stream and reach the lungs where it can cause pulmonary embolism. This is a serious complication and a medical emergency.

 In addition, low air humidity can dry out the trachea and lead to mucus plugs. Airline attendants are typically unfamiliar with the means of providing air to a laryngectomee, i.e., directingair to the stoma and not the nose.

These steps can be taken to prevent potential problems:

• Drinking at least 8 ounces of water for every two hours on a plane, including ground time

• Avoiding alcohol and caffeine drinks, as they are dehydrating

• Wearing loose-fitting clothes

• Avoiding crossing one's legs while seating, as this can reduce blood flow in the legs

• Wearing compression socks

• If in a higher risk category, asking one’s doctor whether to take aspirin before flying to inhibit blood clotting

• Performing legs exercises and standing up or walking, whenever possible during the flight

• Booking a seat in an exit row, bulkhead, or aisle seat that allows greater leg room

• Informing the flight attendants that one is a laryngectomee

• Placing medical supplies, including stoma care equipment and an electrolarynx (if used) in an accessible place in the carry-on luggage (It is allowed to bring durable medical equipment and supplies on board, even as an extra carry-on bag)

• Communicating with flight attendants through writing if the noise during the flight make it difficult to speak

• Inserting saline into your stoma periodically during the flight to keep the trachea moist.

• Covering the stoma with a Heat and Moisture Exchanger (HME) or a moist cloth to provide humidity


These measures make airline travel easier and safer for laryngectomees and other neck breathers.

What medical supplies should be carrying when travelling?

When travelling it is useful to carry all one's airway management supplies and medication in a dedicated bag. The bag should not be checked in and access to it should be easy.

Suggested  items to be included in the bag include: 

•  A summary of one's medication taken on a regular basis, one's medical diagnoses, the names and contact information of one's medical providers, a referral to a speech and language pathologist (SLP), and prescriptions for one's medication  

•  Proof of medical and dental insurance

•  A supply of the medications taken

•  Paper tissues

•  Tweezers, mirror, flash light (with extra batteries)

•  Blood pressure monitor ( for those who are hypertensive)

•  Saline bullets

•  Supplies for placing HME housing ( alcohol, Remove, Skin Tag, glue) 

•  Several HMEs and HME housings 

 •  Carrying an electrolarynx even by those using a voice prosthesis may be helpful in case one is unable to speak  

•  A voice amplifier ( if needed with extra batteries or a battery charger) and an electrolarynx (with an extra batteries). 

Individuals who use a voice prosthesis should also bring these items:

•  An extra hands free HME and an extra voice prosthesis

•  A brush and flushing bulb to clean one's voice prosthesis

•  A red Foley catheter ( to place in the voice prosthesis' puncture in case the voice prosthesis is dislodged)

The quantity of supply items depends on the length of the trip. 

It can be useful to obtain contact information for SLP(s) and physicians at the area of travel.  

   


                                                       A medical supply bag

Preparing a kit with essential information and material when going to the hospital

Laryngectomees may need to receive emergency and non emergency medical care at a hospital or other medical facility. Because of their difficulty in communicating with medical personnel and providing information, especially when in distress it is helpful  to prepare a folder with this information. Additionally it is useful to carry a kit containing items and supplies needed to maintain their ability to communicate and care for their stoma. The kit should be kept in a place that is easily accessible in an emergency.

The kit should contain the following:

• An updated and current summary of the medical and surgical history, allergies and diagnoses

• A updated list of the medications taken and the results of all procedures, radiological examinations, scans and laboratory tests. These may be placed on a disc or USB flash drive

• Contact information and proof of medical insurance

• Information (phone, email, address) of the laryngectomee’s physician(s), speech and language pathologist, family members and friend(s)

•  A figure or drawing of a side view of the neck that explains the anatomy of the laryngectomee's upper airway and if relevant where the voice prosthesis located

• A paper pad and pen

• An electrolarynx with extra batteries (even for those using a voice prosthesis)

• A box of paper tissues

• A supply of saline bullets, HME filters, HME housing, and supplies needed to apply and remove them ( e.g., alcohol, Remove, Skin Tag, glue) and to clean the voice prosthesis ( brush, flushing bulb)

• Tweezers, mirror, flash light (with extra batteries)

Having these items available when seeking emergency or regular care can critically important.