Holiday Information

Before you do anything, talk to your nurse, specialist, consultant and/or GP and ask whether they think it is advisable for you to go on holiday. Details of where you are thinking of going and what you are thinking of doing are important for them to know. It may be that a break in this country is ok but flying or travelling abroad may not be advised.

Once you have had the all-clear, you can begin to plan your holiday. Whether it is in this country or abroad, there are a number of things you can do to ensure a stress-free time.

Check the regulations of the country you are visiting with regard to COVID 19 and ensure that everyone in your party meets the necessary vaccination requirements.

You will need to carry an up-to-date letter from your consultant or GP for insurance purposes containing details of:

• Any medical conditions, including transplant
• Any medicines being taken and the dosage. In some cases it may be useful and necessary to explain why the medication is being taken
• Contact name, address and telephone number of hospital unit(s) and individual hospital reference numbers
• It may be useful to take any personal ‘patient records’ if you have them. This information must be up to date as medicines and dosage may change.
• Take two copies of any paperwork: one for your hand luggage and the other you should pack in your main luggage.

Check that there are no restrictions on the medicines you are taking in to the country you are visiting. This can be done by contacting the relevant Embassy or High Commission.

Be aware that if you are travelling for more than three months you may also need an export/import licence for any medicines.

Medicines treating liver conditions and transplants often have to be ordered in by a pharmacy. Therefore, you will need to plan in advance to ensure that you have enough medicines to cover your trip. If you are planning on taking prescriptions with you, you should allow sufficient time for medicines to be ordered and collected before you travel. Also consider if there is anything special you should take with you on your trip. Your doctor may advise that you carry a supply of antibiotics for traveller’s diarrhoea or an oral rehydration solution, for example. If syringes are needed make sure you take an adequate supply, together with sterilising tablets for use with anything that is reusable.

Make sure that you can obtain any foods for special dietary requirements including infant formula in the location you are travelling to. If not it may be necessary to take supplies with you.

It may also be worth making sure that any ‘favourite’ or ‘liked’ foods are available if this has the potential to cause a problem or upset on the trip.

Some medicines to treat liver conditions or transplants can cause increased sun sensitivity. Buy sun lotion with a protection factor of at least 25+ and follow the directions for application. It may be worth asking your GP if any lotions can be obtained on prescription. It is strongly advised that all transplant patients wear hats and cover up as much as possible with cool clothing.

If you are travelling abroad there are things to think about in addition to the above.

Immunisation

Check whether immunisations will be required, and also the type needed. Find out more on NHS Fit to Travel.

Once you have this information you should check with your local hospital whether the type of vaccine required is able to be given, as live vaccines should not be given to people who are post transplant. Your clinical nurse, specialist or consultant will be able to advise you on this.

Some countries in the world are a malaria risk. Check with your consultant which medicines to take with a liver condition or transplant are effective against malaria.

Available health care

If you are unsure about the health care that is available in the country you wish to visit, ring the Embassy or High Commission of that country and ask for the relevant information.

The UK Global Health Insurance Card (GHIC) lets you get state healthcare in Europe at a reduced cost or sometimes for free. If you have a UK European Health Insurance Card (EHIC) it will be valid until the expiry date on the card. Once it expires, you’ll need to apply for a GHIC to replace it. Apply for a UK Global Health Insurance Card (GHIC) – GOV.UK (www.gov.uk)

Electrical adaptor

Make sure you take the appropriate adaptor for any electrical equipment you may need.

Checks should be made to verify that electrical equipment will work effectively on a particular country’s electrical voltage. A travel kettle may be very useful for boiling water, particularly for mixing medicines and sterilisation.

Flying

There may be limitations to flying with a liver condition or transplant and checks should always be made with your consultant. If there are any special requirements during the flight, airlines are usually happy to assist if you let them know in advance.

Having a liver condition or transplant may mean that you find it difficult to find adequate travel insurance. If you do experience problems, it may be frustrating and can make you feel that you are being penalised for something that is out of your control.

We would advise you to shop around when looking for travel insurance to ensure the best quote. Premiums can be high if travelling with an existing medical condition and it is important to ensure you have the right level of cover. Be completely honest when purchasing travel insurance and be clear of the needs of you and your family. It is also sensible to look at placing the whole family on one policy where possible. If a family member becomes ill and is on a separate policy, there can be problems funding the remaining family members’ travel or further accommodation if a longer stay is needed.

Website Comparison

The following website offers an extensive directory of Insurance companies likely to offer cover to people with pre-existing medical conditions (please note CLDF do not endorse any of the companies listed):

Money Helper website – www.moneyhelper.org.uk. You then search for travel Insurance

Below is a selection of travel insurers who specialise in pre-existing medical conditions, recommended by other parents:

Insure with (for single and annual policies) www.insurewith.com

World First (for single and annual policies) www.world-first.co.uk

Free Spirit www.freespirittravelinsurance.com

Make Sure www.makesureinsurance.co.uk

Staysure www.staysure.co.uk

Avanti www.avantitravelinsurance.co.uk

Insurancewith www.insurancewith.com

World First https://www.world-first.co.uk

AllClear  https://www.allcleartravel.co.uk/

• Does the quote cover pre-existing medical conditions?
• If there is cover for chronic illness does it cover:
  • Loss of medicines?
  • Hospital treatments whilst away?
  • Repatriation (sending an individual, some, or all family members home)?
• Is there an excess and at what level of care?
• What treatments are covered and is there a maximum (capping)?
• Are there any countries that are not covered?
• Is there a cancellation penalty?
• Would you have to pay for treatment, and then return to the UK and provide proof of care given with receipts?
• If you are going to a number of countries, confirm with the insurer that cover applies to all destinations.

Beware if you have not fully disclosed any pre-existing illness and any medicines used, as well as any change in condition or medication before departure, your cover may be void.

As security measures change and can be different depending on the airport and even the airline, check the current situation regarding carrying medicines in your hand luggage before you fly.

All prescription medicines should be carried with you, but you will need to ensure that:

• The medicines are in a bottle or package with prescription labelling
• Medicines are clearly marked with the patient’s name
• The name of the medicine and the dosage are clearly stated
• Any medicines are always accompanied by up-to-date documentation identifying the diagnosis and treatment of any liver disease or transplant in case of queries.

Look at the instruction leaflet on any medicines. Some may need storage at specific temperatures etc.

Find out where the nearest doctor/medical help is available, so you know where to go if necessary. If you are in Great Britain, you can temporarily register with the local doctor if you need to.

It is not uncommon to develop diarrhoea whilst travelling abroad. Be particularly careful and try to avoid:

• Uncooked or unpeeled food
• Shellfish
• Salads
• Ice cubes
• Tap water (use bottled or boiled water at all times, even for cleaning your teeth)

All of the above information is relevant but it is also important that the trip organisers are made aware of any medical needs and have all relevant information to hand.