We just went on our first vacation since my daughter was born seven years ago. While we only went for a few days to a resort that was pathetically near her hospital, it was the first step in what we hope will become a frequent event.
I know some of you are adventurous, but there are plenty of others out there who are afraid to go on vacation and think the entire process is unbelievably overwhelming. This article is for all of you parents who need to bring 12 boxes of supplies and four pieces of medical equipment for just a day trip, and can't even begin to imagine what three days in another state would mean. Hopefully it will make the planning process less overwhelming. Really, you CAN do this!
6-12 Months in Advance: Planning WAY Ahead
The first thing you need to do is decide where you want to go. I recommend thinking about this at least six months in advance, if at all possible. This will give you time to make all of your plans and arrangements, as well as snag the best deal.
Here are some of the things I thought about when choosing a location:
Are there activities nearby suitable for my child with special needs, as well as other members of the family?
Is the climate OK for my child during the season we plan to go? Too hot or too cold? Too many allergens? Too high altitude?
Is there a children's hospital nearby that can meet all of my child's needs in an emergency?
How would we get there? Drive, fly, or take the train? Is this mode of transportation suitable for my child?
Once we decided where we wanted to go, I then tried to find a resort that I thought would be workable for my family and booked it early for a discount. These are some things to consider when making your choice:
What is the refund/rebooking policy for the hotel? If my child gets sick, can we rebook for another date without penalty? Can we cancel?
Does the hotel have a full kitchen available for storage of cold/frozen medication and special meal preparation?
Will the hotel allow special medical equipment (ventilator, oxygen concentrator, etc.), and is the electrical current compatible and adequate?
Will the hotel allow a service animal, as well as provide a relief area?
Does the hotel offer suitable sleeping arrangements for your child and family, such as a separate room or area for your child if necessary?
Can you control the temperature in your individual hotel room?
Is the room wheelchair-accessible? How about the bathroom?
Are common areas of the hotel accessible (restaurants, arcade, pool)?
Are the room locks adequate for a child who wanders?
If your child does not eat or is on a special diet, can this be accommodated within the meal plan or restaurants?
If your child gets sick and has to stay in the hotel much of the time, are there activities within the hotel itself for the rest of the family?
Transportation possibilities should also be looked into as early as possible, especially if you plan on flying, taking the train, or renting a vehicle.
I don't want to talk too much about air transportation, since that is a topic in and of itself. But if you plan to fly, you will need to discuss with the airline a wide variety of things before booking, including if they allow children who cannot sit up to fly, if special harnesses/seats are needed, what type of oxygen they allow on board, how to transport medication and formula, how they stow wheelchairs and strollers, if a transport wheelchair will be on board the plane, if the bathroom is usable, if pumps and other equipment can be used on board, and if they will charge for the transport of medical supplies (as cargo). See this TSA page for specific information.
If you plan on renting a vehicle, you will need to ensure that a vehicle meeting your needs can be available at your destination. Most regular rental agencies do not provide vans with wheelchair tie-downs. Similarly, while some provide carseats, virtually none have special needs carseats or harnesses available. You will need to find a specialty company far in advance to meet your family's needs.
3-6 Months in Advance: Making Arrangements
If your child has a lot of medical equipment and supplies, you will need to make arrangements in advance to ensure your child has everything she needs. Many home health companies will send supplies and equipment directly to your hotel with advance notice. This can be particularly helpful if your child uses a large quantity of heavy items, such as formula.
If your child uses oxygen, you will need to make sure you are able to either have the oxygen delivered to your hotel, or you are able to bring all of the tanks/concentrators you need. You may want to see if your home health company will rent a portable concentrator to you for the trip, especially if you plan on flying. It is also important to ensure that your company can provide extra oxygen if you use tanks and run out. Extra batteries are also a must for portable concentrators. Since your regular company may need to make arrangements with another branch or provider, it is best to begin this process as early as possible.
Children who use medical equipment like feeding pumps, infusion pumps, suction machines, nebulizers, CPAP, or ventilators need to make sure to have backup equipment available. Some companies will provide an extra pump, and virtually all will provide a backup ventilator. If backups are not provided, you need to make sure that your company will be able to switch out a malfunctioning piece of equipment at your location. In addition, you may want to discuss in advance if your company is willing to overnight you any equipment or supplies that you forget or that were damaged in transit. You may also want to bring an extra prescription for any items you use in case you run into trouble.
Depending on your company and your delivery dates, you may need to stockpile supplies for your trip far in advance. Think ahead!
If you are flying, you most likely will need a medical letter giving you permission to travel with your equipment and supplies. Check with your airline how far in advance you can get this letter, and then start bugging your physician, as this type of letter can sometimes take time. You may want to write the letter yourself and have the doctor print it on letterhead and sign it. In addition, airlines require FAA approval for children over 44 pounds using airline harnesses. (See http://www.kidsflysafe.com/how-to-use-cares/cares-for-special-needs-kids for more information.) Make sure you determine what you need and what requirements must be met to use it.
While you are away, you may want to see a show, visit a museum or zoo, or go to a sports event. Since it can sometimes be difficult to get accessible seating together, it is probably wise to book your tickets far in advance to make sure your child can be accommodated.
Finally, if your child needs any special equipment for the trip, such as a specialty swim suit or positioning item, this should be ordered a few months in advance to allow for adequate delivery time.
4-6 Weeks in Advance: Ordering and Making Lists
The most important thing I began about a month in advance was constructing a medical equipment and supply packing list. Over the course of a few days, I documented what supplies we were using on a daily basis, and in what quantities. I also noted down less frequently-used supplies, and the items I would need in case of a sudden illness. After about a week, I had a draft of a good packing list.
This list also helped me to know what supplies I needed to order in advance. If you receive monthly shipments of supply, it is vital to determine how to schedule your shipments so you will have enough supplies to bring or to have shipped to your destination. For example, I knew I would want extra all-in-one catheterization kits for vacation, and so I needed to order these four weeks in advance to ensure we would have them when we needed them. If you receive weekly shipments, you will likely need to arrange for either an early or late shipment to accommodate your vacation.
Of course, I realized over the next few weeks that I had left many essential items off the packing list. This is the primary reason to prepare your list in advance, to give you time to add to the list as you remember more items that are needed, as well as to ensure all items are available.
I organized my packing list by category to make sure I did not forget anything. For example, I had lists of urological supplies, enteral supplies, medications, respiratory supplies, and IV supplies, among others.
This is also a good time to sort out medications. If your insurance is like ours, you can only get refills a few days in advance. I attempted if at all possible to get enough quantities of all medications to avoid needing to refill while away. If this is not possible, it is worthwhile to locate a pharmacy near your destination that takes your insurance. In some cases, insurance companies will also allow you to get a supply of medication in advance for a vacation.
Finally, if you are driving, it may be wise to get your vehicle checked and have routine maintenance performed. Nothing is worse than a broken down vehicle on vacation.
1-2 Weeks in Advance: Confirmation
Panic sets in during the last few weeks. But if you have done all your organizing and preparation, there actually is not much to do. You will, of course, need to buy last minute personal care items and make sure supply shipments are on the way. Beyond that, it is probably best to spend some pleasant time looking forward to your trip and planning your activities.
It is a good idea to confirm your reservations at this time with your hotel, airline, rental car agency, and any other organizations requiring reservations. It is also a good idea to let your primary doctor and any agencies you work with know you will be on vacation. Finally, you may want to confirm with the hospital, urgent care center, and pharmacy at your destination to give them a heads up that you may need their assistance.
This is also a good time to make sure you have appropriate packing materials, such as coolers and ice packs for cold items, and crates or boxes for medical supplies.
1-3 Days in Advance: Packing and Checking
The last few days before a trip are extremely stressful. Try to keep your goal in mind, and you will get through it!
If you have a good packing list, packing should not be too hard. I find it helpful to organize and label supplies in separate plastic crates. For example, all respiratory supplies and medications go in one crate labeled "Respiratory." I have a crate for IV tubing, another for caths, and several for small medical devices, such as nebulizers and pumps, and other items.
It is also wise to determine what items you are likely to need en route, and pack these in a separate and easily accessible crate.
As I packed items, I checked them off of my master packing list. When a crate was full, I made a new list of all the crates and remaining large pieces of equipment (oxygen concentrator, suction machine, etc.) that would need to be loaded in the van. We would then check these off the crate list as they were loaded in the van.
I would also advise bringing your packing list with you on your trip, as it was very helpful to ensure nothing was left behind in the hotel. It's also nice to jot down forgotten items to add to your list for next time. I keep my packing lists on my computer, so next time I travel I can pull up the most recent list and see what I brought. I always come home and add the "forgotten" items to the packing list document.
Make sure you remember to bring the power cords, chargers, and backup batteries for all of your equipment. I also found it extremely helpful to bring a power strip to accommodate all of the medical machines. And don't forget identification, tickets, and reservation receipts!
Finally, make sure to bring a complete list of phone numbers for your child's doctors, agencies, and home health companies. If you need assistance or have a problem, this will greatly simplify your life.
Have a Great Trip!
Once the van was loaded, we double-checked to make sure we had everything and everybody and went on our way. I found that all of my advance planning made everything go very smoothly. Unpacking and organizing at the hotel was a breeze. We ended up having a wonderful time with no complications.
If you approach the process step by step with your goal clearly in mind, it makes what is undeniably overwhelming become manageable. You CAN do it!
Copyright 2010 Complex Child E-Magazine. All Rights Reserved.
The information on these pages is not a substitute for appropriate medical care. Please contact your child's physicians before making any changes in your child's care. Complex Child is for research purposes only and does not constitute medical advice.