Traveling with these lungs

Found this press release from the 2009 Rome Marathon race.

Well, the 2023 addition of the race is rapidly approaching and the realization that I might be taking a part in it again is finally starting to sink in.

It’s been several years since I’ve been back to Italy and well over a decade since I did my last marathon there. If all the hype is true, it looks like this year’s event will be the best yet. The question is, will I be ready?

As with most Spring time races, the bulk of the training has to be done in the Winter months, which can be a huge challenge when you have breathing issues. I’ve been training for this race for almost 4 months now and with only a few weeks to go, I still have not reached my peak distances because of all the storms and unusually cold weather we’ve had in California lately. I’ve also spent a considerable amount of time making preparations for the trip itself.

I wish it were as easy as simply booking flights and accommodations, but for me its not. Almost everything in my life revolves around my lungs and my breathing. So, when traveling I have to pre-plan almost every move I’m gonna make along the way, while still allowing for some spontaneity and adventure. That’s pretty much what this post is about.

While it’s certainly not uncommon for people with severe lung disease to travel internationally, very few travel alone and even fewer throw an endurance sports event into the mix. Because I am doing a marathon while in Rome, I have to not only focus on getting my body in shape, but make sure all the other elements of the trip come together at just the right time. Much easier said than done. Getting everything just right is a delicate balancing act of training enough so that I don’t kill myself on the marathon course, while at the same time not over-doing it with the training, which could trigger a bad flare just prior to the travel departure date. I can’t tell you how many times that’s happened. Having to cancel a trip at the last minute, especially an overseas trip, is not only frustrating, it can be expensive. Anyone can have something pop up at the last minute that forces them to cancel a trip, but when the very reason you’re going on a trip in the first place causes you to cancel it, well that’s the worst.

The logistical stuff, like getting from point A to point B with the least amount of hassles, and choosing where to stay along the way, has been fairly easy to plot out. It’s planning for the asthma “what-ifs” and coming up with contingency plans, that gives me the most headaches. Things that most people wouldn’t normally have to think about, like familiarizing myself with the locations of hospitals in the areas where Ill staying on each leg of my trip, or the position of my seats on all the planes Ill be taking. Im a relatively small person and can sit comfortably pretty much anywhere on a plane, but because I sometimes have to take multiple neb treatments during transatlantic flights, its pretty much a necessity that I reserve an isle seat so that I don’t have to disturb others to get to get up when I need a treatment. You cant really do a neb treatment in your seat and blow Albuterol all over the place.

The extra planning doesn’t end there. In addition to packing clothing, race gear, electronics, medications, important documents, etc, I also have to bring 2 separate nebulizer systems with me. A portable compressor driven unit that I’ll keep in my checked baggage and a rechargeable hand-held mesh neb Ill bring in my carry- on. That way, if one gets lost, I’ll have a back up. Same goes for Albuterol inhalers, I bring 3 of them. One to keep in my pocket, one in my checked baggage and one in my carry-on. I do this because inevitably Ill lose one ( which has happened before). May sound like overkill, but because my asthma is so severe and unpredictable, if I were to loose any of my inhaled medications, it could take too long to replace them and that could be disastrous. I actually lost the inhaler I was carrying with me during my very first marathon in Portland Oregon. Thankfully, I was able to text a friend who lived nearby, and while she couldnt get me Albuterol, she was able to pick up an over the counter medication called Primatine mist at a local Walgreen and bring to me on the course, all within 30 minutes. It saved the day and entire trip for me.

Just like at home, when I travel out of the country I always bring a long a copy my “About my Asthma” note, but printed in the local language in case I end up in a ER or what they call “Pronto Soccorso” in Italy.

Along with travel insurance, I purchase a separate medical evacuation membership, through either Medjet assist or Global Rescue, so I that if Im hospitalized while traveling ,especially overseas, I can be transported back to my home hospital in San Francisco without approval from the travel insurance company. I learned the importance of having this kind of coverage the hard way after getting hijacked at the Boston marathon finish line. It’s even more valuable when you’re visiting a foreign country. While Hospital care in most of Europe is top notch, I wouldn’t want to stay in one very long. When youre sick you need to be closer to home.

Here’s one more for you….have you ever gone to take a hit off your inhaler, only to find out that nothing is coming out of it or very little? It can bring on instant panic, if you need it as bad as I do some times. That’s why I bring along a 2 inch sewing needle, not to sew with, but for opening up a clogged inhaler mouthpiece. It can literally be a lifesaver, or at least a trip saver.

Oh, and because I usually travel alone, all the above mentioned stuff for an 18 day trip, has to be crammed into a single piece of luggage, a backpack and whatever clothes Im wearing at the time. Packing for these trips is a skill in itself.

When it comes to the race itself there are even more considerations. Because my asthma, and degree of my breathlessness changes from day to day, in addition to the full marathon, if offered, I usually sign up for one of the shorter distance races as well. That way if I don’t feel well on race day, I can down grade and do the easier one. Of course it costs more to do this, but it affords me the opportunity to at least participate, albeit in a smaller way. I would hate to travel half way around the world and not be able to participate at all.

Then there’s the course itself. I need to carry not only an inhaler, but also a portable neb and an epi pen. Might not sound like much, but when you include a phone and everything else, that’s a lot stuff to carry when you’re trying to go fast. There are medical stations on the course you can stop at, mostly for muscle strains or cramps, heatstroke, dehydration , etc, but if you stop at one of them for breathing problems, there’s no guarantee they’ll let you back into the race. If I get really tight, I usually stop for a couple minutes on the side of the road, behind a tree or some sort of structure so that I don’t stick out like a sore thumb, and then Ill take a neb treatment, check my pulse ox and get back on the course. If it gets to the point where I cant go any further, rather than wait for one of the SAG busses to take me back to the start line, I’ll usually just take public transit back to where Im staying and call it day. Thankfully that’s only happened once.

For disabled athletes, ie those with mobility issues, blind runners etc, some of these events will provide or allow a guide or spotter on the course with you. Either a friend, or a volunteer runner or cyclist. They are there basically to keep an eye on you in case you have a problem, they’re also good company and motivators for the long hours youll pend out there. When you think about it, it’s really kind of them to do this, as they will complete the entire race with you, but wont receive a finisher medal. I had a spotter with me in all 3 of my Boston marathons. It was great to have them with me, but other than carrying my medical supplies, I didn’t really require their assistance. If offered a spotter in this upcoming race, I’ll probably decline.

So anyway, there are just some of the extra measures that have to be put in place for someone like me, to travel long distance, especially if your crazy and feel the need to walk a marathon while you’re there. Planning for, and taking these extra steps and precautions requires time and patience, but it’s a must when you suffer from severe breathing problems. I think you’ll find though, that the extra effort and cost is worth the anxiety that you’ll save yourself. In the end, its really just about living as normalish a life as possible and doing what you want to do despite your health woes.

Btw, instead of flying directly into Rome like I usually do for the race, this time Ill be entering the country through Switzerland. I’ll be visiting several areas in the north, including a stop in Milan to attend a Eros Ramozzotti concert……il mio cantante Italiano preferito. I can’t wait!!