Safe-cation

FRIGID RAIN LASHED AROUND US AS WE BANGED on the station doors to be let inside. Behind us stood hundreds of other passengers, all frustrated after being unceremoniously herded off the Eurostar train. Just that morning, we were happily chugging our way to Paris, thrilled to be ticking off an item on our collective bucket list, when suddenly we found ourselves braving the elements with no clue as to what was going on. My sister and mother had flown in especially for this once-in-a-lifetime trip. I suppose now is a good time to mention that Mom has stage IV cancer and was in the midst of chemotherapy treatments.

Travelling can be stressful, even for the hardiest of people. For cancer patients, it’s an even more daunting prospect. Managing a safe and relaxing journey when you have a terminal illness involves careful planning and attention to detail. This I know now. I wish I did then.

Back in 2005, my mother was diagnosed with stage IV uterine cancer and given months to live. While there is never a good time for this kind of news, the timing was particularly bad. I was adjusting (badly) to new motherhood, my father had recently passed away, and my husband had accepted a job offer in England.

Nothing could keep Mom away from her granddaughter, so despite her condition, plans were made for her and my sister to visit shortly after we moved abroad. Our main consideration was to work the trip in between her monthly chemotherapy treatments. That and to steal away to Paris – just another girls’ trip, albeit a more glamorous one.

Such travel isn’t unusual for terminally ill patients, according to Dr. Vincent Poirier, senior medical advisor at Air Canada. “We’re seeing it more and more. Medicine has evolved, making patients more stable. We used to see some who were not very prepared for last-minute travel, but now people are aware that it takes more time to plan, so they speak to their doctors and the airline medical desk. It’s a multidisciplinary involvement.”

We kept quiet for the first few days after their arrival in London, wandering through leafy parks and sampling cream tea. We were all so elated to be reunited that touring my new neighbourhood took precedence over exploring what-if scenarios. Preparation was light. Passports: check. Diaper bag: check. Power adapter: check. Packing extra pain medication and prescription refills somehow escaped our checklist. Her doctor’s consent was all the preparation we thought we needed.

Looking back, I was in denial that this trip was going to be any different. Mom’s exuberance over seeing her granddaughter distracted us all from how frail she was. There she was, keeping up on walks, eating like a champ and smiling constantly. Taking the high-speed Eurostar to France seemed like a non-issue.

Somewhere in that space and drizzle at the train station, I realized just how dangerous a situation I’d put my mom in. More trains kept stopping and booting passengers outside the station, where crowds reached 6,000 people. Nobody cared that I had a feisty toddler and a 70-year-old with a shot immune system. Taking matters into our own hands, we found an unguarded entrance and snuck back inside. There we would stand, in that unheated station, for the entire day.

We had plenty of time to worry about a lot of things. Would we ever get to Paris? Would we even make it home that night? Was I a bad mother for keeping my daughter strapped in her stroller for 10 hours? But a curious thing happened that day. The one thing none of us worried about just then was cancer.

Though Mom was cold and tired, she was determined. What sustained her during that dreadful day weren’t the four energy bars she was plied with but her attitude. She was pretty chill during the entire ordeal.

“Illness can prevent patients from doing things for a period of time, but going on a trip normalizes things for them,” says Dr. Jennifer Spratlin, a medical oncologist at Edmonton’s Cross Cancer Institute. “In my opinion, travel may be healthy for [terminally ill] patients, especially when considering their mental health and quality of life [circumstances permitting]. It can give them control over how they’re living their life.”

Our patience and perseverance eventually paid off: After officials determined a passenger priority list, we were put on the last train to Paris. The cause for the delay? A sudden sinkhole near the train track. Who has a contingency plan for that?

Arriving in the City of Light, 14 hours after departing my London flat, we couldn’t have been happier to see that cramped hotel room. Mom went straight to bed, and there she remained for most of the trip. The harrowing journey caught up with her, and she developed a cold.

Lofty plans for climbing the Eiffel Tower and meandering through grand museums were thrown out the window. Changing our game plan forced us to focus on and appreciate the little things: bizarre French commercials, pastries dunked in thick hot chocolate and the golden light shimmering on 17th-century buildings as the sun cast its last rays.

Restaurant reservations were cancelled and meals were eaten picnic-style on top of the bed. With a thriving market close by, we feasted on rotisserie chicken with garlicky roast potatoes, pungent cheeses and ripe, succulent plums. I can still see the juice dripping down my mother’s and daughter’s chins and hear the subsequent giggles. These are the memories that remain vivid.

Kelowna-based registered psychologist Irene Spelliscy reminded me that relationships aren’t fostered just by attending events or visiting places together. “The shared experience is important, but also paying attention to who people are and what they feel and think – this exchange fosters relationships,” she says.

To travel is to remove yourself. Being outside our regular environment allows us to shed the layers that seem to define us – or how we define ourselves. Cancer was a part of my mother, but as I witnessed in Paris, it wasn’t who she was. Leaving her past – and chemotherapy sessions – behind was the most rewarding aspect of her trip.

Travelling gives us more time to live in the moment. How? Spelliscy says it’s because we attend to more new, unfamiliar situations and the problem solving required in that setting stimulates us to pay attention to things we don’t see in our everyday life.

“Mindfulness gives us the space to slow down our thoughts long enough to recognize and be available for the moment,” explains Spelliscy. “Living in the present without judgment or expectation benefits our mental health. It gives people more freedom to experience positive emotions, instead of focusing on how things might improve or what’s missing. It allows us to suspend our judgment about what a situation means and just notice it – and all of its colours, smells, tastes and textures. These sensations bring us joy and provoke lasting memories.

Reality replaced optimism on our return to London. Mom was out of pain medication, but a sympathetic London doctor refilled her prescription. Forget the cost, we were grateful for our narrow escape. Instead of being defeated by our debacle, Mom took it in stride, chalking it up as a life lesson. She died in June 2008 but not before taking a second trip overseas to visit our family.

I’m grateful for that Eurostar fiasco. It taught me, a travel writer, that it’s not about getting to that dream destination against the odds or nailing your bucket list. Fulfillment lurks in that space between all the places you’re trying to get to. Sometimes, going nowhere is the best journey you can take.

Before you pack your bags, ask yourself…

Are you fit enough to travel? Remember, travel can be tiring and bathrooms may not be immediately accessible. Consider how these things may impact you.

• What diseases are endemic to the region you’re visiting? You don’t want to get Montezuma’s revenge in Mexico if you have colon cancer.

• Find out if you can get travel insurance. If not, consider the financial implications if you require hospitalization or an emergency flight back home.

• Who can travel with you? It’s important to find someone you can trust.

Are there medical facilities within a reasonable distance from your destination?

7 steps to a successful trip

MAKE SURE YOUR VACCINATIONS ARE UP TO DATE. Talk to your doctor, as certain live vaccines may not be appropriate, depending on your treatment.

2. BOOK THROUGH A TRAVEL AGENT. This can save you time and money in the long run. Most have suppliers around the world that can arrange medical requirements on the ground. Additionally, they can contact airline medical desks on your behalf and get “fit to fly” forms to your doctor. Anybody with a major medical issue should complete these forms one month before flying.

3. DON’T ASSUME YOU DON’T QUALIFY FOR TRAVEL INSURANCE. As long as your doctor verifies that you’re stable and controlled 14 to 90 days (dependent on age) prior to travel, you could be fine. “Stable and controlled” is defined as “having no change in treatment or medications.”

4. PACK EXTRA PRESCRIPTIONS. Keep all medications in their original bottles; with prescriptions in your carry-on luggage. Carry a letter from your doctor describing the medications you’re carrying (listing both the generic and commercial names), along with a prognosis note that summarizes your diagnosis and recent treatments.

5. ENSURE THAT YOU HAVE YOUR MEDICAL TEAM ON SPEED DIAL. Sometimes a quick call to your doctor or triage nurse can solve a problem.

6. PLOT OUT WHERE THE CLOSEST MEDICAL FACILITY IS. Knowing this ahead of time can save a lot of angst in case of an emergency.

7. EXPLORE WORST-CASE SCENARIOS. Do you want to be hospitalized or stay in your hotel room? Realize that your travel partner might panic and admit you to hospital anyway, whether or not you have travel insurance.