Traveling with Multiple Sclerosis (MS) presents unique challenges, leading many to wonder if air travel negatively affects their health. MS is a chronic condition where the immune system attacks myelin, the protective sheath covering nerve fibers in the central nervous system, disrupting communication between the brain and the body. Current evidence suggests that flying does not accelerate the overall disease course or make MS permanently worse. This article provides guidance on the actual impact of flying and offers strategies for comfortable travel.
Impact on MS Disease Progression
The central concern about flying relates to the unique environment of an airplane cabin, specifically changes in cabin pressure and reduced oxygen levels at altitude. Medical research does not indicate that these physical factors accelerate the fundamental progression of Multiple Sclerosis. Flying does not cause new lesions or permanently worsen long-term disability.
The cabin environment is pressurized, but still exposes passengers to an atmosphere equivalent to 6,000 to 8,000 feet above sea level. This results in a mild reduction of oxygen saturation, but this level of hypoxia is not recognized as a trigger for an MS relapse or increased disease activity. Changes in barometric pressure are generally not considered factors that influence the underlying pathology of the disease. The challenge shifts from a disease threat to managing temporary physiological stressors.
Managing Temporary Symptom Flare-Ups
While flying does not worsen the underlying disease, the environmental factors associated with air travel can temporarily exacerbate existing MS symptoms, known as a pseudo-exacerbation. The most common trigger for this temporary worsening is heat sensitivity, known as Uhthoff’s phenomenon. A slight increase in core body temperature, caused by a warm cabin or waiting on a hot tarmac, can temporarily block nerve signal conduction in demyelinated fibers, making symptoms like fatigue, vision issues, or muscle weakness more pronounced.
To mitigate the effects of heat, wearing clothing in layers allows travelers to adapt quickly to fluctuating cabin temperatures. Packing a cooling vest, neck wrap, or a small portable fan can provide personalized temperature control, especially during boarding or deplaning where air circulation might be limited. Securing an aisle seat near an air vent may also help with temperature regulation and allow easier movement.
Travel-related fatigue stems from the stress of navigating airports, changes in routine, and time zone shifts. It is beneficial to choose direct flights whenever possible to minimize the physical strain of layovers and gate changes. Taking advantage of the flight time to rest, such as using a travel pillow and headphones, helps conserve energy for the rest of the trip.
The dry air within the airplane cabin can also contribute to dehydration, which may worsen overall well-being and potentially aggravate bladder dysfunction, a frequent MS symptom. It is helpful to increase fluid intake, focusing on water and avoiding alcohol or excessive caffeine, which have dehydrating effects. People with bladder issues may consider booking a seat close to the lavatory and utilizing airport assistance to minimize long walks to the restroom.
Essential Travel Planning and Logistics
Successful air travel with MS depends on thorough preparation and proactive communication with airlines and healthcare providers. Before booking a trip, consulting with a neurologist or MS specialist is important to review current health status and adjust medication schedules. This consultation can also yield a personalized letter explaining the necessity of carrying syringes or specific medical equipment.
Medication management requires planning to prevent loss or damage. All MS medications, particularly injectables, should be packed in a carry-on bag to avoid exposure to extreme temperatures or pressure changes in the cargo hold. For refrigerated medications, an insulated bag with a freezable ice pack is necessary, and travelers should be aware of how long their specific drug can remain at room temperature. Keeping medications in their original, clearly labeled containers helps streamline airport security screening.
Mobility and airport navigation can be significantly eased by arranging assistance well in advance of the travel date. Airlines and airports are equipped to provide wheelchair or electric cart services from check-in to the gate, and this assistance should be requested at the time of booking. For passengers using personal mobility devices, confirming the airline’s policy on storing and handling equipment, and removing detachable parts before storage, helps prevent damage. Utilizing pre-arranged assistance allows travelers to bypass long lines and conserve energy, reducing overall travel stress.