Travel Tips For Kidney Transplant Recipients To Belize

Travelling after a kidney transplant is possible, but it requires extra planning. It is recommended that kidney transplant recipients wait at least six weeks before driving, six months before travelling abroad, and 12 weeks before returning to work. However, the type of work done may require more recovery time, and travel outside the continental US is not recommended for the first six to 12 months. When travelling, it is important to take extra medication, keep it in its original packaging, and carry it onto the plane. It is also important to be aware of the risk of greater sun exposure and to take precautions to protect the skin.

Vaccinations and medication

Vaccinations are a critical aspect of travel preparation for kidney transplant recipients, as they are at an increased risk of developing infections, including vaccine-preventable diseases. Here are some essential considerations for vaccinations and medication when planning a trip to Belize:

• It is recommended to consult a doctor about special vaccinations or medications required for the specific region you will be visiting.
• Inactivated vaccinations: Kidney transplant recipients should receive age-appropriate inactivated vaccinations as recommended for the general population. Inactivated vaccines are generally considered safe for kidney transplant recipients and can be administered after transplantation. Examples include pneumococcal, influenza, hepatitis A and B, tetanus-diphtheria, and Haemophilus influenzae type b vaccines.
• Live vaccines: Live attenuated vaccines are contraindicated for kidney transplant recipients due to the risk of infection. Examples include measles-rubella, varicella (chickenpox), oral polio, bacillus Calmette-Guerin (BCG), and live oral typhoid vaccines. If a live vaccine is required, it is recommended to receive it at least four weeks before transplantation.
• Pre-travel vaccinations: If traveling to endemic areas, additional vaccinations may be necessary. For example, if traveling to areas with a risk of yellow fever transmission, a yellow fever vaccine is required. Other recommended vaccinations for Belize include typhoid, polio, chikungunya, rabies, COVID-19, pneumonia, meningitis, shingles, and measles, mumps, and rubella (MMR).
• Medication management: It is crucial to bring an adequate supply of medications and keep them in their original bottles. Carry them with you during travel, especially when flying, to ensure easy access and avoid losing them. Additionally, be mindful of timing your medication doses, especially when crossing multiple time zones.
• Sun protection: Transplant medications can increase sun sensitivity, so pack and use proper sun protection, including hats, sunscreen, and long-sleeved clothing. Avoid excessive sun exposure during peak hours.
• Food and water precautions: Practice safe food and water hygiene to minimize the risk of diarrhea and other infections. Avoid tap water, and opt for bottled water for drinking, brushing teeth, and washing food. Be cautious with ice, and avoid raw or undercooked foods, except for peeled fruits and vegetables.

Travel safety during COVID-19

As a kidney transplant recipient, it's important to take extra precautions when travelling during the COVID-19 pandemic. Here are some essential tips to ensure your safety:

• Stay up to date with vaccinations: It is recommended that everyone, including high-risk groups, stay up to date with the latest COVID-19 vaccines to prevent severe illness and hospitalization. Even if you've been vaccinated early in the summer, consider getting the updated vaccine in the fall for better protection against circulating variants.
• Get tested for COVID-19: If you experience any symptoms, no matter how mild, get tested for COVID-19. Antigen tests are widely available at drug stores and pharmacies. If you test positive, follow the latest CDC guidelines for isolation and wear a high-quality mask when interacting with others.
• Avoid travelling if positive: If you test positive for COVID-19, it is recommended that you do not board a plane or engage in other forms of travel, as you risk infecting others. Follow CDC guidelines and only end isolation if you are fever-free without medication for a day and your symptoms have improved.
• Notify travel companions: If you test positive during your trip, immediately notify anyone you are travelling with and modify your plans as necessary. Follow local guidelines and avoid indoor group events or meals where you cannot wear a mask.
• Take preventative measures: When travelling, take preventative measures such as wearing a high-quality mask, maintaining physical distance, and practising good hand hygiene. Consider getting a Paxlovid prescription before your trip, especially for international travel, as it can reduce your infectiousness and the duration of your illness.
• Check travel restrictions: While COVID-19 travel restrictions may be a thing of the past, it's still important to check the U.S. Department of State's list of countries and their health entry rules and travel advisories before planning your trip.
• Plan for potential delays: When travelling as a kidney transplant recipient, always carry more medication than you think you'll need. Take your medications in their original bottles, and keep them with you in your carry-on luggage to avoid losing them if your checked luggage is delayed or lost.
• Adjust your medication schedule: Time your medication doses according to the time zone changes at your destination. Consult your doctor to determine your medication window, and consider setting a watch to your home time zone for reference.
• Take precautions in the sun: Transplant medications can make you more sensitive to sun exposure, so be sure to pack and use proper sun protection, including hats, sunscreen, and long-sleeved shirts. Limit outdoor activities during peak sun hours, usually from 10 am to 4 pm.
• Practice safe eating and drinking: Avoid uncooked foods and be cautious about drinking tap water when travelling, as people who are immunosuppressed are more susceptible to catching diseases. Stick to bottled water and well-cooked or peeled fruits and vegetables.

Remember, having a kidney transplant doesn't have to keep you from travelling; it just requires some extra planning and precautions to ensure your health and safety during the COVID-19 pandemic.

Exercise and physical activity

Exercise is important for kidney transplant recipients as it improves cardiovascular function, regulates blood pressure and blood sugar, and reduces the negative side effects of immunosuppressant drugs. Cardiovascular health is also the main contributor to post-transplantation mortality, so it is important to reduce the risk of cardiovascular disease through exercise.

Before starting an exercise program, kidney transplant recipients should consult their doctor to determine their suitability. The duration of rest required before beginning to exercise depends on the patient's age and health condition. Generally, patients can start with light-intensity, low-impact exercises such as walking. Once their fitness level has improved, they can incorporate strengthening exercises into their routine.

Transplant patients can aim for 60 minutes of activity 2 to 3 times a week, including both aerobics and resistance training. If time or fitness level is a concern, shorter durations of 20 minutes several times a day can also be beneficial. It is recommended to exercise at least twice a week.

Some examples of moderate physical activities include brisk walking (5.5 km/h), hiking, dancing, cycling (less than 15 km/h), or gardening. Vigorous activities include jogging/running (8 km/h), swimming laps, biking (more than 15 km/h), aerobics, and team sports.

It is important to be cautious and avoid heavy contact sports such as rugby, martial arts, boxing, football, or ice hockey, as these can risk damaging the new kidney.

When travelling, it is beneficial to incorporate physical activity into your routine. For example, you can walk during your lunch break, take the stairs instead of the elevator, or park farther away from your destination to increase your walking distance.

Remember to always consult your doctor or healthcare provider for personalized advice and guidelines regarding exercise and physical activity after your kidney transplant.

Diet and food

Belizean cuisine is a rich medley of Maya, British, Spanish-American, African, Indigenous, Caribbean, and Creole cultures. The diet of a kidney transplant recipient travelling to Belize should be well-planned and based on their medical requirements. Here are some tips and insights into the local food and diet in Belize to help you plan your trip:

• Breakfast: A typical Belizean breakfast includes sides of bread, flour tortillas, or fry jacks, often homemade and accompanied by various cheeses, refried beans, eggs, and tea or coffee. Cereal with milk is also common.
• Midday Meals: Lunches can vary from lighter options like rice and beans, tamales, panades (fried meat pies), and various soups to heartier meals featuring rice and beans, meat, and salad or coleslaw.
• Dinner: For dinner, you may find dishes such as rice and beans with meat and salad, seafood including fish, conch, and lobster, or game meats like iguana, deer, peccary, and gibnut.
• Local Specialties: Belize has a diverse range of local specialties due to its multicultural population. The Garifuna community, for instance, is known for their cassava-based dishes, including ereba (cassava bread) and hudut (a fish stew with a coconut milk base). The Maya are known for their chocolate, tamales, and masa (corn dough). Creole settlers brought rice and beans, hearty soups, and engaging spices to the local cuisine.
• Seafood: With its coastline along the Caribbean Sea, seafood is a prime component of the Belizean diet. Conch fritters, made with diced conch, onions, garlic, peppers, and flour, are a popular dish. Other seafood options include grilled, broiled, or steamed spiny lobster, snapper or grouper prepared with lime juice, and ceviche made with conch, shrimp, cucumbers, tomatoes, and onions.
• Spices and Sauces: Belizeans enjoy their food spicy, and hot sauce is a common condiment. Marie Sharp's Habanero Pepper sauces, made with fresh peppers and produce, are a local favourite. Another popular sauce is bos a pepa, made from habanero or jalapeño peppers.
• Drinks: Belikin is a local beer that is widely loved by Belizeans. The country also has a range of wines made from berries, cashew, sorosi, grapefruit, and rice.
• Desserts: Cassava pudding, a Garifuna specialty, is a tasty dessert made with grated cassava, sugar, ginger, nutmeg, cinnamon, coconut milk, and eggs. Other sweet treats include wangla, powderbun, cakes, pies, and potato pudding.
• Street Food: Garnaches, a popular street food, consist of fried tortillas topped with refried beans, onions, shredded cabbage, tomato salsa, and cheese. Meat pies, filled with chicken, beef, or pork in spicy gravy, are another tasty snack.
• Dietary Considerations: It is important to be cautious about consuming uncooked foods and tap water. To minimize the risk of diarrhoea, stick to peeled fruits and vegetables, and consider carrying anti-diarrhoea medication. If you have dietary restrictions, be sure to plan ahead and bring snacks that accommodate your needs.

Remember to consult with your doctor or healthcare provider before your trip to Belize, and follow their recommendations regarding your diet and food choices while travelling.

Skin and sun exposure

Skin cancer is the most common cancer to develop in organ transplant recipients. Transplant medications can make patients more sensitive to sun exposure and more susceptible to skin cancer. Squamous cell carcinoma is the most frequent type of skin cancer found in transplant patients; it is 65 times more common in people with transplants than in people without transplants. Other forms of skin cancer, including basal cell carcinoma and melanoma, are also more common in transplant recipients.

There are three important steps that you can take to reduce your risk of skin cancer:

• Protect yourself from the sun. Sun protection starts with the regular use of sunscreen. Pick a sunscreen with an SPF of at least 30. If you have had skin cancer or are very fair-skinned, a higher SPF of 50 or 75 may be preferable. It is important to use a sunscreen that is labelled "broad spectrum", meaning it protects against UVA and UVB rays. All sunscreens should be applied 15-20 minutes before going outside and must be reapplied every 2 hours. Using a large enough quantity of sunscreen is also important. Sun-protective clothing and hats are great ways to get long-lasting protection throughout the day. A regular white t-shirt does not provide much protection, but newer lightweight UV-protective clothing can. Seeking shade between the hours of 10 am and 4 pm and using extra caution around water, sand, and snow are also important.
• Perform skin self-exams. In addition to sun protection, it is important to examine your own skin once a month. This way, any worrisome spots that do occur can be identified and treated without delay. You will often be the first person to notice a new or changing skin lesion. When you check your skin, be sure to look at all areas, including your scalp, hands, feet, genitals, and even your nails. Skin cancer can occur in areas that are not exposed to the sun. Having a partner or friend look at areas that are difficult to see can be helpful. You should seek medical attention for any red or scaly areas, bleeding or scabbed spots, painful lesions, or changing moles.
• See a dermatologist for a full skin examination. Even if you do not notice any areas of concern on your skin, you should have a doctor check all of your skin at least once a year. Your doctor may be able to find skin cancers and precancerous lesions before they become visible to you. Patients who have multiple skin cancers may need to see their dermatologist more frequently, even up to once a month. For higher-risk patients, there are medications and treatments that can be used to address precancers and decrease the rate of skin cancer development.

Frequently asked questions