How a cancer, diabetes and heart disease survivor travel around: Here’s their playbook

“Insulin won’t survive checked-in luggage, extreme temperatures or misplaced bags,” says Lalvani, who has been living with Type 1 diabetes since the age of eight. She set up the NGO Blue Circle Foundation, a patient-led organisation and support group for empowering people living with all types of diabetes and caregivers. “Apart from essentials, the diabetes kit — insulin, continuous glucose monitoring (CGM) sensors, glucose tablets, backup insulin and syringes — is a key component,” says Lalvani. “Insulated pouches are a must for insulin, especially when travelling in very hot weather. Control is often an illusion, and travel has a way of proving that quickly. So be prepared,” she adds.

Food becomes a negotiation the moment one enters an airport, which Lalvani feels, is built around carbohydrates. (Express Photo)

However, food becomes a negotiation the moment one enters an airport, which Lalvani feels, is built around carbohydrates. “Instead of fighting that reality, I work around it by making intelligent choices, prioritising protein, eating low carb and sometimes doing intermittent fasting. At my destinations, I pick foods that work for me. This isn’t about restriction, it’s about reducing unnecessary glycemic volatility,” she explains.

Technology is also a helpful tool during travel. A CGM means Lalvani does not have to guess how stress, long walks across terminals, disrupted sleep or unfamiliar food are affecting her blood sugar. “I watch trends instead of reacting to single numbers on my glucometer, something that becomes crucial when routines disappear entirely. CGMs are expensive and we advocate for affordable healthcare,” she says.

Lalvani also clears airport security by carrying a Blue Circle Diabetes Foundation Diabetes ID card and uses the Hidden Disabilities Sunflower Lanyard, which is now recognised at a few airports in India and many around the world. (Some disabilities, conditions or chronic illnesses are not immediately obvious and wearing the Hidden Disabilities Sunflower discreetly indicates to staff and health professionals at the airport that the person needs additional support, help or just a little more time).

Time zones also bring their own challenges and Lalvani usually sticks to her home time zone for basal shots and adjusts gradually if needed, watching patterns rather than making abrupt changes. “Climate plays a bigger role than most people realise. Heat, cold, and humidity all affect blood sugar and hydration. Hence living with type 1 diabetes means carrying an invisible responsibility wherever we go,” she says.

Travel has taught Lalvani patience, self-trust and adaptability. “It has also reminded me to ask for help when you need it, lean on the community and keep moving. Life with diabetes can be inconvenient and unpredictable but it can still be absolutely worth the trip,” she says.

**********

Cancer isn’t the whole story

Sikkim-resident Kanti Tiwari, 64, has been travelling to Delhi every month for chemotherapy after being diagnosed with ovarian cancer in June. While her journey on local taxis and flights is strictly managed, she had a bad bout of nausea while attending a family function. “Although we took all precautions, she still became extremely nauseous on the winding hill road. She needed medicine to prevent nausea and vomiting,” says her daughter Priya Khadka.

When they travel to Delhi for her treatment, they take a taxi from Gangtok in Sikkim to Siliguri in Bengal and then board a flight from there. They pack bottles of boiled water and the entire day’s meal — fruits, dry fruits and eggs to munch on while waiting at the airport, and a simple meal of rice, vegetables, and chicken or fish for dinner when they land. They leave for the hospital the next morning, come back and cook at the homestay they check into, have dinner and take the flight for Siliguri the next morning. “My mother has bland food so that she does not get nausea or GI infection. Her immune system is too weak but we plan our journeys in such a way that we can make fresh meals. The idea is to break down the journey in a way that doesn’t tire her out or make her sick,” says Khadka. Tiwari is always masked up outdoors to avoid respiratory infections. She packs loose clothing, a light blanket, neck pillow, compression stockings and hand sanitiser.

Tiwari is always masked up outdoors to avoid respiratory infections. (Express Photo)

“It is essential that all cancer patients — those undergoing treatment or those who have just finished it — take some precautions to prevent infections. Like sanitising surfaces and hands. Not getting a urinary tract infection is essential when it comes to gynaecological cancers such as ovarian, endometrial, or cervical cancers. People can avoid using public washrooms as much as possible or they may use products such as sterilising sprays or receptacles that allow women to use the washroom standing up. This may reduce their risk of getting a UTI. Anyway while travelling, many patients tend to drink less water because they do not want to use the washroom frequently, this also increases the risk of a UTI,” says Dr Pakhee Aggarwal, senior consultant of gynaecological oncology at Delhi’s Indraprastha Apollo hospital. “Patients should eat freshly-cooked simple meals when they are travelling. Protein supplements and other nutritional supplements may be added as per requirement,” she adds.

She advises that a medicine kit — containing common over-the-counter medicines for diarrhoea, fever and vomiting and other specific conditions — should be carried along with cancer medication. “Importantly, the survivor must listen to their bodies while doing any physical activity. Patients usually ask me whether they can dance when they go to a wedding. I tell them they can absolutely shake a leg but they should not stress out their body. The body gives us signals — aches, pains, and tiredness — we usually think it is nothing and we can push through it. Cancer patients should learn to be mindful of these cues and listen to their bodies,” says Dr Aggarwal.

Patients — even those who have just completed treatment — should not undertake any strenuous activity, especially of the kind they had not attempted before their diagnosis. “Cancer patients should start physical activity about four weeks after their surgery or treatment completion. And, even then, they should begin at 50% of what they used to do and gradually scale up. If someone is starting a new activity, they should do it under strict supervision of a trainer,” said Dr Aggarwal.

*********

Heart-healthy in the air

When 52-year-old Chandan Singh, a businessman with coronary artery disease, had to travel from Delhi to Assam for a work meeting after a procedure, anxiety set in long before the journey itself. The concern was not his work, but the long flight, a change of weather and the fear of something going wrong mid-air. He drew up a plan after a detailed discussion with his cardiologist, Dr Varun Bansal, senior consultant, Cardiothoracic and Vascular Surgery, Indraprastha Apollo Hospitals, Delhi. In fact, Dr Bansal coordinated with a local doctor in Assam for local support should the need arise.

Singh organised his medicine packs, including emergency doses and medical reports, and kept them in his cabin bags. On the flight, he opted for a very light meal and kept himself hydrated. He travelled comfortably and his fear was gone for subsequent travels.

According to Dr Varun Bansal, patients travelling across cities and countries for work, leisure or treatment, frequently ask whether their heart can handle long flights, train journeys or extended road travel. “Most fears revolve around fatigue, missing medicines, or the possibility of a sudden health issue while away from home. However, travel is often safe when the heart condition is stable and properly assessed,” he explains.

The focus should be on planning rather than avoidance. Before any domestic or international journey, heart patients should discuss their travel plans with their specialist, understand their individual risks and recognise warning signs. At the airport, carry certificates for any device that has been implanted like pacemakers and cardioverter-defibrillators. Patients should research local hospitals and emergency contacts.

Comfortable modes of transport and sufficient rest can significantly reduce stress on the heart. “Patients should avoid uninterrupted long journeys and plan breaks wherever possible. Moving the legs, stretching and walking during flights or train travel helps circulation. Staying hydrated, avoiding alcohol and smoking, and not lifting heavy luggage are essential precautions. Monitoring symptoms such as chest discomfort, breathlessness, or dizziness and keeping emergency contacts accessible can be life-saving,” says Dr Bansal.

Diet plays a crucial role during travel. Light, easily digestible foods such as fruits, vegetables, curd, soups and simple home-style meals are recommended. Oily, salty, fried or processed foods, especially those at the airport or roadside eateries, should be avoided. Smaller, regular meals and adequate water intake help prevent bloating and blood pressure fluctuations.

A basic health review before travel helps confirm that the patient is stable. This usually includes blood pressure checks, an ECG, and tests relevant to the existing heart condition. “Any recent changes in symptoms or medication should be discussed beforehand to ensure the journey does not interfere with treatment or recovery,” advises Dr Bansal.

Patients should carry all prescribed medicines in sufficient quantities, along with extra doses in case of delays. “Medicines should be kept in hand luggage during flights, accompanied by prescriptions and a brief medical summary. For international travel or time zone changes, medicine schedules should be discussed with the doctor in advance, says Dr Bansal.

Mild and moderate climates are generally better suited for heart patients. Extreme heat, humidity, cold, or high-altitude locations can increase strain on the heart. Allowing time to acclimatise and taking additional precautions in challenging weather conditions can make travel safer and less stressful. “Heart disease does not mean putting life on pause. With proper medical advice, thoughtful planning and awareness, patients can travel safely,” adds Dr Bansal.