I recently headed off backpacking around Europe with my friend. You can see our route on the picture above. I was a bit apprehensive. It’s the first time I’ve travelled so far, I’d be travelling across 6 different countries, and the first time I’ve backpacked.


I wondered:

  • Will travel insurance be really expensive?
  • Should I take my Humira and Methotrexate injections with me?
  • What rucksack would be best for my back?
  • What do I do if I flare?


Sorting the travel insurance was easier than I expected. This was the first time I was going away and wouldn’t be covered by my parents’ travel insurance, and was the first time going away on my own while taking biologics.


I was worried it would make insurance really expensive, but actually I got a years worldwide insurance with winter sports included for just over £40! Not bad at all!

I shopped around and found a company that suited me best. I was surprised that none of the insurance questions about my arthritis asked if I was taking medications that could suppress my immune system. I was so surprised that I actually called the insurance company I used to make sure that I hadn’t missed anything on the form. I was assured I had completed it correctly.


My holiday crossed two biologic and DMARD injections. I was worried about storing Humira. When you’re travelling in hot countries, living in hostels with fridges that are shared with everyone in the hostel and living out of a backpack, how are you supposed to make sure you have stored Humira at the correct temperature?


I talked to my Biologics Nurse who spoke to my consultant and together they decided that I could take both medications Humira a day before I travelled and not take my next dose until the day I got back from my travels. Phew!! That was one big worry off my plate!

My Biologics Nurse and I also discussed how to stay safe, I was encouraged not to drink water from fountains that didn’t specifically say they had safe drinking water, and to be careful when eating food from street vendors to reduce the risk of getting any infections whilst away. We also briefly talked about flares and decided that I should take my NSAIDs with me while away just in case of a flare.


Then I had to think about what backpack would be appropriate to carry everything I needed and didn’t hurt my back. I reached out to the NASS who put a post on Facebook asking for opinions, and the consensus was one that had a hip belt.


Then I went out to a local outdoor shop that had a selection of rucksacks with various designs to try. I finally settled on a bag with a detachable smaller rucksack and had both a hip and chest strap. I felt that this gave me quite a lot of support with the weight of the back and didn’t hurt my joints once I had adjusted it so that most of the weight was on the hip/waist strap. I definitely think going to the shop and trying out a few different bags was worth it, then I could find one that was the most comfortable for me.


In terms of the actual travel on flights over to Dubrovnik and back from Prague, I wasn’t too concerned. I researched all the airports we were flying from and to before going away and found that none of the airports were that big and some only had one terminal, which meant that I felt I would be able to get around without enquiring about accessibility.


The same went for the flights, I felt that my joints were good enough that I didn’t need to book an aisle seat and I could leave those free for someone who might have needed them more than myself.

The travel I was most concerned about were the long bus trips and the single overnight bus that we took between Dubrovnik and Zagreb. I wasn’t sure how my joints would like spending the entire night in a sitting position. Perhaps fortunately, the toilet was broken on this bus, which meant we stopped regularly for toilet breaks, which was an opportunity to walk around. I decided that for most of the bus journeys the best way the pass the time was to catch up on some much needed sleep. This worked for the most part but I should have taken a travel pillow as my neck did bother me.


All in all, the holiday was excellent and my arthritis was really well behaved. There were some days that we were walking 31,000 steps up and down steep hills, which would have been really difficult for me if I hadn’t been on an appropriate treatment plan.


We tried to incorporate rest breaks into our day by making a rough outline of what we wanted to do and taking our books with us so that if we found a nice spot in the shade, we could have a break and relax. I think a big factor in my arthritis not flaring was that we considered how to get from the bus stops to the hotels and selected our hostels based on their reviews and the length of walk from where our bus was dropping us off. This meant that we were often not walking longer than 30 minutes with our heavy rucksacks, which I think contributed to how well my joints felt while we were away.


Jenni is a 21 years old, fresh out of Uni Physiotherapist, you can follow her story on youngarthur.blogspot.co.uk

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