69. Traveling with a Chronic Disorder with Dr. Linda Bluestein, Kristin Koskinen RDN, and Jennifer Milner NCPT

Episodes have been transcribed to improve the accessibility of this information. Our best attempts have been made to ensure accuracy,  however, if you discover a possible error please notify us at info@bendybodies.org

00:00
Dr. Linda Bluestein
If you don't have your pit crew, really important to have your list of medications, your one sheet. And then you can have your one sheet, and then you can have like your three sheet version of the one sheet. But I would always have the one sheet. Always be ready to offer more information, but start with the really super succinct version. 

00:32
Jennifer Milner
Preparing for a trip is never easy, but if you have chronic health issues like EHR Danlow's syndrome, mast cell activation disorder, or Dysautonomia, your health issues may need their own suitcase, both emotionally and physically. How can we prepare? With prudence and forethought, yet travel fearlessly. Welcome back to the Bendy Bodies podcast, bringing you state of the art information to optimize your health. This is co host Jennifer Milner, a former professional ballet and Broadway dancer who struggled for years with hypermobility related problems. Now I train dancers to ensure the next generation of hypermobile artists are better equipped to work to their fullest potential. 

01:09
Dr. Linda Bluestein
I am Dr. Linda Bluestein, the hypermobility MD. I started Bendy Bodies to provide accessible information about joint hypermobility. Combining my medical education and personal experiences enables me to treat and coach patients and clients to optimize their quality of life. This information is for educational purposes only and is not a substitute for medical advice. Today we've got bendy bodies. 

01:32
Jennifer Milner
Team member Kristen Koskinen. RDN back with us. Kristen, hello. Hello. And can you tell everybody who doesn't know you? Can you tell them about yourself? Sure. 

01:43
Kristin Koskinen
I'm a registered dietitian nutritionist. I grew up as a dancer and now I work with dancers and hypermobile people of whom I have hypermobile people in my family to help navigate this somewhat convoluted world that can be fun and exciting and confusing to find best results for performance and for life. Excellent. 

02:06
Jennifer Milner
And we appreciate all of that excellence that you have to offer everybody. So Kristen is going to help us tackle the topic of traveling today. Traveling with a hypermobility disorder or a chronic illness can have its own set of challenges. So we are here to give you some handy suggestions. Let's start with the time leading up to traveling. Do you guys have one or two tips as you prepare for the trip? Linda, what do you got for us? 

02:33
Dr. Linda Bluestein
A couple quick things. So I would think about time zone changes. So are you going to be going east or west? A significant enough amount that you will be in a different time zone? And if possible, start thinking about possibly changing your sleep cycle a little bit so that when you get there, maybe it'll be a little bit easier for you. Also, you can start thinking about the timing of your medications beforehand, so it's easier to do these things before you have the haste of the actual travel itself and or the exhaustion and things like that. So I would plan the timing of the medications beforehand and also start thinking about where you're going? Is it likely to be super dry, super humid? What is the weather likely going to be that is really helpful? 

03:23
Jennifer Milner
Just sort of planning what's coming up in your life, like time zones is something that I don't always I mean, I think about it like, oh no, I'm not going to be able to sleep. But other than that I don't think about it. Preparing medications is also really great. Kristen, what do you have for us? 

03:37
Kristin Koskinen
I would just dovetail on what Linda said and planning is absolutely essential. So we know people with Ehler Stanley's come with a lot of different others, right? Whether it's MCAs, Pots, any sort of neurodivergence. And so the planning can be really important, one that helps to remove anxiety. You really can have a degree of control and we know anxiety can flare any of those conditions. So one, let's plan and the things that planning that go for medications can go for food too. So if you arrive and you know you have GI issues and now you're in a time zone that's two or 3 hours different than your own, how's that going to relate to you and to eating? Particularly if eating is something that can be a challenge to you at home. Number two, sometimes people do better or worse in different parts of the country. 

04:29
Kristin Koskinen
So I have people who live, say, in Denver, clients who live in Denver who may not do as well in Denver because of altitude or temperature, but when they travel south to someplace closer to sea level, maybe warmer, all of a sudden their symptoms start to back off and resolve a bit. And it actually gives them the opportunity to eat in a way that's more liberalized than they do at home. And so that's something that we can look forward to. And for clients that I work with, we use as a planned strategy to see what they tolerate when those other stressors, those environmental stressors are off their plate. I would include looking at places when you're traveling that may be more damp or humid and if mold is an issue, to simply be aware of that and how much control you have over that, you may not. 

05:19
Kristin Koskinen
But if your symptoms start to flare just to be able to keep in mind whys can be helpful. So definitely plan and looking at and before you leave home, we need to know how are you traveling? Is it by plane, train, automobile, boat? If you're traveling by plane, you're going to have a different set of circumstances simply getting from here to there than if you're going by car. So if you're traveling by plane, depending on what your circumstances are and what your limitations are and what you really need to have for food, for beverage, for supplements, all those things, plan in advance. Make sure that you have room in your carry on luggage and personal luggage for the essentials so your personal bag, your purse, your body bag, whatever, you really have to have that planned out because you might have lots of things that go in there. 

06:14
Kristin Koskinen
Number two, look at getting. 

06:18
Dr. Linda Bluestein
A card. 

06:19
Kristin Koskinen
From TSA or through your physician so that you have some pre screening options if you need to take specific foods to take your meds, to keep your Pots under control, whatever it is. Because you have MCAs and you can't eat what's on the plane because you're already going to be maxing your physical components. Check and see the rules change, right? We just know rules change as we go. So check with TSA in advance to get a medical exemption card. The endpoint, from what I understand at this junction, is that the TSA agent kind of determines what goes and what's not. There's been some recent information about peanut, but are not going through or whatever because it's a gel. So know what you can get through easily, know what may be a problem. Have everything marked very clearly. Don't have mystery white powders going through TSA if you can keep things in original containers so they're not guessing because you may look a little suspicious. 

07:13
Dr. Linda Bluestein
With your meds, your SUPs and all. 

07:15
Kristin Koskinen
The things people could have dabs of that. Make the system easy on the people you need to help you so that things go as smoothly as possible. So plan then, plan and have a plan B, and maybe even have a plan C, because if you have all that stuff in place, you're going to minimize the anxiety when you get there. Start planning two or three weeks out if you can, because it may be a lot and you may not have the energy spoons to do all that at once. Have other people help you with that planning too. If someone else can contact your physician or TSA, your airline, see what your airline will allow. A lot of times they will say as you're boarding a plane, there are FDA regulations, you can only have two bags if you qualify for a different exemption. Check with the airline, make sure you have all those things in place. 

08:07
Kristin Koskinen
Print out anything you've received from someone in authority that you can have because not everyone will know the information you have and they have rules and guidelines that they're expected to follow. So if you deviate from those rules or guidelines, just make it as easy as you can on everybody so that those accommodations go through. 

08:26
Jennifer Milner
Those are really great suggestions and I love thinking about how can you help the people you're going to be encountering further down the road so that it will go as smoothly as possible. So Dr. Bluestein talking about time zone changes and Kristen talking about altitude changes. These are all things that a lot of people take for granted, but that we aren't necessarily able to take for granted. And so we do need to think through so these are great. Thank you. I would say, from my point of view, I think it's really important to plan what you're going to be doing movement wise before you go. So if you're going to go to hike the Grand Canyon, don't start the week before you go, right? If you have these goals and these things you want to accomplish, as Kristen said, talk about look at the altitude and look at what that's going to be. 

09:19
Jennifer Milner
I have hiked the Grand Canyon, I have not hiked the whole thing, but I have seen what those altitude changes do to healthy people and knew my limitations. So from a physical point of view, if you're going to be doing something, if you want to take a walking trip of Europe, you want to start planning several months ahead of time, start building up that stamina and look for people to help hold you accountable, people to encourage you, whoever you're going to be going on the trip with, maybe checking in with them and talking to them about it. If you have a personal trainer or a Pilates trainer or a yoga trainer that you work with, even if it's in a group class setting, speak with them and get tips from them about what to do while you're off on your own. They know your body by then. 

09:59
Jennifer Milner
They can give you some great release moves that you might need when you're tight. They can say, hey, if you're going to be going into this different altitude, let's train your cardio a little bit differently. Talk to your doctor if you have Dysautonomia like pots and say, are there signs and symptoms? I should be aware of things that are going to tell me, hey, I'm pushing my limit. You probably already know what those are. But in a different situation, it may not present itself the same way. So from a preparation point of view, for me, it's all about starting to build up that strength and endurance, planning a long time ahead of time, as much as you know, for being able to keep moving on your trip, but not overdoing it by being physically prepared. So while we are talking about all of this as we're packing, we haven't gone on the trip yet. 

10:51
Jennifer Milner
What is one thing that you cannot live without while you are traveling? Linda, let's start with you. 

10:57
Dr. Linda Bluestein
Well, I'm sitting on a cushion right now, so I always go with it with a cushion, but I'm always sitting one in the car, so I just take it out so I don't have to pack it, per se. But I do almost always start with my medications and supplements because that takes quite a bit of time to get those organized. Because I have all of my regular daily medication that I have, and then I have also my as needed medication, and then I have extra baggies with extra antihistamines and extra things for immune support. And what if I have a pain flare? Or I have these extra things that I rarely ever use, thank goodness, but I want to be prepared just in case. And I always carry these in my carry on. It kind of drives my husband crazy, but I don't want to be separated from my medications if I can possibly avoid it. 

11:50
Dr. Linda Bluestein
I also always bring at least two to five extra days of medication, depending on how far I'm going and how long I'm going to be gone, because you just never know if something could come up and you end up having to stay longer. Medication is supposed to be in its original package, and I'm glad Kristen brought that up. It's not always practical. So another option is to if you put things in baggies and containers like that, like a lot of people do, just to make it more condensed, then it's a very reasonable thing to take pictures of every bottle of your medication and also bring a record from your pharmacy of all your prescriptions. And then the last couple of things. I always keep a baggie with the absolute most essential things, like, actually on my person, so in a zipped pocket, and then you can carry, like, a small flexible flask, so you have a little bit of water that you can have in your jacket pocket without having to worry about a backpack or a bag. 

12:47
Jennifer Milner
Wow, that's a great tip to think about, having just that little bit on your person. I hadn't even thought of that, but now I'm mildly obsessed with it. Kristen, what about and you know what? Before I move on, I will say I have traveled a bit with Dr. Bluestein, and it is true, she does have that little cushion that has a little handle thing. And it's so smart because you don't know what you're going to be sitting on. You might be sitting on the floor of the airport for 12 hours. So I have great respect for that. That's a really great choice for your essential. Kristen, what about you? What can you not live without while traveling? 

13:20
Kristin Koskinen
I would say probably taking a water bottle because you can get it through TSA. And so we're speaking now, just air travel, because that's the most restricted, right? So I would say some sort of fluid container, because you can do a lot with it. So one, if it's big enough and it depends, you can take something very small or even I like what Linda said about having the small flask. If you could have a botabag or something for water that you could keep on you. But really, if you get stuck on it, the concerns are the contingencies, right? We're planning for contingencies here. That's what we're really looking at. We're not looking at if everything goes the way we want it to, then we don't need to do any of this. But when we're packing for contingency, so I would say some sort of fluid container. 

14:08
Kristin Koskinen
And then with that, I'm going to go with the supplements and snacks. So Linda's covered medications, but I'm going to say, what essential supplements do you have or what do you know? Absolutely. Is effectively medicinal for you, as well as snacks, things that you tolerate or that make you feel know, and things that you can get through TSA. You can always refill the water bottle in an airport so that will give you a degree of hydration if you need. And I'm counting as supplements like electrolyte powders and things like can you can stick those through drive and shove them in your pockets or into a purse when you're done. And don't let yourself get behind or get to an airport and realize they don't have anything I need and become frustrated or you just don't know. So having some snacks on hand can make the trip pleasant as well. 

14:58
Jennifer Milner
Yeah, absolutely. And I feel very seen with this entire conversation. I always make my family travel with empty water bottles as we go through TSA, and then we fill them up the water bottle know, I am so paranoid about being caught without water, without some hydration of any sort, and I get so thirsty and dehydrated. And I do carry my little packs of liquid IV. I have them everywhere. And my family and friends laugh at me because my backpack is filled with enough sustenance for the entire A train should it break down underground in New York City for like seven. Like, I am always like, we have to have snacks, we have to have this. But having that nut mix, something salty and proteiny and fatty and sweet, having that, having protein bars or whatever it is that I love to travel with. I don't stress about going to the airport and worrying that there's nothing at the airport that I can eat. 

15:50
Jennifer Milner
So that's a really great thing to think about and to not feel bad about. And we also, when we go on family vacations, like, half of one suitcase is filled with snacks. We pre buy the protein bars and the applesauce squeezers and all of that and fly with it so that when we fly home, there's room for our souvenirs, which makes a lot of sense. 

16:12
Kristin Koskinen
And I think you really nailed it, Jen, when you said you're not stressed. That kind of psychoemotional stress can flare things. So, yeah, totally. Take what you need. Plan for contingency. Absolutely. I want to travel with Jen in her vending situation. 

16:29
Jennifer Milner
Exactly. Yes. I have all the snacks, all the foods. The other thing that I cannot live without when I travel is a couple of release balls. So I travel with my lacrosse ball. I travel with a smaller squishy ball, like an Eric Franklin ball or a Yamina ball or yoga rollout ball. Right. So something softer as well. And I will always have at least those two things to release my feet, to release my calves, to release my glutes, anything that starts to get tight on me when my sciatic nerve starts to feel, I always travel. Even if I put them in a carry on and it's just an overnight thing, I will travel with a couple of those. If I'm on a flight for a long period of time, I will stick one of those release balls underneath my leg and let it start digging into my hamstring to try to keep all of that from tightening up. 

17:18
Jennifer Milner
So cannot live without my snacks, my water bottle and a little release ball or two. So we're going to turn to travel itself. What are some of the ways to combat the effects of traveling? Sort of the swelling, the joints, the headaches and so on. Kristen, I'm going to start with you. 

17:35
Kristin Koskinen
This, you know, a lot of people, whether they're hypermobile or not, suffer with the effects of traveling. So GI issues can be a big one, including getting constipated is huge. So looking at those things, one, as much as you can acclimate, again, we're going back to that planning. If you can acclimate before you get to a different time zone, that will be helpful. Two, making sure you're drinking as much water as possible and keeping those electrolytes in can be very helpful. For all of the above, plan for some discomfort right, that happens across the board. And then be ready and dial into your things. So, again, constipation is one I get so often. Are there things or do you have foods that are safe for you with regard to fiber to make sure you're keeping the fiber up when you're traveling and you don't have access to those fresh foods or foods that you normally eat at home, it may be a little bit more challenging. 

18:26
Kristin Koskinen
But if you keep it in mind, you can do that. So we can go through. And even when you get to your destination, what are some easy to grab things that you could have or things you could pack with you to keep things going? And these won't work for everyone. Foods are very particular. So if I say something and you're like, oh, my gosh, but so much histamine, I get it. But things that are easy and that you could have and that you could actually travel through TSA with would include kiwi, dried fruits like raisins, prunes, things like that. And those electrolytes, because people who get behind on their electrolytes we will also see have slower motility. So those would be three things I look at. 

19:08
Jennifer Milner
I love that. Linda, what about you? What can we do to sort of combat the whole travel? 

19:17
Dr. Linda Bluestein
So I agree that air travel is the more complicated because you have to go through all TSA and all those extra things compared to car travel. So I'm going to make a few comments that are specific to air travel. My son tried for the longest time to get me to buy a spinner suitcase, and I resisted. I resisted, and oh my gosh, once I finally got one, I thought, why did I torture my shoulders for all those years with a regular pullby? I had to pull my husband's the other day for a short time, and I tried pushing it in front of me, and that didn't work anyway. So for me, the spinner suitcase is huge. We already talked, obviously, about hydration, but especially when you're up in the air, you're getting dehydrated so much more than when you are at sea level. So extra water and electrolytes, hugely important. 

20:07
Dr. Linda Bluestein
Even if everything's gone smoothly, compared to most people, they can get away with kind of forgetting to really drink a lot on the plane. And of course, they don't really offer you a lot of liquids anymore, but make sure that you, yes, the water bottle. Staying hydrated mid flight. And then also, I think whenever possible, taking a non stop flight is helpful because then if you don't have to worry about the connecting flight and having this race to get from one gate to the other because your first flight was delayed. So whenever possible, take a nonstop flight. I have TSA pre check, and I think it is absolutely essential then you don't have to take off your shoes every once in a while if I'm in a situation where they're like, oh, no, we don't do pre check here, and you're going to have to take off your shoes. 

20:48
Dr. Linda Bluestein
You may not have to walk with my shoes off just because I normally have some kind of padding on my shoes. So definitely TSA pre check is helpful. You can leave on a lightweight jacket. You don't have to take as much, you don't have to take out your computer, for example. It's just a lot easier. I would also say don't be afraid to, because a lot of times, I know people are, you know, they feel awkward about the accommodations, whether it be reserving a wheelchair ahead of time, know the pre boarding thing. And definitely, as Kristen mentioned, about bringing a note from your doctor, I would bring extra copies of a note from your doctor, and they don't have the right to have a lot of information, so don't be afraid to just say it's medically necessary. And if they start asking you a bunch of questions, you can show them the letter and you can say, you can contact my doctor. 

21:35
Dr. Linda Bluestein
And I'm thinking, particularly if you're like standing in line at TSA, and you can't stand for hours like that. You can't stand for an hour, you can't even stand for 30 minutes. It is a good idea to kind of sway, do calf raises, squeeze your butt, those kind of things, to try to keep the blood flowing. But sometimes there's not a lot of space, so it's kind of hard to move around. I also would research the airlines. They're very different in terms of how much padding they have on the seats. There are certain airlines that I will not fly no matter what because their seats are like I don't know what they do, but they are so incredibly uncomfortable. I don't know if it's the padding or the incline, the amount of space in between, but I usually go with the more major airlines just because I found a couple that I tried that were so uncomfortable. 

22:26
Dr. Linda Bluestein
So I am picky about that and try to research that as much as I can. I try to move around as much as I can during the flight, get up and move whenever possible. And also last two things, packing lots of layers, I think can be very helpful. So you can be peeling things on and off as you are changing temperature, even if around you the temperature isn't changing. And then lastly having a flare plan written out ahead of time, so that if you're on the plane and something happens and you're starting to feel more pain or something, you can look and go, oh, that's right, because when you're in the flare, you don't really think about these things. So you have to have the flare plan ahead of time. 

23:08
Jennifer Milner
What about compression socks? If it's not something that you normally use, is it worth investing in and trying on when you're definitely and I. 

23:15
Dr. Linda Bluestein
Had those under my devices section, but I'm glad that you brought that up because that is especially important for air travel. Yes, I am a big fan of compression socks and whether you're traveling or not, I think they're a very helpful thing for people that are somewhere on the Dysautonomia spectrum. And you can get all the way from prescription grade compression stockings that go all the way up to your waist that are 30 to 40 mercury and you feel like you're squeezing toothpaste back into the tube. And I mean, it's hard to get those on right, but they're very effective. I mean, they really help to increase the venous return and help improve cerebral blood flow to your brain. But very few people can get those on. I can't get those on because of my hands. I have so many problems with my hands, I can't get them on. 

24:02
Dr. Linda Bluestein
So lighter compression is still beneficial, but the more surface area that you can cover, the more effective they are. And the higher compression, the more effective they are. 

24:13
Kristin Koskinen
Great. 

24:14
Jennifer Milner
Awesome. And we will hopefully hear a little bit more about that coming up. But that's something that I had wondered about, too. I know for me, when traveling, as you both have said, moving around is really key. And when I'm on the airplane, some people like to take their shoes off, some people don't like to take their shoes off because their feet swell and it's hard to put the shoes back on, so there has to be some thought into that. But if you are in a type of footwear, I wear comfortable shoes and then take my shoes off and put on big fuzzy socks and then switch back when I land. But I like to periodically do the alphabet with my feet and just write the letters of the alphabet to keep them moving in a full range of motion, keep that blood flowing. It definitely helps me. 

25:00
Jennifer Milner
And when I stand up and use the restroom, not if, but when I stand up and use the restroom, I try to do some fascial gliding, even if it's just my neck and trying to release my neck while I'm standing there, or through my arms or through my lower back and my hamstrings. I try to do whatever I can without invading other people's space, because everything does start to tighten up. And part of trying to combat the effects of travel for me is my hydration levels leading up to it, because you don't want to be getting up every half an hour while you're on the plane. But I try to make sure that I have hydrated myself as much as possible so that when I land, I'm as little dehydrated as possible. Try to sort of put some in the bank, I guess is the best way to say it, and then start drinking as soon as I land again. 

25:51
Jennifer Milner
But anything I could do with that. And then as soon as I land and get to wherever it is I'm going, I like to take my shoes off and do really easy doming and foot exercises and bare feet on the floor. And if I can, I like to lie on my back with my feet up the wall and just give myself a little bit of a rest there and do some vagal breath and recenter my body from going many miles up in the air and then all the way back down again. So we've landed, we've gotten where we are. We're hopefully in pretty good shape. Kristen do you have maybe three top tips for finding food that you can actually eat while you're on vacation? 

26:31
Kristin Koskinen
Yes. Number one plan scout in advance. If you're staying in a hotel, find out where you're staying, what's nearby, and then you can look at menus online. You can do all kinds of things. You can call restaurants in advance and ask about accommodations, and usually you can get a pretty good feel if they're like, oh, yeah, we do this all the time. Certain cities will better at that than others. If you are one of the coasts, chances are that's going to be easier to find than other places. The west and East Coast tend to have a lot of establishments that are accustomed to making modifications, then have a plan B if those places fall through for any reason because things happen, the chef. Got sick, the restaurants closed on a Monday and you didn't anticipate that, or they're closed on a half day. Have a plan B, then. 

27:22
Kristin Koskinen
Have a plan C where you've got your snacks or whatever, and look for grocery stores or places that are familiar to you. There are major retailers that you can find a lot of times across the country. Even if it's not your primary retailer, find a box store that you could go to and get stuff if you're in a real pinch that you could go. So you're going to find a Walmart in a lot of places or a Target. Find local grocery stores, see what you have in advance and avoid the frustration. If you're staying in a hotel, call ahead and find out if they have a mini fridge that's not a standard for every room. Find a mini fridge and put things in that you can have on hand. If you need a microwave, check with those things too. Again, if you've traveled with food, that might be helpful. 

28:16
Kristin Koskinen
If you're staying with friends or family, that would be an easy accommodation more likely because they can help you with those things in advance. But really it's that pre search and plan that things can or will go wrong on at least two levels. If they don't, awesome. 

28:36
Dr. Linda Bluestein
But if they do, you're not stressed. 

28:40
Kristin Koskinen
Out, you're not frustrated, and a lot of people just don't know or understand. And we're getting there, which is why we have conversations like this, but just don't do that. And I think the third thing is if you're traveling with other people and something just feels like it's too many spoons for you to go out or to sit or to wait that long for food, I think it's important to kind of have everyone has a reasonable expectation of where you're going to be. So it's like if you're staying back on a particular evening because maybe you have a big day the next day and it's more important for you to show up the next day for the Grand Canyon hike or whatever it is, that's okay and that's just how you're going to navigate the trip and you're ready. 

29:24
Jennifer Milner
And that's such great advice is to give yourself some grace too, and not feel like you have to go to every restaurant and experience every we do associate food as a big part of our vacation, giving ourselves permission to eat things we wouldn't normally eat, experience amazing new restaurants, have the bonding time with friends and family over the know. There's a very social aspect to it as well. So having emotional permission to not do that every night and to know, eat whatever it is that you picked up at Walmart that day and know that it's going to be okay and have that special meal with family and friends the next day or something, that's really great that you brought that up. Can I just push a little bit further and say anything about going way outside your comfort zone, like traveling abroad and not knowing there's not a walmart. 

30:17
Kristin Koskinen
Traveling abroad is interesting, and it can beneficial. So we know it's going to be harder getting there from the US. To wherever abroad is. Well, unless abroad is Mexico or Canada, and you live in the north or south, but a lot of times the food quality and preparation in other locations can be different enough that people tolerate it. For example, gluten. If you go to Europe, a lot of people who do not tolerate and I'm not speaking about celiac disease, but if they just don't tolerate gluten, or they just generally don't feel good on gluten, or when they have gluten in the US. They go to Italy, they can eat the pasta, they can eat the cheese, they can do all these things, and their bodies feel good. It's not just that they can get away with it, but they actually feel good. And it speaks to the food production in the US. 

31:04
Kristin Koskinen
Where we produce for mass, as opposed to meals being really special and the quality of the food. Again, if you're going places, you'll find things, they're going to be things that are similar. Right. I would suggest in those situations, if you're going abroad, learn enough of the language that you can communicate your food needs. It sounds like a really big plus or add on. However, if your needs are to that degree, figure it out sometimes. Again, you can call ahead, depending on what you're going abroad for, and see if there's a point of contact where you can call the hotel and say, is there a market nearby? When you go to those markets, you're going to find familiar foods. It may not be packaged the same way, but you'll find food that you recognize. 

31:59
Jennifer Milner
So don't travel with the spirit of fear when you're traveling abroad. Right. It's okay. And you may go to that market in Marrakesh and see these amazing stalls of produce and be like, wow, this is great. Right? 

32:16
Kristin Koskinen
Yeah, that's awesome. And if you do have limitations at home, for example, if histamine foods from histamine tend to not be your friend, then maybe talk to someone, get a list of things that may or may not be okay for you and stick with things that feel more familiar, and that's okay, too. And that's okay, and you can enjoy all the other things. 

32:38
Jennifer Milner
Exactly. So, Dr. Busin, I'm going to turn to you and say, what advice do you have for traveling without your pit crew, without that group of support that you sort of come to rely on your massage therapist, your doctor, that you can call it a moment's notice, that sort of thing. 

32:55
Dr. Linda Bluestein
So I think this is an important time, too, to bring up that a lot of people are traveling for doctor's appointments. So I have people that fly to come see me, and they have to stay in a hotel, and they're sick enough that they're coming to see me usually. So they also have a lot of additional challenges when they're traveling, and they're traveling for this purpose. So definitely, whether you're traveling for a doctor's appointment or something much more fun like going on a hike, I think it is a good idea to bring your one sheet of medical problems. And all the time when I tell people about the one sheet, they say, oh, I couldn't possibly fit everything on the one sheet. And it's like, that's the point. The point is that the one sheet contains the most critical pieces of information that somebody needs if they were to take care of you. 

33:49
Dr. Linda Bluestein
And so, for example, you might have on there a section with your medications, and you can even kind of group them. Some people have incredibly long lists, but you can just say antihistamines, for example, if it's really hard to fit everything on the one sheet. If you're on TPN, for example, and you've got just tons and tons of surgeries that you've had, you can condense that, and you can say three cervical spine fusions. And when the person wants more information, they'll ask for more information. But right there in that one line, you've given a lot of information rather than trying to write it all out. So the whole idea for the one sheet. 

34:34
Jennifer Milner
Is. 

34:37
Dr. Linda Bluestein
When you have only one sheet, what are the critical things that you're going to put on that one sheet? So you're going to put your allergies your medications, and again, those could be in different boxes in different areas. You're going to put your most significant medical problems. So, for example, my basal cell cancers are going out. They're not on the one sheet. That kind of thing is absolutely not going to make it onto the one sheet. My knee scope, not going to make it onto the one sheet. So it's the most crucial things that you want your healthcare team to know about. And another thing I thought about when Kristen was talking about perishable foods and then going to the grocery store and some of these different things. I totally forgot that when I was traveling for work towards the end of my anesthesia career, I would have so much pain at the end of the day oftentimes that I would lay on an ice pack or something. 

35:33
Dr. Linda Bluestein
And my hotel rooms had refrigerators, but not freezers, and they would routinely keep freezer packs in their freezer. For me. Now, I was also going back to the same hotel multiple times, so I don't know if other hotels would do that. But if you're traveling for a doctor's appointment, and you normally do use ice as one of your tools for a pain flare, you could even call ahead and say, if I bring one of my soft ice packs, would you be able to put that in your freezer. Alternatively, I would bring those ice bags. They're very old fashioned, they have like the screw top on top and then it's just like a collapsible bag that you can fill and I would just put a few ice cubes in there and that way you could ice a given area. It doesn't get as cold as those other ice packs, but at least it's something that you can pretty much anywhere get ice. 

36:21
Dr. Linda Bluestein
In fact, I did it multiple times on a plane because I was having so much pain from different things. So I would have them fill the ice bag for me on a plane. So those are a couple of things that I would do. If you don't have your pit crew, really important to have your list of medications, your one sheet, and then you can have your one sheet and then you can have your three sheet version of the one sheet, but I would always have the one sheet. You can always be ready to offer more information, but start with the really super succinct version. 

36:56
Jennifer Milner
That's great. And thank you for breaking down sort of how to make that medical one sheet because it can be really overwhelming for people trying to figure out what to put on that one piece of paper, right? And I will say, from personal experience, having traveled a lot as a dancer, one of our favorite hacks to make an ice pack is to get like a quartz ziploc. Put some water in it. Don't really fill it with water, but put some water in it. And then put a little tiny bit of vodka or rubbing alcohol in there. Just a tiny bit. And then you can freeze it and it won't freeze like a hard block, it'll freeze a little softier and sluttier. And then put another ziploc, maybe like a gallon size over that. And those make really good portable ice packs as well. 

37:40
Dr. Linda Bluestein
That's perfect. And I do help people oftentimes make their one sheet in one one appointments. So we will go through and figure out because again, I have the full spectrum from I'm still dancing professionally and just want some help with a few tweaks here and there to I'm pretty much spending all day in bed and have this exhaustive list. And maybe they're not in an area where I can actually take care of them and have them as a patient, but I can help them organize their information so that they can get better care from their local providers. 

38:16
Jennifer Milner
Yeah, that's really great. And it's nice to have someone else help you do that, right? To be able to have someone else say, no, I can help you with that. And that's one of the things that I will do with my clients as well in helping them prepare is putting together a list of exercises or something that they need to do. So if I'm trying to help my clients get ready for a trip and they're trying to figure out how do we stay moving and how do we do all of that without their usual classes and trainers and their pit crew? That's one of the biggest things that we will do. First of all, I'll say if you're comfortable in a group class, what props do you need to bring? Like what extra stuff? I always encourage my clients to have like, a yoga block to help prop them if they need it, to give them a little bit of proprioception. 

39:03
Jennifer Milner
And my favorite travel item is one of those small, soft, like, eight or nine inch exercise ball, like a Pilates ball, because you can completely deflate it, you can inflate it really easily and you can blow it up just a little bit, put it under your sacrum to give your sacrum a really nice rest. But you can also take it with you to group classes and use that in your group classes for a little bit of propping or proprioception. If it's someone that I work with regularly, we'll put together a travel exercise routine that's 20 or 30 minutes and they'll just use like a couple of the small round therabands grab those and throw them in their bag. Throw in that small smooshy ball and it takes like zero room. But they'll have 20 to 30 minutes to be able to work out the kinks and tweaks and things that they need to do if they need to get their Glutes firing because they have that unstable si joint, they've got the exercises that they can do ahead of time. 

39:55
Jennifer Milner
So I encourage you to talk to someone and try to get that. Or if you don't work regularly with someone, put the routine together for yourself before you go, so that when you're there, you're not, oh, what should I be doing? I have so many exercises I could do. Have your exercises prepared ahead of time so you can get up and do it. I love I'm not a yoga trainer at all, but I have a really nice yoga sequence that I like to go through on vacation because it feels good. It makes me all stretchy and loose and ready for hiking or whatever it is that we're going to be doing that day. So I like having those few little things that I need. If you're going to try out new classes, if you're going to an all inclusive resort or the hotel offers them in downstairs and you want to do it, just know yourself and know whether or not you have the ability to modify as needed or you're a people pleaser that's going to do whatever they tell you to do. 

40:44
Jennifer Milner
So know yourself before you step in there and make sure that you understand what is about to happen. And then give yourself permission to rest, right? Allow yourself to have rest days. Don't feel like I'm in Italy and I'm wasting it in my hotel room. It's okay. Lie in your hotel room and lie in your magnesium bath salts and enjoy the day and eat some gelato when you get out, like, whatever you want to do. You don't have to be pounding the pavement every single time that you are out there. So those are my tips for making sure that you can kind of survive while you're out there without your pit crew. And don't be afraid to reach back out to them. I have people reach out to me while they're traveling all the time and say, oh, this is hurting. And we'll do a ten minute well, here's where you put your lacrosse ball to help release that. 

41:29
Jennifer Milner
And then they're on their way again. So don't worry about reaching out to people. 

41:33
Dr. Linda Bluestein
I think I book a session before my next trip, get that 20 to 30 minutes program with you, right, to. 

41:42
Jennifer Milner
Get your little metaphorical one sheet of exercises. It's so helpful. And I think that's one of themes that's come up today from all three of us is plan ahead. Kristen talks about planning ahead with your food and eating and researching and have a plan a, a plan b, and a plan c. And I think that's what we're all saying is plan ahead. It takes away that anxiety, which, as Kristen said, can cause flares. It removes as many moving pieces as possible, and it makes us feel prepared and ready so that we can go out and be spontaneous and have let's plan for our spontaneity. Okay, everybody, plan for that spontaneity. But planning will just take away some of that travel stress and the wear and tear that can be on your body. 

42:25
Dr. Linda Bluestein
All right? 

42:25
Jennifer Milner
So last words of wisdom, okay? One or two of your best travel tips. Go dr bluestein. 

42:32
Dr. Linda Bluestein
Okay, so for me, I'm always thinking cost benefit analysis. What does a given prop that I might be bringing? So, like, the ice bag or braces or KT tape or I have a collapsible reacher. I use the reacher at home to pick things up off the floor. I have a collapsible version of that. I have different ergonomic tools. So with every single item that I am considering bringing, I'm thinking, okay, what does it weigh? How big is it? Like, I'm so glad you pointed out that eight to nine inch ball can collapse and then reinflate, because that's brilliant. How big is it? What's the potential for need? And that's always based on what's been happening with me lately, because my needs, man, have they changed dramatically over time. And then the last part of that is, what's the risk if I don't have it? So I actually did forget my cushion one of my trips once, and I was in such a panic, and I was like, okay, you forgot it. 

43:31
Dr. Linda Bluestein
You can't be anxious. I was anxious, but I was just trying to mitigate my anxiety because I knew that would just make it worse. So what are the risks if you don't have the thing? And then factor all that into consideration when you're deciding what things to bring? Because I could fill an entire suitcase with all of the different paraphernalia that I have, but hopefully I won't need most of it. So also the last part of that I would say is what's the chances that you could buy it if you had to? So if it's something that's been custom fitted for you, it's not that big, you might need it and you can't replace it, then maybe throw it in your bag. But if it's something that's over the counter that you could just buy at Walgreens, I'm thinking of my wrist supports that I have. 

44:19
Dr. Linda Bluestein
Maybe I leave that at home because if I really get in a pinch and I really need it, I could go buy another one. So those are kind of the things that I think of when I'm thinking about devices in particular. And for me, I plan first kind of my medications and devices and those things, and then I figure out how much room is left for clothes, and it's usually not very much. So if you see me wearing the same things or at least the same pants every day, there's a reason. For me at this point in my life, it's all about comfort. And the fashion part is I've tried to look nice and be clean, but other than that, you have to be practical. 

45:07
Jennifer Milner
Well, and I think the cost benefit analysis is brilliant and a great thing to use as you're looking at your empty suitcase and trying to figure out what you can fill it up with. And honestly, the parthenon or the Grand Canyon or the nation's capital, whatever it is, they won't care if you're wearing the same shorts you wore the day before. So I think that's great. Kristen, what about you? 

45:28
Kristin Koskinen
My recommendations really mirror Linda's number one plan, then plan again for contingencies and then prepare to the best of your abilities and recognize, you know, part of the adventure may be misadventure. So do you have some ways to maybe undo any misadventures as part of your planning? So if that's antihistamines or specific supplements you use or anything along those lines and the packing, I'd say exactly the same thing Linda was saying is start with the things that are going to be essential for your comfort and what taking care of your body and yourself. And then the clothes. Can really make sure you have comfortable shoes when you're traveling, unless you're traveling, like for a wedding where you're going to be around your family and things like that. And the apparel is very important. If the apparel is that important, ship it ahead of time. Get the wedding clothes there because heels take up a lot of space. 

46:31
Kristin Koskinen
I don't know who's if you're in the capacity where you can heels ship things ahead of time so that you have the things that you need on your person or above or below your seat with you. And just manage the traveling first. Like, let's take care of that and then we'll take care of the stuff when we get there. And again, some of it doesn't matter. It's being there, it's being in the experience. Your travel mates really don't care if you wear black things or find things that can be hand washed or find out if there's a laundry service where you're staying. We just don't need to pack that many the clothes and shoes have a spare, right? 

47:09
Jennifer Milner
That's what you need. 

47:10
Kristin Koskinen
Buy stuff when you get there. Dress like a local and really make room for the food. Make room for the things that you need for your health and well being. Worry about the rest later. 

47:23
Jennifer Milner
That's fantastic. 

47:24
Dr. Linda Bluestein
Yeah. 

47:24
Kristin Koskinen
Wear layers on the plane and then you've taken care of about 90% of it. 

47:28
Jennifer Milner
That's right. You can wear 90% of your travel wardrobe on the plane and then just push it under the seat or sit on top of it if you get hot. And then I would say my top tips. I love the idea of the cost benefit analysis and I like to apply that while I'm traveling, too. Is the cost of hiking the Grand Canyon worth know to the best of my ability? Absolutely. Is the cost of standing around at something I don't really care about or walking through a mall that I don't really care about worth it? No. So weighing those things just for me, right, weighing those things out and deciding which ones I want to do and which ones I do not want to do, and going along with that, along with managing what I do and when I do it, is also managing expectations. 

48:15
Jennifer Milner
So hopefully you're not traveling with anyone that you cannot be honest with about what you can and cannot do. And so have a conversation with those people and say, girlfriends weekend at the winery, I am all in. Probably not going to match you all drink for drink, right? But I want to be there and I want to hear the funny jokes and I want to be part of it. I may go to bed early, I may sleep later. And just being able to manage expectations, going to a cousin's wedding and saying, I want to be here for your big day, I might not make the bridal shower and the girls night out and the rehearsal dinner, I may have to cut some of those things short. Manage expectations ahead of time so that you don't feel like you're letting people down in the midst of it. 

48:56
Jennifer Milner
And then from a purely practical point of view, plan your shoes wisely. It is not the time to be looking for the cute footwear and the flip flops and the sandals that are super know. Get those really great sneakers and have arch supports in them. They will change your life. If you are walking around Rome or walking around the Black Hills of North Dakota, wherever it is, you want something comfortable and supportive as you're walking around. So that's where I kind of draw the line. I'm, like, don't care so much what I look like. For my teenage daughters who love their flat, Chucks and KENS and those sorts of things, I just buy drugstore arch supports for each pair of shoes because they will not take them out and change them. So we have arch supports in each pair of shoes that they're going to wear. 

49:46
Jennifer Milner
And I strongly encourage you to find shoes that make you feel good and make you feel supported and strong and as comfortable as possible. You will enjoy the trip exponentially, I promise. All right, I think that's all from us. If you guys have other questions, we would love to hear it, because a lot of people have talked about how difficult it is to travel with these things. So if you have additional questions about travel, throw it in the comments or reach out to us on social media. And speaking of social media, where can people find us? Kristen, where can they find you? 

50:18
Kristin Koskinen
They can find me on Instagram at Kristen K-R-I-S-T-I-N underscore Koskanan, underscore RDN. And I'm guessing that'll be in the show notes or at my website, WW dot Eatwellpros Pros.com. 

50:34
Jennifer Milner
Excellent. And Dr. Blue scene. What about you? 

50:36
Dr. Linda Bluestein
Either at my website, WW hypermobilitymd.com, or I am on a lot of different platforms instagram, Facebook, Twitter, LinkedIn, Pinterest. I think those are the main ones at Hypermobilitymd. 

50:51
Kristin Koskinen
Excellent. 

50:52
Jennifer Milner
And of course, you can find all of us on social media at bendybodies or WW bendybodies.org, and you can find me on Instagram at jenniferperiodmilner or my website, Jennifer Milner.com. So thank you so much, Team Bendy Bodies, Dr. Linda Bluestein and Kristen Koskinen for hanging out today. I am Jennifer Milner, and from all of us at Bendy Bodies, thank you all so much for listening. 

51:23
Dr. Linda Bluestein
If you found this helpful, follow the Bendy Bodies podcast. To avoid missing future episodes. Please leave a review and share the podcast so more people know about Bendy Bodies and Joint Hypermobility screenshot this episode. Tagging us in your story so we can connect. Our website is WW bendybodies.org and follow us on Instagram at bendybodies. We love seeing your posts and stories, so please tag using hashtag Bendybuddy. This information is not intended to diagnose, treat, cure or prevent any disease. The information shared is for educational purposes only and is not a substitute for medical advice, diagnosis or treatment. Please refer to your local qualified health practitioner for any medical concerns. We'll catch you next time on the Bendy Bodies podcast. Rest.