Traveling with a vestibular disorder, wheather you've been dianosed with vestibular migraine, PPPD, or any other condition, can seem daunting. While you can't control crowds at an airport or traffic on the highway, there are many things within your control that can help ease the journey: Plan, Pack, Prep, Passage, and Pause
Plan your travel
Start with a mini-vacay
If this is your first time travelling since being diagnosed with a vestibular disorder, you may want to plan a mini-trip to test out some of these tips, see what works and what needs to be worked out.
Research your accomodations
Is your hotel room on the ground floor or on the 23rd floor? If heights trigger your symptoms, ask for a room on a lower level.
Does your hotel, condo, house have busy wallpaper or carpeting? If you experience dizziness in visually complex environments, you might want to ensure clean, simple decore that won't bring on your symptoms.
How many stairs will you have to climb? Some types of dizziness such as Postural Orthostatic Tachycardia Syndrome (POST) or Post-Concussive Dizziness are exacerbated with exertion. If this is the case for you, make sure there is an elevator, or see if you can stay on the ground floor.
Weather
Some vestibular disorders, such as vestibular migraine or Meniere's Disease, can be worse with sudden and huge shifts in weather. Many of my patients with vestibular migraine can almost predict the weather, noting that their symptoms start just days before a significant shift in barometric pressure. Check out the barometric forecast in your destination and plan rest days when you suspect your symptoms will be worse due to weather changes.
Also, if you are sensitive to light, consider how sunny your destination is, or how many hours of daylight there will be.
Changes in pressure
If you are sensitive to pressure changes, try to avoid rapid pressure changes during your travels and throughout your stay:
If travelling by land, check to see if/how many mountain passes you need to cross. Or what the elevation of your destination is.
Avoid taking multiple hopper flights that are short in distance/duration and result in quick changes in pressure. Some of these planes may not be pressurized. For some post-operative conditions, it may be contraindicated to fly. Always check with your surgeon if this applies to you.
Avoid scuba diving or free-diving, or hiking up to high elevations.
Travel Itnineraries
Avoid red-eyes or traveling too late to avoid any disruptions in your sleep patterns.
Try to book direct flights, buses, or trains.
If changing time zones, try to incrementally adjust your sleep/wake times by 15 minutes the days leading up to your trip to get close to the new time zone.
On long trips, schedule a one day layover where you can get some sleep and slowly adjust to the time change.
Pack
Have these items handy as you travel:
Medications and supplements - make sure you have enough of a supply (and then some) to get you through your entire trip.
Assistive device - if you need a cane or walker when feeling more imbalance. Or ensure there is one at your destination.
Food and water - Pack snacks that you know won't trigger any symptoms (not just dizziness). Bring a water bottle, so you're drinking more than the 2 cups they might offer you on an 8 hour flight.
Sunglasses/hat or blue light filter glasses for light sensitivity. I recommend FL-41 glasses for blue light sensitivity.
Anti-nausea - Peppermint oil or candies, ginger chews, lavendar oil, Sea-bands or accupressure bands
Earplugs/gum/headphones - Noise cancelling headphones can be helpful if you are sensitive to sound. Earplanes or chewing gum will help alleviate pressure while flying.
Travel Pillow - try to get some sleep!
Prep for travel
Set your self up for success by:
Hydrating the day before
Getting a good night sleep the night before
Eating a good, nutritous breakfast the morning of
If traveling by car (or personal yacht), packing it up the night before
Reviewing your travel plan and making sure you've packed all your essentials to avoid any unwanted stress the day of travel
Passage
Stay hydrated. Drink about a glass of water (8 oz.) every 1-2 hours. Try sparkling water if you're feeling nauseous.
Eat regularly to help maitnain your blood sugar.
Stay active - Take regular restroom breaks on a road trip to stretch your legs and walk. Or get out of your seat on a plane or train to walk a little and stretch. Feel free to touch seats, walls, and overhead compartments if that helps you feel more balanced. If you can't stand up, do seated exercises like marching, kicking out your legs, ankle circles, or simply squeezing your muscles in your legs and buttocks.
If you tend to get motion sick, avoid reading or using your phone while moving.
If you are riding in a car or train, face forward and be sure you can see out the window so you can keep your eyes on the horizon.
If you are riding in a boat, try to sit near the middle of the boat (but with view to the outside) to avoid excessive rocking.
If traveling by plane and you have a layover, see if the airport has a yoga or prayer/meditation room. These can be quiet spaces for you to rest, ground, and recoop before the next leg of your journey.
Pause after travel
You've made it! Give yourself some gratitude with some time and space to relax.
Go for a gentle walk and focus on the horizon to help recalibrate your vestibular system.
Perform some of your grounding, mindfulness, or meditation strategies.
Plan a low-key day after travel to give your brain and body time to recuperate and reset.
Be kind to yourself. Remember feeling off after travel can be normal for people without a vestibular condition. It's okay to feel a little off. Just go back to what you know works to manage your symptoms, get back on track, and enjoy your trip!