Since developing chronic pain that accompanies an autoimmune condition, I’ve continued to indulge my love of travel, but learned to adapt my bookings and my belongings to minimize pain and maximize comfort.

 

Flights of six hours or so are regular occurrences for me and my family. I’ve had a couple of very painful trips of this duration, but, more typically, I can tolerate them by adjusting my medication slightly and employing a few aids such as wrist braces, inflatable cushions, and hot water bottles.

 

This winter, I faced the longest single flight I’ve ever taken: 12 hours and 40 minutes just for one leg from Los Angeles, CA to Auckland, New Zealand. The combination of traversing the United States from our New England home (6.5 hours), crossing the Pacific (12.7 hours), then connecting to our final destination of Christchurch, NZ on the South Island (1.4 hours) made for a total time in the air of 20.5 hours.

Of course, one must also add to that total the requisite airport waiting time required by international flight connections, customs, security, and the necessity of allowing adequate buffers in case of delays. At least two full days of my calendar were bound to be eaten up by this voyage in each direction.

After considering many options, I elected to travel in two distinct stages for both directions of travel. This meant parting ways with my husband entirely for the domestic portion of our trip. His schedule doesn’t allow for an unnecessary day spent in transit where tighter connections are possible.†

I was away from home for a total of fourteen days; DH, by taking his domestic and international flights serially on the way out—and heading home on a red eye straight off the international leg—traveled for twelve days.

Though this post isn’t really meant to be a trip report, it must be said: even two weeks is barely adequate for visiting the antipodes. If you can squeeze more days out of your schedule, use them for a trip of this magnitude.

New Zealand is awesome, and well worth every hard won vacation day.

My itinerary outbound:

BOS-PDX on Alaska Air 33, Saturday 16:20-20:10

Three night stay with family in the Pacific NW

PDX-LAX on Alaska Air 568, Tuesday 10:50-13:22

LAX-AKL on Air New Zealand 5, Tuesday 21:40-Thursday 07:20*

AKL-CHC on Air New Zealand 527, Thursday 09:00-10:20

My itinerary for the return:

CHC-AKL on Air New Zealand 574, Friday 20:00-21:20

AKL-LAX on Air New Zealand 2, Friday 22:50-13:35**

Overnight hotel stay at the Crown Plaza LAX

LAX-BOS on Virgin America flight 1360, Saturday 07:05-15:34

Itinerary adaptations to reduce pain

I’ll repeat what I feel was the single most important adaptation I made to my itinerary to accommodate my autoimmune condition and its symptoms: I took extra time.

Travel. Stop. Recover. Repeat.

Heading west, I took advantage of family who live near the Portland airport who don’t seem to mind my visits, spending three nights at their home. This sleepover gave me time to recover from the initial cross country flight and ease my body’s adjustment to a change of three time zones.

Upon arrival in New Zealand, I had already acclimated from the Eastern to Pacific zone (USA West Coast) which represents half of the total time shock. Though the flight is lo-o-o-o-ong, most of the travel between California and New Zealand is in a southerly direction. You only drop three more time zones on that 12 hour flight.

Heading west is also usually less difficult in terms of jet lag.

If you’re headed from the eastern USA toward Oceania, consider an overnight stopover on the West Coast or even in Hawaii. There were relatively affordable flights on other airlines transiting the Pacific via Fiji or other islands. Stopping here would offer the benefit of a shorter flight duration of the longest leg for a sensitive, aching body.

If I hadn’t been traveling according to my husband’s work schedule, and if money were no object, I would have opted for a Hawaii stopover of a night or more. The flight leg from there to New Zealand is a relatively quick 9.75 hours.

While I was willing to cross the USA on my own as I have many times before, the pleasure of my husband’s company was perhaps my highest priority for the novel Transpacific portion of this particular journey.

Separate ticketing for distinct needs

I booked my flights as several separate and distinct tickets to get the combination of stops that I wanted. This carried some risks as, for example, a major delay with one part could have resulted in a missed flight for which the initial airline would bear no responsibility.

Travel insurance and/or more than ample connection times are vital under these circumstances.

My husband and I also had completely separate bookings. We do this often, especially when I tag along on one of his business trips. It is helpful because his travel paperwork must be submitted for reimbursement by his employer or sponsoring institution, a task made easier when the receipts are kept separate. It also frees me to make any modification I desire if my health deteriorates without impacting DH’s ridiculously overburdened schedule.

Of course my husband would stay with me if I had a real health emergency, but if I have a flare and opt at the last minute to skip a trip, or if I decide to lengthen an intermediate stop to take extra recovery time, his itinerary remains unaffected by my preference for a slower pace.

The added benefit of going it alone? Airline fees, if any are incurred, apply only to the single changed ticket. The downsides of foregoing each other’s airline loyalty perks and potentially being seated separately are manageable for sensible adults.

The seating issue is a problem I take much more seriously when traveling as a mom, especially with my younger kid. I believe airlines should be required to seat children under 12 years old in the same row as a parent or guardian.

Class of service is vital on a 12 hour flight

I’m no stranger to the Economy section of a plane, but I would suggest that those with chronic pain or arthritis consider an upgrade to Premium Economy or higher when any single flight hits a double digit duration in hours.

When I purchased my ticket ahead of our New Zealand trip, I checked fares, then returned to complete the sale during a promotion. I paid for Premium Economy scarcely more than the Economy fare had been when I initially looked at prices.

Premium Economy varies between airlines, but the key differences worth their weight in gold for my symptoms are, ranked roughly in order of importance:

• Extendable foot and leg rest to ease pressure on an arthritic hip that seizes up when I sit in the same position for too long
• More legroom, in my case most useful for allowing me space to stand up on rigid feet and knees without losing my balance since my petite stature doesn’t really demand the space sitting down
• Access to a reserved premium cabin restroom (or restrooms), reducing wait times and giving me an excuse and destination to get up and move more often
• Wider seat (2-4-2 arrangement vs. Economy’s 3-4-3) allowing room for my inflatable cushions to protect my aching elbows from armrests that feel too hard when my pain levels are high

Air New Zealand offers Premium Economy passengers the option to check in at the Premium ticket counter alongside Business Premier travelers. For me, this meant a wait time of zero to check bags. My connecting flight from PDX meant I was quite early to arrive at LAX, though, so there were only a few souls in the Economy line anyway.

Splurging on a Business Premier seat would get you access to an upper class lounge for a more comfortable wait while in the airport. The leap in seating quality from a larger reclining chair to a lie flat bed is a much bigger upgrade. Expect to pay thousands of dollars more for a Business Class seat over Premium Economy, and the ample space is what you’re really paying for.

I couldn’t afford the cash difference between Premium Economy and Business Premier at booking, but I did sign up for Air New Zealand’s “OneUp” bid-to-upgrade scheme after I bought my ticket. At a difference of hundreds instead of thousands of dollars, I was successful in moving from Premium Economy to Business Premier in just one direction. Paying an extra 38% of my original fare on the day of travel, I enjoyed a much more comfortable outbound international flight.

Read about my first upgrade bid win with SwissAir here.

If you can afford to fly Business class, your arthritis will thank you. It is the extra space and flat bed that make a real difference to chronic pain sufferers, though the more personalized service and fancier meals are enjoyable perks. You would have to be a whole lot more sensitive to your social position than I am to find anything lacking in Air New Zealand’s Premium Economy service, however.

Don’t upgrade just for the difference in amenity kits. Their contents are almost identical.

Premium lounge access can be a big help for travelers with pain. Air New Zealand offers access to their Koru lounges and Star Alliance partner lounges like the one at LAX with Business Premier tickets. Premium Economy passengers are left to the public waiting areas with everyone else.

Other ways to get into these airport oases include paying to join an airline’s lounge program, achieving a high level mileage plan status that includes it as a benefit, or with programs like Priority Pass, often bundled with higher end, travel-oriented credit cards. Day passes are sometimes available for around $50 per lounge visit.

Available amenities in exclusive lounges such as hot showers and more abundant, more comfortable seating—including couches and chaise longues where you can stretch out and put your aching feet up—can help decrease pain. Lounge staff can often assist with ticketing and other questions on the spot so you can spend less time scurrying around the airport.

Free snack buffets and drinks are common, with some lounges also offering restaurant style meal service, sometimes for an extra fee. I hear Turkish Airlines has roving massage therapists in their flagship Istanbul lounge, and I once enjoyed a brief workout on a treadmill in an American Airlines Admiral’s Club in Texas. Visiting an exclusive lounge can put some of the fun back into the process of modern air travel.

I don’t usually use the requisite pancake machine in my own favorite airline’s lounge—Alaska Lounge, formerly known as the Alaska Board Room—but it is rare for me to pass through an Alaska Air hub without stopping in for an espresso or a latte. It doesn’t compare with a great barista’s manual artistry, but I’d vote it equal to a mediocre Starbucks brew.

Airport assistance: free, and fabulous

Traveling domestically, I almost never request special assistance through the airport. Booking my trip to New Zealand, I put in the request for a wheelchair transfer immediately. I can’t predict when my symptoms will flare, but stress and prolonged periods of sitting are both likely triggers.

I’ll be honest here: I feel embarrassed being wheeled through the airport. I watch elderly travelers walk by carrying their own bags, and I feel like a selfish fraud sitting in my chair and jumping to the head of the line with my escort.

DH tried to reassure me that every passenger who needs help in the airport is getting it. I hope that’s true. I wonder if the occasional elderly or less-than-fully-able passenger is aware that free mobility assistance can be had in airports just for the asking.

Try to heed my husband’s sensible advice and ask for help if you think it likely that you will need it. You can always wave the wheelchair away if you deplane feeling full of energy and without pain. My own experience was that 12+ hours on the plane, even in a premium cabin, left me stiff, aching, and dropping important documents (passport, customs forms) due to rigid fingers.

Riding in a wheelchair, I could access whatever customs requested from my bag without dumping everything to the floor. That is a courtesy to my fellow travelers who might have been stuck behind my slow-moving self.

I did kind of wish to be standing instead of enduring yet more sitting in the wheelchair, but the hip pain competes with my foot pain, and no one was kept waiting by my lowered ability to manage at checkpoints.

The most amazing perk of taking advantage of a wheelchair escort is jumping the queues. It had been long enough since my last escort that I’d forgotten about this convenience. It was the first time I went through customs in a chair. DH thanked me for my infirmity because the escort takes back passages and brings his/her charge straight up to every checkpoint. I suppose the airport doesn’t want to pay employees to stand in line with their escortees.

In US airports, it is customary to tip wheelchair attendants a few dollars for their help, but payment isn’t required. Airport employees in New Zealand absolutely refused any remuneration as unnecessary, though DH tried there, too. After one attendant gave back to me captive in the wheelchair the NZ$5 my husband had pressed upon him, he stopped attempting to tip Kiwis.

When you’re receiving wheelchair assistance, it typically ends at the curb of the terminal. Both in Auckland and Los Angeles, my escorts brought us to the curb to catch a shuttle between the international and domestic terminals. The attendant waited with us until the conveyance arrived, so no extra standing was required of me.

In Auckland, we rode the standard shuttle bus together with able bodied travelers, though the driver let us board first; at LAX, a special “mobility assistance” shuttle was dispatched via the escort’s radio. After riding these shuttles on our own, both airports had radioed ahead and a new attendant was ready and waiting with a wheelchair at the next terminal when we disembarked. They were willing to escort me wherever I needed to go, even when DH’s and my disparate itineraries made things a little more complicated than might be typical.

I found it odd that the “mobility assistance” shuttle at LAX had so many steps for boarding! I can climb stairs and board a plane without the wheelchair, but I’m assuming there must be a lift for people with lesser mobility. That little bus had at least six or seven*** four stairs at the door.

It’s also worth noting that the airport wheelchairs included a carry on luggage “shelf” beneath the seat. Only my personal item rode on my lap where I could access my travel documents, and DH wasn’t tasked with carrying my travel bag as well as his own. It still pays to travel light when your strength or dexterity isn’t great, but this was a concern I hadn’t considered very well managed by the available equipment.

You can use any special programs or perks to which you are entitled while being escorted in a wheelchair through the airport. At LAX, for example, the escort brought us to the Global Entry kiosks and even helped us keep track of which paperwork to have in hand at which checkpoint.

With Global Entry,‡ I rarely find the US customs process overly onerous or time consuming, but every minute out of long queues is a better one during travel.

Speaking more of crowds than queues, at least once, the gate area for our connecting flight was unreasonably small and already full of travelers when we arrived. Keeping my seat in the wheelchair until boarding meant a tolerable perch and a lot less jostling under crowded conditions. With 13+ hours of travel already under my belt, I was really grateful for every iota of extra comfort.

Airline assistance: a little extra time

Remember also to inform your airline of your need for special assistance. If boarding early will ease your anxiety or give you time to get settled more comfortably (some of us have half a dozen props to inflate and deploy), the airline is usually happy to oblige.

I don’t know if the privilege of pre-boarding due to special needs is a government requirement in the USA, but it seems to be offered by every airline worldwide. Some gate agents announce it over the PA system, but others prefer to quietly invite those who’ve requested extra time. It’s worthwhile to check in when you arrive at the gate, but less necessary when arriving with a wheelchair escort. These service professionals make it their business to whisk you aboard as soon as the plane has been cleared.

If you’re traveling light i.e., no need for overhead bin space, don’t forget that waiting and coming aboard at the last moment can reduce your time in that seat by nearly an hour.

I was always offered assistance with boarding the jet itself if I needed or wanted it. Since I can walk and climb stairs, if a bit more slowly a dozen hours into a trip, I never took them up on this service.

DH was always available to help me with stowing my larger carry on—a lightweight Tom Bihn Aeronaut convertible pack—overhead in the locker/bin during this trip. I suspect that any escort who wheeled a traveler aboard would help with this task, but, as a short woman, I’ve always gotten unsolicited offers of help from other passengers when the reach was a challenge.

Remember to re-pack your possessions after clearing security if necessary to get what you need on the plane in your smaller, under seat bag. I forgot to shift some items during one layover, and it became a real problem when I wanted my liquids pouch while DH was sleeping. There’s nothing quite like having a sweet British octogenarian offer to take down your bag for you when your hands have lost the flexibility to unlatch the overhead compartment and she’s watching you fumble.

My Air New Zealand flight attendant in Premium Economy was very proactive about offering to put bags up and bring them down for takeoff since I was seated in the bulkhead row where no under seat storage is available. Had I organized my things better post-security, her automatic assistance would have been sufficient for my access needs during the flight.

Travel carefully, but keep moving

I wrote just last week about one way fear and pain have affected my travel planning. The two key takeaways I offer on the subject are:

1) Keep doing what you love in spite of chronic illness because you deserve to enjoy the fullness of life, and

2) Planning can make some difficult tasks easier. Travel is one of them.

Though I’ve staggered along the line between the general and the specific in this post in my eagerness to share it, I hope it offers a little help or a lot of motivation to others who might hesitate before undertaking the trip of a lifetime, or even a much needed casual getaway.

Don’t make me quote the abysmal facts about Americans and their failure to recharge themselves by using their vacation days!

Getting ready for this journey was a major undertaking for me, and came after a less than healthy stretch of winter. I had real anxiety about how I would fare on the long flight, but my fears were out of proportion to my actual physical suffering.

How often that turns out to be the case with anxiety!

♦

†As it was, our New Zealand trip exceeded the length of any we’ve taken together since I asked him for two straight weeks of togetherness in honor of our tenth wedding anniversary.

*There was no Wednesday. We simply didn’t have one that week! While we both adjusted reasonably well to the new time zone, neither DH nor I ever felt clear about what day it was while in New Zealand. The international date line is just a weird experience.

**Longest. Friday. Ever! Notice the days and times. We left Friday evening… yet arrived back in the States early on Friday afternoon. Time travel!

***Proof of how bad I was feeling: I was sure there were more steps up when I wrote those words. I’m updating this post four days later having found the snapshot of the LAX shuttle bus which has four, not 6-7, stairs to climb.

‡The Global Entry program simplifies the customs process for frequent international travelers who pay for the privilege and provide extra personal data for security pre-clearance.