Arriving KTM airport in Nepal with wheelchair assistance

Nepal is a fascinating place, home to generous, warm-hearted people with a long, rich history and a complex mix of cultures. The natural beauty of the Himalayas is impressive even beyond the grandeur of other monumental peaks I’ve seen such as the Alps or Denali.

The effort undertaken to reach this place is worthwhile.

Snow capped mountain peak behind lush green foliageFor those of us with physical limitations or health issues, however, the voyage itself represents a significant hurdle. I live in—and traveled from—New England, in the United States, to this land-locked south Asian nation nestled between India and China.

Most of my readers, I suspect, would, like me, endure a long and arduous journey to reach Kathmandu, the capital of Nepal. I hope that, by sharing my personal experience of the process, I can make the trip less daunting for others who travel with chronic health conditions or mobility impairments.

Knowing what to expect can ease anxiety.

Each of us deserves equal access to the wonders of the world, but a little extra preparation can go a long way toward smoothing an otherwise bumpy path for those with special needs.

Arriving at KTM airport

I was fortunate to have the means to fly business class between the USA and Nepal, but 16+ hours of flight time still induced a flare of my autoimmune condition.

I will write a separate post reviewing my flights on Qatar Airways in the near future. You can also look forward to my review of the resort where we stayed for six nights while DH attended a conference on site.

My husband and I traveled from Boston (BOS) to KTM (Kathmandu) via Doha, Qatar (DOH) in late 2022.

Special Assistance is free, but it takes extra time

As is true in most of the world’s major airports, cost-free* wheelchair assistance is offered at KTM, Kathmandu’s Tribhuvan International Airport. I have never encountered fees for special assistance, including in both Qatar and Nepal.

Special assistance should always be requested in advance, ideally when booking your airline ticket. It is much harder, when traveling on common carriers, to call for a wheelchair at the last moment than to decline one that was ordered just for you. If there’s any chance you’ll need ride through an airport, have it noted in your reservation.

You may change your mind at any later point and walk yourself through the airport without creating negative consequences. I’ve never had refusal of a wheelchair at a departure or intermediate airport affect subsequent legs of the same trip, I’d never been lowered from a jet in a scissor lift before this trip, then did it twice on one day. If you’ve never seen one of these conveyances, imagine a shipping container (or very large commercial elevator car) with accordion-folding doors on each end and a scissor lift beneath to raise and lower the box. Outside each door is a small platform with safety railing to bridge the gap from lift to plane door, or from lift to tarmac..

Usually, one can specify the need for assistance through the terminal, only with stairs, and/or to be taken all the way to one’s seat on the plane itself.

Typically, one can enter a special request for assistance while self-booking online, a travel agent can do it, or it is also easy to add to a reservation after the fact with most airline mobile apps and websites. Calling the airline reservation center should also be an option, and generally would not incur a fee for speaking to an agent.

While I can and do walk in my daily life, and I don’t constantly require an assistive device to get around, I do occasionally use a cane when a knee or hip acts up.

I wrote about acquiring my cane in this post.

Purple aluminum HurryCane walking stick freestanding on a wood floor

I always benefit from not over-exerting myself while in transit. I sometimes struggle with stairs, and my energy often flags across long distances. In a strange airport, it can be hard to predict exactly how far one will need to walk, or when a new challenge might loom.

Scissor lift assist when jet bridge isn’t available

For my connecting flight—landing in DOH—and upon arrival in Kathmandu, exterior staircases were used instead of jet bridges to offload passengers from the planes. This can be an intimidating sight when your joints have stiffened up after sitting for many hours or if you’re bleary eyed with fatigue.

Special assistance meant waiting to be the last guests taken off each flight, but being lowered in a scissor lift in a group with other less-abled passengers felt much safer than navigating steep steps holding a carry on bag and my cane after dozens of hours of travel.

I’d never been lowered from a jet in a scissor lift before this trip, then did it twice in one day. If you’ve never seen one of these conveyances, imagine a shipping container or very large commercial elevator car with accordion-folding doors on each end and a scissor lift beneath to raise and lower the box.

Outside each door is a small platform with safety railing to bridge the gap from lift to plane door, or from lift to tarmac.

View over shoulder of passenger seated in wheelchair showing door to scissor lift and Qatar plane behind

Passengers step or roll via mobil ramp across the entry platform to enter the lift’s boxy compartment. Airport staff—always two or more, in my limited experience—direct and assist passengers throughout loading and unloading, and one specific employee, perhaps appropriately called the driver, operates all the scissor lift machinery.

Doors are secured before the vehicle moves up or down, and every step of the process feels as though passenger safety has been carefully considered.

Inside the two lifts I experienced, one had eight installed seats filling half of one side of its interior space to accommodate self-mobile passengers like me, and the other was just a large open space. Both lifts arrived at the jet with airport wheelchairs already on board, so it was always possible for me to sit during the transfer process, whereas my able-bodied husband only took a seat for the fifteen minutes or so of the transfer on the former lift design.

At KTM, wheelchair attendants rode the scissor lift from the plane with their assigned guest. At DOH, by contrast, the lift lowered passengers to the tarmac, a transfer bus brought us to the terminal, and only at the airport building did an attendant take over care of a passenger.

Kathmandu’s system was much quicker than Doha’s, if not speedy overall, but also reflected the smaller size of Nepal’s airport, making the trip by foot/wheelchair between any two gates fairly trivial.

Analog wall clock showing 12:06

Do yourself a favor if you have any mobility impairments at all, and insist upon at least an extra hour’s time cushion if you require special assistance at Doha (DOH) or Kathmandu (KTM.) We waited 15-20 minutes longer than passengers who could manage stairs before we were able to deplane.

KTM airport wheelchair does not have luggage shelf

While some airports provide sturdy, rigid-framed wheelchairs including a shelf under the seat for a full-sized carry on bag, KTM did not offer this type of chair. They gave me a ride in a basic, folding transit wheelchair with a sling seat. I was fortunate that DH was traveling with me and could manage our bulkier hand baggage.

View of passenger in wheelchair inside lift used to lower people from planeMy tote bag sat in my lap while I used a wheelchair in Tribhuvan International Airport. If you will travel alone and require wheelchair assistance here, pack a spinner-type wheeled bag that can easily roll alongside while you hold its handle or use luggage you can hold comfortably in your lap.

Tarmac beyond exit gate from scissor lift with gate still closed

Compared to other airports I’ve passed through, one spends more time outdoors crossing the tarmac and exposed to the elements at KTM. Ideally, be dressed for the climate upon exiting the plane here.

I was glad to be visiting during the dry season where feeling cold was our only concern.Crossing from plane to airport terminal at KTM in the open air

Passport control in a wheelchair & airport experience

Our flight touched down three minutes early, at 01:12. While that’s a disorienting time to arrive, a benefit is that port facilities are less likely to be crowded in the pre-dawn hours.

I’d read of confused—and confusing—hoards at KTM, especially slowing down the Visa on Arrival process where one needs to visit several distinct counters in a specific order, but we conducted this necessary business fairly quickly. Certainly, I’ve waited in much longer queues for Passport Control in Boston and at other major airports.

Buddha statue at entrance to KTM from runway with arrivals hall and passport control visible beyond

Because I had a wheelchair attendant conveying me through KTM, we went directly to the correct station for our visas and then passport checks. That doesn’t mean the process was completely without hiccups, however!

As I’d read online, completing a Nepal tourist visa application online and printing out the subsequent confirmation sped up our arrival paperwork. Having entered two sets of data for myself and my spouse, however, on the same computer and at roughly the same time… my information was immediately found in the system, but there was no record of my husband’s application.

We both had submission IDs and printed receipts, too.

Here’s a link to the Online Visa Application for Nepal. Make sure you visit the official Nepalese government site as there are a few scammy looking ones that come up in search results.

Two printed confirmations of Nepal online visa application submissionThere was a bit of conversation between the wheelchair attendant and the gentleman working the visa counter, but nothing more than time was required of us, the visitors. Either the clerk re-typed DH’s data off the printed confirmation form I’d handed over, or he discovered it in the computer after all. Within ten minutes or so, we were given the receipts necessary to proceed to Passport Control.

I brought the mandatory $30 visa fee for each of us in US dollars and had the funds paper clipped to our printed copies of the online visa application acceptance document. This worked smoothly, and kept me from having to fumble in my wallet in a state of exhaustion, stiff-fingered and stupid with fatigue.

If I can avoid flashing cash and showing what is in my wallet in public while traveling, I do so. For similar reasons, I carry at least one credit card, a photo ID, and some cash somewhere else on my person in addition to my wallet as well.

As advised by the internet, I did take care to use fairly clean, smooth bills to pay the visa fee; I’ve seen it reported in many places that crumpled, marked, or even folded dollars might be rejected by money changers in Nepal. I opted not to take the risk of bringing currency in poor condition.

After the visa process, I found it interesting that the wheelchair attendant took me to a counter signposted for those with free visasi.e., not my nationalitywhen we approached the passport control booths. The same fellow directed DH to the regular lanes for foreign nationals.

Passport control was one of the rare times when we did not stay together in transit. Staying with one’s group is typical when only one member requires special assistance.

US Passport book and airline boarding pass

Also, while my attendant cut the line and took me directly to a particular passport control booth, my husband’s paperwork was actually processed much sooner, and he stood waiting for me on the other side of the row of inspectors for approximately 15 minutes. I got the impression the attendant intentionally brought me to a certain agent, possibly a manager, but I have no confirmation of this notion.

The agent who processed my passport disappeared with it for several minutes after another employee walked up and asked her what seemed to be an urgent question. I experienced some trepidation as my identification left with her from my line of sight! Upon her return, there were no other unusual questions or procedures, and I did get my passport back in the end.

If standing for an extended period of time is taxing for you, I recommend requesting special assistance at KTM and taking advantage of a wheelchair escort. There’s no telling exactly how long each step in the immigration process will take, and it is much easier to manage forms, documents, and funds while seated and with reduced pain.

On the other hand, Kathmandu’s airport is not particularly large. It requires far less walking than Doha, for example. At KTM, I would base the decision to opt for a wheelchair on:

  1. ability to descend stairs,
  2. time one can spend comfortably standing in line at customs, or
  3. concerns about being jostled in a crowd.

Distance traveled is not the most difficult feature of Tribhuvan International Airport.

Exiting the airport & finding your ride

Our instructions from DH’s conference organizer told us to claim our baggage, then proceed to the ground transportation area. There, we would find a chauffeur holding a sign with our name ready to drive us to the hotel.

Still riding in the wheelchair conducted by the same attendant, we passed through a security checkpoint on the way out of Customs and Passport Control. There was a standard metal detector—i.e., not the arms-up body scanner glass box—but I wasn’t asked to get up or walk through the arch.

Fortunately, we also didn’t need to remove our liquids or electronics at this checkpoint, either. I’m not even sure the metal detector was turned on because it didn’t sound when I rolled through it in a metal chair.

This was my first experience of security at the exit of an airport.

Baggage claim was lively and crowded, but, again, not excessively so compared with other busy airports. Given the early hour, however, I imagine it could be a circus at its peak capacity.

According to Wikipedia, the international terminal at this airport currently serves more passengers than its official stated capacity.

Screen grab of KTM Wikipedia page showing passenger volume statistics highlighted

Because we were the last ones to leave our plane, and since my passport control process was slightly protracted, our checked suitcase was already off the conveyor belt and waiting in a small collection with a dozen or so others on the ground nearby.

I’d read that baggage claim tickets would be compared to the tags on suitcases at KTM, but no one inspected our tags as we left with our checked bag.

Photo of luggage on airport baggage cart

I’d also read that enterprising types would attempt to trick us into paying for an airport luggage cart though these are actually free for anyone to use at KTM. The attendant procured a cart on our behalf, however, so there was no need for us to fend off overzealous would-be porters.

Luggage in tow, the wheelchair attendant escorted us down a long, curving hallway and outside to the ground transportation area where taxi drivers jockeyed and chauffeurs with signs waited across the roadway. I rode in the wheelchair; DH pushed our baggage cart.

I noticed the room with a row of ATMs I’d read about online at this point. It was quite near the terminal exit. Only one cash point appeared to be working if my quick glance as we sped by can be trusted. I based that assessment on all screens being dark except for one.

I was glad we didn’t have an urgent need for currency. The area felt secure enough, but there were a few people lingering near the bank of ATMs.

Outside, the special services attendant brushed off an aggressive taxi driver and directed DH to go find our chauffeur in the scrum across the way. The attendant waited with me in the chilly night air, asking politely about our travels.

Tip for wheelchair attendant & currency conundrum

When DH returned, reporting that he’d found our driver who would get his vehicle and circle around shortly, I thanked the attendant for his assistance and offered him a $10 tip in US dollars—the only currency I had—which he accepted and appeared to appreciate.

I told him I would be fine to stand for the few minutes it would take until the driver picked us up, and I wanted to stretch my legs before climbing into yet another vehicle for the trip to the hotel. There was no reason this fellow needed to wait outside with us in the cold when he could return to helping other passengers inside the terminal.

It’s hard to know when and where wheelchair attendants expect a tip. Those of us requiring special services are a minority, and tipping culture is controversial anyway. My feelings about tipping these vital members of port staff are as follows:

  • Many people require assistance
  • Not every person can afford to tip, and there are valid reasons for travel that don’t require the passenger to be a rich person such as family reunification and medical care
  • I can afford to tip and am traveling for leisure
  • Some places in the world, like the U.S.A., allow “tipped minimum wage” salaries that are pitiably low if no voluntary tips are offered by people like me

In this case, I had no local currency, so I tipped the same amount I would have for similar service in the U.S. i.e., more than might be the going rate in a country with a lower standard of living, like Nepal. The gentleman who assisted me will have to convert those funds to his own currency, and I preferred to overpay to make up for that inconvenience.

Pile of money

I would love to hear from other users of airport special assistance about how they handle tips in the comments. I can’t be the only internet user struggling to figure out whether—or how much—to tip for wheelchair assistance around the world, and I’ll gladly provide a forum to host that discussion.

From our plane’s arrival to driving away from KTM, we spent roughly one hour and ten minutes in the airport making use of wheelchair assistance for ~45 minutes of that time.

Jolting through the night from KTM to The Terraces

It was 02:24 by the time I sent a text message home letting the family know we were in a car and headed to our hotel. Though the airport itself bustled with people, the streets we drove through thereafter were deserted save a few stray dogs.

I’ve read about Kathmandu’s traffic, and appreciated skipping that, but I would have enjoyed seeing more of the city itself as we passed through it.

The driver informed us it would take a maximum of one hour to reach our destination.

My immediate impression of Nepal in darkness was a jumble of buildings in combinations unlike any I’d see at home, winding roadways formed on no obvious plan, flashing lights on one block with pitch black the next, and signs in a mixture of foreign script and Roman characters I could interpret.

Air pollution’s effect on sensitive individuals

We chose to wear masks throughout our travels though none were required, but I could still smell woodsmoke on the air through my N95 in some areas. The smoky scent increased as we climbed the foothills and left the city for its outskirts.

Sensitive travelers should know, I experienced readily discernible air pollution, but just enough to tickle my throat, and the level did seem to improve noticeably as we left the city for our hotel on the valley’s rim. My advice is that anyone with asthma or environmental allergies take all possible precautions before coming to Kathmandu.

Rough roads challenge easily injured bodies

DH’s conference was held at the comfortable, modern resort, The Terraces, which compares favorably to fine hotels worldwide. The road to get there, however, plainly reflects Nepal’s status as a developing nation.

I felt I was being literally beaten by the vehicle as it pitched and jolted over the uneven surface. There were switchbacks and hairpin turns, and, a few times, our wheels skidded on loose gravel.

Frankly, I was glad to pass this way in the darkness. I wasn’t sure I’d enjoy seeing what were likely sheer drops with no guardrails by the side of the road.

For those with chronic pain or anyone sensitive to rough motion, it might be advisable to stay overnight near the airport and take extra time to recover from flights before venturing forth on Nepal’s roads. Given the status of their infrastructure, getting from point A to point B may present more pain than those of us from wealthy nations are used to.

Again, if you live in pain even without an outside stimulus causing it, this may be the time and place to consider other modes of travel—I expect to take my first ever helicopter ride here—beyond buses or automobiles for anywhere outside Kathmandu itself. The people of Nepal are eager for improved roadways, but they haven’t got them yet.

Warm greetings on arrival at our destination

Sign at entrance gate to The Terraces resortThirty-four minutes later, we came to the gate of The Terraces. A security guard let us in after conferring with the driver, and our long journey ended with a gracious greeting by not one, but two, night clerks at the front desk.

Though getting to Kathmandu presented me with challenges and more physical discomfort than most flights and drives, I can’t stress enough how very welcoming every Nepali individual was along the way. You will have to work to make it here, but you will find those you meet eager to assist you if they can.

If you can manage the challenges I’ve described, take the journey. The cost may be high—in dollars, energy expended, or discomfort to be endured—but so is the value of the experience. Nepal is a place of wonders, magnificent and replete with compassion and joy. It’s worth the trip.

* American carriers and airports are required to provide mobility assistance free of charge to any passenger who requests it in advance, though tipping these assistants is common practice in the USA.

For comparison, I’d say wildfire smoke in southern Oregon affects my throat and breathing more than what I found in Kathmandu on arrival, but the air quality is not unlike Los Angeles was in the early 1990’s when the smog I breathed in on a trip there caused me to lose my voice over a period of a few days.

Home education success: elite college acceptance!

For modern, middle class American parents of high school seniors, there can be perhaps no better holiday gift than finding out one’s child has been accepted into the college of his or her choice. Getting the financial aid package one needs to make attendance feasible is often a close second.

My own baby-who-is-now-technically-an-adult received the good news this week. He was accepted Early Decision* to his preferred university. The kid certainly did most of the hard work for this achievement… but, as a home educating parent, I’m going to take at least a small bow for my part.

Together, we took the road less traveled by, and that gamble appears to have paid off. It may not have “made all the difference,” but our unique choices do appear to have impressed the admissions officers in question.

About 3% of U.S. students elected home education over the past decade, except during the pandemic, when the rate jumped to an unprecedented 11.1%. (Source: Census.gov)

According to published statistics from my child’s intended university, just over 11% of applicants were accepted in its previous class. I mention this statistic as a nod to my kid’s hard work and success, but also as vindication of the fact that the typical way is not the only way to get into an eliteschool.

My kid never took an AP course or exam… but he did start attending Community College courses as a high school freshman.

If you’re lucky enough to live in a school district that offers a Dual Enrollment program to its students, your children might earn actual college credits for less than the fee required to take an AP exam that only claims to approximate college level learning for the high school audience.

Why settle for the simulation?

My own selective private college did not grant any credit for students arriving even with the highest AP exam result of five out of five. All I got for that expensive test fee ($96 in 2021) was the ability to replace mandatory Freshman English Composition class with the Literature course of my choice. Total savings: $0. A department placement test could have granted the same privilege for nothing but an hour of my time.

AP classes and exams, like the SAT, are products offered exclusively through the “nonprofit” organization, the College Board.

This Wikipedia article gets at some of what bothers me about the College Board.

I’m all for high standards, but I think that an annual gauntlet of standardized tests actually lowers the level of meaningful engagement for most while offering any given student no educational advantage. Does anyone believe kids today find the standard curriculum particularly relevant or intellectually stimulating? Test takers themselves get nothing for the hours they spend sitting these exams.

I also think a test all but required for university admission should be much less expensiveto everyone, without submitting embarrassing financial aid forms–than the SAT is. Not everyone can spare $55 plus all the extra potential fees one could accrue, but we’re all aware that wealthy families typically pay hundreds if not thousands more for “optional” tutoring, multiple test-taking attempts to increase scores via brute force attack, or to flat-out fraudulently pay a ringer to replace their less able children at the desk on exam day.

No, if a test is going to be mandatory for college admission, it should be offered, at minimum, at every public high school for free, perhaps in place of one of the other annual exams our taxes already pay for.

Beyond the College Board’s offensive effect on students’ schedules and pocketbooks, I’d argue that the directors of an education nonprofit reaching its fingers into the pockets of every college-bound student in the country should earn far less exorbitant compensation. The CEO earns well over $1 million annually. There’s no genius required to squeeze money out of a captive audience desperate for the elevating power of a prestigious degree.A red leatherette University degree folio stacked with a black High School diploma case

In case it isn’t obvious, I’m a huge fan of the move toward test-optional admissions that the pandemic accelerated. My child did choose to submit scores because one of his safety schools requires them specifically for home educated applicants. His efforts earned solid, if not spectacular, results. That was “good enough” because home education for high school allowed for the accumulation of more than thirty actual college credits along the way.

What better evidence that one is well-suited to college level work than a 3.96 GPA… at college?

I’d like to see even more options available rather than definitive “test blind” policies dictating against even considering any test results.

Given my druthers, I would let students select for themselves how to put their best individual feet forward. I appreciate startups like the CLT (Classic Learning Test) seeking to disrupt the status quo though I liked them a lot more when the CLT10 alternative to the PSAT was free for all takers. It now costs $44, and the SAT-equivalent CLT $54, while being of interest to far fewer institutions than the SAT or ACT.

As a rule, I abhor most of what the College Board stands for today as a barrier between those who yearn for an education and college admission. Historically, when the SAT was closer to an IQ test than a Common Core final exam, its limited usefulness was more obvious for students whose schools didn’t offer advanced coursework. I’m happy that we engaged so little with that organization, with an October sitting of the SAT our sole act of acquiescence to their extortionist monopoly.

Perhaps it would be better if individual institutions returned to more unique applications and processes, testing would-be students for themselves on exactly what matters to their program. The Common Application (and its cousin the Coalition Application) may have removed the drudgery of filling in repetitive information across multiple similar forms, but the ease of shotgunning applications has also led to ridiculous bloat in the average number of schools considered by each student.

The average cost to apply to each college in America was $44 apiece in 2020 (arithmetic mean, most likely), but elite schools more often charge around $75, and some institutions expect more than $100 per applicant just for the chance to be rejected! Here’s looking at you, U.C. San Diego & (bafflingly) Arkansas Baptist College.

Kids are applying to more universities because they are afraid they won’t get in to any of the places they’d really like to attend. A return to specialized applications could ease this inanity.

I tend to be somewhat contrarian, if that’s not obvious, and I made that fact clear to my child as decisions were made during his home education journey. “Typical school enrollees do this,” I would point out, “and here’s how I feel about that, but this other position might make you more competitive.”

My opinions did seem to influence my kid, but the application process was his own. We did not supervise or monitor his application. We didn’t even see it§ until he was finished. At that point, he asked both parents to be proofreaders a day or so before the submission deadline.

That’s the way it should be when a child reaches the cusp of adulthood. That was the underlying foundation of every lesson I sought to teach my child via home education. If he had an idea for a way to reach the goals we’d set, it was his right to try that way unless it proved ineffective or inconvenient.

Modern institutional schools are a mere blip in human history, and learning is available to all of us, from far more corners than educational power brokers would lead the masses to believe. Strict policies and procedures tend to be convenient for bureaucrats, not conducive to individual excellence.

My hat is off to my dear child who did the work, made his choices, lived with their consequences, and seems to be reaping the just rewards of all that effort.

If you’re a potential homeschooler or home educating parent reading this while mulling your own options, I encourage you to follow your instincts and do what feels right for your child or yourself if you are the student. That may look “normal,” or it may give the relatives pause. Where the result is a young person gaining skills and internalizing the value of education for its own sake, damn the optics.

My child is one more data point showing there’s more than one way to get admitted to an excellent college in 2021. Your kid could be the next.

Best wishes to the class of ’22, and may all of your dreams–college or otherwise–come true.

*Early Decision, as the name implies, is an application process whereby a student submits materials early to one and only one college, creating a binding agreement to matriculate to the chosen institution if accepted. “Early” means applying by November whereas the usual deadline is January. In exchange, the student knows by mid-December instead of in the spring if s/he’s been accepted.

Early Action is a similar, but non-binding process, for those who’d like earlier decisions without committing to attend a certain school. Often this is to allow for comparing merit-based financial aid packages, which can make or break a deal for middle class kids.

I’ll use the term “elite” because this university ranks within the top 50 domestic schools according to US News & World Reports. For my child’s privacy, I prefer not to make public his choice of institution.

Dual Enrollment, sometimes called Concurrent Enrollment, usually refers to a program wherein high school students take college courses and earn simultaneous credit toward a secondary school diploma and future university studies. Wikipedia offers a more detailed description, but these programs vary widely in availability and cost between states or even by local community. For example, our district offered full tuition for one course during a single year of of my child’s high school period. Because the state program funding Dual Enrollment was directed toward communities in need, and our city’s demographics improved at the community level, he was only eligible for free tuition in 9th grade. Since then, we paid out of pocket for higher education classes, mostly at our affordable local community college.These costs were significantly lower than private high school tuition would have been.

§As a home schooling parent, it was my responsibility to prepare a letter in place of the usual college admissions counselor recommendation, but I logged on to the application through a separate portal unique to educators. I could only see what the student applicant would normally show a counselor.

Transparent pricing is literally the least we can do to improve US health care

There are very few actions or aims of the current administration of the United States Executive Branch with which I agree, but one such rare alignment won a legal victory this week when Judge Carl J. Nichols ruled against the insurance-dominated medical establishment in favor of American patients.

The U.S. District Court ruling agrees with the White House that it is reasonable to force medical service providers to publish a full accounting of negotiated prices for their services. Disclosing the price a patient would pay if s/he elects to pay cash will also be required.

Insurers say their negotiated prices are their own secret treasures to share with providers, and that we—the consumers, the patients, the worried loved ones—don’t deserve to know what they are. I say that insurers offer so little value relative to the enormous fees paid to them that their wishes are irrelevant and a distraction from the goal of almost all Americans to have better health care with fewer going bankrupt to pay for it.

I believe that the administration of the U.S. medical care system could be improved in almost every way. That said, cost transparency requires no bipartisan agreements on contentious issues such as rationing of care or how much in dollars a government owes each citizen in the provision of health care.

Price transparency will cost almost nothing save a few hours of administrative work by hospital staff. Typing up and publishing these lists will take a minuscule fraction of the labor hours currently spent on insurance billing. In exchange, and, for the first time in decades, cost-conscious consumers of health care—the ill, the injured, the infirm—will have at least a passing chance to vote with the pocketbook by taking business to more efficient providers. Continue reading

Children, First Class, disability & who “deserves” to sit where in an airplane

Because I at least try to be a considerate and thoughtful traveler, I regularly look up phrases to suggest “the best way” of doing things. One such example? Parents traveling in First Class whilst their children trail along in steerage a lesser service category.

What I find most fascinating about the search results is the concurrent expression of two opinions that lead inexorably to parent shaming without a solution:

  1. Children don’t belong in First Class unilaterally!, while
  2. Parents who “abandon” their kids in Economy while riding up front themselves are monstrous jerks who should be drawn and quartered (or at least shot.)

Essentially, the sum of those two arguments leads to the conclusion that parents ought never travel in First Class while their children are under age.

Here’s where I’ll swing back around to a point I’ve stressed on this blog before: I often purchase tickets in premium cabins because of my health. Chronic autoimmune illness makes that option more comfortable—but also safer and healthier—for me.

I live with chronic pain.

Every day, I probably ache in at least a few joints. Travel—otherwise one of my great joys—can make my symptoms worse. A larger, more adaptable seat does help. More room, easier access to a lavatory, and the simple comfort of a foot rest or extensible leg support makes the difference between a successful trip and a multi-hour torture chamber.

Note that the acquisition of a more comfortable seat is something I do in addition to taking the most powerful opioid painkillers I’ve got. In transit, I will still suffer more pain than my daily average with these interventions. I choose the world-expanding possibilities of travel in spite of the cost, but the calculus for any given trip can be complex.

If there were legal protections on a minimum amount of space per passenger on a plane, the actionable facts in this argument could be different. If I were guaranteed a seat in Coach that provided enough room to shift position and freedom from being kicked and elbowed by even a plus-sized seat mate, I’d be open to debating the courtesies of keeping younger travelers out of the pointy end of the plane.

Since that is a pipe dream, however, the traveling public is going to have to tolerate my presence in Premium Economy and better, when I can afford it. And, where I go, there also will travel my children when I deem it desirable that they join me.

Given these facts, which option is preferable to the segment of society that objects to children in First Class and kids seated away from their folks?

My own choice is usually dictated by my finances.

When I score an awesome cheap fare up front, I typically book my little guy (middle school aged, so not so terribly tiny) in the seat next to me. He is delighted by the idea of a luxury trip, though modern domestic First Class is a far cry from gold-plated splendor. I prefer having his company to sitting alone.

Then again, I do actively discourage any sense of entitlement to this, my more peer-influenceable child. He has also known the joys of sleeping in a cramped Economy seat on a too-long/too-short transatlantic flight, and he knows full well how to wait his turn in the interminable queue to board, settle quickly into his seat and stow his own carry on, and then keep himself to himself en route to make the uncomfortable as tolerable as possible for everyone else aboard the jet.

The older teen would rather sit on his own regardless because he’s way too cool to be seen with me, so he’s stowed in steerage unless a really high Coach fare is actually a poor value compared with the mileage earning and family togetherness opportunities of a bargain up front.

Don’t gasp–it does happen! Leisure travelers who covet rock bottom fares and business travelers whose companies pay top dollar tend to prefer flights on different days and times.

Always check fares in all classes before booking! You may find First Class for less than Coach. It’s rare, but I have seen it* myself.

This summer, I’m accompanying my husband to a conference in the UK and we’re bringing the little guy along. On the way out, his ticket, purchased with frequent flier miles, is in Comfort+ (i.e., Premium Economy) while his father will be four rows ahead but behind the magic curtain in Delta One.

My own flight, also bought with miles, will be on a different date, itinerary, and airline entirely. We don’t have that many miles on any given airline at one time. Also, I often depart ahead of time to allow a day (or more) of recovery before entering full “tourist mode” and because I enjoy travel so much more than DH does. He rarely takes even a single day off concurrent with his business trips.

It’s a transatlantic redeye, so the kid is expected to sit, settle, and sleep. His “solo” presence is unlikely be a bother to anyone at all under these circumstances, even offering his adjacent seatmate a bit more space due to his small stature. Purchasing the equivalent to his dad’s company-paid Business Class seat was simply out of our reach.

To be clear: I, personally, am not talking about abandoning a toddler 40 rows back from his responsible adult companion. Perhaps non-parents need to be told, too, that there is no single age when every child will be ready to sit alone. As with staying home alone without direct supervision, I’d judge the right age to be over six years at a minimum and by the age of 13 for almost everyone.

Our return to the US presents a completely different set of circumstances. The lo-o-o-ong nonstop flight from Ireland to the Pacific Northwest should see the boy wide awake and therefore more likely to want or need something from a parent, if only to ask if my usual strict limit of one sweet drink per flight could be adjusted, “just this once.” I also found a relatively low fare in a premium cabin whereas Economy on the direct flight I wanted was rather high. In this scenario, I’m opting to pay to seat my child up front next to me.

It’s been argued that children don’t appreciate the “best parts” of the premium cabin experience. For many travelers, that appears to be getting drunk! True, my son won’t be sipping champagne, and he isn’t overly inconvenienced by the cramped conditions in the cheapest seats so the extra room is “wasted” on him.

Both of us will enjoy easier access to the lavatory, however, and the better service offered by less harried flight attendants. My younger son is outgoing and friendly; he will appreciate plenty about traveling with a more gracious level of service. The fact that different elements of Business Class will tickle his pre-teen fancy doesn’t make his experience count for less.

Where will my teen be during this jaunt? Well, he would rather fly alone to visit his grandparents sooner and leave the UK to the rest of us. Somehow, I’ve produced offspring that aren’t as interested in foreign travel as I am. After a bit of practice sitting in Coach 20 rows behind me, he graduated to a solo flight with Unaccompanied Minor service around age 12. Now, though still in high school and underage, he’s old enough to manage his own passage through the security gauntlet and onto a direct flight without paying for the airline’s hand-holding.

My solo teen might also annoy those who like to complain, but he’s not an intrusive passenger with his slim build and quiet habits. On his last trip to visit Grandma, he texted me joyfully upon landing from his ultra cheap middle seat that the guy by the window didn’t need to pee even once. Never having to get up once makes a great flight by his metrics.

Glasses of wine and water on airplane tray tableFeel free to compare that behavior to the tipsy adult who spills his third drink all over you and your laptop. The guy may offer to pay for your dry cleaning, but you’ll be wearing stained and sticky pants for the next half a day regardless.

*This actually seems to be most likely around holidays when families travel to be together. What a great way to treat yourself if clan gatherings are a source of great stress as well as joy for you.

If there were a way to get him booked into a hotel without an adult in the event of delays or flight cancellations, I would trust him to make connections, too. The boy is downright competent!

10 hour airport layover teaches me: airport showers are awesome & often accessible

If you’ve never stepped foot in an airline lounge, you might not know that some of them have shower facilities. That isn’t very important for most of us who take the occasional domestic flight, but it can be a real game changer after a red eye or when laying over before an international long haul.

img_7364You don’t need a First Class ticket to use an airport shower facility, though you’re more likely to gain access for “free” if you spent a lot more for your ticket. At DFW, for example, the Minute Suites Terminal D location–a nap cubicle “hotel” past security in the airportalso sells shower passes with no private suite rental required.

Expect to pay around $30 to buy access to a fee-based airport shower facility, or around $50 per traveler if you’re purchasing access to an airline lounge like the American Airlines Admiral’s Club I used at DFW.

I probably wouldn’t have paid for a shower during my ten hour layover in July, but, having taken one in part to kill time after I’d visited every terminal and viewed all of the public art in DFW’s brochure, I would consider paying for a shower the next time I’m spending more than a few hours cooling my heels en route.

For me–an introvert with arthritis–I got about equal pleasure from two separate aspects of this experience. First, being totally alone in a room after hours of being in public. Second, the nice, warm shower itself, which always does some good at easing my joint pain.

DFW Terminal A Admiral’s Club shower

img_7366img_7367Can you ever feel really, REALLY unhappy when looking at a pile of fluffy white towels someone else has placed for your comfort and convenience? I can’t!

Everything you need comes with the key to the private shower room at the Admiral’s Club-DFW Terminal A location. Ask at the front desk to get access.

Shampoo, shower gel, Q-tips, and cotton balls are in place in the room, ready for your use. I used my own, of course, since sensitive skin is another fact of my life, but the products offered weren’t overly perfumed. This is a reasonably safe space/experience for those of us who get headaches from strong fragrances.

DFW Admiral Lounge AA shower - 1There were more towels than I needed, enough that I might ask, next time, for just what I would plan to use to save the water/energy of washing untouched linens. The space was quite scrupulously clean. There’s also a luggage rack to keep your suitcase above* the damp, and a hairdryer if you want it.

Since I was feeling quite well, I forgot to ask if there were accessible showers, but either they all are in this Admiral’s Lounge, or I just happened to get one that was. It had a fold down bench in the shower enclosure and an adjustable height hand shower wand in addition to the rain shower head. You won’t lose out on luxury if you just need grab bars sometimes, like me.

If you can’t stand at all, you might need to ask the staff to lower the hand shower to an appropriate height on your behalf. Mine was set way up at the top of its range when I walked in.

London Heathrow AA Arrivals Lounge shower

In addition to the Admiral’s Club shower at DFW, I took advantage of the same perks included with my First/Business ticket, purchased with Alaska Airlines frequent flier miles on AA, and visited the American Airlines Arrivals Lounge after retrieving my checked bag at London-Heathrow (LHR).

LHR Arrivals Lounge AA shower - 2LHR Arrivals Lounge AA shower - 3

LHR Arrivals Lounge AA shower toiletries - 1Though without a doubt the more hygienically important shower I enjoyed during the trip, the Heathrow shower room was smaller, less well appointed with little extras, and decidedly not accessible. (Again, I failed to ask specifically for a stall equipped for mobility impairments, so this is what you get without asking for special treatment.)

LHR Arrivals Lounge AA shower - 1There was no luggage rack in the compact LHR Arrivals Lounge shower room, leaving me to wedge my full size carry on next to the sink on the lavatory counter itself. I had checked a mid-size rolling suitcase, which you can see standing on the floor beneath the counter and blocking the exit door in my photo.

Perhaps there was luggage storage somewhere else for those who pack heavily, because there certainly wasn’t space in the shower room for large checked bags!

It was as clean as you would expect, however, and made the transition from night flight to the Tube less stressful than it might have been in spite of temps in the 90’s on London’s non-air-conditioned subway cars.

 

Dublin, Ireland 51st & Green Lounge shower

Upon my return from the United Kingdom to the USA, laying over at Dublin (DUB) airport, the 51st & Green Lounge, post security, was free for USA-bound Business and First Class customers, but accessible to anyone willing to pay the €39 entrance fee.

DUB departure Lounge 51st and Green shower - 1Shower use is included in the price, but there is just one accessible stall available, and it is combined with the only wheelchair accessible toilet in the space.

img_7478 This accessible bathroom/shower—also serving as the sole baby changing space— is in a different area than the main restrooms, also off the main entrance hallway but a bit further along from the front door. Thankfully, this made it a bit closer to the lounge’s seating areas. The primary restrooms felt like a real trek as my arthritis acted up during my wait.DUB departure Lounge 51st and Green showers - 1

Knowing that no other handicapped toilets were available if I opted to use the shower made someone with generally good mobility like me hesitate to even consider taking one, though I was having noticeable symptoms even before my nine hour flight home and the hot water might have felt good. There was another passenger in the lounge who appeared to be confined to a wheelchair when I was there, reinforcing my feeling that taking an unnecessary shower would be a bit selfish.

The standard shower room looked reasonably spacious for my purposes, but it didn’t have a safety hand rail. With a knee acting up that day, it didn’t seem worth taking a risk.

Fortunately, it was neither a blazing heat wave such as I suffered in London, nor a double digit hours layover like my time in Dallas, so foregoing a test of the 51st & Green shower facilities an hour after I’d left my Irish hotel was no real sacrifice, except to my ability to share the experience with readers here. There are few reviews of this particular shower, but most USA bound flights from Ireland leave in the morning, so perhaps the demand is simply low, and a single stall is adequate.

The 51st & Green Lounge was lovely, very new, and everything else was to a high standard, though, leading me to expect the showers would measure up.

*Though the shower drained properly and no water spilled out of the enclosure or anywhere near my luggage, I would advise travelers to always assume the worst with unknown plumbing and place all belongings somewhere high and dry, just in case.

I thought I was going to see a man laden with bags die in front of me on the London Underground. Ugh!