Pat’s Place: Flying The Friendly Skies – Should I Wear A Mask Post-Transplant?
I just returned from my first air travel since my stem cell transplant in July.
It has been ten weeks since my stem cells were infused back into my body and seven weeks since I returned home.
All of this begs the question: Should I wear a protective mask in the airport? How about on the plane?
Those of you who read my column regularly know I normally take an aggressive stance when it comes to what I can and should do now that I’m home.
So far, all has turned out OK. I began eating out as an outpatient, even before I returned home. I paid for that a bit when mouth sores appeared, probably caused by glasses or utensils that weren’t clean enough for my fledgling immune system.
I followed this phenomenon closely—glad to learn the sores would heal in a matter of days. My immune system was working again!
I have gone shopping regularly since returning home. I am already doing housework—and even some light yard work—using a protective mask and rubber gloves.
So far, so good!
So it might surprise you to learn I decided to use my mask—at least on the airplane—during this trip.
I have received mixed messages when it comes to doing this. My oncologist’s physician assistant, Rick, reassured me I wouldn’t need to wear a mask by week ten—even on a plane.
“Airplane air circulation has come a long way,” I remember him saying. “Just stay away from anyone coughing or sneezing.”
My transplant procedure manual, provided by the Bone Marrow Transplant Unit at Moffitt Cancer Center, ironically begs to differ. It strongly suggests wearing a mask in an airport and on a plane for at least six months.
I have also read that wearing a mask on a plane is a good idea. Fellow transplant recipients have certainly suggested the same.
So in this case, I decided to comply and act conservatively. I wore my mask as I wrote this, flying at 30,000 feet over the Gulf of Mexico.
Fortunately, the plane was only half full. And since there wasn’t anyone sitting next to me (nice!), I probably could have skipped the mask. I did remove it long enough to eat some peanuts and suck down a cold beverage—non-alcoholic, of course!
Actually, wearing the mask was the easy part. The hard part was as I shook hands and hugged friends and acquaintances I saw on my trip and started thinking about my immature immune system being bombarded by all of those germs. I'll write more about that next week.
Feel good and keep smiling! Pat
Pat Killingsworth is a multiple myeloma patient and columnist at The Myeloma Beacon.
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Hi Pat,
Again, an excellent topic. A topic that I'm sure all of us MM patients have wondered about.
I still do not understand how my bloodwork can show a fully functioning immune system, but I'm told that it's fragile and not fully functioning.
I'm always suspicious that hospitals and doctors are required to go way overboard in advising us in order to protect themselves from liability.
I had my first SCT a week or two before you. I came home 3 days ago from my second SCT (21 days ago). Today I'm going to drive to town and put gas in the car. I will not wear a mask, against the pamphlets advice. But I will use my hand sanitizer religiously. On the other hand, I would approach flying with more caution, especially if this was the flu season.
Are there studies or is there hardcore evidence to support the need for these extraordinary measures of safety? I do not like wearing a mask and broadcasting my situation to the world. Maybe to a fault.
Pat,
Good topic. I have wondered about this as well.
I'm with you Pat, definitely wearing mask on airplane, through airport and in restaurants and restrooms.
I tend to side on the err of caution, since a minor bug can become a major problem post SCT. I would definitely wear the mask as well.
As much as I would not want to be stared at, I would console myself knowing, those folks are more a danger to me than anything and their sniffles, coughs, and sneezes can result in a life threatening infection..so I'm just gonna have to be stared at.
Funny thing about the masks is that I think folks think the wearer is contagious...lol
Have you seen the movie Contagion? Well, post SCT, I would even be willing to suit up with my own inflatable head gear with a hose to personal oxygen in my back pack.
I suppose what I am saying is that I am far more afraid of an infection than looking very odd and paranoid.
Stan and Suzie-
Thanks for your feedback! Interesting point about the restrooms, Suzie. I saw a report about how a flushing toilet can send water droplets flying and misting through the air for yards. Yuck!
It seems to be 'Murphy's Law' that if there is a person on board sick and coughing and sneezing, they will be near you in the plane! I have flown on quite a few trips since the SCT and did catch some colds afterward, even though I used a mask. It was just a light weight mask though, so probably wasn't good enough to keep out bacteria and viruses. Recently, I flew again and sure enough, was sitting next to a young man who was really ill and trying to stifle his bad cold or flu. I didn't get sick after that, so 18 mos. after the SCT, I think that my immune system is pretty good again. But I only have received my 'non-live' vaccines and have to wait for the 'live' vaccines until next year. Just hope I don't encounter anyone with measles!! Good point about not reading the magazines etc. BTW, I don't think one should feel self-conscious about wearing a mask in public...after all, in Japan, lots of people seem to use them routinely!
Dave sat at the window and I sat at the middle seat and would wipe everything down before he would touch them. Seat belts, tray table and magazines in the pouch were OFF LIMITS!
Nancy,
Just curious about your vaccine remarks.
Following a SCT do you have to have all immunizations again?
Hi Again! The way I understand it, all your immunities are wiped out when they give you the heavy chemo such as malphalan right before the SCT. After all, the purpose of the chemo is to destroy your existing bone marrow. Your marrow is where your antibodies are produced, nest-ce pas? In MM, it is the plasma cells that are mutated and cancerous and of course that is not good either since your antibodies are that very light chain protein which is a problem when it accumulates in the blood. So MM is a disorder of the immune system as well as all the other problems...which is why a person may have had multiple infections before the diagnosis (I know I had many infections but didn't connect the dots to it being a blood cancer).
So, anyhow, since your existing antibodies that you have built up over your whole life, including your childhood vaccinations, are gone, you can be re-vaccinated. Here, the public health clinic has a special nursing section for SCT patients. Interestingly to me, is that people who are going to have an organ transplant also get new vaccinations...I am not quite sure why though. Although I was anxious to get re-vaccinated and started asking my oncologist about it about six weeks before the one year anniversary, I had to wait and go thru the Bone Marrow Transplant Clinic to be signed off and approved. It's cute to go into a health clinic with all the little babies and toddlers and be one of their clients! I know from chatting to other patients that not everyone takes this route...some never got re-vaccinated but it seems like a good precaution to me. Last year I got vaccinated for Diphtheria, Tetanus, Polio, Meningococcus, pnuemoccus (a lot of strains of pneumonia are in the vaccine), influenza, including the dreaded H1N1, hepatitis B, HIP b.
nEXt year I can hopefully get the 'live' shots... measles, mumps, rubella and others deemed necessary (rabies, typhoid, cholera etc.). O f course I am not planning any trips to areas where other diseases are prevalent in the near future-- malaria, yellow fever, etc.
I was very scared when was going thru my SCT because at that time the H1N1 flu was prevalent. SomeonE i knew, one of my daughter's friend's mother actually died from that. She had an immune disorder and could not fight it off. It's scary to lose your immunity but in our cases hopefully we can build it back up again!
I'm glad you wore your mask Pat. Better to be safe than sorry. I will be wearing mine next month when I fly up north. I'm now 15 months post-SCT and I still get sick very easily. Right now suffering with my 2nd bout of bronchitis this year. All it takes if for one germy person to be near me. Dr. Rick at Moffitt wrote me a script for amoxicillin and it's another 10 days of antibiotics. My Team in Training workouts are stopped until this has cleared up. So far I've received 2 cycles of the 5 booster vaccines and the next round will be in December according to Dr. Alsina. So we all need to get those baby shots again after a SCT.
Hiya, Pat! Fantastic to hear that you are getting back into the swing of things.
I underwent my tandem ASCTs (outpatient at UAMS/ Feb & March 2009) and for a year after the last one, I wore a mask while flying. Because I'm in weekly maintenance chemo and have lowered WBC counts, I continue to carry antibacterial gels with me, take disinfectant spray for hotel stays and I don't pick up magazines in waiting rooms. I wash my hands often, don't touch doorknobs, bathroom fixtures or anything else my fidgety hands want to grab, w/out a paper towel and inspect things as best as I can in restaurants. I currently bring a mask in my carry on for air travel in case I end sitting up next to a fellow passenger whom seems to be successfully incubating some wildly interesting germs.
If I run into someone with a cold, I politely share that I am susceptible to colds and flu- they always understand and we skip the handshake or cheek kiss without problems.
In life I try not to set up situations to tempt others into questionable behavior e.g. I don't leave money hanging out of my pocket or my car running with the doors open.
And I don't tempt germs to take an easy access joyride through my body. Unwarranted or overboard? Rhett Butler and I don't give a ...darn. Stay well, Pat!
Wow Nancy!
That's for the terrific explanation.
While I understood that the disease was of the immune cells, I simply never connected the dots to a SCT abolishing all prior immunities. This is overwhelming. The thing about my diagnosis is that I only have the B in CRAB and really have not had any infections. Truth be told, that is the story of my life, I simply do not get all the colds, flu, upper respiratory tract infections despite living in cold climates. Other than having the mumps and chicken pox as a child I have not had infections nor has my family. So, I suppose we have been blessed not to be a household that gets colds/flus every season.Often times, I think the immunities I built up were due to working in the health care field in medical offices/hospitals.
But it is startling to learn how all those immunizations will have to be administered again. Like you, I would be especially worried about the measles since so many of these parents today do not vaccinate their children with MMR and the cases of chicken pox and measles are more virulent. All of which is to say, I would have been absolutely terrified to go into a facility with large numbers of little people under 2 years old who typically are exposed to so much stuff at daycare and the infants who are just beginning to muster an immune system of their own. Would have wanted to have on a decontamination suit, lol.
sigh
The good news is stories like yours give me hope. I know that the course is perilous but it is surmountable/achievable to get to a relapse phase.
I am so frustrated with the fear...because when I worked in HIV during the height of fatalities in the 80s there was so much hysteria and misinformation about the disease we use to have a poster and tell people that fear was an acronym for false evidence appearing real.
Unfortunately MM is not that type of fear...goodness gracious o how I wish it was.
O, BTW
I think you might have sent a reply yesterday as early on I saw your name in the forum ticker tape...but later on it was gone..and I did not know how to get back to where your response was poster.
All of which is to say, I was not ignoring you but rather just have not mastered moving around the site well.
Thanks for responding Nancy.
Hi Suzie Rose and All...I like the ability to chat online and discuss these sorts of issues. The other day, the topic was on how much to disclose to others.... fellow patients do have the same interests on this topic. If I talk about health issues to others, I should be prepared to listen to their problems too..although I find that with the 'C' word, sometimes other people don't want to bother you with their issues, and then you kind of get isolated from day to day concerns of others. And it doesn't matter how hard you try to explain it, bone marrow cancer is difficult for people to grasp, especially SCT issues!! And the topic of cancer scares people, with good reason.
Although of course I was dismayed to learn I had MM, I have done a lot of reading on the topic since then. Since my BSc (way back when in the '70s) was in Microbiology, I found that I could follow the writers for the most part and did review the immune system and other health topics. It doesn't hurt that my husband and one daughter are doctors, and the other daughter a registered nurse! Thus we are very involved in health care in general. The whole time I was in the SCT process, I felt that I was part of a cell biology experiment! Thank goodness the clinical trials for that were done in previous years, and by now the procedure is fairly standard and routine, even if it is pretty hard to take at times. AND it still has risks, which we must strive to avoid. And I guess I am still a teacher at heart, since one job I held was as a science teacher.
Enough said...thanks for feedback and like Pat says 'knowledge is power' ..Take good care of yourselves.
Looks like everyone is doing a great job communicating without me getting in the way! One xtra thing I'm doing this year is traveling to see my parents in Illinois in early November, instead of later in the year. Hopefully fewer colds and a bit warmer weather--and airline tickets were cheaper, since I'm not flying near the holidays- Pat
Hi Pat,
I would wear a face mask on an airplane if traveling now. I am four months post-transplant, but my lab values are still somewhat low thanks to two months on Bactrim to prevent PCP, a kind of pneumonia (I have changed to a different medication now.) So I think considering one's level of immunity is a factor. I will be flying over the Christmas holidays, and I definitely will take a mask or two in my purse just in case. I can handle looking "funny" better than being scared.
If my counts are still low in three months, instead of handshakes and hugs, I will continue to put my hands together in a prayer-like gesture, and if necessary, say I need to take a rain-check on shaking hands for a while longer. I've had people be very understanding thus far.
Thanks for bringing up this topic, Pat. I thought I was the only one who still considered wearing a mask.
Linda
You bet, Linda!
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