My husband Dilip and I have always enjoyed traveling. We like to see new places, and since we both have family members who live in different provinces and different countries, travel has allowed us to see many places.

This routine changed suddenly when I was diagnosed with myeloma in the summer of 2009. We did not travel at all while I was undergoing in­duc­tion therapy and the stem cell transplant.

We slowly resumed our travel routine once I started low-dose therapy with Revlimid ^[1] (lenalidomide) in 2010. Once I completed my Revlimid treat­ments in 2011, we were fortunate to be able to travel as we wished. I was in remission and did not have to worry about taking chemotherapy for more than three years. It was a window of opportunity to be carefree that I knew could be partially or fully closed at any time, given the recurrent nature of myeloma.

Last fall, my husband Dilip and I planned a week away to warm Hawaii in December. By this time, I had relapsed and started treatment with Revlimid plus dexamethasone ^[2] (Decadron).

It was clear to me that this trip would be different from the ones we have taken before because it would be the first time I would be traveling while being on such a strong treatment.

The first thing I did was to contact our travel insurance agency to let them know of my change in medications. This is a requirement from my private travel insurance plan. Even though any myeloma-related claim would probably not be covered (because, with my current plan, I have to be on the same drugs, or no drugs, for a year to get coverage), I nevertheless carry travel insurance to cover other medical emergencies.

When we told my oncologist about the trip at an appointment in early December, he suggested that I take precautions against developing blood clots, a potential side effect of Revlimid. I’m already taking low-dose aspirin, along with the high-dose Revlimid (25 mg), for the prevention of blood clots. However, my doctor recommended that I take four doses of Lovenox (enoxaparin), by injection, to avoid any clots from forming over the course of the direct, seven-hour flight. These doses would be administered on the days of and following the flights. In addition, the oncology nurse advised me to get up and walk around on an hourly basis during the flight, if possible.

When I packed for the flight, I prepared a vanity bag full of medicines of various types. The bag contained the Revlimid, dexamethasone, low-dose aspirin, trazadone (a sleeping pill for dex days), and a laxative. I care­fully put this into my carry-on bag, since I wouldn’t want to be without my meds in case my luggage was lost.

In addition to the Lovenox injection, which my husband administered to me before and after our flights, I put on a knee-high pair of compression stockings to help with blood circulation during the flight. The Lycra in them was so tight, it reminded me of a swimsuit with so much elastic in it that it instantly makes a person look 10 pounds slimmer!

Fortunately, all went well with the flight, and we found ourselves in what surely is a paradise on earth, the volcanic isle of Maui.

We rented a vehicle, but I did not sign on as a driver. When I am taking dex, I don’t want to be driving on highways in a different country.

Our condo unit was located in an area of beautiful gardens next to the ocean, which made it easy for us to walk along the beaches, stroll the sea walk pathways by the shore, and splash in the surf.

The condo was also convenient in that I could take a rest any time I needed to without having to give up my hobby of nature watching. I could sit on the patio and rest while simultaneously watching little geckos, birds, and butterflies. This place was just ideal for that.

Despite our intentions, we did not go snorkeling this time. My husband slightly chipped a tooth during one of our meals, and the resulting tooth ache would have made it difficult for him to use the snorkel.

More importantly, it occurred to me that maybe my husband was relieved not to go snorkeling with me in the ocean while I was taking dex. I learned during my induction therapy that dex changes my judgment from what it is normally. The ocean currents and strong waves can be a hazard, and who knows what may have happened to me while snorkeling out there.

On our way home, I had a sore throat, which eventually developed into a cold. There were many people coughing and sneezing on the plane, so I was not surprised about my sore throat. I nevertheless asked myself whether it was a sign that I was developing neutropenia, another common Revlimid-related side effect, which increases the risk of infections. Fortunately, the cold went away within a couple of days, and I have not caught anything since then, so I don’t think I’m neutropenic yet. I will know for sure when I get the results from my next blood test.

We had a wonderful time in Hawaii and brought back lots of photos and memories to think of during the course of our long winter here.

I realize, however, that traveling while taking these strong myeloma drugs is a different kettle of fish than what I experienced during my carefree travel days when I was not receiving treatment.

Do you have any travel experiences to share while receiving treatment?

Aloha!

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The quotation for this month is a Hawaiian saying: "Mohala i ka wai ka maka o ka pua,” which can be translated to "Unfolded by the water are the faces of the flowers."