Flying The Bladder Friendly Skies – Fresh Tastes by Bev

By Bev Laumann, Author of A Taste of The Good Life: A Cookbook for IC & OAB


Priorities and planning

Trends in airline food service seem to occur in cycles. For a several years fare cutting and meal cutting are the popular approach, then the airlines switch styles and the same companies try to woo passengers with better service and regular meals again– for a price. As an veteran IC patient who’s done quite a bit of travelling, I’ve found my top priorities in choosing an airline no longer involve anything like the price of the fare. No matter how much I save, nothing is worth the agony of my IC, IBS and fibromyalgia all flaring at once. Bodily comfort before, during, and after a flight is crucially important. I want to enjoy the stay at my destination.

I try to book flights that result in the least time in the air– even if it costs a little more. I plan ahead to avoid pre-departure stress. And I wear comfortable clothes– no matter how I look. I can always change in the rest room when I get to my destination.

I think avoiding pre-departure stress has been the most crucial for me. I pack most of my things well in advance. I have two lists: what I pack in several days advance, and the few last minute things I need to slip in the luggage. These lists are similar from one trip to the next, so I have them stored on my computer for easy print out. Several days before departure I pack the items on the first list in my suitcase and then just set the luggage aside. Sometimes as I walk by that suitcase I’m reminded to toss in something I hadn’t thought of. While others are hurrying around madly packing before leaving for the airport, I just put in the last few personal items and I’m done. No stress, no stress-induced bladder flare.

If your airline serves anything during the flight, the one thing you can count on is that it won’t be bladder-friendly. But if you plan ahead when making reservations, you can order special meals better suited to our needs. There’s only one hitch: your request has to fall into certain broad categories. Most airlines for example, allow you to request a vegetarian meal, a low-sodium meal, or a low-fat meal. You can request a gluten-free meal or a bland (no hot spices) meal. But you can’t request individual foods as you would from a menu. And you can’t combine the offerings to get say, a vegetarian meal that is also bland. Of the major airlines I surveyed, none served a meal with features of the IC diet– one that is low-acid, low-tyramine and bland. However, by asking about meals when you make reservations, you may find one that you can at least eat most of. Each airline has a person responsible for planning what is served on each flight. By calling the airline’s information number and being persistent, you will eventually get connected to the right person and find out what will be served on your flight. A travel agent may be able to get you this information quicker.

Overseas flights, overseas frights

Traveling overseas can have its own problems for IC patients and healthy people alike. You will be more likely to get “American” food if you take a straight-thru flight than one with stop-overs. Shorter flights between foreign destinations, even if the airline is US-based, are likely to serve unfamiliar regional food. Here’s one writer’s experience:
Winging his way from China toward Japan on a Northwest Airlines flight, Jeff settled in to enjoy an exotic oriental dinner, a bit of meat arranged attractively on a green leaf. As he savored his first mouthful of meat and a bit of leaf, he felt his tongue burning, then breathing became difficult. He told his wife to find him medical attention. Luckily, the symptoms abated in a few minutes. He didn’t die, but he could have. The cause of his close call was a poisonous, oxalate-laden taro leaf. (If he had been a woman with IC and vulvodynia, the dose of oxalates could have also triggered a long episode of agonizing vulvar pain.) After arriving home in the U.S. he discovered that meals served on flights between Asian destinations are designed by Asian chefs for Asian passengers. In a classic case of a failure to communicate, the chef in Hong Kong never thought anyone would eat a taro leaf. The U.S. airline officials never thought a chef would decorate a plate with a poisonous item. And the American passenger assumed anything leafy on a plate was edible.

Since Jeff’s close call, Northwest Airlines has tightened the management of its caterers and taro leaves won’t be used. But the incident points to something we all need to be aware of: food customs differ. Don’t assume everything on a plate is edible, and if it’s not instantly recognizable, ask a flight attendant about how the food is prepared. Anything that is aged, fermented, smoked, or air-dried (particularly if it is protein-rich) will contain high amounts of bladder-irritating tyramine.

When money talks, airlines listen

People with IC are not alone in putting their health first when considering airline food. In a poll taken by the Response Analysis Corporation of Princeton N.J., and reported in Vogue magazine, 63% of frequent flyers said they’d be willing to sacrifice taste for health in airline meals. Ten years ago, most articles written on the subject of airline food deplored the lack of taste, quality, and healthiness. Today many articles praise gourmet selections available in first-class, and the wide variety of low-fat, healthy meals available to everyone. The airlines know they can get a competitive edge by catering to the desires of the flying public– a fact that we IC patients can use to our advantage if we are vocal. Write to the airlines. If enough requests for IC diet meals (low-acid, low-tyramine, and bland) are made, they may offer it. Such a diet would also benefit the millions of people who have to avoid tyramine because they take MAO inhibitor medications or because they have migraines. Millions more who have gastrointestinal difficulties such as GERD, IBS, Crohn’s, or ulcers may be happy to eat our mild IC diet fare too.

Vegetarian trailblazers

Vegetarians have long been the recipient of specially prepared meals in flight, mainly because there are so many of them and they haven’t been shy about asking the airlines to meet their needs. In 1998, when the staff of Vegetarian Times surveyed 6 major airlines, they discovered that vegetarian meals account for 30% to 50% of all special meal requests. If following both a vegetarian diet and an IC diet is difficult at home, it’s just about impossible in the air. I surveyed some major airlines and didn’t see much a vegetarian IC patient could safely eat. The airlines’ vegan meals are heavy on acidic fruit, salads with vinegar-based dressings, and dishes with tomatoes. Vegetarian offerings aren’t much better and often include yogurt or aged cheese. The most bladder- friendly solution for many IC patients may be to “do-it-yourself”.

Catering your own meal

While airlines don’t advertise it, they do allow passengers to carry on board their own meals. If you can fit it under the seat or stow it in the overhead luggage compartments, you can bring it along. They prefer that it fit under the seat and that it’s stowed during take-offs and landings. A few rules of etiquette and common sense apply here too:

  1. Be absolutely sure your container is leak-proof, or stow it in such a way so that it won’t leak all over the floor, seat, or someone elses’ luggage or clothing. Double layers of plastic bags come in handy. Remember too that the cabin pressure will change and may cause plastic container tops to pop loose.
  2. Watch out for particularly odorous food. In the confines of a cabin, some odors like cauliflower, garlic, and fish spread quickly. Flight attendants have to play food police if others are offended, a task they despise.
  3. Be aware that other people may be jealous. Even the pleasant aroma of warm french fries can cause annoyance if everyone else is hungry and you pull out your meal just after take-off. Wait to eat until the attendants start serving everyone else.
  4. By far the safest way to dine is by packing home-cooked food. If you fly frequently you may even invest in food storage items specially designed for travel. (Check out the use of hot and cold packs, but be careful to isolate them from food in case pressure changes cause them to rupture.)
  5. Some hotels will pack bag lunches for you and, if you find something you can eat on the menu, airport restaurants increasingly offer carry-on food. Perhaps a favorite restaurant near your home serves bladder-safe take-out too.

More tips for travel comfort and eating-on-the-fly:

  1. ABSENT MEALS – If your specially-ordered meal doesn’t make it to your flight, ask the attendant what they can do for you. They may be able to assemble something you can eat from extra meals and snacks on board. Carry a small “emergency” snack along with your Tums or Prelief in case the worst happens.
  2. REMINDERS – Dolores offers this idea that worked for her: If you’re new to the IC diet and tend to forget what’s a no-no or what has caused bladder flares in the past, write it down on a 3 x 5 card and carry it with you.
  3. SPECIAL SEATING – If your IC or fibromyalgia is so severe that you are on disability, you can request seating up front near the bulkhead where you have more room to stretch. (You may be bumped out of the spot though, if someone in a wheelchair needs it). You can inquire about this when you make reservations.
  4. FRESH AIR – The air at 30,000 feet is thin and cold. The air in the cabin is stale, heavy with carbon dioxide, and dry, although it is recirculated and oxygen is added from the outside. The dry air can be especially hard on those of us with allergies, sinus problems or dry eyes. The lack of oxygen coupled with hours of sedentary posture could adversely affect your fibromyalgia and IC too. Airlines keep the cabin’s fresh air minimal to save money but you can request that the captain turn up the fresh air, since it’s under his control.
  5. HUMIDITY – Salt water nasal sprays, artificial tears, and soothing skin lotions can keep a sensitive body comfortable. Be aware of dry air’s effect on your inner humidity too– especially if you take Atarax, Ditropan or Ultram. Sitting for long periods, taking Tums or antihistamines, and drinking less may add up to serious constipation and concentrated irritants in your urine. Try to remember to drink adequate fluid or set a watch alarm to remind yourself. If your doctor okays it for you, taking baking soda for bladder pain may also help fight constipation.
  6. TOILET FACILITIES – Mary is a pleasant older lady with IC who doesn’t normally need to wear Depends. But she wears them when she flies just in case she can’t get to the toilet when she needs to. She also finds it helpful to carry the ICA’s “can’t wait” card when she travels (a card indicating you have a medical condition and need to use the potty IMMEDIATELY). You can also request to be seated near the toilet (but you’ll be disturbed often by the other passengers). If the captain mentions at the outset that he expects turbulence, keep your bladder emptied in case everyone is suddenly told to stay in their seat.
  7. MEDICATIONS – I found out the hard way about this: don’t pack all your rescue medications in carry-on baggage. Have at least one dose of everything on your person. Turbulence, food carts, or some other circumstance may prevent you from getting to baggage in overhead compartments. And if you travel to foreign destinations, keep your meds in their original pharmacy bottles. You don’t want to be mistaken for a drug smuggler.

This article originally published December 1999, revised and updated by the author March 2004.