Trekking Kilimanjaro

[DXB]

Hello all ,

I have been lately diagnosed with CIS (15 brain T2's and 2 C-Spine , Positive CSF) and I was put on Gilenya as my neuro says it is MS most probably.. Onset was ON (now resolved)and my symptoms currently minor foot tingling and low frequency unilateral tinnitus.. Its been a year since first Symptom

As I am doing fine for now I am considering Trekking Kilimanjaro in December , does high altitude and possible Acute mountain sickness contradict MS ? , as I am on G I can't take recommended routine vaccines for people traveling to that part of world so I am a bit concerned about infections .. any thoughts ?

[Special Kay]

Altitude has never affected my MS negatively. Since getting MS, I've traveled to two high-altitude locations (Cusco, Peru, and Lhasa, Tibet), and have tolerated it better than some of my (non-MS) traveling companions. Neither one of those is quite as high as Kilimanjaro, though (they are both ~12,000; Kilimanjaro is, what, 20,000?).

I think it just depends on whether you are one of those people who gets altitude sickness and how much it wipes you out. Also, will oxygen be available to you?

As to vaccines, I think you can take vaccines made from "killed" viruses, just not the "inactivated" or "attenuated" ones. I'd ask your neuro about that and whether he/she would worry about such travel with or without vaccines.

I've been to several tropical destinations with my MS and while taking Tysabri, and have gotten nothing that I could have been vaccinated against. I did once contract Cholera, of all things, but it hit when I got back and only lasted a few days with antibiotics.

You might consider bringing some antibiotics along just in case. My doctor has offered this to me before trips, with instructions on what they would be used for.

[DXB]

Thanks kay

Kili is 19,331 ft and I live at sea level !, Yea I can't find any evidence high alt affects MS or makes symptoms worse ,but I'm more worried about not taking the vaccines.

I might open this up with my neuro but I'm not sure , I'll research what vaccines are live and what are not and maybe take the "dead" ones.

If I'm careful about the food , use insect repellants , and premeditate against malaria, I may mitigate the risks , I'll definitely take with me emergency antibiotics and Diamox for altitude sickness.

Hope it does work out , this thing is metal I wanna push my self and enjoy this experience while I still can !

[KatieAgain]

So Totally Awesome!!

Make sure you can get in Country though without a Yellow Fever Vaccination Certificate. If you need Yellow Fever...your neuro needs to be involved....probably should anyway, just to be safe.

[Pipes123]

I'm also on Gilenya and I think you're right to be concerned. Tysabri only lowers immune response in the brain, but with Gilenya the reduced immune response affects your whole body. Don't get me wrong. It sounds like a great trip and I think you should find a way to make it happen.

[onlyairfare]

Yellow Fever is a live vaccine, and there are countries that require this vaccine before entry. Also, if you have in the past visited a country with yellow fever (border agents will see the passport stamp), some other countries will not admit you without the vaccine having been given.

You may be able to obtain a waiver from the yellow fever vaccine requirement if you are not able to take it, such as a person who is immune suppressed. You may need to see a doctor who specializes in travel medicine to do this, but the valid Yellow Fever vaccine is given only in WHO (World Health Organization) licensed centers anyway, where they should have the waiver information.

You may also be advised to take the meningitis vaccine (Menommune or Menactra) before traveling to Africa. This vaccine is not a live vaccine, so it is probably safe for you.

I got my Yellow Fever vaccine updated before I went on Gilenya for just this reason, and I have had both meningitis vaccines; it's not recommended to have both, it's just that the newer one is better than the older one, which I had gotten when it first came out. None of them caused me any unpleasant side effects.

Malaria does not have a preventive vaccine so I always take the prophylaxis medication (mefloquine for me) and follow the recommendations for insect repellants, long sleeves/pants, be careful around dawn and dusk. Malaria is an unpleasant disease, causing very high fever, so for those of us MSers who are heat sensitive, it would not be fun. I've never had malaria fortunately.

You may find that you need your neuro and a travel medicine doc to collaborate. I've found that neuros don't usually know a lot about travel medicine and necessary vaccines, while travel docs don't know much about MS.

I always buy travel medical insurance that includes emergency treatment in an appropriate hospital, and medical evacuation to that hospital, and then on to my home hospital when stable. To cover pre-existing conditions like MS, I have to buy it within 2 weeks of my first payment (even a small deposit) for the trip.

Have a great trip!