Should I take my asthma in to consideration when booking a holiday?

You should take your asthma into account when you plan your trip, because it may influence where you go or what type of holiday or activities you choose.

Having asthma may affect your choice of destination or activities, depending on:

• What triggers your asthma symptoms.

• How mild or severe your symptoms are.

Before you book your trip, talk to your GP or asthma nurse about where you're thinking of going. This is particularly important if your asthma is severe.

Your asthma may be affected by:

• The climate; for example, hot dry conditions or cold air temperatures.

• Type of terrain; for example, if you're walking or climbing on steep, rocky ground.

• Air quality or pollution, particularly in some cities.

If your asthma is severe, you should also consider what medical services may be available at your destination.

Once you've decided where you want to go, your healthcare professional will help you write an asthma self-management or action plan.

Scuba diving is not recommended for people with asthma.

You may prefer to avoid holidays where you’ll come into contact with the trigger of your asthma. For example:

• If you're allergic to pollen, you may want to avoid camping during the pollen season.

• If you're allergic to cat fur, you may prefer not to stay with friends or relatives who have cats.

If your asthma is triggered by the cold or by exercise, you may have difficulty doing activities at high altitude.

For mountain activity holidays, such as climbing, hiking or skiing, your asthma plan should include information about what to do if high altitude affects you.

The altitude that planes reach should not cause problems for people with asthma as cabin pressures are adjusted to compensate.

My daughter has diabetes and we are going abroad for the first time this summer. What should I take with us?

Your daughter should wear or take some form of medical ID, such as a bracelet or identity card. If your daughter needs medical help while you're away, this will show medical staff that you have diabetes.

If you use medication such as insulin or tablets, you should take:

• Twice as much medication and related supplies as you normally need to cover your time away.

• A letter from your GP confirming that you need medication and (if appropriate) syringes or needles for your health condition. Some GPs may charge to provide a letter like this.

Also take:

• A basic first aid kit, in case of minor injuries.

• A copy of your travel insurance documents, in case you need medical help while you're away.

• If you're travelling in Europe, your European Health Insurance Card (EHIC), which entitles you to free or reduced-cost healthcare.

Before you go, it is also a good idea to take the following steps:

• Make an appointment to see your diabetes team or GP, well before your trip. Their advice can help you avoid health problems while you're away.

• If you are travelling across time zones, and you take insulin, you may need to change when or how often you take it.

• Hot or cold climates can affect how blood glucose monitors and insulin work. You may need to adjust your dosage or check your blood glucose levels more often.

• You may also need to adjust your diet or insulin dosage if you’ll be more or less active than usual while you're away.

• Diarrhoea or sickness can be more serious if you have diabetes. Get advice on what to do if you're ill while you're away.

• You may need travel vaccinations.

When you take out your travel insurance, remember to declare that you have diabetes.

Following the tips below can help your journey to run smoothly:

• Show your daughter's GP letter to the airline staff.

• Check your daughter's blood glucose levels regularly.

• Carry all insulin in your hand luggage. If you pack spare insulin in your suitcase, it may freeze in the plane's cargo hold and become unusable. Liquid restrictions at airports exclude any essential medicines or liquids a diabetic may need, but all items should go in a clear 20cm square plastic bag for security screening.

• Your daughter needs to eat regularly, so take some extra food or snacks with you, in case of delays on your journey. You could also take some diet or sugar-free drinks, as well as some sweeteners.

• You can eat standard airline meals. You don't need to ask for special diabetic meals.

What is Munchausen's Syndrome?

Munchausen's syndrome is a rare psychological and behavioural condition in which somebody fabricates or induces symptoms of illness in themselves.

Munchausen's syndrome is named after a German aristocrat, Baron Munchausen, who became famous for telling wild, unbelievable tales about his exploits and past.

People with Munchausen's syndrome typically display a set pattern of behaviour. This pattern may include:

• lying about their symptoms and typically also lying about other aspects of their life, such as their past or level of education,

• manipulating test results to suggest the presence of symptoms, such as adding blood to urine samples,

• actually inflicting symptoms on themselves, such as poisoning themselves with an overdose of medication, and

• travelling from hospital to hospital in different parts of the country, and seeing many different doctors.

People with Munchausen's syndrome know they're making their symptoms up and can be highly manipulative, but their behaviour brings them no obvious benefit. Instead, they often undergo painful and sometimes life-threatening surgery, even though they know it is unnecessary.