By Stephanie Swirsky
4 Aug

On CHD and Traveling

Friday, August 04, 2017

When I found out that I was going to Cuba with CubaOne on their TuCuba Literary trip, I thought about the Cuba I see in photos on the news and Instagram. A run-down Cuba and beautiful Cuba. A Cuba that is trapped in time, and Cuba that is rapidly progressing forward.

I also couldn't help but wonder, if Dan were still alive, could he travel to Cuba? Dan had tricuspid atresia, an uncommon and serious form of CHD. Yet for most of his life, he was asymptomatic, and with annual check-ups and medication, he felt mostly fine. He traveled a lot, spent a semester in high school in the U.S. Senate page program in D.C., another semester studying abroad in Israel. After graduating college, he drove across the country by himself to L.A. He was lucky and privileged in many ways, but he also knew that his life could be cut short any moment, and that awareness pushed him to do all he possibly could.

I traveled to Cuba with a group, and one of my tripmates had CHD too. I asked her what it's like traveling with CHD. She said that she's lucky to be asymptomatic and travels often, including to Cuba. She did have a health scare when she was 11. She suddenly came down with a fever that kept rising. A Cuban doctor recommended a medication that would reduce her fever, but her parents couldn't reach her cardiologist in the States and didn't know how the medication would interact with her CHD. The Cuban doctor made it clear that she absolutely had to take the medication to avoid serious consequences. Her parents consented, and the fever went away. She got better.

Americans might think that Cuban doctors have less expertise than their American counterparts. But according to a 2015 article in Forbes, Cuba's most valuable export is neither sugar nor tobacco, but medical expertise. Cuba has sent its doctors overseas as far back as 1963 and to over 100 countries. Cuban doctors may not individually profit from their hard work, but they serve people globally and take pride in that. Cuba considers healthcare a human right; it's written in its constitution. A 2012 journal article in the American Journal of Public Health looks in detail at the Cuban healthcare system.

When I went with Dan to a highly regarded research hospital, the doctors there had never heard of tricuspid atresia. I found myself in the room teaching them about the specifics of his condition – me, a 20-year-old junior in college with no medical training. At the end of the night, an intern visited Dan, asking questions about his medical history. This intern seemed to be the only person invested in learning more about Dan's condition. Other people bustled in and out and did guesswork on care that was best for Dan's flu. Then there was the other time that a paramedic doubted Dan's condition and wondered was what drugs he was on. (A diuretic, beta blocker and ACE inhibitor, I told him.) That experience showed me that knowledge and dialogue are an important part of medical care, regardless of where you're from or where you went to school.

I wonder how lifting the U.S. Embargo would change healthcare. While Cuba remains committed to providing healthcare for its citizens, Cuba continues to lack medication and supplies. Would Cubans have better access to the medical resources they needed? How could it benefit the U.S.? A promising vaccine for lung cancer, developed in Cuba and already in use in several countries, is finally in U.S. clinical trials and may turn lung cancer into a curable disease for some patients in this country. What else could an open dialogue between medical professionals in the U.S. and Cuba bring? We often think about how the embargo affects Cuba, but we don’t consider how it hurts the U.S.

When traveling with CHD, it's important to keep an open connection with your doctor, talk to them before you travel, have extra medication on hand, and remain aware of your body. It's always easy to avoid travel and stay at home, but I will always be grateful for the travel that Dan was able to do, that he stayed aware of his medical needs and knew when he needed to take a rest or go to the doctor. Having CHD – or any chronic condition - should not stop you from living your life to the fullest. You may be surprised how far good preparation can take you. See ACHA’s travel guidelines by clicking here.


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