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I’m not even sure where to start. Almost immediately after my return from the HealtheVoices conference, I left for two weeks of vacation in Florence and London. I guess there’s a good reason I feel like I haven’t slept in my own bed for a while.

First home base was Florence. This is the view from the Ponte Vecchio.

First home base was Florence. This is the view from the Ponte Vecchio.

Let me first say that it was an amazing trip. My husband and I had a wonderful time and thoroughly enjoyed ourselves. However, when you have a chronic disease, there are always two parts to the trip. There’s the trip itself, then there’s dealing with the disease while you’re traveling.

The most challenging part of the entire trip was getting from Dallas to Florence. We took a flight from Dallas to Houston where we had a four-hour layover before picking up a British Airways flight to London Heathrow. We then had to clear customs and immigration and make it across London in rush hour traffic using the London subway system (and dragging our baggage) to London City Airport where we took a second BA flight to Florence. By the time we made it to the hotel in Florence, we had been traveling 28 hours. We were completely exhausted and jet lagged (there is a seven-hour time difference between Dallas and Florence).

We had been to Florence before when I was sent on business and my husband joined me for a couple of days at the end of the trip. This time we really got to explore the city and enjoy it at a reasonable (slow) pace. Our hotel was located just outside the city center — a few steps from a tram and bus stop that took us into the city within a matter of minutes.

The Basilica of San Lorenzo is just a few steps from the train station.

The Basilica of San Lorenzo is just a few steps from the train station.

Of course, in addition to all the sites, Tuscany is famous for its wonderful food (of which we took more than ample advantage). Since I was there last, Florence’s Central Market had added a floor of restaurants above its main market floor where you could get incredibly fresh food cooked to order.

Bistecca fiorentina, or T-bone steak, is a Tuscan favorite. At this restaurant in Florence's Central Market, they cut the meat immediately before cooking it for you.

Bistecca fiorentina, or T-bone steak, is a Tuscan favorite. At this restaurant in Florence’s Central Market, they cut the meat immediately before cooking it for you.

Sweet shops abound in Italy.

Sweet shops abound in Italy.

We used Florence as a home base to visit both Venice and Lucca. Venice is, of course, the city of the fabled canals. Lucca is a smaller town close by that has a wall surrounding the city. You can actually go up on the wall and walk around the city or bicycle.

St. Mark's Square in Venice.

St. Mark’s Square in Venice.

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The interesting ladies’ “toilet” at the Lucca train station offered some challenges, particularly with hip and knee replacements.

We had also planned to go to Sienna, but it came to the point where my husband and I were both just completely worn down by the travel, so we swapped the side trip for a day of rest where we did just that — slept in late and took it easy the rest of the day, venturing out only for something to eat.

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I need a walk-in shower because it’s difficult for me to get in and out of tubs. This is the “accessible” shower in our Florence hotel. No shower curtain, so the place was soaked when I got done.

After a week in Florence, it was time to head to London for the second part of our trip. London is one of our favorite cities and we’ve been fortunate enough to visit at least once a year for about 12 years. I’m not sure that RA will let me make many more trips. But it almost felt like coming home.

I dislike crowds and really don't like heights, so of course we took a turn on the London Eye.

I dislike crowds and really don’t like heights, so of course we took a turn on the London Eye.

We tried a different hotel this time, the Marriott AC St. Ermin’s, which was wonderful. Not only is it a great hotel with a superlative staff, it was conveniently located close to both the Underground and major bus routes. We were also only a few blocks from Buckingham Palace.

St. Ermin's has more than 200,000 bees at their

St. Ermin’s has more than 200,000 bees at their “Bee Hotel” and they use the honey throughout the hotel.

We visited most of our favorite haunts and restaurants in London and then took our life in our hands. We actually rented a car and drove north to Duxford, the location of the Imperial War Museum’s aircraft museum. Other than the terrifying experience of driving on the “wrong” side of the road, it was a perfectly lovely trip.

I never found out what was growing in these beautiful yellow fields we saw on our drive to Duxford.

I never found out what was growing in these beautiful yellow fields we saw on our drive to Duxford.

We saw the very rare site of an SR-71

We saw the very rare sight of an SR-71 “Blackbird” stealth bomber being towed to a hanger while we were at the IWM at Duxford, north of London.

We were fortunate to take in the London Film Museum’s collection of Bond cars. In addition to the cars, they had supporting information such as story boards and early drawings of the cars. For Bond fans like my husband and I, it was great.

Bond in Motion - the most complete collection of Bond cars in the world.

Bond in Motion – the most complete collection of Bond cars in the world.

Kate and William’s new daughter, Charlotte Elizabeth Diana, the Princess of Cambridge waited until we were in town to make her appearance. Even the taxi cabs celebrated the new princess. (See sign on cab below that proclaims “It’s a GIRL!”.)

Even the taxis heralded the arrival of a new royal princess.

Even the taxis heralded the arrival of a new royal princess.

On our final night in London, we took in the theatrical production of “American Buffalo” with John Goodman and Damian Lewis. It was probably one of the best plays we’ve seen.

American Buffalo. Image courtesy of Sheffield Theater.

American Buffalo. Image courtesy of Sheffield Theater.

I often say I can tell how good of a time I had by how beat up I come back from a vacation. I must tell you that I am black and blue in most places plus have a pretty good case of the crud. I couldn’t have done the trip had I not had steroid injections in both my knee and my shoulder and been on 10 mg of prednisone during the entire time. Even then it was a struggle.

I am off one of my RA meds due to elevated liver enzymes (something that I now need to address since I’m home). My biologic, Kineret, is a daily injection that has to be refrigerated, which means that I had to take 14 pre-filled syringes with me to Europe and keep them cold for two weeks. Not an easy feat. I’m not sure the Kineret is really working so the prednisone was the only thing standing between me and a total flare during the trip.

Kineret comes in a box holding a week’s worth of injections (seven syringes), so I packed two boxes in an insulated bag with the ice packs that the specialty pharmacy uses to ship them in. I really didn’t have a problem getting the medication through security at DFW, they just sent it on through. We stayed inside security at the Houston airport, so I didn’t have to do a second screening. Halfway across the Atlantic, I got worried that the ice packs were thawing, so I asked the flight crew to fill some zip-lock baggies I’d brought with ice. That helped, but the bags leaked and soaked everything in my carry-on tote, including some of our travel documents. It was when I got to London City Airport to catch the flight to Florence that I ran into the first issues. They wanted to look at everything, they needed to see the note from my doctor prescribing the drug, they needed to test the ice packs to make sure they were ice packs and not explosives. All this was fine, but it added another 15 minutes getting through security (which already takes a long time since I set off the metal detectors).

Once I got to the hotel in Florence, I was able to store the drug in the minibar and the night before we left, I got the staff to refreeze my ice packs for me to use for the trip to London. Everything went well from Florence to London and then at the hotel until about halfway through the trip. Then there was a mishap with the minibar and my syringes became unrefrigerated. At that point, I had decided I should quit taking it anyway because I was getting sick. (And we all know you’re not supposed to take immuno-suppressive biologics if you have an infection.) The itchy, scratchy throat I’d developed in Florence (and thought was allergy related) turned into a real sore throat with a very active, very productive cough. This eventually spread to my nose and sinuses and down to my chest, finally enveloping my left eye in a bright-red case of conjunctivitis (pink eye) the night before we left London. I was visibly ill and I was actually very concerned that they might not let me on the plane and/or let me back in the country. Since the entire Ebola scare, the immigration folks at DFW are pretty gun shy when it comes to sick passengers.

But it all worked out. We had a direct flight from London Heathrow to DFW which made the trip about as easy as it could be. I have antibiotics now that I’m home that seem to be helping the nose/throat/chest infection and some antibiotic eye drops that are helping the eye. Now comes all the unpacking, laundry and getting caught up with real life.

It was a wonderful trip, but I’m really, really glad to be home again.

Thanks for checking in.

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