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My Trip To Nepal: Tracey’s mast cell perspective

Updated: Jun 21, 2023


I’ve always loved to travel. I’ve been doing it since I was just a few months old. Growing up in Canada with parents from different countries meant that we would have to travel to visit extended family. That meant trips to Germany to see my mom’s family and trips the USA to see my dad’s family.


I’ve always associated certain emotions with travel: excitement for the airplane ride, connection with friends and family, and most importantly a sense of calm.



Yes, travel for me is associated with calm. One of the earliest reasons is that my mom was always visibly more relaxed and, in her element, when she was away from the expectations of running a household and raising a family, and instead was back in the environment she grew up in surrounded by steadfast relationships. Germany was the place I travelled most often to, so the state of calm I experienced there was something I always associated with travels.



The Calm Before the Storm



After university, in the summer of 1991, I embarked on my first backpacking trip across Europe. Almost three months of no schedule, no plans, no responsibility. Just me, a rail pass, a backpack, and my Lonely Planet guide to Europe (this was before internet or cell phones).



I stayed in hostels with kitchens so I could cook my own food – not because I understood the connection between what I ate and my symptoms, but because it was cheap. I had never heard of histamine or mast cells then.


Words are lacking to describe that trip. I travelled through six countries, at my own pace, meeting people from all over the world at each place I stayed. I went to the World Ballroom Championship in Liverpool with a guy I’d met from Germany, saw Prague with a guy I met in Vienna who was from the States. I connected with a friend of a friend in London, and we made our way through campgrounds in Italy in his tiny two-man tent.


I was hooked for life. I was a globetrotter.


I continued to travel whenever I could. As a teacher I had holiday breaks in December, March, and then the two-month summer break. I met the love of my life while studying in Germany during my summer break in 1993. He was also Canadian and had a job lined up in Switzerland.


After over a year of having a long-distance relationship, we met up in Korea to live together and work there.


The Storm


I’ve had MCAS (mast cell activation syndrome) since I was born. Slowly, steadily with each passing year it progressed. As a young child, all I knew was that I sometimes had rashes, eczema, hives, and was often itchy. Sometimes there were smells that made me feel a bit nauseated. These were the only symptoms I was consciously aware of – I never gave them too much thought because they were just my normal. In those early years of my life, travel didn’t impact my symptoms.


Until one day it did.


Tracey and friend Kyoung-hee


Korea is where MCAS really reared its ugly head. Debilitating nausea and fatigue became my new normal. I was able to work part-time but struggled with more and more skin issues – hives that covered my whole body on occasions, and bulls-eye eczema all over my torso. I didn’t have an MCAS diagnosis yet – that wouldn’t happen for another 25 years.


We had to leave the country for my boyfriend to get his work visa. We decided to go to Malaysia.





I didn’t understand it then, but I now know my mast cells were already in a flare. I was living with mold illness and didn’t know it. Mold exposure is one of the triggers to MCAS.


Travel in Malaysia, Singapore and Thailand felt so different than any of my previous travels. Where was the calm I usually felt when travelling? Where was the excitement to see the next place? Why couldn’t I muster the energy to chat up new acquaintances?


Tracey shopping for food close to her apartment in Seoul

I struggled with food. For the first time in my travels eating became stressful. Up until this trip I had always had access to a kitchen and would do most of my shopping and food prep. That just wasn’t an option in Southeast Asia at that time. Loads of cheap places for backpackers existed, but none with kitchens.


Much of the food was spicy. If I tried to eat it, I suffered from extreme stomach pain. Sometimes I couldn’t find something to eat that wasn’t spicy and would suffer the consequences.






I was still motivated to keep moving from one place to the next, because the markets, temples, and beaches were all so awe inspiring, but mentally and emotionally I was not in a great place. Physically I was struggling to manage a vaginal yeast infection, eczema on my lips, and a severe response to mosquito bites. All of this on top of generalized fatigue and brain fog.



My mast cells were on full activation creating this storm in my body. I didn’t understand what was happening or what to do to feel better.




Nepal


Despite the experience of that trip, my love of travel continued, and Nepal was one place that was on my bucket list of places to visit.


A few months ago, when my friend Jonathan Kane mentioned he was organizing a trip, I immediately knew I wanted to join. His tea shop, The Naked Leaf would partner with Nepalese Tea Collective to offer a tour focused on tea, cultural experiences, and cooking. How could I resist?



Unlike my earlier travels, now that I knew I have MCAS, and knowing how to manage it with a variety of tools and strategies now gave me the confidence to go boldly forth to explore new unfamiliar parts of the world.


I also know that I can’t always control everything, so I must go with the knowledge that I can be as prepared as possible for a variety of situations, but that I’ll have to let go of the rest and just do the best I can.


Getting Prepared


Depending on your symptoms, travel preparations may have some additional considerations. Here are some things I encountered or thought of as I was getting ready for my trip that I thought may come in handy for some. Things to consider preparing for the trip ahead for those who struggle with histamine or mast cell mediated issues:

  1. Can you sit for long periods of time, or is it better to break up your trip into shorter distances or flights. Breaking up a trip and stopping overnight somewhere – whether with a road trip or when flying – can help you pace yourself and give your body a break from being in the same position.

  2. Do you need extra comforts? Having a specialized pillow along can often make a big difference when it comes to comfort. Do you need a cushion to sit on, to have behind your back, or around your neck? Another option might be a blanket that you can fold different ways to cushion body parts as needed. I like to take an inflatable ball to sit on or put behind my back because I can blow as much or as little air into it as I need. I also like to take a neck pillow that is narrow behind my neck and clips shut in the front. Having a neck pillow helps my TMJ pain.

  3. Plan to pace yourself. Make sure that you have breaks in your itinerary. Only you know how much activity you can tolerate in a day, so plan accordingly to what feels right for you. If you are travelling with friends or family members, make sure there are activities that they can do without you, so that if you need a nap or some quiet time, you can take it without impacting them.

  4. Talk to travel companies, hotels and other people involved in your trip. Communicate your dietary needs in writing, as sometimes information gets lost in verbal exchanges. While it is unlikely that anyone will be familiar with a low histamine approach, use more familiar language such as gluten free, dairy free, no fermented foods, no spicy food… Explain that you have an immune response to certain foods, or say that you have an allergy. Allergy is a term that people understand. Double and triple check that there will be meal options available for you before you leave.





What to pack


Being prepared on any trip is important, but when you have histamine or mast cell symptoms, you need to take a few additional steps.



1. Medications:

  • Pack any medications you normally take and have something extra in case you have a flare in symptoms.

  • Talk to your doctor before you go to make sure you are prepared with any prescriptions you may need.

  • All prescription medications should have the label from the pharmacy on the bottle. Medications must go in your carry-on bag in case checked luggage gets delayed or lost. Make sure you have enough plus a few days extra supply in case of flight delays.

  • Bring along your written prescription in case anything gets lost. You can take it to a local pharmacy if necessary.



2. Supplements:

  • Supplements should be in their original containers.

  • Ask your doctor or naturopath for a letter explaining that you have a medical reason to be on the supplements. You may not need the letter, but it’s always a good idea to have it for security or custom purposes.

  • Take more than you think you need. It’s always better to be over prepared than under.

3. Devices:

  • Is there anything else that you routinely use to help with symptoms management? If it’s too big to pack, is there a travel version you can get?

4. Food:

  • Pack food for the flight or trip. Good low histamine options that pack well include apples, firm pears, carrot or celery sticks, low histamine nuts like pistachios or macadamia nuts (these are generally tolerated well without soaking), and homemade muffins or bars. I like to pack the Blueberry Muffins or Blueberry Pomegranate Bars from our cookbook.

  • If you are flying, keep in mind that airplane food is high in histamine. If you decide to eat it, make sure to have DAO enzymes along. These are a must for me, and I take extras when I travel. In Canada, and want to purchase some for yourself? Connect with our online supplements account.

  • If you are driving, do a restaurant search in advance of your departure so you know where you can get food on your route. Local restaurants tend to be better options for fresh food, rather than chain restaurants. They're also often quite willing to customize your meal.


Letting Go


I was as prepared as I could be for the trip. I had my meds and supplements ready. I had my comfort pillows for travel. I had checked out hotel menus and knew the breakfast buffet would have options for me.


I had communicated that I was gluten free. That’s all I said. It is far from my reality, but I knew I was just going to have to roll with food options on this trip because we would be in people’s homes learning to cook local food. I decided to let go of worries about food and do the best I could to manage my symptoms with the strategies I have. This approach will not be suitable for everyone.


Most of the food in Nepal has some spiciness to it. I quickly discovered that when restaurant staff told me it was not spicy, it was mildly spicy. My mast cells don’t like spicy, so even a little spicy caused some tummy pain.




I had a few extra capsules of my compounded medications with me, but I mostly relied on liposomal quercetin to manage a flare in symptoms. Not everyone tolerates quercetin, so discuss this with your doctor or practitioner to find out if it is right for you to try. I took it along with DAO before each meal to stabilize my mast cells before eating, and I started taking it at bedtime, which became an easy way to manage any symptoms the might impact quality of sleep.


Our trip guide, Nish Banskota, of Nepal Tea Collective was great at helping make sure that restaurants didn’t include hot spices, and that when we were at homestays, food should be set aside for me before spices were added. Having him as an advocate for me made my trip much more relaxing and enjoyable. I knew I was being taken care of.


Rice and lentils are staples of the Nepalese diet. While they are low in histamine, they are very high in lectins. I’ve known for a long time that lectins were a trigger for my mast cells and caused histamine release. This was the biggest “let go” for me. I decided I would take extra digestive enzymes along to have anytime I ate, and I decided I was just going to focus on the deliciousness of the food.


Getting stressed about lectins would just signal danger to my mast cells and make me more reactive. Creating safety in the body is a big part of what we do here at Histamine Haven and this trip to Nepal was the perfect time to practice the emotional practice of letting go to keep my mast cells feeling calm. It helped that I was surrounded by great people at each meal.



Upon arriving home

I did arrive home feeling generally inflamed. My joints were achy, and I had some eczema, but I had decided beforehand that there had to be some give and take. Those symptoms are slowly reducing, and mostly, one month after getting home are now resolved.



The trip to Nepal took a bit out of me physically but in exchange, it gave me some very rich experiences and meaningful new friendships. This is what stays with me. I will always cherish those.




If you dream of travels, I hope these strategies help you hit the road with a bit more confidence.


Happy landings wherever you go! - Tracey


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