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Taking on MS by Ship

This exclusive ActiveMSers cruise guide details everything someone with a chronic illness or physical disability needs to know to go sailing on an ocean liner or riverboat. The guide includes why cruising is recommended, how to select a trip, advice on booking a cabin, the best excursions to choose, and how to pack. The handbook also addresses best practices for embarkation, life on the ship, and how to maximize experiences in port.

Cruise Ship

One of my favorite ways to travel with MS is by ship. Now before you harrumph me and, with nose high, say you are not a “cruiser,” know that I am not your typical cruiser, either. I am a traveler. An explorer. A voyager. And setting sail to faraway lands is as old as, well at least two millennia (indeed, the first boats are said to be 45,000 years old!).

Over the past decades, I’ve spent a lot of time—over 6 months in total—crisscrossing the world’s seas. Indeed, in my early 20s I even did the Magellan thing, sailing completely around the world with Laura on Semester at Sea, a floating university that today is more popular than ever and highly recommended. (Before you silver-spoon me, back then we traveled on a creaky repurposed decommissioned cruise ship that listed, slept in a tiny cabin with no windows, and took 1-minute navy showers since water was scarce.) The experience changed our lives and set in motion our wanderlust.

Ships have gotten us to myriad countries worldwide, and since getting diagnosed with multiple sclerosis in 2006, Laura and I have been on a number of cruises—one when I had virtually no disability, one when I had a modest handicap (requiring forearm crutches), and when I’ve relied exclusively on a wheelchair. I’d like to pass along to you the best and most essential tips that I’ve learned from those and past voyages cruising the planet’s oceans, seas, and rivers.

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The benefits of exploring via ship (and call it a ship, not a boat) are many. And the benefits escalate if you have a disability like multiple sclerosis. While cruising has drawbacks, and I’m aware of pretty much all of them, the ease and convenience of traveling by water cannot be overstated.



  • Pack and unpack once. Save your strength (physical and mental) for the fun stuff. That also means that you don’t have to be concerned about your medication overheating in the trunk of the car since your meds are safely in your cabin. Or leaving your passport in the hotel safe (uh, don’t do that).

  • Room service. Pshaw, why does one need room service? Unless of course you have issues due to your stupid disease. Then getting breakfast in your room with facilities close at hand sounds mighty awesome. Or having dinner delivered to your room is just the ticket when you crave quiet and mental downtime. On our last cruise, we had breakfast in bed every day except for one and it was fantastic to start the morning just chilling.

  • Convenient nap facilities. Bonking after a busy morning of touring? Just head back to the ship and hit your cabin for a nap. And if you need to call it a day after some rest, then do that. Maybe take a dip in the pool or hell, have dinner in bed and watch a movie on TV while sipping on a mojito. It’s a cruise. That’s legal.

  • Flexibility. Kids have energy. Parents are old. Spouses need space. On a cruise, people of all different needs can come together… and then blissfully separate. Sure, I’ll eat dinner with the fam, but I’ll also carve out alone time with Laura.

  • Minimize stress. No fighting about directions to the inn. No consternation about where to eat because of different diet restrictions. No worries about staying out too late, or bathrooms at restaurants located down a flights of stairs, or feeling too fatigued for the 6-hour drive you have to take since you have a standing hotel reservation that can’t be cancelled.

  • In-room fridge. That cooling vest you own that you never take on a trip because you don’t want to lug a cooler to keep it cold in between hotels? There’s a fridge for that. And it moves from city to city with you.

  • Childcare. We don’t have kids. But parents tell me this is a big deal. Some say a HUGE deal. Others say it is a MASSIVE deal. I’ll take their word for it.

  • On-site medical facility. You don’t want an MS relapse, a bout of optic neuritis, or an untimely fall. But they occasionally happen, and when they do it’s nice to have a medical team onboard to provide care. Call it a security blanket you hope you never have to cuddle up with.

  • The intangibles. The benefits of cruising aren’t limited to the above. You get to dip a toe into an area you might want to spend more time exploring in the future (or not, depending on your experience). It can be quite economical, the planning is easy, there’s lots of variety in different ports, and you get to discover more of the world you might not otherwise have visited. For example, Montenegro really surprised us, but I would not have chosen it as a destination. In contrast, a place we’d always wanted to visit—Santorini, Greece—was so over-touristed (and steep) we unlikely will be back.

Advantages of Cruising
sunset on a cruise.jpg


There are many things to consider when choosing a handicap-accessible cruise. I sum them all up here. If you need nudging in a certain direction, drop me a line and I’ll try to help. Note: While I've made the rounds by sea, I have no experience (yet) with the following popular destinations: Galapagos (too hot), Antarctica (too rough), and European river cruises (limited accessibility on most boats).



  • Destination. Where to go??? Nowadays you can cruise virtually anywhere there is water deep enough for a boat, so the choices can feel overwhelming. Fortunately, having been to so many ports and more than two dozen countries by ship, I have yet to encounter a dud of a trip. If it sounds good, it’ll probably be good.

  • Time of year. We prefer shoulder seasons, when it might not be as bonkers in port and temps tend to be moderate. For instance, for an Alaskan cruise we opted to go in late spring, before the hordes and summer vacationers. Just one modestly sized ship in port can change the feel of a town. Five ships in town can turn it into a chaotic zoo of flip flops and sun hats. Also note that there are specific seasons to cruise to certain areas. For instance, after mid-September Alaska all but shutters to cruise traffic. Also, if you are heat sensitive, a cruise through the Panama Canal, while extremely memorable, is bound to be toasty. For that reason (among others), the Galapagos, the Nile and Burma might stay on my wish list for a long, long time.

  • Type of cruise. Some cruise lines are known for being more of a party ship (Carnival), some for families (Disney), others for education (Crystal), expeditions (Lindblad), and luxury (Seabourn). Choose what fits your personality, budget and abilities. Going on an adventure cruise stocked with kayaks doesn’t make that much sense if you are physically unable to kayak. Trips to Antarctica sound great, but you better be able to board the Zodiacs (and handle the notoriously rough seas). Also note that European river cruises, as a rule, are not wheelchair accessible. The reason? These boats often dock side-to-side, meaning passengers have to travel in and out of multiple boats, navigating stairs. Don’t count on being the closest boat to shore. River cruises also tend to stop in small towns loaded with cobblestones, in fact these towns probably import them just to mess with us.

  • Size of ship. The size of your ship can vary from the dozens to nearly 6,000. The mega ships are small cities unto themselves (complete with neighborhoods) while the smaller ships can convey an almost yacht-like feeling (often demanding a budget that only yachters can afford). Newer ships tend to have more accommodations for those who have a disability. The larger the ship, the rule goes, the more shipboard amenities, from restaurant choices to entertainment options to number of pools. We prefer smaller ships that can get into tight ports typically off limits to the big boats. They also tend not to swamp towns like the larger cruise ships for a more authentic on-shore experience. Of course if your small ship is in town with a big one, that advantage goes out with the tide.

  • Itinerary. This of course is going to depend largely on where in the world you are going, but there are some key things to look at when reviewing a potential cruise itinerary if you are disabled. Obviously it is wise to investigate the towns you are visiting for general accessibility. I can usually make anything work, but if every port feels like a trek up Everest, your personal Sherpa (i.e., caregiver) might just quit. Also note how long you stay in port. We vastly prefer late port stays in order to enjoy more time in town, which can be especially pleasant after other tourists have gone back to their hotels and earlier-departing ships. An added bonus: extra time means more leisurely mornings when my MS body tends to act up. We really enjoy overnight stays, but those are often few and far between in today’s go-go-go world. Finally, don’t poo-poo “at sea” days as a day of squandered travel. It’s a perfect time to recharge the batteries and vacation on your vacation.

  • Review number of tenders. It is always wise to see if there are any tenders required, which means instead of debarking via gangway, you take a small boat ashore. These are often not terribly wheelchair friendly (if at all) and they can be challenging to board even for the fully abled, especially in rough seas. Indeed, one time on a trip to Colombia, seas were so rough the entire port had to be cancelled. So I try to limit the number of tenders, but sometimes schedules change and they are unavoidable. Another tender issue concerns who manages the tender. Why does this matter? On one Mediterranean adventure, our ship had tenders that were mostly accessible and level with the ship. But for our Greek ports, our ship was required to use the Greek tenders, which didn’t match well with our ocean liner. Combine that with dicey seas and a gimpy dude with MS and egad!

  • Specialty cruise travel agents for accessible voyages. These days I rely on the experts; you should too. One MSer who has traveled even more extensively than I have is Sylvia Longmire. She runs Spin the Globe Cruises and she has visited some 50 countries using a wheelchair (three dozen as a solo traveler!), sailing on more than a dozen cruises and almost as many different cruise lines. She knows her stuff. Heck, she even wrote the book: Everything You Need to Know About Wheelchair Accessible Cruising. Rely on her expertise and take the stress out of your next trip. Plus, she’ll likely save you money and hook you up with insider treats as an award-winning travel agent.

Selecting a Trip
dave in a cruise cabin.jpg
Booking a Cabin


Once you’ve settled on your ship and destination, you’ll want to reserve a cabin and plunk down some change. My recommendation is to do this sooner than later, especially if you need an accessible cabin, as they tend to disappear quickly. Things to consider when booking a cruise cabin: 



  • Accessible cabin. If you primarily use a wheelchair, ask for an ADA wheelchair-accessible room with a roll-in shower. If you need grab bars and wide doorways but are mostly ambulatory (say, using a cane), the cruise company likely will resist your request for an accessible room, preferring to reserve them for passengers who use mobility devices. On one trip on a newly built ship, the cabin door opened automatically with a wave of my key card (or push of a button from the inside). The bathroom was enormous. Totally trick.

  • Cabin location. Getting a cabin close to an elevator is a bonus when you have issues with stairs. Being close to restaurants (often toward the rear or aft of the ship) when you can’t walk far distances is a good thing, especially if you are on ships nearly as large as an aircraft carrier.

  • Port or starboard. Pay attention to what side of the ship you are on (port or starboard) because it may matter. A lot. Especially if you have a balcony! You may only be able to see land from one side for the entirety of the trip depending on the route.

  • Grab bars. Since you are on a ship, and ships move, there usually are grab bars in the shower. But you might want to confirm, especially if said grab bars are mandatory.

  • Standard cabins. Most non accessible cabins have narrow doorways and hallways. This is good for wall surfers (you know who you are), but not so good if you use a wheelchair or walker and want to visit friends or relatives staying in another cabin. You’ll likely need to stand up (if you can) and fold up the chair to get it inside. Also don’t be surprised if there is a step up into the bathroom. I’m not a ship designer, but they always seem to have steps unless you are in an ADA room.

  • Travel insurance. After the ship has your deposit, consider purchasing travel insurance. You have about two weeks to make the commitment in order for the trip insurance to cover pre-existing conditions. After that, anything related to your MS (or other condition you are traveling with) will be exempt from coverage, a nasty surprise when you need to cancel any or all of your trip due to an unforeseen relapse. We like Travel Guard, but there are other good policies out there. I recommend, however, NOT to purchase your policy from the cruise line or travel agency in the unlikely event one folds before you depart.

dave getting on an accessible van.JPG


Every cruise features a long list of activities one can do in port (for a fee, of course). Fortunately, they almost always detail the physical requirements, and often get down to the nitty gritty, from the number of steps required to ascend/descend to the number of meters or miles necessary to walk. They will also state whether an excursion is wheelchair accessible. If you have questions, ask the shore concierge. Other tips:



  • Book early. Book excursions early, before you get on the ship, because they will fill up. If you have your heart set on riding a horse on the beaches of Costa Rica, get on your imaginary horse and sign up asap. Trips designated for disabled travelers also book up early, so don’t figure on playing the gimp card.

  • Small groups. Consider a tour with a private car or van, especially if there is a group of you traveling. In Russia, my parents and aunt and uncle really appreciated having the extra assistance of a private guide and van, especially because they are getting slower in their old age (although nowhere as slow as I am). And because we could divide the flat price six ways, it was cheaper than many of the posted tours on the ship. If the ship doesn’t offer a private trip in a port, ask about one.

  • Go private. The more disabled you are, the more you should rely on private travel. Respect your fellow travelers and don’t go on excursions where you’ll slow down companions with slothful walking and/or frequent loo breaks. Yes, it is more expensive. Yes, it is worth every penny.

  • Custom handicapped tours. Better yet, use a third party that specializes in disabled travel. There are a number of organizations that cater to visitors who need more assistance. We’ve used Sage Traveling in many of the ports we’ve visited. The travel company, started by my friend John Sage, uses wheelchair accessible vans (when needed) and their guides (usually) are skilled at working with clients in wheelchairs. In Turkey, when we were visiting historic Ephesus, our guide Tugrul Sokmen absolutely made the trip, and knew exactly where to go and how to get there safely, a feat in an ancient ruin. In Venice, Sage guide Davide Calende expertly motored me throughout the challenging city, knowing every accessible bathroom and every possible noise (angry barking, whistles, honking, forceful “scusas!” and more) to get clueless tourists to move out of our way. Both were two of the best guides we've ever had in our years of travel.

  • Guide advice. Even with the best of planning, your guides might not be up to snuff. It happens. They might be great at managing disabilities but know less local history than a fifth grader. Or they are veteran historians with several degrees, who then get a rude awakening when they discover the stairs on your walking excursion are not wheelchair accessible. Don’t let it bother you too much.

  • Skipping side trips. Or skip booking excursions entirely. Enjoy seeing cities and town completely at your own pace and don’t fret about trying to keep pace with a group and that obnoxious green umbrella. On one trip I met an MSer who rarely left the ship. He just enjoyed the food, the ocean, and the scenery as he sailed. He and his wife might venture off for a touch, but that was never a goal. Just watching the world as they glided by was more than enough.

Choosing Excursions
Brown Luggage


When you cruise, there is a tendency to over pack. And honestly, that’s okay. You might have a formal night or two on board, so dress up. Or call the cruise line, explain your disability, and threaten to sue their rear ends if they don’t let you go to dinner without a dinner jacket that you will overheat in. Bring an extra pair or two of shoes. Tuck in a fave book that you may not get around to reading. Use canes or trekking poles? Bring both! More tips:



  • Meds. Bring your meds, duh. And supplements. Don’t forget your stool softener, Vitamin D, sleeping aids, etc. Seasickness meds are recommended just in case (I’ve rarely used them), but the ship should also have them on hand.

  • Hand sanitizer. Bring lots of it. Use it.

  • Placards. Have a handicap placard? Bring it! Not driving or plan to use a car? Bring it! Many overseas museums and sites require proof of a disability to get discounted (or free) tickets for you and your companion. Without it, or other proof (some countries provide a disability card), no dice. I reminded my mom to bring hers at 5 a.m. the morning of our international flight and it saved her bacon. Without it she would have had to hike to the top of the Acropolis—no exceptions.

  • Wheelchair tip. If you use a scooter or wheelchair, see what the restrictions are set by the cruise line. Ships usually require a foldable wheelchair if you plan to get off at any ports requiring a tender.

  • Bonus wheelchair tip. Speaking of wheelchairs, those with inflatable bike tires can more easily handle the cobblestones found in many European cities. (Note: bring a pump and patch kit, or get familiar with local bike shops.) That said, I don’t have inflatable tires on the wheelchair I usually travel with and I’ve only managed to bust it once on huge cobbles in Riga, Latvia. Those damn cobbles.

dave being carried up stairs of a cruise


Departing on your cruise should be a fairly seamless albeit busy process. They may shuttle you to the front of the line if you have a visible disability. That said, there are things to keep in mind to help the embarkation procedures run smoothly.



  • Arrive early. Arrive at your embarkation port a day early. This is a vacation, not a time to stress when your plane gets delayed and you start to freak that the ship is going to leave without you and you are going to have to take a float plane to the next port. Not worth it.

  • Pre-arrange transport. Arrange transportation from your hotel to the ship. Cabs and ride shares work fine, but if you need more assistance, like a van with a lift, get that hooked up before you arrive.

  • Carry on all of your medications. In the unlikely event your bags get lost or get dropped overboard after a rabid pack of gulls swarms an unsuspecting dock worker, you’ll be thankful you still have your necessary drugs. Also, it can take hours for your bags to arrive in your cabin after boarding.

dave and laura dining on a cruise ship.j


Once aboard your ocean liner, you’ll gather your bearings in your cabin. When you do, here are a few words of advice.



  • Carry a ship map. And circle all the bathrooms (hey, you have multiple sclerosis). If you need an accessible bathroom, note where those are. Sometimes the nearest potty is above or below a deck instead of all the way down a long hall. And especially pay attention to the nearest facilities after security when you board, as bladders tend to kick into high gear when it senses impending access to a commode. Stupid MS bladders.

  • Note where the fitness center is located. Circle it on your map. Plan to go there regularly, even for just 15 minutes. Maintaining your health with MS or another disability is too important, and you are never on vacation from that (sorry).

  • Lifeboat drills. If you use a wheelchair, you will be told during mandatory lifeboat drills that you will be the last to board. Basically when abandoning ship it’s everyone else, the band, and then—drumroll sans drummer, since that dude already is off ship—you. You will be told on the plus side that this means you’ll be first out. Um, untrue. You will still be last off. In other words, don’t watch Titanic before your voyage.

  • Dining. When dining, request tables that aren’t on the other side of the moon if walking or the thought of running to facilities mid dinner are problematic. And if you are riding to dinner, a table on the fringes is wise lest you get trapped when waiters start marching around a baked Alaska.

  • Pools. Take extra care around the pool area, as it may be slippery. This is common sense, but on vacation common sense often goes to the pool and has an extra margarita. Oh yeah, and identify the nearest toilet there, too. Just sayin’. Many newer ships have lifts that will aid wheelchair users.

  • Medical facility. Note where the on-ship medical facilities are located. Then note that you have every intention not to visit them, nosiree.

  • Repairs. Did you mangle your wheelchair and bust the right brake like I did in Greece? The ship’s expert mechanics can fix such things in a jiff.

  • Sterilize. Wash your damn hands. Often. And until you do, don’t touch your face, rub your eyes, dig into your nostrils, or pick out that piece of corn that got wedged between your teeth with a fingernail. Seriously, you don’t want to get sick.

On Ship
dave looking out on lake wheelchair.jpg


You’ve finally made it to your destination and you are ready to explore. But before you do, some final sage words.



  • Gangways. Gangways are usually, usually, pretty easy. But one time the tides were so extreme in Riga, Latvia, it turned into a long staircase. Don’t be afraid to ask for help. And if you are using a wheelchair, the crew will either carry you and wheelchair down the gangway together or walk you and the chair down slowly. Don’t freak if a crewman has his head in your crotch for extra leverage. It happens.

  • Scooters. While the ship’s crew usually has the muscle to get you on and off, lifting you and a battery-powered scooter might be a non-starter, especially on a tender. In that event, they may lift you and your lightweight wheelchair onto the tender boat (or dock), and then take your electric transportation separately. When you arrive on shore, you’d then do the swap and they’d hold your folding wheelchair for when you return.

  • Balancing. “Hey, you’re now on land,” your brain is going to inform you. But your body is going to feel like it is still at sea. No, the land is not rocking, but you may feel a bit unsteady. This happens with or without MS, and the effects are even stronger if you’ve been in rough water. If you are questioning whether to bring walking aids ashore, don’t. Bring them and use them.

  • Restrooms. If needed, plan ahead for restroom stops (there are mobile apps for that). Wheelchair accessible bathrooms overseas are not be terribly plentiful. That was an issue in Lisbon, Portugal, but thankfully we had a guide who knew exactly where to go. That McDonald’s on the main drag? Nope. But there was Burger King around the bend that had an accessible side entrance and an elevator tucked in the back that you had to take to the third floor to reach the accessible bathroom accessible with a key code. If I was battling MS urgency, without this knowledge I would have been doomed.

  • Go for it!  When I was in Mexico, I had the opportunity to try surfing. But I had just been diagnosed with MS, and thought maybe I shouldn’t push it. Now surfing is off the table, and won’t be barring some big medical advances. I should have rolled the dice and gone for it when the opportunity was there. Trust me, you and your body will surprise you.

In Port

So there you have it, our best recommendations and advice for cruising with multiple sclerosis or other disabilities. For more travel tips, be sure to read our exhaustive guide on traveling with a disability


Have fun and bon voyage!

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