All I can say is my mother lived for a period of time in Panama and wow the medical care was far superior too what we have here, caring loving Dr's she ended up in the ER with a very sore hip and was unable too walk, she just got the best care they even had an orthopedic Dr come and see her right away and he gave her an injection and wow she was find for our whole stay. He even kissed her good bye and called her the follow two days too see if she felt ok. Once I am a little better I am going back too Panama with my mother and stay in her house for a while and chill by the beach and the pool it might do me good, too get away .

Sounds like I want to move to Panama!

Panama is beautiful and the people are very kind. Basically their summers are our winters and during the summer it can rain a lot but if you go up too the moutain beach area where my mother lives its dry all winter long our summers. She has a house close too an area called coronado where all the expats live I think there are more expats all the time each time I go more and more people are moving there b/c if you buy a house you get 20 years of tax free payments. Also if you are older then I think its 55 you get discounts for evrything and if you go lets say too the bank the older people go first. I am in awe each time I go and when I go too the Dr with my mom she has a primary care Dr there she is so concerned and caring and takes so much time for her then she bills her 25 dollars lol no insurance. But one of my friends who lives in Panama has told me recently the city has become more dangerous in certain areas its a shame as it used too be ok too walk anywhere. Also they have a medical building / hospital run by John Hopkins and most of the Dr's there were trained at John Hopkins I don't know if anyone there knows about mast cell condition though I have not been back since i got sick but listening too you makes me feel as though I should go.

All I can say is in Panama they do, I took a tour of a very poor hospital actually in a very poor area. Just walked in and told them my mom was looking too buy a house up the road, its amazing how behind the gated community how they live then you go about one mile and see such poverty. Two years ago when I was well I took my daughter there for Christmas and we bought a whole luggage full of toys for the kids there. We went up the road from my mom's house about one mile and we handed out toys from the trunk of our car you would not believe it how many kids came out of the cracks in the houses and floors and what was so amazing not one kid pushed another they all lined up waiting patiently for their toys and were happy with what ever they got, as they have nothing. One of the children got there late and I felt so bad b/c we ran out of toys and a what I saw still brings tears too my eyes another child offered too share her box of crayons and half of her coloring book with this other child without being prompted WOW. I love it there. I am so happy my mother has  a house there., WHOOPS I got side tracked see my mind is so iffy lately what I wanted too say is that everything was so clean and all the IV fluids were in sterile containers and all the needles were sterile as well, I am a nurse so i was so interested in seeing everything they were so kind too show me around. I was very impressed.

I don't mean to be negative at all, but this makes it very urgent for you to see a mast cell specialist ASAP!  You need to be as stable as possible on sufficient medicines so you don't run into trouble either on the plane or at the hotel.

Airing out the room will not remove all the sweet smelling spray.  There will still be enough to trigger a problem.  Even if they don't use the spray that day, it can still linger for several days.  (I've had this experience before.)  I would call the manager and ask for your room NOT to be sprayed with any air fresheners.  I usually say that I have severe allergies and get migraines from it, since they won't understand mast cell disorder.  If they can't guarantee that, I wouldn't go there.  You don't want to spend your vacation in a foreign hospital.  Do also make sure you have room with a balcony or windows that open.

You can also run into problems with fragrances on an airplane, and you have no control over what perfume others wear.  I would suggest looking into a mask with a carbon filter to carry, just in case.  You can also try to get a front row seat in the plane, so you won't have someone in front of you.  Talking with the airline ahead of time might help you reserve one of those.  It might cost a little extra, but it would be worth it.  I would also want a row with only 2 seats in it unless there are 3 of you going.  That way no stranger scent danger.

As for swollen feet, compression nylons can help that problem.  Definitely talk it over with your doctor, but as severe as it sounds, you might want to get graduated compression of 30-40 or 40-50.  I tried the 15-20 and they weren't enough.  20-30 is supposed to be enough to help with ordinary pooling and clotting, but I don't know what's causing you this problem or what your doctor will say.  I find that panty hose works better and is more comfortable than knee-hi or thigh hi.

If it's an all-inclusive resort with a meal package, you'll have to be very careful about food that's been sitting on a buffet table too long.  My allergist told me to eat vegetarian when I travel because it's safer.

Be sure to take enough meds with you, as not everything is available in other countries, e.g., I can never find Pepto-Bismol.  Also, meds will have different names.

You may already know all this, but thought I'd throw it all out there just in case.

You might also want to research if there's a good hospital where you're going and which one has the best ER, just in case.  My doctor has me carry 4 epipens when I'm in the U.S.  You might want to ask your doctor what you should carry for emergency meds.

I hope you can get everything okay so you have a fun and safe trip!  I find sea air to be very good for me.  I hope you find the same.

Yes, my life is much more normal (except for the boatload of meds every day and more doctor appointments) than it was before I was diagnosed.  Some days are difficult.  I've figured out how to recognize early warning signs and am willing to cancel my daily schedule when I'm not feeling well.  That helps to minimize lengthy setbacks and flares.  That means I don't put myself in situations where I might have to cancel out when someone's counting on me.  

When vacationing, I don't take ANY chances with environment, food, scents, etc., and I never reduce any meds while away.  I would say that most days I can do 80-90% of what I used to do.  On flare days, I try to do 0% of anything.

However, and I know I sound like a broken record.  This will probably  happen only after you've seen or had your doctor consult with a mast cell disorder specialist, and you get on the appropriate medicines for your diagnosis  It can take a few months to get stabilized to the point where it's safe to travel internationally, so please don't delay.  

As Starflower mentioned in a previous post, definitely sign up for trip insurance to cover every facet of your trip as well as evacuation if you should need it.  There are several reputable companies that are more reasonably priced than the one the airlines sell, especially when you need full coverage for your resort, too.