Many of us are contemplating either taking a vacation or traveling to see friends and relatives during the summer. Most of us can go through these trips with no problem. However, it is wise to remember a few basic safety tips to make vacationing safer and more pleasant.
Before you travel
If you have a serious medical condition, become familiar with the health-care delivery centers in the area where you will be vacationing. Check that the center you select will accept your health insurance.
Make a list of all prescription medications you are taking and carefully calculate what you will need when away from home. Bring a couple more for extra days; you never know when you will be stranded overnight in an unfamiliar area. It is far easier to bring your own meds than have to purchase them when away.
Medications should not be placed in checked luggage. They should always be in your carry-on luggage. If you are carrying narcotics, it is wise to have the original doctor’s prescriptions with you.
I’m sure most readers are familiar with the controversy between state and federal laws in the medical use of marijuana. The medical use of marijuana is only legal in California and a handful of states. It is not advisable to carry marijuana when flying out of California. Even in marijuana-friendly states, required documentation varies from place to place.
Getting there
Flying is now a very common mode of transportation and extremely safe but can also offer challenges. Modern aircraft fly at 30,000 to 40,000 feet of altitude. The cabins must be pressurized to provide enough oxygen to passengers and crew.
However, cabins are not pressurized to the equivalent of sea-level altitude. In-cabin pressure is comparable to an altitude of 6,000 to 8,000 feet. People with severe respiratory or cardiac problems may encounter some difficulties. When in doubt it is best to discuss your travel plans with your physician.
Flying at great altitudes also makes the air in the cabin relatively dry. As result we must compensate by drinking plenty of non-alcoholic fluids to prevent dehydration.
Blood clots in the legs (Deep Vein Thrombosis), although not a very common problem, have been reported after prolonged flights. This is caused by being in a sitting, cramped position for long periods of time with little opportunity for the blood to circulate freely in the legs. Toe, feet and leg exercises while sitting are always helpful. Also, as much as possible, take short walks in the cabin and change positions on the seat. If you have a propensity for swelling legs or blood clots, consider discussing using “compression stockings” with your doctor.
While you are there
I have traveled extensively, especially through the Middle and Far East, and have gotten sick only twice: once in Ireland and the other in Las Vegas. That is because I let my guard down.; I did not think I could get sick there.
International traveling may be as easy as going to New York City or very complicated, depending on the destination. The Centers for Disease Control has a website dedicated to travel (http://wwwnc.cdc.gov/travel/) with lots of excellent information.
It is very important when you visit some parts of the world to be current in your vaccinations. The CDC recommends you be up-to-date on your routine vaccines, including measles-mumps-rubella vaccine, diphtheria-pertussis-tetanus vaccine, chickenpox vaccine and the yearly flu shot. It is also wise to have another dose of polio depending on where you’re going. The same applies to other vaccines, like yellow fever, hepatitis A and B, rabies and typhoid.
Another issue that comes up very often is prophylaxis against malaria. Malaria is endemic in many parts of the world and it is important to get a prescription for prophylaxis medication.
Disaster relief workers are particularly vulnerable to this condition since they don’t often have the opportunity to have adequate protection against the mosquitoes. For instance, everybody whom I knew working in Haiti (after the earthquake) was taking prophylaxis meds against malaria.
Travelers’ diarrhea is the most common condition affecting people traveling. It is hard to get accurate statistics of this condition’s occurrence but 20 to 50 percent of modern travelers may be affected by diarrhea. The most common cases are travelers to developing and underdeveloped countries. The most common cause of TD is contamination of food or water with bacteria. The most common source of bacteria is fecal contamination of water or food.
The CDC does not recommend using prophylactic antibiotics to prevent TD. Bismuth subsalicylate tablets (Pepto-Bismol) have been used with significant success in preventing TD.
The best course of action for people considering traveling to developing countries is to, once again, access the CDC website dedicated to travelers. Large medical centers usually have international medical offices that can advise you appropriately, and even prescribe vaccines and medications if required.
If you want to prevent the unpleasantness of TD you must be very disciplined. Never eat anything that is not piping hot. Forget the chips and salsa that may have been at room temperature for days. Drink only carbonated beverages. If you open the bottle and the content is flat, return it. Do not add ice to the glass because you have no assurance that the water used to make the ice is safe. Eat only fruit you can peel. Pass on the decorative trays of fruit all neatly cut up.
Under no circumstances eat from street vendors. A good friend of mine, during a particularly hot day in Cairo, had a small amount of something similar to Italian Ice bought from a street vendor. She spent the rest of the trip in bed. It is not easy to be disciplined but it is easier than spending most of your vacation in the bathroom.
Cruises
Cruises simplify things in many areas, but you may also have surprises. Usually, a qualified physician is aboard, which is reassuring, but health-care facilities vary from line to line and ship to ship. We have become familiar through newspapers with people stranded at sea for several days. For healthy people that may be an inconvenience and sometimes an adventure but for somebody with a medical condition it may be a serious problem. A ship with no power has no air conditioning. Passengers, depending on the latitude where they are traveling, may be exposed to very high temperatures.
Of course, well known to anyone reading a newspaper or watching television, diarrhea is another problem affecting cruise ships. Versus what is seen in the typical TD, which is caused by bacteria, the typical cruise ship-related diarrhea, although not exclusively, is most of the time caused by viruses. These viruses can be contagious, affecting the entire ship in a very short period of time.
Depending on your propensity to sea-sickness and the area and season where you will be travelling you may need medications. It is always best to start the meds before you board the ship.
In summary, enjoy your travels. Traveling is one of the most rewarding activities, but plan ahead and seek more information whenever necessary. Discuss your travel plans with your family physician if you have a serious medical condition or you are planning to go to remote areas. Bon voyage.
