Smart travel: How to stay well abroad

Travel, to many people, is one of the great joys of life. But travel marred by illness can be a nightmare – and it has been estimated that as many as 40 percent of travelers abroad experience some health problems. Even if your health is excellent, travel to a foreign country can disrupt your normal diet and sleeping habits. This added degree of stress may make you more susceptible to illness or accident.

Any chronic medical problem you have doesn’t get left back home, either. And since you’re cut off from your usual medical care in another country, health problems that arise become magnified. Advance planning, combined with common sense while you’re away, can eliminate or at least minimize health-related problems – and leave you to enjoy your trip to the fullest.

Before You Go

Make appointments for medical and dental exams if you haven’t had them recently. Even if you’re up-to-date, tell your physician about your planned trip and discuss any special needs you might have. If you have a heart condition, ask your doctor if you should arrange to get supplemental oxygen in-flight. Since cabin pressure is often equivalent to atmospheric pressure at 8,000 feet, the amount of available oxygen may be low enough to cause problems for some cardiac patients.

To expedite care in a foreign country, request a brief written summary of your health history, including any drug allergies and, if you have a heart disease, a copy of a recent electrocardiogram. Include your doctor’s office and home phone numbers.

Get the generic names of your medications, since they may be known under different brands elsewhere. Always bring more medication than you need, so that if you decide to extend your stay, you won’t need to worry about finding more medication. Keep it on your carry-on luggage to prevent it from getting lost. Check on medication taken on a fixed schedule; if you are crossing several time zones, you may have to make some adjustments. Those traveling east who are taking insulin, for instance, may need to decrease their usual dosage slightly on a one-time basis, while those traveling west might have to increase it.

It’s a good idea to prepare a personal medical kit and include it in your carry-on luggage. It should include the following:

• Extra pair of glasses or contact lenses (with ample supply of lens solution), plus a copy of your prescription.

• Typed prescriptions for all medications, with generic names.

• Prescription pills and capsules in original containers (stuffed with cotton to prevent damage in bottles); liquid medications in self-sealing bags.

• Nonprescription pain medication such as aspirin or aspirin substitute (for example, acetaminophen and others).

• Diarrhea medicine, such as Pepto-Bismol, Imodium, or Lomotil.

• Motion sickness medication, such as scopolamine skin patches (Transderm).

• Insect repellent with at least 38 percent deet.

• Sunscreen with SPF 15 or higher (minimum of SPF 30 if going to tropical countries).

Make sure your immunizations are current. Traveling to exotic locales may require special shots. Inquire from your physician or you may access the Internet for information (for example, the US Centers for Disease Control and Prevention web site at www.cdc.gov/travel/index.htm is among the most comprehensive). Travel agencies are not reliable sources of medical information.

Check your insurance company about coverage for hospitalization outside the Philippines. Many insurers will not cover your medical expenses abroad. If so, you may be able to obtain additional short-term coverage designed specifically for travelers. Talk with your insurance agent about obtaining such coverage.

Make sure you know what the physical demands of your trip will be. Will there be a lot of walking and climbing, for instance? If you are not already in shape, start a walking exercise program. Begin modestly, and build slowly –a crash fitness program may do you more harm than good.

If you are on a restricted diet, order a special meal from the airline at least 48 hours in advance. Many offer either low-fat or low-cholesterol meals, as well as low-sugar, low-sodium and vegetarian. Wheelchair travelers should contact their carriers at least 24 hours in advance.

Getting There

Air quality is a concern for jet travelers. While the low relative humidity on planes – often down to 5 percent – should not cause any serious medical problems, it can be dehydrating and produce discomfort in the eyes, mouth, and throat. To minimize this, drink plenty of nonalcoholic fluids before and during flight.

Drinking fluids may also help you avoid potential circulation problems, such as swollen feet or muscle cramps in your legs, which can be exacerbated by sitting for long periods of time. If possible, take frequent walks and book an aisle seat so that you can stretch your legs. During ascent and descent, chew gum, swallow, or yawn frequently to equalize the pressure on the eardrums.

After You Arrive

One of the most common complaints of a long-haul travel is jet lag, which affects older people more than younger folk. This condition, which causes restlessness at night and drowsiness during the day, along with headaches, lethargy, irritability, and/or an upset stomach, results from disruption of your circadian rhythm – your internal clock – as you cross time zones, particularly from west to east.

Here are some tips to overcome jet lag:

• Start preparing well before you are handed your boarding pass. Try walking or exercising more during the month before your trip.

• About three days before your flight, start shifting your sleeping and waking times. If you’re traveling west, go to bed and get up an hour later each day. If traveling east, move your bedtime an hour earlier each day.

• While on the plane, drink plenty of nonalcoholic, caffeine-free fluids (if caffeine keeps you awake). Sleep if you can.

• Once you’ve arrived at your destination, don’t stay inside and don’t take catnaps. Get outdoors into the daylight as much as possible, exercise, enjoy yourself, and adhere to the local time schedule.

Eat, Drink and Be Wary

Generally, water and food are safe in countries like the United States, Canada, Europe, Japan, Australia, New Zealand, and Scandinavia. Elsewhere, haphazard refrigeration and poorly regulated water supplies may expose travelers to parasites, viruses, and bacteria. Contaminated water and food can cause the infamous traveler’s diarrhea – as well as more serious diseases like cholera and hepatitis.

When you are away from well-traveled areas, do not drink the water, brush your teeth with it, eat raw foods washed in it, or even use ice cubes. If available, use only bottled water. Avoid raw greens since "night soil," or human waste, may have been used to grow them. Vegetables are safe only when cooked. There’s no reason why you can’t enjoy fresh fruits, but peel or skin them yourself. Meat and fish – especially shellfish, which can harbor hepatitis – should be well cooked. Dairy products are safe only if pasteurized and served cold.

Should You Need Medical Attention

You can get a directory of good English-speaking physicians in various countries from the International Association for Medical Assistance to Travelers (IAMAT). Doctors listed have been screened carefully to ensure their competency. Membership is free (donations are accepted). Write IAMAT, 417 Center Street, Lewiston, NY 14092.

Safeguarding your health while traveling may seem like a lot of work. But taking a few precautions is a small price to pay to see the sights firsthand rather than watching them from your hotel (or worse, hospital) window!