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Jay Medicine Hat

If you're planning your summer vacation--and, if history repeats, 41 percent of us are doing just that--you may be consumed with details like getting a dog sitter, tinkering with the light timer and having your newspapers held. But as you rush from the cleaners to the bank to the passport office, don't overlook the task of staying healthy while you're away from home.

Even veterans fall short: They'll forget to get needed shots, have their favorite boots resoled, check out an area's water supply or pack needed medical supplies. So for travelers of all experience and all destinations, here's a quick guide to keep you well here, there and back again.

before you go

REVIEW YOUR HEALTH INSURANCE. Look at your policy or contact your insurance company or HMO to verify your coverage. Ask about any specific travel-related policies, such as a requirement to call your member-service office before or soon after obtaining medical care.

If you do need to purchase health coverage during the trip, a variety of insurance companies, cruise lines and travel agents offer it, usually bundled with insurance for trip cancellation and emergency evacuation. While costs vary, a couple going on a $4,000 cruise might pay about $200 for a policy with these and additional benefits, says Claudia Fullerton, a spokewoman for CSA Travel Protection.

GET IMMUNIZATIONS EARLY.

Traveling to exotic locales brings the risk of yellow fever, typhoid fever, hepatitis and other dangers. Vaccines can protect you against many of these illnesses--if you plan ahead.

Immunizations often take several weeks to reach maximum effectiveness. "It would be ideal to come to us at least a month in advance," says Joseph Cervia, M.D., an infectious-disease specialist at the Travel and International Health Service of Long Island Jewish Medical Center in New York. To find out what immunizations you need for your trip, the federal Centers for Disease Control and Prevention posts a regional guide at cdc.gov/travel/vaccinat.htm.

And if you do need last-minute immunizations, take heart: In healthy patients, multiple vaccines can be given without boosting adverse side effects, according to a report in the Journal of Travel Medicine.

STOCK UP ON MEDICATIONS. Bring a supply of your prescriptions that exceeds the amount of days you plan to be gone. While pill totes are popular, "it's wise to keep the medicine in its original container, which has the original labeling," says Cervia. "That shows the [security] screeners who may find it that it's a legitimate prescription."

Keep your physician's contact information on hand; if you run out of your medications, he or she may be able to fax or phone in a prescription.

PREPARE FOR THE FLIGHT, Try to minimize nasal dryness since breaks in the mucous membranes can facilitate infections. Take along an over-the-counter zinc-based nasal gel like Zicam or saline gel such as Ayr, says Terri Rock, M.D., a family physician and travel-medicine specialist in Santa Monica, Calif.

For natural prevention of motion sickness, take ginger supplements, says Rock; about 250 milligrams three times a day is a commonly recommended dose. Ginger tea can work, too, adds Christian Dodge, N.D., a naturopathic physician at Bastyr University's Center for Natural Health in Seattle. "Have as much tea as you want," he says.

during the trip

WASH YOUR HANDS OFTEN. On land or in the air, frequent hand-washing prevents the transmission of respiratory and gastrointestinal diseases. Take along alcohol-based hand sanitizers, says Phyllis Kozarsky, M.D., chief of travelers' health for the CDC.

KEEP MOVING. The American Council on Exercise suggests that passengers should move around an airplane cabin every 15 to 30 minutes. Women on oral contraceptives are at higher risk for blood clots when airborne, according to the Archives of Internal Medicine, so they should stay hydrated and walk whenever possible. If you can't get up, do a series of in-seat exercises like toe wiggles, ankle rotations, knee lifts and shoulder shrugs.

Compression stockings, available at drugstores and medical supply stores, have been shown in studies to reduce clot risk; wearing them during and a day after the flight is recommended.

AVOID QUESTIONABLE FOOD OR WATER. Ingesting contaminated food and drink can cause a variety of infections, from E. coli to giardiasis and hepatitis A, according to the CDC. This is a particular problem for travelers in developing countries. Boil water vigorously or disinfect it with iodine; portable filters impregnated with resins, sold at camping stores, are another option. Consider all your water sources; even ice cubes in a soda or brushing your teeth with tap water can make you sick. If you don't know the safety of the local fare, choose cooked or steamed food over raw. Peel fruit before eating it, and avoid salads and unpasteurized milk products.

after the trip

STAY ALERT. Problems can surface after your safe return. "It can be weeks before parasitic infections show up, and some malaria can hide for up to a year," says Cervia. "The most important symptom to be aware of is fever, particularly fever with chills." Depending on your itinerary, your doctor may need to rule out malaria, typhoid fever or other problematic "souvenirs."

first aid to go

Even when you're traveling to an urban area, it's better to pack your own health supplies than to go searching for bandages in a strange city at 3 a.m. Be sure your first-aid kit includes the following, according to Stuart Rose, M.D., a travel and emergency-medicine specialist in Westfield, Mass., and Lynn Staneff, a spokeswoman for Magellan's, a travel-supply store. Assemble your own package or buy one ready-made at a pharmacy, travel store or online at magellans.com or travmed.com.

For travel domestically or to developed countries:

Antihistamine (for allergic reactions)

Pain reliever

Bandages and butterfly closure

Antibiotic ointment

Moleskin for blisters

Thermometer

Tweezers

Insect repellent

Sting-relief ointment

Pocket-sized first-aid book

For travel to developing countries or remote areas:

Contents of domestic kit, plus:

Anti-diarrhea remedy

Oral rehydration salts (for post-diarrhea dehydration)

Water-purification tablets

Sterile dressings, elastic (Ace) bandage, adhesive tape

Irrigation syringe (for wound cleaning)

Suture and syringe kit (for use by doctors in areas where needles may be reused)

the top travel health problems

Prevention is best in each case, says Jay Keystone, M.D., of the University of Toronto's Centre for Travel and Tropical Medicine. (What about jet lag? See page 55.)

Sunburn

Wear a sunscreen or sunblock with a minimum SPF 15, says the American Academy of Dermatology. Protect yourself further by wearing a wide-brimmed hat and densely woven clothing. Remember that the sun's rays are especially strong reflecting off water or snow. For more advice on sun protection, see "Let It Shine" (page 30) and "Save Your Skin" (page 94).

INSECT BITES

The CDC suggests using insect repellents with the chemical DEET, and your clothing can be treated with permethrin-based protectants like Permanone. Natural repellents include citronella and eucalyptus.

DIARRHEA

Minimize the risk by avoiding potentially contaminated water and food. Travel with a supply of antibiotics in case diarrhea strikes; taking them preventively is not recommended, unless you're heading for a particularly primitive area. Over-the-counter drugs like Imodium and Kaopectate ease the problem by slowing the activity of the intestines; these may interact with antibiotics.

A natural-remedy option is Saccharomyces boulardii, a probiotic related to brewer's yeast, says Drew Francis, O.M.D., who runs the Golden Cabinet Medical Healing Center in Santa Monica, Calif. He advises travelers to take 500 milligrams twice daily.

the top 3 travel

According to Jay Keystone, M.D., these are the health problems for which travelers are least prepared.

CONSTIPATION

It's common, and it can wreck a vacation. There are numerous over-the-counter options with active ingredients that include bisacodyl, milk of magnesia and psyllium; the latter is a natural soluble fiber derived from the husks of a seed grain. For relief, Drew Francis, O.M.D., recommends a gentle formula of Chinese herbs called tiao wei cheng qi tang. Take three or four 500-milligram capsules at bedtime--"and take that again in the morning if you're not better," he says.

ACCIDENTS

Accidental injuries cause more than half of all travelers' deaths, according to a recent report in the Journal of Travel Medicine. Motor-vehicle accidents are a major cause, and they often result from ignorance of foreign road rules. Research local driving safety and security before your departure by visiting the Web sites of the Association for Safe International Road Travel (asirt.org) and the U.S. State Department's Bureau of Consular Affairs American Citizens Services (travel.state.gov/road_safety.html).

UNSAFE SEX

Sexual interactions with relative strangers, mostly unsafe and lacking protection such as condoms, is surprisingly common during leisure and business trips, Keystone says. Many people don't consider the risk of sexually transmitted diseases and don't take precautions. If you decide to let your hair down, don't let your guard down as well: Sexually active men and women should always carry condoms.

jet lag remedies

The joke about your luggage arriving in better shape than you is less amusing if you've just crossed a dozen time zones. Here are nine ways to lessen the lag.

ONLY TRAVEL WEST

OK, this one's not very practical, but flying east tends to produce worse jet lag than flying west, probably because lengthening the day is easier on the body clock than compressing it. The traditional view is that jet lag happens when your brain clock gets out of sync with the time at your destination. But researchers Gene Block and Michael Menaker of the University of Virginia say that other parts of the body have clocks that must be re-regulated as well. So your brain may be in London, but if your liver clock is on L.A. time, it's bad news for the feet that want to go sightseeing.

MOVE YOUR MEAL TIMES

To coax your internal clocks forward (or back), Block and Menaker advise that, beginning a day or two before a trip, you adjust your meal times to match those at your destination.

MAKE MINE MELATONIN

"For jet lag, melatonin has the best track record," says Christian Dodge, N.D., of Seattle's Bastyr Center for Natural Health. Taking supplements of this hormone, normally made in the body while you sleep, can trick your body into regulating its circadian rhythms.

ADD LIGHT

Combining melatonin with exposure to natural light upon your arrival is a better approach, says Al Lewy, M.D., senior vice chairman of the department of psychiatry at Oregon Health & Science University in Portland. He suggests consulting a travel-health specialist for how and when: "Proper timing for both the light exposure and the melatonin dose is critical, depending on your direction and the number of time zones crossed."

SLEEPING PILLS/WAKING PILLS

Need to rest? Santa Monica, Calif., physician Terri Rock, M.D., sometimes prescribes the sleeping pill Ambien (zolpidem tartrate) for short periods of time. "One of the best ways to help with jet lag is to conk yourself out, and taking Ambien is a safe and acceptable alternative for most people." But she advises taking any new drug at home first to avoid being surprised by adverse side effects; also, she does not recommend sleeping pills for long flights because of the need to move about to help prevent deep-vein thrombosis (see page 50). Another pharmaceutical remedy is Provigil (modafinil), a "wake-promoting" agent that many travelers use; however, it can have serious side effects, cautions Rock. The FDA has only approved Provigil for narcolepsy, sleep apnea and shift-work disorder.

LOW-INTENSITY EXERCISE

When you arrive, taking a 15-minute walk at a moderate pace should help you feel energized again, says Ryan Bradley, N.D., of the Bastyr Center for Natural Health.

THE NATURAL WAY

To feel more refreshed, try Chinese ginseng, says Bradley; it can reduce the short-term stress effects of sleep deprivation. If you need to be alert for a morning meeting, rhodiola may help, he adds.

FLY ZEN AIR

Making your long flight less stressful will reduce your travel hangover. On some flights, Virgin Atlantic has added a meditation channel to its in-flight audio programming. The program, dubbed Meditainment, guides listeners through a series of mental journeys to peaceful settings.

COPYRIGHT 2004 Weider Publications
COPYRIGHT 2004 Gale Group