to Stay Healthy on Your Next Trip
FOR SAVVY TRAVELERS
by Susan Foster
If you are healthy and fit when you leave on your trip, the chances are better that you'll stay that way throughout your travels. The most common illnesses travelers experience are colds and diarrhea caused by exposure to unfamiliar bacteria and viruses. If you're healthy when you leave home, it's easier to fight off these potential problems.
Planning and organizing in advance for a healthful trip can help eliminate “last-minute stress syndrome.” Just like Mom said: Get adequate rest, follow a good exercise program, eat a balanced diet, and take your vitamins.
Bring Your Medical Records
Before departure, prepare a medical history for yourself and for all family members traveling with you. Keep one copy with your valuable documents, one in your suitcase, and leave one at home with family or friends. It should include the following:
1. Your name, address, and phone and fax numbers
2. Passport number(s)
3. Driver's license number(s)
4. All doctors‚ names, addresses, office and emergency phone and fax numbers
5. Health insurance provider, 24-hour phone and fax numbers, your policy and group or ID numbers
6. Your blood type(s)
7. Chronic health issues such as heart problems, high blood pressure, or diabetes
8. Any known allergies to medications, food, or environmental agents
9. Eyeglasses prescriptions
10. Name, address, and phone number of a family member or close friend to contact in case of an emergency
Pack a Take-Along Medicine Cabinet
When traveling, particularly internationally, it is very important to pack your own medications. There is nothing worse than being sick in a strange place without the medication that can help you feel better. It is difficult to buy an antihistamine in China when you don't speak Chinese and in some countries the product quality may be suspect.
Here is what I carry:
· Antibiotic cream
· Aspirin, acetaminophen, or ibuprofen
· Band-Aids, gauze pads, tape
· Cold medication
· Constipation remedy
· Diarrhea treatment (Imodium® A-D, Pepto-Bismol®, or Lomotil)
· Hydrocortisone cream
· Insect repellent
· Moleskin or “2nd Skin®” for blisters; Band-Aid has a product called “Blister Block Cushions.”
· Motion sickness pills, wristbands (Sea Bands) or patch
· Nasal decongestant
· Prescriptions and vitamins; these can be counted out and packed in a small container for domestic travel. For international travel, it is wise to take medications in their original container and pack a copy of each prescription to prove you're not carrying illegal drugs, should authorities ask.
· Spare eyeglasses; eyeglass repair kit
· Thermometer (mercury thermometers may be banned on international flights)
Stay Healthy On the Road
To stay as healthy as possible, maintain as much of your at-home fitness program as possible while you travel. If you normally jog, pack your running clothes and ask at your motel/hotel desk for a map of a safe running route. If you swim, book a place with a pool and plan this into your schedule.
Portable exercise equipment includes jump ropes, plastic “weights” that you fill with water (Magellan's) and aerobics tapes that you can play on your hotel room VCR. Some of my trips are so walking intensive, I don't need much more exercise!
Stay Healthy In-Flight
Sitting in cramped quarters for long stretches is bound to make any traveler cranky and uncomfortable. Try the following for a stress-free flight:
1. Travel in loose and comfortable clothing.
2. Move around as much as possible to improve circulation and minimize the possibility of blood clots in the legs. Vascular specialists suggest taking aspirin before a long flight; it thins the blood and helps prevent clots. Request an aisle seat; it's easier to get up and take a walk every hour or so during flight (or more often if you don't have to disturb seatmates).
3. Take off your shoes (make sure to wear a pair that is loose enough so you can put them on again after your feet have swollen!) and elevate your feet by propping them up on a pillow or blanket, suitcase, briefcase or purse. Do not cross your legs —it cuts off circulation.
4. Avoid dehydration. Sahara-like dry air with only 1-10% humidity can result in general discomfort, digestive problems, headaches, sinus problems, fatigue, and increased symptoms of jet lag. Drink 8 ounces of water or other plain beverage for each hour of flight. Avoid alcoholic beverages, anything with caffeine, including soft drinks, or salty drinks like tomato juice; they only increase dehydration. I often carry my own bottled water so I have enough and don't have to pester the overworked airline crew. Drinking so much liquid also forces you to walk frequently — to the bathroom.
Dry air also causes red, sore eyes. Adding artificial tear drops to your eyes several times during a flight brings great relief. Most frequent travelers wear glasses rather than contact lenses for comfort during long flights. If you must wear contacts in transit, soft or gas-permeable lenses breathe the best.
Super-dry air dries out upper respiratory passages, increasing susceptibility to infection. Keep nasal passages moist by using a saline nasal spray every 2-3 hours.
To hydrate the skin, apply hand lotion frequently; use a good moisturizer before boarding and reapply during the flight. Use a spritzer bottle (Evian® atomizer) to refresh your face and hair. After arriving at your destination, take a steamy shower or bath to rehydrate your body and your upper respiratory tract.
5. Always fly with an inhaler handy if you are asthmatic.
6. Prevent ear pain during take off and landing by swallowing or chewing gum. A decongestant taken before flight and again an hour before descent also helps, as does nasal spray 30 minutes before and during descent. EarPlanes˙ are a product designed to relieve pain caused by rapid changes in cabin pressure (Magellan's). If none of these succeed, use the “flight-crew maneuver.” Close your mouth, pinch your nose tightly, and try to blow through your pinched nose. This should cause your ears to pop. Repeat during descent.
Ten Tips for a Healthy Back
If you are part of the 80% of the population with a significant back problem, and even if you're not, these tips are for you.
1. Pack your suitcase on a higher surface than the bed — the dining room table, a dresser, a kitchen counter. Reaching and twisting to pack on a low surface can cause back strain.
2. Pack into two smaller bags; they're easier to manage than one large one.
3. Purchase luggage with wheels or use wheelies.
4. Tip a sky cap to lift your luggage.
5. Check your luggage. Lifting a heavy bag into the overhead bin can aggravate back problems; so can trying to get it under the seat in front of you. Check luggage on trains and buses too.
6. Use a small pillow to support your lower back and a neck pillow for your head. When seated, your knees should be above your hips to take pressure off your back. Sit with your feet on a pillow or blanket or on top of your briefcase or purse.
7. Slide your bags onto the back seat of your car rather than lifting them up into or out of the trunk. If you must use the trunk, lift your bags carefully, then back away from the car and turn. Don't lift and twist at the same time!
8. Adjust the car seat so that your knees are slightly bent. A lumbar pillow or built-in lumbar adjustment in the seat also helps.
9. Stop every hour or so to take a walking break if you are driving. If traveling by plane, get up to stretch your legs several times during the flight.
10. Request a firm mattress when you make your hotel reservation.
Minimize Jet Lag
Jet lag is a major complaint, particularly on international trips. Although you can't eliminate it entirely, there are several things you can do to minimize it.
1. Start your trip well rested. Begin a gradual transition to your new time zone before you leave. For example, go to bed an hour earlier and rise an hour earlier if you are heading east. This is more helpful when traveling from coast to coast than from continent to continent.
2. Switch to your destination time zone when you get on the plane. Sleep and eat accordingly to get into the rhythm of the new time zone more quickly.
3. Avoid alcohol and drink plenty of water. Eat lightly, avoiding salty, rich, and fatty foods. Request a special meal from the airline at least 24 hours in advance; the low fat or seafood meals are nice. Do exercises in your seat or get up and move around as much as possible
4. Make yourself comfortable so you can get some sleep on the plane. Do not sleep during descent; it's hard on the ears.
5. Schedule your travel so you can take a flight that arrives at night, if at all possible. Stay awake for as long as you can during the flight, nap on board, then go to bed at a reasonable hour after checking into your hotel and unpacking.
6. Reset your body clock if you have arrived during the morning by not going to sleep immediately. Go out for a daylight stroll for an hour or two, have a snack, and then return to your room after noon to nap for a couple of hours. When you wake up, it will be time for dinner and a normal evening, followed by bedtime at 11 or so.
7. Plan a light work or tourist schedule for the first full day to give your body time to rest and recover from a long trip. Doctors recommend one day or more of rest for each time zone crossed, which is a great idea in concept but often difficult in reality.
Plan For A Healthful International Trip
When traveling internationally, think about health issues well in advance. Have all regular medical check-ups prior to travel. What is routine care at home can become a costly medical emergency in a foreign country. Get dental work done before departure. Small cavities can erupt into excruciating toothaches during high-altitude flights.
Ask your doctor to refer you to a travel specialist or clinic for the latest information on required inoculations and health issues in the area where you plan to travel. There are now more than 500 travel clinics in the US. Their specialized training is in tropical medicine, international health and infectious diseases, and wilderness medicine. They recommend an appointment 4 to 6 weeks prior to departure because some immunities take time to develop.
The major hospitals in my city have travel clinics that provide:
· Immunizations for diseases such as yellow fever and hepatitis
· Medications/prescriptions for preventing malaria (the leading cause of illness and death in the developing world), motion sickness, diarrhea, and other possible problems
· Post-travel follow-up for conditions such as rashes, fever, and jet lag
Travelers who don't have the proper vaccines required for entry into developing countries may be quarantined and forced to get shots at the border, possibly administered by a border guard who doesn't have disposable syringes.
A directory of physicians in the US and Canada who specialize in travelers‚ health and tropical medicine is available free from the American Society of Tropical Medicine and Hygiene http://www.astmh.org . You can also do research on your own by checking with the Centers for Disease Control and Prevention (CDC) http://www.cdc.org). They operate a free travelers‚ hotline that includes information on vaccinations.
Heads-Up Health Tips
A Conde Nast Traveler survey revealed only one-third of the world's nations have tap water considered safe to drink. For Americans traveling outside North America and Europe, that means drinking the local water is likely to make you sick. Generally, the more tropical and populous and the poorer a region is, the higher the risk of contracting something even more serious than “travelers‚ diarrhea.”
1. Avoid problems by drinking only bottled water. The CDC recommends carbonated water over flat water because it is harder to tamper with and its slightly acidic nature helps inhibit bacterial growth. Choose brand names you know whenever possible and make sure that all bottled water arrives sealed and is opened in your presence.
In A Journey of One's Own, author Thalia Zepatos recounts a telling story: —After drinking the ‘filtered water’ for a week at a guesthouse on the beach in Oaxaca, I got up early one morning to witness the filtration process. A young woman held a dirty dishrag over the end of the garden hose to fill the container. It did catch the pebbles and insects...”
2. Avoid ice cubes. If the water isn't safe, ice will not be safe either. Use ice to chill a container; don't put the ice into the liquid. Wipe off cans and bottles carefully; even a few drops of unclean water can cause illness. Use a straw when drinking from a can or bottle.
3. Use bottled water when brushing your teeth and rinsing your toothbrush. Do not swallow any water while showering or swimming.
4. Hot drinks made with boiling water are safe to drink. Avoid using milk or cream in tea or coffee unless it is in sealed individual containers that have been kept cold.
I am very cautious about what I eat when traveling, even though I love food. I survived food poisoning once and never want to repeat the experience. As with water purity, the risk of food being unclean and making you sick is generally higher in tropical, crowded, and poor areas.
Choose busy restaurants (all of those patrons can't be wrong) that look clean and opt for made-to-order dishes rather than buffet items that may have been sitting for long periods at an unsafe temperature.
In many countries, street food is so tempting — it smells wonderful and is usually very cheap. Eat at your own risk. Sheila must have a cast-iron stomach — she successfully ate street food throughout Southeast Asia and loved it. I am very selective; I avoid anything that is not quick-cooked before my eyes. In Asia I choose stir-fried noodles with vegetables because high heat kills bacteria. I eat no meat — the food vendors have been in the heat for hours with no way to keep raw foods cold. Single-use, disposable paper or plastic plates are safest; I watched a street vendor rinse her dishes in cold tap water on the sidewalk and she called them clean! I always take my own paper-wrapped, disposable chopsticks or plastic utensils. Utensils that you carefully wash yourself are also OK.
My bout with food poisoning is nothing compared to other diseases you can get from food. Hepatitis A is a viral infection of the liver spread by fecal contamination of food and water and is constantly present in many of the world's most appealing travel destinations. It is spread through unclean food-handling practices and the risks are highest in poor, tropical countries where the standard of hygiene is low and the water is unsafe. Expensive hotels offer some protection if they are diligent about safe food handling and hygiene practices but remember that the staff all goes home — to possibly poor local hygiene.
SAFE FOODS (at least most likely to be so) include:
· fruits that are easily peeled or that can be sliced open without contamination
· freshly baked breads
· fresh, fully cooked hot dishes, served hot
· packaged or canned foods
UNSAFE FOODS (at least most likely to be so) include:
· shellfish and seafood
· raw or under-cooked beef, pork, sausage, or fish (ceviche)
· cold foods, salads, and raw vegetables (may contain impure water and have greater risk of contamination from the hands of infected food handlers)
· buffet dishes and foods left out at room temperatures
· sauces left out on the table
· milk and milk products unless you are positive they were pasteurized and have been handled properly
· custards, cream pastries, cream sauces, and anything made with mayonnaise
· foods stored and reheated after cooking (lasagna) or cooked and served at room temperature (quiche)
· unpeelable fruits or fruits peeled by others
Pay Attention to This
Hepatitis A is now completely preventable with new vaccines that provide 100% protection for at least ten years. Two doses are required, one 4 to 6 weeks prior to travel and the other within six months to one year (depending on the drug used). No traveler can afford to ignore this vital hepatitis A vaccine. Ask your doctor and insist on being protected.
You don't have to be traveling internationally to be exposed to Hepatitis A. JoAnne and Dave were 75 miles away from home and stopped in a fast food restaurant for a snack. Both contracted Hepatitis A; they were very ill for a month and recovery took weeks after that. In adults there is a two percent risk of liver failure and a death rate of one in 250, so treat this illness with respect.
According to The American Society of Tropical Medicine and Hygiene, travelers’ diarrhea affects approximately 30-40% of travelers to the developing world, with contaminated food, water and beverages being the most common sources of infection. Following the above suggestions for water and food will help improve your chances of avoiding this common problem, as will careful and frequent hand washing.
Should you become a victim, the first line of treatment is to replace lost fluids and electrolytes. Drink plenty of pure water, decaffeinated tea or carbonated beverages, broth, or juice. Consider packing oral rehydration salts such as Ceralyte® (Pedialyte® for children) with you if diarrhea has been a problem during past travels or you typically have a sensitive tummy. Consult with your doctor or local travel clinic for advice and diarrhea fighting prescriptions before you leave home.
Bites or stings from mosquitoes, fleas, ticks, and flies are more than just itchy; they can cause painful irritation or debilitating and sometimes deadly diseases. Malaria, Lyme’s disease, dengue, yellow fever, Rocky Mountain spotted fever, and plague are all extremely serious insect-borne diseases. The CDC can tell you if you are venturing into a problem area so you can prepare yourself. Even though no current anti-malarial drug guarantees protection against malaria, you can help yourself avoid it by doing your best to prevent mosquito bites.
Apply insect repellent to your hands first and then rub onto your skin. Use it liberally and frequently, covering all exposed areas (avoiding the eyes and mouth) — insects can detect an unprotected area the size of a dime! Wear light-colored, long-sleeved shirts, and tuck long pants into your socks when venturing into areas with concentrated insect populations. Spritz or spray your outer clothing with repellent as well. Insect repellent for your room and a mosquito net for sleeping are important in some areas.
Natural repellents such as citronella work for some (but must be reapplied every 1-2 hours). Daily doses of vitamin B-1 are a natural mosquito repellent for others. Since insects view me as filet mignon, I choose a repellent with 20 to 35% DEET (the most effective insect repellent ingredient), as recommended by the CDC. Higher concentrations of DEET, even though they will last longer, can cause skin irritation. DEET concentration of 35% will last 4 to 6 hours, so reapply accordingly. DEET of 100% lasts for up to 10 hours and is used by outdoor sports people for maximum protection.
I carry a small lipstick-style insect repellent in my purse when I am in buggy areas. Repellent towelettes are also handy. Be diligent about using insect repellent no matter where you are going. I got the itchiest mosquito bite I can remember while inside a store in Shanghai. Pack an itch relief product such as calamine lotion or hydrocortisone cream too.
Buy insect repellents in the United States; products purchased overseas may contain ingredients illegal for use in the US and whose effect may be worse than the bites. Camping and sporting goods stores or departments are good sources for serious insect repellents.
From Smart Packing for Today’s Traveler by Susan Foster. Copyright © 2000 by Susan Foster. Excerpted by arrangement with Susan Foster. $19.95. Available in local bookstores or call 800-962-4943 or click here.