March 24, 2012

Human Pin Cushions

Imagine every medical decision you'll have to make over the next year - eye doctor appointments, prescriptions, annual check-ups, teeth cleaning, over-the-counter meds, insurance coverage, birth control, etc... And now imagine that you have to make all of those decisions in advance, at around the same time. That's basically what we're doing in preparation for our trip. We know we don't have to have everything we need before we go - you can certainly buy headache medicine and Bandaids nearly anywhere, and we're almost always 100% on-board with any remedies offered by locals. Side note: One time, when I had a bad cold and had lost my voice in Jamaica, I accepted a home brew from a local Rasta Jamaican I had grown to know and respect very much while living in Negril. It didn't look great and appeared to have small twigs and leaves floating in it, so I held my breath, pinched my nose and took it like a shot. It tasted surprisingly good - like a thick fruit juice, loaded with honey and ginger and something earthy. It immediately started working and I was myself again by the next day. I found out later that the concoction included several buds from the, um, local herb. I swear that this home-brewed remedy was the fastest-working medicine I've ever taken, so I'll never knock the local ways.

While we certainly don't have to be prepared for every ailment or illness we may face on the trip, there's still a lot of medical preparation to do, starting with vaccinations. Last month, I filled out a questionnaire from the travel clinic of my doctor's office, telling them where we'll be going and for how long and describing our activities. They mostly want to know if you'll be staying at resorts vs. budget accommodations (budget), staying only in tourist areas (probably not), eating from street vendors (definitely), coming into contact with livestock or animals (probably), or spending time on a farm (I hope so). I've used this travel clinic for less-adventurous trips in the past and have easily secured prescriptions for Cipro and, for longer trips, a few Ambien to help recover from jetlag. For this trip however, because of our activities, locations, and length of stay, they referred us to the San Francisco Adult Immunization and Travel Clinic. My consultation appointment was last week and I.CANNOT.BELIEVE how many shots they say I need.

Here's the full list (keep in mind that I have fainted several times from shots/vaccines/IVs/giving blood, so this gives me serious anxiety):

A little vaccination humor
  • Hepatitis A (series of 2 shots)
  • Hepatitis B (series of 3 shots)
  • Influenza
  • Japanese Encephalitis (series of 2 shots)
  • Polio Booster
  • Rabies (series of 3 shots)
  • Tetanus, Diphtheria, Whooping Cough
  • Typhoid

That's 14 shots. FOURTEEN. I'm pretty sure I had the Hep B vaccine series my freshman year of college, but I can't find the record so, in the very least, I have to get blood drawn so they can test to make sure I've had the vaccine. That means 3 less shots (yay!), but still means giving blood (boo!). This is lose/lose.

They also recommend we take along prescriptions of Cipro and anti-malarial medications. On top of that, they suggest treating all of our clothes with mosquito-repelling chemicals, avoiding all street food, avoiding any raw fruits and vegetables, avoiding cold sauces (including chutneys), always sleeping under a mosquito net (also treated with chemicals), and basically being the most paranoid, pessimistic travelers ever. No thanks.

Steripen Water Purifier

Before you get all worked up, we're not idiots. We're going to make sure we're up-to-date on nearly all of the recommended vaccines. We're just skipping Japanese Encephalitis (there are only 2 or 3 reported cases of this disease each year and the vaccine is SUPER expensive) and rabies (also very expensive and, even with the vaccine, if you are exposed to rabies, you STILL have to seek immediate medical attention and get 2 more booster shots). We're also going to take some antimalarial meds with us, but we're not going to take them every day of the entire trip as the clinic basically suggested. We'll start taking them 2 days before we head into high-risk malaria areas (the clinic gave us great maps showing high-risk areas) and will take them while we're there and then for 2 weeks after leaving the area. We'll definitely use strong, DEET mosquito repellent, but we won't treat all of our clothes with harsh chemicals. If we're heading into the jungle for a trek, we'll treat those particular clothes with the chemicals. And we're going to eat street food. I couldn't imagine avoiding those foods, which are often some of the best there is. But we'll make sure to get food from busy and popular vendors and will certainly avoid tap water. For locations when it's difficult to find safe drinking water, we're taking along a Steripen Ultraviolet Water Purifier to purify and decontaminate the cleanest option we can find. We're going to be careful on our trip, but we're not going to be paranoid. We fully expect to get "Delhi Belly" at some point (the Indian version of Montezuma's Revenge), so we're making sure we know the appropriate ways to treat it if/when it happens, which will probably include nicer digs and pre-packages foods. (See Tom's post, Street Meat and Squatty Potties)

Other things we're doing to prep for our trip? We're definitely getting top-notch travel insurance, including evacuation coverage. This means we pay for medical and prescription costs upfront, but are reimbursed for them by the insurance company. If there are any major emergencies for which it's best for us to be treated in a different, more developed, location or country, the insurance covers the evacuation/travel to that location. The insurance is fairly cheap and, while we hope we don't need it, we've been warned that a major illness/injury or evacuation can bankrupt travelers without insurance, so we consider this an obvious decision.

Seriously, isn't it cute?

We're also putting together our own little First Aid Kit. I purchased an Adventure Medical Kits that has already come. I did a lot of research before choosing this kit. It's small, waterproof, and "ultralight," so I'm happy with the choice. It's also pretty cute (I love things in miniature), so it gets bonus points for aesthetic appeal and adorability adorableness. It's packed full of bandages, medical tape, antiseptic, ibuprofen, aspirin, tweezers, etc... I'm also obsessed with Boiron Homeopathic Medicines. I first used Boiron while on vacation in Italy in 2004. I had a cold and the local pharmacy had these little blue vials of dissolving pellets. I thought they were only a Euro-thing, but they're not, and they've been a regular staple in our house for years. (The company started in France, but the products are readily available in the US.) I'm not anti-medicine, but I think it's great to treat things naturally or homeopathically when you can. They also have great ointments. When I got The Great Black Eye/Face of 2010 right before our wedding (if you want to see this, email me, I'll send you the pic), I took a zillion Arnica pellets each day and constantly rubbed Boiron ArniCare Gel on my face to help with the bruising. Boiron is great for traveling because the packaging is so small (and also very cute - I love the way Boiron store displays look) and there are products for nearly every ailment you can imagine. For The Trip, I used to stock up on Boiron. I ordered:

I also bought some Burt's Bees Res-Q ointment, which is great for insect bites and stings. We'll add some sunblock, DEET, permethrin (mosquito-repelling chemical for treating clothes), anti-bacterial gel and get some prescriptions for Cipro, Ambien (used very sparingly) and a basic antibiotic, and I think we'll be good to go.

The last thing we're doing to prep, medically for our trip, is taking care of any medical needs we've been putting off and getting all of our checkups before we go (and while we still have awesome insurance). I've had a small hernia since I was a child that I've needed to have repaired. It causes me virtually no pain or discomfort and it's rarely even noticeable. But, if it ever ruptures or becomes suddenly worse, I would need emergency and immediate medical care, which may not be possible on our trip, so I'm getting that surgery in the next few months. We're both getting full medical workups, eye exams and teeth cleaning before we go and I'm going to get another pair of eyeglasses.

Stay tuned for Part II of this post, where I'll be covering "lady business." Get excited!

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