Coping with medical needs overseas

This item appears on page 41 of the March 2011 issue.

Annie and Fred Dintzis of Peoria, Illinois, sent in a request: “We’d like to know how travelers with medical problems cope in different locations overseas. Please solicit readers’ experiences, comments and tips on dealing with diabetes, various allergies, high blood pressure, etc.”

So we invited each of you to write in. We limited any experiences cited to those outside of the US and requested the following: in describing any experience and the steps you took, include where you traveled and when your trip was. If discussing situations on airplanes, name the airline and the seating class you were in.

We’re presenting here some of the replies, with more to come. If you have a thought to add, write to Coping with Medical Needs Overseas, c/o ITN, 2116 28th St., Sacramento, CA 95818, or e-mail (include the address at which you receive ITN).

My suggestion to other travelers — check with a pharmacist!

During our trip to Scotland in July-August 2010, my prescription eyedrops for glaucoma treatment did a disappearing act. We were in the town of Wick in the northernmost part of the country.

I went to the pharmacist at Boots (a drugstore chain) and asked how I could get a bottle of the eyedrops. She said she would order a bottle to be sent up from Inverness in the next day’s delivery and directed me to the health clinic to get a prescription.

At the health clinic, I filled out a form registering as a visitor to Scotland. I was directed to return the next day for the prescription, which I did, then I returned to Boots, handed in the prescription and received my eyedrops — at no cost to me. Problem solved!

In some countries, medications can be purchased from the pharmacist without a prescription, so check!

Sally Aber

Albuquerque, NM

I lived and worked in Manila in the Philippines from 1986 to1990 and had the opportunity to travel widely throughout the region. During my tenure there, I, unfortunately, endured many bouts of food poisoning, diarrhea, yeast infections, etc., but I survived them all and now have plenty of good stories to share.

Here are my recommendations.

• Keep a list of all your medications, surgeries, family medical history, doctors, etc., both with you and with family or friends back home.

• Pack as lightly as possible. You can buy many things in Southeast Asia a lot cheaper than you’d be able to in the US, including medications.

• Before you go, ask your doctors what the equivalent names of your medications would be overseas. If they know the language spoken where you will be traveling, have them write the names down for you in that language.

• On a lengthy flight, make sure you pack your own healthy snacks and carry along some anti-jet-lag remedies, such as the homeopathic tablets you can get at Trader Joe’s stores and other places. You also may want to carry some melatonin to regulate your body clock once you arrive at your destination. It will help you sleep better.

• While traveling with my father in Thailand, I learned from our Thai tour guide the BEST remedy for food poisoning: STRONG Chinese black tea, white rice and dry toast. (No greasy bacon and eggs.) It really works. Rest helps a lot, too.

• Wear light-cotton underwear to avoid or minimize yeast infections. Use body talc to help keep dry. It’s also good to drink cranberry juice, but it may be difficult to get in some places overseas.

• Take along extra zip-lock bags and cotton swabs. They come in handy in times and places you wouldn’t even think of.

• In certain countries, register with your embassy, just in case there’s any kind of emergency or you might need some quick action.

Wishing you safe and happy travels wherever you are going!

Maryann Hrichak

San Francisco, CA

We are at the age at which we sometimes feel like a traveling pharmacy.

I am a type II diabetic on oral medication. I travel with 10 different prescription pills and two prescription topical lotions. The latter come in containers larger than those approved by the TSA for liquids and gels in carry-ons.

Three years ago my wife and I did a two-month-long trip around the world. For that, I purchased a special carry-on case (about the size of a cosmetics case) in which to carry all my pill bottles. That worked okay, but it was way too bulky, especially since we were traveling with carry-on baggage only.

Since then, I have always prepackaged — combined in small 1½"x2" zip-lock bags — my twice-daily doses of meds, and that has worked well for me. I mark each bag with a marking pen for a.m. and p.m. use and keep them segregated in two larger zip-lock bags.

I always pack several extra days’ worth of meds, just in case. And, of course, I always carry my meds onto the plane.

Lotions and liquids in oversize containers must have the pharmacy prescription label affixed to the container and be handed to the inspector during the security check. This has always worked smoothly, although usually I have to peel the adhesive label from the box, myself, and affix it to the actual container.

I am taking a blood thinner, which requires my having a blood test every two to three weeks. I have had excellent and inexpensive service overseas from Barnard Memorial Hospital in Cape Town, South Africa, as well as at a small clinical lab in Auckland, New Zealand, where I just dropped in and presented the letter from my medical provider. Getting the results back, myself, I could either adjust my dose or phone my provider for instructions.

How to keep track of when to take meds? If you are taking meds just mornings and evenings, it is pretty simple: take them at the usual hour by the local time overseas. If they have to be timed more precisely, ask your physician for advice.

Purchasing medical equipment overseas could be difficult without a prescription from a local physician. It might be best to carry along all that you expect to need plus a little extra, in case of travel delays.

On a trip to Italy in May ’08, I came down with a nasty respiratory infection and became concerned it might develop into pneumonia. When we reached Florence, I asked at the hotel desk for help and was directed to the Misere (a Catholic community clinic), a block away on Via Calzaiuoli, not far from the Piazza del Duomo.

I got an appointment for that afternoon with an English-speaking physician, who prescribed a 10-day course of antibiotics. The office visit cost €15 (near $21) plus a voluntary donation to the collection box. This was way less than my copay would have been with my Kaiser HMO.

Anyone who is past what the French call “a certain age” and has medical issues of any kind should avoid flying in economy class, if possible. Sitting in the rear section of a 747 is just NOT something that my aging, 76-year-old, 6'3" body is able to deal with.

Developing deep-vein thrombosis is only one of the concerns. After the stresses of having to arrive at an airport two hours before flight time and stand in long check-in and security lines, being able to just rest in a comfortable seat is important.

Ticket and baggage check-in lines for business-class passengers are very short. Also, some airlines give business- and first-class passengers passes to use the shorter security lines used by the crew, and sometimes mobility-impaired people are allowed to use them as well. It’s nice when that happens, but you can’t take it for granted.

Even in business class, the types of seats there are depend on the airline. Some just use reclining seats, while others use lie-flat seats, which are way more desirable on long-haul flights and give you a chance to actually catch a few hours of sleep and elevate your legs.

With advance planning, you may find reasonably priced international business-class fares. If you wait until, say, two months before travel, the cost of that round trip to Europe can be very pricey, indeed.

My medical provider, Kaiser Permanente, offers each of its members a computer “thumb drive” (small portable memory storage) — containing your entire medical history — for a nominal charge of $5.

The records are password protected, so you need to make sure that a travel companion knows the password or, as I have done, you can add a small Word document to the thumb drive that contains the password and any additional information desired.

When needed, a provider can simply plug the drive into a computer’s USB port, and a folder comes up that I’ve titled “READ ME FIRST.” It contains emergency contact numbers, an abbreviated living will and the PIN needed to open my protected medical summary, including x-rays.

The “thumb drive” comes on a necklace or ribbon, and I always wear mine when traveling out of the country. Digital medical records are only now becoming mainstream, so not everyone may have this option.

Finally, be sure to carry a list of your prescriptions (by brand and generic name) in your passport or wallet.

Peter Klatt

Berkeley, CA

I am an insulin-dependent diabetic and, while traveling, carry disposable needles, pens of insulin, alcohol swabs and some food in a cooler lunch bag. I refill a wide-mouth clear plastic bottle with ice twice a day to keep the food and insulin cool.

My husband, Richard, and I took a tour of Costa Rica with Caravan Tours (Chicago, IL; 800/227-2826) in December 2010. We had seven flights during our trip, and my cooler bag was opened and inspected only once.

Coming back into Dallas, Texas, from Costa Rica, a newer agent was given the task of going through the bag as a training exercise. He swabbed everything in the bag before passing it through. Nothing was removed. (It was mentioned that pain creams for arthritics could set off the machines.)

In several of the hotels in Costa Rica there was a small refrigerator in our room and I was able to use it. At the JW Marriott Guanacaste Resort, the mini-bar was emptied so that I could use the refrigerator. There was no charge.

At the same hotel, because all the meats had garlic on them and I am allergic to garlic, the chef cooked me a chicken breast. When I thanked him for his help, he said, “Almost everything is possible at the JW Marriott.” Great hotel!

We were very pleased with all the arrangements, hotels, meals, bus and escort on this tour. They were able to provide food for me without garlic.

Florence Wood

Whitesboro, NY