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Adding Health Precautions to the Travel ChecklistBy
FRED BROCK
New
York Times, June 8, 2003
While that may be an overly pessimistic approach to traveling in these times of terrorism and SARS, there are precautions that older travelers should consider during the vacation season — especially if they have health problems and are headed to foreign destinations. Dr. Maria Mileno, the director of the travel medicine service at Miriam Hospital in Providence, R.I., advises older people to consult a travel medicine specialist a month or so before they depart to discuss the risks that certain destinations may pose to underlying medical problems and needs — and to receive necessary vaccinations. "Many times internists and family doctors don't have information available," she said. "Or often they won't have the specialized vaccinations a traveler going overseas may need." The Web site of the International Society of Travel Medicine, www.istm.org, has a worldwide listing of travel medicine clinics and specialists. Those in the United States are listed by state. Dr. Mileno is active in the organization; she is also a specialist in infectious diseases and an associate professor of medicine at Brown Medical School in Providence. "The I.S.T.M. list of doctors and clinics can also help if you get sick on the road," she said. "Certainly you can start with them. They can advise on where to get treatment if they themselves can't help." Dr. Mileno strongly recommends travel insurance — including provisions for emergency evacuation — for older travelers or for anyone with a medical condition that could flare up into a serious problem. She points out that Medicare will not pay for treatment overseas or evacuation, and says private insurance policies may or may not. Chartering an air ambulance can cost tens of thousands of dollars. The policies cost a few dollars a day over the course of a typical two- or three-week trip. "But in addition to an air ambulance, these policies mean you have someone working for you," she said. "You have a number to call for help. You're not just rummaging around in the middle of a remote area trying to call various numbers. My experience has been that people have been very satisfied with the assistance they received in an emergency from the insurance companies that issue these policies." Companies that sell such policies include World Acess of Richmond, Va.; HTH Worldwide of Radnor, Pa.; the International Medical Group and Specialty Risk International, both of Indianapolis; Medex Insurance Services of Towson, Md.; and International SOS of Singapore, which has offices in Houston and Trevose, Pa. An online broker, eHealthInsurance.com, also sells travel insurance policies. Dr. Mileno also offered the following recommendations for older travelers: • Keep a list of your medications and take along enough of them, in their original containers, for the entire trip. It's also a good idea to have a letter from your doctor describing the medicines you are taking, especially narcotics. Never carry unlabeled medications through airport security checkpoints. • If you have heart problems, carry a copy of your most recent electrocardiogram. That provides a base line for comparison to a doctor who has not treated you before. • Take along a spare pair of eyeglasses. • If you use a wheelchair or other medical-assistance devices, take along the owner's manual. Sometimes, security personnel at airports remove parts to check for bombs and weapons. • Don't overextend yourself on a trip. Strenuous or prolonged activity and sudden changes in diet and climate can cause serious problems for older travelers. If you are traveling in an area where there have been cases of SARS, Dr. Mileno recommends taking along surgical masks and gloves as a precaution, as well as a dry hand purifier you can use anywhere to "wash" your hands. "In the case of SARS, most of it is in hospitals," she said. "Because of this, the risk for a traveler is remote. It's highly unlikely to get into a hotel. But we still recommend taking along the masks and gloves just in case." Dr. Mileno and her colleagues in travel medicine also provide help and
advice for high-risk travelers, like those whose vision or hearing is
impaired, are physically disabled or require kidney dialysis. Some
organizations and companies can help arrange for dialysis treatment
overseas. One company, Dialysis at Sea Cruises in Largo, Fla., even
arranges ocean voyages on regular cruise ships for dialysis patients (www.dialysisatsea Does Dr. Mileno ever counsel people not to travel, either because of their own health problems or problems at their destination? "I rarely advise people not to make a trip," she said. "I'm in the business of facilitating travel." Copyright
© 2002 Global Action on Aging
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Recent cartoon in The New Yorker showed an older couple sitting in their
living room, the man engrossed in a newspaper. The woman says to him,
"Let's update our will and go on vacation."