Family Health Magazine - growing older
Travel Tips for Snowbirds
What to know before you go
Winters in Canada can be long and harsh. Just as birds head south for warmer climates before winter settles in, many Canadians feel the urge to escape to warmer areas when winter is at its most challenging. Some people go south so regularly in the winter that they are known as 'snowbirds.'
Many go to the warmer states of the United States - California, Arizona, Texas, Florida, Hawaii. Others keep going across the American border into Mexico or Central America. Their travels may last a month or extend up to four or five months. Are you a snowbird? If you are, you know that humans have to plan their migratory flights a lot more carefully than birds do. Especially where your health is concerned, preparation done before you travel can help prevent serious problems while you are in another country.
1. Have a complete physical check-up before you leave. This includes a dental and eye examination.
If you have a chronic health condition such as diabetes, heart or lung disease, talk to your doctor about situations that may cause problems for you. For instance, if you cannot walk up a flight of stairs without feeling short of breath, you should have oxygen available for plane travel. Your doctor can make those arrangements with the airline.
If you have severe allergies, particularly to foods or insect stings, your doctor can prescribe medication to carry with you. If you are asthmatic, you should carry an inhaler, even if your last attack was years ago.
2. Plan what you need to take with you
A. Prescription medications
- Carry enough to last for your whole trip plus an extra week.
- Carry a written prescription so your medication can be replaced if necessary.
- If you need syringes for a medical condition such as diabetes, it is very important that you take enough for the length of your stay.
- Carry a letter from your doctor listing your medications and explaining that they are for your own use.
- Carry your doctor’s name, plus office and emergency phone numbers.
B. Other medications
Some over-the-counter medications may not be available in other countries. If you have any that you take routinely, take them with you:
- for pain and fever - analgesic (e.g. ASA™ [not recommended for children] Tylenol™)
- for allergies - antihistamine (e.g. Bendadryl™)
- for itching - calamine lotion (e.g. Caladryl™)
- for motion sickness - anti-nausea medicine (e.g. Gravol™)
- for stomach upset - antacid (e.g. Diovol™)
- for diarrhea - anti-diarrhea medicine (Pepto Bismol™, Imodium™)
- for serious diarrhea, 3-5 day prescription of antibiotic - usually a quinolone (e.g. Cipro™)
- for cuts and insect bites - antibiotic ointment (e.g. Polysporin™)
C. Extra considerations
- If you have a medical condition, wearing a Medic-Alert™ bracelet is strongly recommended during travel. This could save valuable time in an emergency. In Canada you can phone Medic-Alert™ at 1-800-668-1507. In the United States, contact the Medic-Alert™ Foundation: P.O. Box 1009, Turlock, California 95381-1009 or phone 1-800-825-3785.
- If you have severe medical problems, ask if your doctor can give you the name and phone number of a medical doctor at your destination. IAMAT (International Association for Medical Assistance to Travellers) provides a directory of English-speaking doctors worldwide. If you plan to be in several countries, an IAMAT membership may be worthwhile. Their headquarters address in Canada is: 40 Regal Road, Guelph, Ontario N1K 1B5 or phone (519) 836-0102. In the U.S., the membership office is: 417 Center Street, Lewiston, New York 14092 or phone (716) 754-4883.
- Carry spares of medical items that might be difficult to replace. These include eye glasses, contact lenses, and batteries for hearing aids or glucose meters. If you wear glasses you should carry a copy of your current lens prescription.
- If you wear contact lenses you should pack enough cleaning solution for your whole trip.
- Carry a basic first aid kit to take care of minor emergencies.
- assorted bandages, tape
- scissors, tweezers (or Swiss Army knife)
- moleskin (for blisters)
- antiseptic towels
- topical antibiotic ointment
3. Supplemental Health Insurance is crucial*
Do not make the mistake of relying on your provincial health plan to pick up the tab if you get sick or are injured in a foreign country. At best, your health plan will cover only a portion of the bill. It is your responsibility to obtain and understand the terms of your supplementary insurance policies. Some credit cards offer their holders health and travel insurance. Do not assume the card alone provides adequate coverage.
Be sure to ask whether or not your policy:
- pays foreign hospital and related medical costs. If so, does it pay up front or expect you to pay and be reimbursed later?
- provides for your medical evacuation to Canada.
- pays for required medical escort (doctor, nurse or companion) to accompany you back to Canada.
- excludes pre-existing medical conditions. If such conditions exist, notify your insurance company and get an agreement in writing that you are covered for these conditions. Otherwise, you could find your claim null and void under a pre-existing condition clause.
- covers premature births and related neonatal care. The mother may be covered, but is the baby if the birth occurs while she is away?
- allows for cash advances if a hospital accepts only cash in advance.
- pays for the preparation and return to Canada of your remains if you die while travelling.
Carry details of your insurance with you. Also, tell your travel agent, a friend or relative at home and your travelling companion how to contact your insurer.
Remember to always submit original receipts for any medical services or prescriptions you received while travelling abroad. Most insurance companies will not accept copies or faxes.
If you need medical care, get a detailed invoice from the doctor or hospital before you leave the country you have been visiting. There is nothing more frustrating than trying to get the proper paperwork from thousands of kilometres away.
* The information in this section is from Bon Voyage, But... Tips for Canadians Travelling Abroad. It is produced by the Department of Foreign Affairs and International Trade and is available from the passport office.
4. Remember that old saying, 'An ounce of prevention is worth a pound of cure.'
Your doctor is the person to help you with your existing medical problems before you travel. For special risks at your destination, a travel health specialist is your best source of information. A travel clinic offers complete information and immunization service to all travellers, whether your destination is Arizona or India.
- Is your tetanus and diphtheria immunization (Td) up to date (within the last 10 years)? If not, get it before you leave. It’s much better to have adequate Td protection than to need an injection in another country.
- Have you had your flu shot this year? Flu vaccine is free for all seniors and anyone with a chronic health problem. The vaccine is available starting in early October every year. The pneumococcal (pneumonia) vaccine is also free for all seniors, as well as for anyone with a chronic health problem. One dose of pneumococcal vaccine is enough to provide lifetime protection for most people.
- If you are travelling further south to Mexico or Central America, you should protect yourself with immunization. Hepatitis A is a liver virus that is carried in contaminated water and food (especially raw or undercooked shellfish). It causes jaundice, nausea and severe fatigue. If your travel south of the American border may involve primitive conditions or is longer than a month, you should consider typhoid vaccine as well, especially if you are a frequent user of antacids, which lower stomach acidity.
- If you eat in restaurants, you are at the mercy of someone else’s kitchen. The safest foods are those that are freshly cooked and served hot. Beware of undercooked protein foods such as poultry and shellfish, or foods cooked and then served at room temperature. Uncooked foods like fruit and vegetables can be risky if other people have handled them. Restaurants in Mexico may look modern, but Mexico is well known for 'Montezuma’s Revenge' - traveller’s diarrhea. That is a sure sign that sanitation is often substandard. Make sure that everything you drink is clean. Tap water usually is not clean enough to drink or even for brushing your teeth. Drink bottled water or water that has been boiled. And remember that ice cubes may be frozen tap water. Tea and coffee are usually hot enough to be safe, and commercial bottled beverages are safe.
- If you will be preparing your own meals, food safety is easier as long as you have proper facilities for washing, cooking and refrigeration.
- If you do get travellers’ diarrhea (TD), make sure you drink enough fluids to avoid dehydration. The medications in your first aid kit (Pepto Bismol™, Imodium™) usually help reduce symptoms until the bug clears your digestive system. Occasionally, TD is more serious and may need antibiotic treatment. Most travellers’ diarrhea gets better by itself but it certainly does not enhance any holiday. It can cause serious problems for older people or those with health problems. There is no shot for TD but care with food and water can prevent most of it.
- Travel to countries south of the American border may also carry other health risks. Dengue fever is a virus carried by daytime-biting mosquitoes. It is found in some parts of Mexico, and throughout Central America and the Caribbean. Cases have even been reported in Texas, since the mosquito is migrating north. There is no vaccine against dengue, commonly known as 'break bone fever.' Remember that mosquitoes can be disease carriers. Protect yourself with insect repellents and clothing that covers your skin (e.g. long pants).
A night-biting mosquito carries the parasite disease malaria. If you are in Mexico or Central America you need to know which areas are risky. In malaria-risk areas you need to be extra careful with insect protection, including during the times when you are asleep. Choose a room with screened windows or use mosquito netting which has been treated with the insecticide Permethrin. If you will be in the malaria area for more than a few days you may be advised to take anti-malarial pills.
- Take your time to adjust to the hot climate. Expose yourself gradually to sun, and avoid too much heat. As you age, you are more at risk of heat stroke. Drink plenty of water to avoid dehydration.
- Sun effects can be deceiving. Avoid sunburn by wearing a good sunscreen of at least SPF (sun protection factor) 15 and by wearing a hat and sunglasses. Stay in the shade during the hottest part of the day (11 a.m. to 4 p.m.).
- Drink extra fluids. Do not wait until you feel thirsty. Drink enough to keep your urine a pale colour.
- It is great to be away from snow but unless you are used to regular exercise, increase your activity gradually.
Does all this planning and preparation make you wonder why you want to go away? Is being 'a snowbird with a plan' worth the effort?
It most certainly is. There can be a lot to consider about your health but with a travel clinic and your family doctor to help you, this planning can be done efficiently. Then you can wing your way south, confident that you have done everything you can to ensure a healthy winter.
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2012, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 2S6 [GO_FHc00]