Top five things to look for in a travel doctor, and why you should have one

travel doctorsDespite writing about food and adventure travel for a living, I used to be somewhat blasé about the concept of travel medicine. Multiple incidents of Giardia/dysentery/traveler’s diarrhea/full-body outbreaks of mosquito and sand fly bites just taught me to carry a serious stash of antibiotics in my first-aid kit. At least I’ve always been conscientious about travel immunizations and educating myself about the primary diseases indigenous to my destination.

When you’re young and healthy, it seems silly to have a travel medicine specialist. Although this article is primarily directed at adventure travelers, odds are, the worst thing you’ll come home with is a backpack full of crappy souvenirs. But no one’s invincible, and should you require a specialist for something not responding to conventional treatment or with progressive symptoms, time is of the essence. Many “exotic” diseases progress rapidly, and can cause irreversible damage or death if not properly diagnosed and treated. Even with incurable diseases, the earlier you catch them, the easier it will be to manage symptoms and prevent them for worsening.

No, I’m not a doctor, although I come from a medical family. But I got seriously schooled after visiting Ecuador two years ago. After a fantastic month of adventure activities in remote parts of the Andes and Amazon Basin, I fell seriously ill the last day my trip. Two years of at-times crippling symptoms, 10 CT scans, five medical facilities, dozens of specialists, four surgical procedures, two surgeries, one cancer diagnosis, and near-medical bankruptcy later, I’ve become an expert at being my own advocate.

My infectious disease doctor believes that I contracted a form of bartonellosis called Oroya Fever after being bitten by sand flies. The good news: My health is currently stable, but we don’t know if the disease is in remission or not. But I have permanent cognitive damage, scarring or tumors on most of my internal organs, and intermittent arthritis. But believe me, I feel lucky.

I don’t want anyone to go through the health and medical nightmare I’ve endured, so I’ve compiled a list of essentials in a travel medicine doctor. Ergo, number one with a bullet:

1. Is he/she a travel or tropical medicine specialist?
Pre-bartonella, I used an internist as my GP/prescriber of antibiotics. If you can find an internist, gastroenterologist, or infectious disease doctor who is also a specialist in travel medicine, that’s a huge plus.travel doctors 2. Does he/she have personal experience traveling or practicing in developing nations?
There are a lot of practicioners who aren’t globally aware, so to speak. You can’t diagnose what you don’t understand, know about, or have first-hand experience with. Period.

3. Is he/she a good listener and empathetic?
It’s difficult to find these qualities in any doctor, especially in today’s medical climate. But it’s imperative to find someone you can communicate with, and who understands what you’re going through if you’re suffering from a mystery travel ailment. Don’t settle, even if you need to travel to another state or country to seek treatment (what stumps doctors here is often commonplace in the country of origin).

4. Does he/she have a good network of colleagues in multiple specialties (including travel/tropical medicine) to consult for additional opinions?
My current mantra is to seek a third opinion, from at least two different medical facilities. That, and to have a travel physician who actively consults colleagues and does additional research to assist with a diagnosis and/or treatment. My infectious disease doctor talked to specialists at a medical school in Peru on my behalf, and even tracked down a relevant medical paper from 1897 as he honed in on a diagnosis. And while I wouldn’t consider it a deal-breaker if the answer is no, see if your doctor is an active and participating member of the International Society of Travel Medicine.
travel doctors
5. Does he/she return your calls/provide you with email, pager, or office number so you can get in touch directly?
I’ve learned that a good doctor who is invested in your recovery will provide an open line of contact to address questions, concerns, and exchange pertinent information. Tip: Please don’t abuse this privilege. Physicians work insanely long hours, under constant stress. And don’t expect to hear back immediately if you leave a non-urgent message; be realistic. A couple of days, fine (many specialists aren’t in clinic every day). A week? Make a polite follow-up.

Whether or not you end up getting a travel doctor, the International Association for Medical Assistance to Travelers (IAMAT) provides loads of useful information, including a directory of global travel medicine clinics with English-speaking staff, and a destination-specific travel health planner. And depending upon what you plan to do on your trip, where you’re traveling, and your financial situation, you may want to invest in travel insurance.

[Photo credits: blood transfusion, Flickr user CarynNL;patient, Flickr user kk+; legs, Laurel Miller]

The Ultimate Travel First Aid Kit

Top five travel documents to email yourself before you travel

A lost or stolen passport or ATM card is a surefire way to add stress to any trip. As a preventative measure, I keep a list of travel documents (scanned, as necessary) in my inbox, so I have them at the ready should I run into trouble. Before you head out on your next trip, make sure you have the following documents, copied, prepped and prepared in the event you need them quickly:

1. Passport
If your passport mysteriously goes missing from the hotel security box or hostel front desk, or you’re mugged or robbed on the road, scanning a back-up copy can save you hours of paperwork and waiting. If you need a visa for travel, scan a copy of it, as well.

2. Medical and travel insurance cards (if applicable)
Not all medical insurance covers travel outside of the U.S., so check before you get on a plane. If you plan on visiting a region prone to civil unrest, natural disasters, or general sketchiness, have a medical condition, or are a fan of adventure travel, travel insurance might be worth looking into.

3. Bank and credit card collect call numbers
Keep the bank phone numbers nearby. It won’t bring your cards back if they’re lost or stolen, but at least you can report and cancel/put holds on them, ASAP. Most financial institutions have collect call numbers you can use from a foreign country.

4. Emergency contacts and relevant health information
At a recent appointment with a new physician, he noted that I was allergic to penicillin, and asked what happens if I take it. I explained I have a family history of anaphylaxis, and he asked why I don’t wear a medical alert bracelet, especially given my occupation as travel writer. It’s a good idea that never would have occurred to me. So while you’re typing up that list of contacts, including doctors, add in any life-threatening allergies or medical conditions. Should you wind up in a medical emergency, odds are someone, somewhere, will speak English. Or write it down in the language of the country you’re visiting (Lonely Planet Phrasebooks are invaluable for this kind of translation, even if you need to say it in Urdu or Thai).5. Itinerary
Be sure to send copies of your travel itinerary to family and/or a close friend. If you’re backpacking and don’t know where you’ll be staying or don’t have a world phone, the ubiquitousness of global cyber cafes makes it easier than ever to stay in touch, even in rural areas.

*Bonus round

U.S. Department of State contact info/Embassy and Consulate list
If you spend a lot of time overseas, especially if you fall into the category cited in #2, it’s a very good idea to register your trip with the U.S. Department of State. In the event of an emergency requiring evacuation, you’ll be in their system. It’s also helpful to keep the embassy/consulate link in your inbox and on your person, in case you or a fellow traveler runs into trouble.

Immunization card
Some countries or regions require you to present this, to prove you’ve had the necessary vaccinations before being admitted entry. Admittedly, I’ve never actually had to produce this document, but better safe than denied. For a list of recommended and required inoculations for destinations, go to the Centers for Disease Control and Prevention site.

[Photo credit: Flickr user cubicgarden]

Check your insurance – International travel tip

One the most important — and overlooked — things to do before traveling abroad is to check into your medical insurance coverage.

Call your insurance company to see if you and your family are covered overseas. This is especially important for destinations where disease and illness is more common, or for trips where a lot of physical activity occurs. If your medical insurance doesn’t extend internationally, consider purchasing supplemental insurance for the time you’re abroad.

Also, before leaving home, write down all your insurance information and carry it with you at all times. It’s also a good idea to make copies for any family member traveling with you. Finally, consider providing copies for family or friends staying at home … in case of emergency.