Ask Gadling: You develop a serious illness while traveling

by Laurel Miller on

The very thought of acquiring a serious illness or injury while traveling strikes fear into the hearts of even the most stalwart adventurers. Speaking from personal experience, it’s terrifying to find yourself alone (or not) in dodgy accomodations, in a remote area of a developing country, with a raging fever and/or an uncontrollable case of the runs or other unsavory symptoms. Which isn’t to say the same ailments suffered in the comfort of a five-star hotel in Paris are a picnic, either. Any way you slice it, getting sick in a foreign country sucks.

And sometimes, despite taking precautions, you fall ill anyway, as I can attest. It can be a matter of circumstance (That water my guide “boiled” in a bamboo culm on a Thai Hilltribe trek? Yeah, I pretty much saw the resulting case of dysentery coming), or just bad luck. I’ve been on my own during most of my unfortunate on-the-road maladies. Between my experiences and those of fellow travelers, I’ve accumulated some wisdom over the years for dealing with sudden-onset illness in less-than-ideal circumstances.

For the purposes of this article, I’m not going to include injuries, pre-existing conditions, or focus on food poisoning, which was well-covered in a previous Ask Gadling post by Melanie. I also want to stress that we’re not medical professionals here at Gadling, myself included. For the technical stuff, I turned to Dr. John Szumowski, Clinical Fellow of University of Washington Medical Center’s Division of Allergy and Infectious Disease.

After the jump, tips on prevention, what to do when illness strikes, and how to get yourself home in the event of a full-blown medical emergency.

[Photo credit: Flickr user MoHotta18]

Before you leave home

Hit the internet
Do a bit of research on emergency medical options for a worst-case scenario. The U.S. Department of State produces a list of American doctors and hospitals in foreign countries.

If you have specific questions (about, say, where to find the best dentists in Europe), Lonely Planet’s Thorn Tree travel forum can be a useful place to get ideas (please do additional research before following any advice). Take the diagnostic-related questions directed to forum members with a heaping grain of salt, and save them for your doctor.

Get vaccinated
Check the CDC’s (Centers for Disease Control and Prevention) website to see what, if any, vaccinations you need before your trip. You can also get updates on things like outbreaks of cholera or bird flu. Be sure you allow ample time before your trip for the protective effects of vaccines to establish themselves. Dr. Szumowski also recommends the CDC’s “Survival Guide to Safe and Healthy Travel” webpage.

View more Ask Gadling: Travel Advice from an Expert or send your question to ask [at] gadling [dot] com.

Keep an immunization card on you (some countries require proof of certain vaccinations) as well as an online record, like Google Health.

All travelers should get flu and tetanus shots. If you’re a frequent world traveler, get vaccinated for hepatitis A, typhoid, and polio. Depending upon where you’re traveling, you may require a Yellow Fever or Japanese Encephalitis vaccine, or malaria prophylaxis.

I used to think a rabies vaccination was overkill until I saw a fellow traveler get seriously nipped by a puppy we were playing with in a remote village near the Myanmar border. The deathly silence that followed was sufficient motivation. Adds Dr. Szumowski, “It’s still important to remember that excellent wound-care and post-bite medical evaluation are necessary, even if a person has had prior rabies pre-exposure vaccination.” The International Society of Travel Medicine has a list of global travel medicine clinics.

I also carry an EpiPen, because you never know what could trigger anaphylaxis while you’re abroad. It also bears mentioning that you can develop a life-threatening allergy to something previously benign. A chef I know went into anaphylactic shock after tasting one of his dishes containing taro root, even though he’d been cooking with it for over 20 years.

If you get sick

Stay calm, and assess your symtoms
It’s easy to get carried away and assume the worst, but odds are your sudden fever isn’t malaria.

Try to identify the source of infection or illness

Know when to seek professional medical assistance
In general, says Dr. Szumowski, some symptoms or exposures that should prompt “expeditious” medical evaluation include:

  • high fevers (over 101ºF, especially if sustained or accompanied by shaking or drenching sweats)
  • bloody diarrhea
  • inability to keep food or liquids down in situation of significant vomiting or diarrhea
  • confusion or severe headache
  • severe cough, especially if accompanied by shortness of breath
  • animal bite or other animal-related attack

Tips for self-care

Stay hydrated
If you’re vomiting or have diarrhea, stay hydrated with (purified/bottled water), and Gatorade or other electrolyte beverages. If you absolutely have to travel, take Imodium as an anti-diarrheal.

Eat bland foods
Remember the BRAT diet for gastrointestinal upset: rice, bananas, applesauce, and toast.

Control your fever
To lower a high fever, take the recommended dosages of acetaminophen (Tylenol) or ibuprofen (Advil).

Wear ID
Wear a medical alert bracelet for serious conditions, allergies, etc., Write down your condition in your destination country’s language in both your phrasebook, and place a card in your passport.

Emergency Measures

Know when to self-diagnose
Sometimes, you find yourself in a position where you have no other option. That said, this is something you want to avoid for obvious reasons. Says Dr. Szumowski, “Self-diagnosis and treatment can be appropriate for less serious conditions such as traveler’s diarrhea, but it is important not to delay evaluation by a medical professional for more serious illness [see warning signs above]. If someone chooses to self-treat, it’s important to be aware of potential for counterfeit medications locally.”

What if the only available hospital/clinic/doctor’s office is seriously sketchy?
If you’re in a situation where the medical facility is primitive/lacking in sanitation, you’ve got a tough call on your hands.

I posed this question to Dr. Szumowski. He says, “It depends on the acuity and seriousness of the condition. In general, evaluation and treatment in a facility with adequately-trained staff and more comprehensive resources is preferable whenever possible–this may mean seeking evaluation in the capital, at a private hospital, or even returning home. Aside from limited diagnostics and medications, smaller/less-resourced facilities may have inadequate sanitary practices (e.g. reuse of equipment) and screening of blood products, raising the risk of contracting pathogens such as hepatitis C or HIV. Therefore, having evacuation insurance is advisable, especially for extended travels in the developing world.”

In other words, you may be shit out of luck. But this is why you’re reading this article–so you can be prepared for all kinds of situations! Read on.

OTC antibiotics
In many countries, you can buy OTC antibiotics, and indeed, this may be your only option, but heed Dr. Szumowski’s warning, above. Caveat emptor.

If you need to be evacuated, the U.S. government offers financial assistance and/or repatriation loans. The American Citizens Service and Crisis Management (ACS) is linked to U.S. embassies and consulates all over the globe. It’s a good idea to enroll in the U.S. Department of State’s “Smart Traveler Enrollment Program (formerly known as “Traveler Registration)” if you’re traveling for a long period of time, to a high-risk region, or doing any extreme adventure activities.

Travel prepared

Get antibiotic prescriptions (and carry copies with you) from your primary care doctor or internist, or visit a travel medicine clinic, and pack them in you travel first-aid kit (You don’t have one? REI has some great options). Some people also carry sterile latex gloves and hypodermic needles with them. If you’re diabetic or have another condition that requires injections, this makes sense, provided you have a note from your medical provider. For everyone else, this is a personal choice that comes down to, “How comfortable are you with the knowledge that you’re carrying drug paraphernalia?” If you backpack, travel in places with notoriously corrupt law enforcement, or countries like, say, Malaysia, you may want to hedge your bets.

Email yourself and family or a trusted friend copies of medical insurance, itinerary, and a list of medications, and doctors.

Consider traveler’s insurance.

If the worst happens

In the highly unlikely event you do come home with a mystery disease that isn’t responding to medical treatment, get to a specialist, asap. Depending upon where you’ve been, this may be an infectious disease or tropical medicine doctor, a dermatologist or rheumatologist who specializes in tropical medicine, etc.. You may need to travel–out of state–to find the right specialist. Find someone who has first-hand experience traveling/training or practicing in developing countries, and in diagnosing diseases not found in the U.S.. It may even be best to try and seek medical treatment in the country where you became ill (even if that means a return trip).

Unfortunately, I can speak with authority this subject, because I’m in my 22nd month of diagnostics following a trip to South America. If you do find yourself harboring a travel-related (or not) disease that defies diagnosis, you must be your own advocate. No one is more invested in your health than you are, and doctors are human. They may make mistakes, despite their best intentions. Seek not just a second, but a third opinion, from at least two different medical facilities.

And finally, don’t let anything in this article scare you and put you off travel. Odds are, you’ll come home with nothing more than great memories, and the eagerness to plan your next trip. I know I can’t wait.

[Photo credits: vaccination, Flickr user alvi2047; mosquito, Flickr user tonrulkens; toast, Flickr user snowriderguy; farmacia, Flickr user ibirque; drugs, Flickr user cavale]

Inside Virgin America’s mid-continent arrival

by Stephen Greenwood on

I don’t think I actually understood the implications of Virgin America’s launch into “fortress-hub” Dallas/Fort Worth until we touched down on the tarmac.

As we taxied to our gate, I could see nothing but a endless row of silver fuselages; all adorned with the iconic blue & red “AA” logo. It felt almost as if we were silently making our way through the front gates of a modern-day Troy.

The only difference, of course, was that this Trojan horse was bright red, equipped with mood lighting, and ready to be received by a cheering crowd of residents, city officials, and the rebel billionaire himself, Sir Richard Branson. To top it off, the tarmac was host to a pen of live bulls, tent with cocktail service, and full fledged Texan barbecue – the type of spectacle I’ve come to know, love, and anticipate when Virgin wants to catch people’s attention.

And it certainly seems as if American has already taken notice. In the weeks leading up to the launch, the legacy carrier lowered fares by 20% and offered double frequent flyer miles aboard Dallas-San Francisco and Dallas-Los Angeles routes.

DFW Public Affairs Manager, David Magaña, also mentioned that American hasn’t been able to stop talking about Virgin’s arrival preceding the event, as it signifies the first of several low-cost carriers that will be entering the Dallas market in 2011. While this loosens American’s 85% share of flights from the hub, it spurs competition and ultimately lower fares for passengers.Virgin America’s first mid-continent destination comes at a good moment in the airline’s young story. They posted their first quarterly net profit (as opposed to operating profit) in Q3 of 2010 and were rated top domestic airline for the third year running in the 2010 Zagat Global Airline Survey. At this year’s Farnborough Air Show, they announced plans to more than double their fleet with a purchase of 40 new Airbus A320’s. Now, with their entrance into Dallas consummated, they’ve shown that they’re ready to make their presence tangible and (thankfully) shake thing up a bit.


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However, to make a significant impact, they’ll have to add more flights. At the moment, Virgin America will offer two daily nonstop flights between DFW and Los Angeles, and two to San Francisco. Although it plans to add a third on each route, it would require significantly more options to directly compete with the hundreds of flights per day that American and American Eagle offer.

“It signifies a second stage for the company. We knew eventually that we’d be going into the middle of the country but now seemed the right time since we’ve blanketed most of the coasts. So this is the second stage of our network development.” Virgin America CEO David Cush said in an interview on the flight.

He also emphasized the company’s dedication with hiring “creative, smart, risk-tolerant people who are willing to go out and push the envelope.” as they grow, and that they’re “not sitting back”, but pursuing the development of a “new in-flight experience” that could be ready as soon as 2012.

The night proceeded to unfold in Dallas’s emerging and surprisingly modern downtown arts district with an intimate performance by activist & music icon, Willie Nelson. Following Nelson’s recent arrest for possession of marijuana, Branson donned a shirt that read “Free Willie” and cheekily quipped that the 77-year old musician looked good after “losing six ounces”.

In partnership with nonprofit foundation Stand Up To Cancer, Virgin transformed the Winspear Opera House into a glowing red hub of its own; filled with Dallas’s elite and hundreds of donors that had gathered friends for Stand Up To Cancer’s cause.

It was an impressive occasion that only an airline leveraging Branson’s magic could pull together, and one that sent a clear signal to the rest of Dallas. Virgin America has entered the mid-continent rodeo, and is ready to take the legacy bulls by their horns.

For more information, check out Virgin America’s introductory fares and schedules right here.

The Gadling budget travel manifesto

by Alex Robertson Textor on

Over the past two weeks we’ve upped our budget travel coverage here at Gadling. We’ve published stories on budget-friendly Caribbean destinations, budget-friendly European destinations, Thanksgiving hotel deals, hardcore budget travel suggestions, New York City budget travel tips, local budget travel secrets, cheap local fast food worldwide, great sites for planning budget-friendly European travel, and how to find affordable ski deals.

Our recent hyperactivity around budget travel is no accident. We want to improve Gadling’s standing as budget travel resource, as a go-to site for budget travel tips, information, and inspiration.

In order to give this new resolve some oomph, a Gadling budget travel manifesto is in order. The goal here is to intervene in a travel media landscape that sees luxury travel as the universal objective of all travelers by glorifying budget travel and budget travelers. Budget travel is exciting and sophisticated and it needs to be recognized as such.

The lure of aspirational travel

People love to read about expensive resorts and impossibly dear travel accessories because they’re exciting to contemplate. In this respect, they fulfill a function not a million miles from pornography. And like porn, they’re also a lot of fun. The problem is that just as pornography does not provide a good map for most human relations, aspirational travel does not offer a useable guide for most forms of travel. Worse yet, aspirational travel often comes to cloud impressions of travel and actually convince many, many people that travel is an endeavor that can only be engaged at unmanageably high price points.

The focus on aspirational travel in the travel media creates all sorts of strange situations. Reading through a typical American travel magazine or even the weekend travel section of big newspaper, one might believe that $500 per night is a reasonable mid-range rate for a night’s hotel accommodation. Honestly, this is outrageous. When push comes to shove, how many people can actually afford such rates?

Budget travel can mean many things. It can mean finding a deal on a hotel, cruise, or air journey. It can mean traveling with very little money and simply making do. It can mean organizing travel around friendship networks, or joining home exchange or couchsurfing membership programs. But however it might be defined, it doesn’t include hotel rooms that run $500 per night.

Budget travel is sophisticated travel

Here are three assertions about budget travel in general and in relation to luxury travel that might at first seem counterintuitive.

1. Budget travel enables better interaction with local culture than does luxury travel.

2. Budget travel is more sophisticated than luxury travel.

3. Budget travelers are more creative than luxury travelers.

I’ll anticipate a few knee-jerk criticisms and try to answer them here in advance. Obviously not all budget travelers are savvy. Many are in fact the opposite. But it is just as certain that many, many (most?) luxury travelers are not at all sophisticated–not truly and fully in the spirit of cultural engagement and courageous exploration.The first assertion here is probably the most self-evident. Budget travelers very often stay in modest accommodations run by locals or long-term expats in settings surrounded by locals. Unlike luxury travelers, who are typically cocooned in hermetically-sealed compounds radically separated from the surrounding locales and their residents, budget travelers have an easy time experiencing the richly local dimensions of their destinations.

Points two and three: Budget travelers work creatively to find interesting places to visit and build itineraries. Unlike many luxury travelers, they don’t particularly care about international brands, and don’t stop thinking about how to spend their time after they’ve booked a stay at a particular five-star chain hotel and exhausted the menu of in-house spa treatments. Budget travelers approach their travel with open minds about where they might stay and about which sorts of inexpensive accommodations might be on offer in particular locations.

Budget travel glamour

Budget travel is real travel. It’s often challenging and not always predictable, yet it’s also often far more glamorous than its reputation.

There is glamour in amassing tons of passport stamps on a dime, in accumulating personal top ten lists of the best dive bars in a particular city, and in getting your high culture quota in the standing-room only zone. There are joys in cheap apartment sublets, in couchsurfing, in volunteer tourism, in hitchhiking, in slow buses. There are pleasures in delicious and fresh local fast food.

But evidence of the glamour of budget travel is too often absent even within the tiny budget travel media, which often prioritizes an upwardly-mobile demographic and ignores countless very good budget accommodations in favor of stylish hotels with stratospheric nightly rates. This approach may be good for advertising revenue but it renders the very concept of budget travel unrecognizable. And in the process, the real glamour of budget travel is lost.

Gadling’s budget travel content

Moving forward here at Gadling, we are committed to providing better targeted budget travel advice in the form of hotel and restaurant tips, strategic booking suggestions, local secrets, and solid general information for getting the most for your money.

We want to hear from you. We want to know which budget travel questions you want answered and which types of budget-friendly advice you most need. How can Gadling best deliver the budget travel goods?

[Image: Flickr / cyclonebill]

How to find affordable ski deals this winter

by Amy Chen on

Skiing isn’t the most budget-friendly winter activity, but you can find affordable ski deals if you know when and where to book lift tickets.

Evan Reece, co-founder of Liftopia.com, reveals how to save on lift tickets at popular ski resorts around the U.S.

Buy lift tickets in advance and pick your days carefully.
If you buy a lift ticket through Liftopia at least the day before you plan to ski, you can typically save an average of 35 percent when compared to booking a one-day pass in person at the ticket window. Mid-week lift tickets are generally cheaper, and skiing on Sundays typically costs less than Saturdays. “Many customers will go up for the weekend and intend to ski both days, Reece says. “But they’ll end up being tired on Sunday. And faced with a four-hour drive, they’ll just say, ‘Let’s go.'”

Ski on Christmas Day.
When everyone else is preoccupied with opening gifts on Christmas morning, hit the ski slopes and save. Based on last year’s data, the average price of all lift tickets booked in advance through Liftopia for Christmas Day skiing was 39.7 percent less than what you’d pay at the window, Reece says. Other bargain days include New Year’s Day, Jan. 2, and Super Bowl Sunday.Seek out smaller ski resorts.
Rather than following the crowds to Breckenridge or Vail, venture to smaller ski resorts for a more intimate experience. Though you may sacrifice the big-name glitz and apres-ski scene, let’s face it: most of us aren’t skilled enough to take advantage of all the ski runs to justify an $80 lift ticket.

Look into combo passes with added value.
Some resorts, such as Keystone in Colorado, add in meal credits with the purchase of a lift ticket. For example, a one-day lift ticket plus a $15 lunch credit bought through Liftopia will save you about 11 percent when compared to buying the same package on-mountain. Even the resort food will taste better than “eating a smushed peanut butter and jelly sandwich,” Reece adds.

Consider packages that bundle ski rentals and lift tickets.
Other than saving on checked baggage fees, many resorts now carry top-of-the-line rentals that are most likely newer and better than anything you have stashed in the garage.

How Liftopia Works: Tickets purchased through Liftopia are nontransferable, nonrefundable, and date specific. Or as Reece explains it: “You can’t buy a Friday concert ticket and expect to show up the next day.”

[Photo by Amy Chen]

Budget Travel Tips for Europe

by Alex Robertson Textor on

Practical, how-to budget travel advice is indispensible. There’s something particularly valuable about travel advice that opposes the emphasis on expensive hotels and other forms of high-end consumption that characterizes the contemporary travel media, perhaps especially in regions like Europe where costs are generally quite high.

Budget-friendly travel in Europe is no impossible dream, and the following sites are good for inspiring shoestring feats, assessing likely costs, and, above all else, disproving the idea that you have to spend hundreds of dollars a day to see Europe well. For some ideas about where to travel affordably in Europe, check out last week’s ten budget-friendly European destinations post.

1. Less Than a Shoestring. Though no longer publishing on a regular basis, the archives of this blog are astoundingly helpful in their low-budget audacity. Particularly useful for anyone scared off at the thought of Europe’s cost index are the blog’s “Baring my Budget” posts, which run through budgets for various short trips in great detail: three nights in Malta for €50 (currently $66); five days in London for £85 (currently $133); four nights in Venice for €91 (currently $120), all departing from Berlin. Costs breakdowns are provided in these “Baring my Budget” posts, as are the freebies encountered along the way. The mention of freebies is particularly helpful, as it reveals how often tourist information, maps, museum admission, and various cultural performances can be accessed free of charge. Though this series ran over two years ago, it is still very relevant.

2. EuroCheapo. Disclosure: I worked as an editor at EuroCheapo for almost three years and continue to do occasional freelance projects for the site. Phew. Glad I got that out of the way. Personal loyalty aside, EuroCheapo really is an enormously helpful resource. It is first and foremost as a hotel review site with useful descriptions of hotels written by trained hotel reviewers. EuroCheapo also edits a great blog full of essential budget-oriented tips penned by correspondents on the ground.

3. Guardian’s budget travel section. To be fair, the Guardian’s budget travel section is good for destinations around the world, though the density of articles on the UK, France, Italy, Spain, and other European countries is impressive. Recent articles that showcase well the newspaper’s creatively open approach to the subject of budget travel include Susan Greenwood’s budget Stockholm journey story, indebted to insider tips provided by a local blogger; a piece on backpacking in the Crimea by Maxton Walker; and Benji Lanyado’s TwiTrips series, for which the author receives tips via Twitter about the city he’s visiting and then liveblogs his discoveries. The most recent TwiTrip series installment sees Lanyado visiting Liverpool.4. Flycheapo. This site felt buzzing and electrified back when Europe’s low-cost airlines were announcing new routes weekly. With all the route cut-backs and cancellations of the last few years, the site sees far fewer regular updates. Nonetheless, Flycheapo is still an essential place to look for route information for inexpensive flights around Europe. The site provides new route news snippets, a route index, an airline index, and a route search, all of which are helpful for figuring out potential itineraries for low-cost air journeys across Europe.

5. Deutsche Bahn. Indispensible for figuring out train itineraries, Bahn.de features Europe-wide train schedules in enthralling detail. Bahn.de is also a much cheaper place for purchasing advance train fares than US-based agents. A very helpful run-down of how much cheaper these fares can be as well as information on how to access Deutsche Bahn sales personnel in English can be found in two posts by the editors of hidden europe magazine, here and here.

(Image: Flickr / vxla)