Warning to all tourists taking prescription drugs…Could result in a Costa Rica nightmare…

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Yesterday we shared a photo of an Owl Eyed Butterfly, and today, we have a winking Barn Owl.

“Sightings from the Veranda in Costa Rica”

Ulysses was creating a perfect trim on the hedges at the villa.

After yesterday’s scathing tongue lashing on Monday’s less than a pleasant attempt at renting a car, we hesitated to go down a somewhat negative path two days in a row.

For the majority of tourists, today’s post will have little significance. You book a vacation/holiday in Costa Rica, staying at a resort for a week or two. If you take prescription meds, you bring along a sufficient amount for your entire stay. If innovative, you bring enough for an additional few weeks in the event of some mishap or delay in returning to your home country as initially planned.

Creatures in Costa Rica are colorful, including this massive spider in her web.

However, suppose travelers like us plan to stay for an extended period. In that case, it’s an entirely different scenario when no prescription drugs (including non-narcotic meds) may be shipped into the country. Also, no vitamins or supplements may be shipped into Costa Rica and will also be confiscated.

Why is this? These are stringent drug laws, coupled with Costa Rica’s intent to create a revenue source from selling their prescription medications in the local and chain pharmacies. As a result, other than prescribed narcotics, mood-altering, or brain function medications, most medicines are sold over the counter without a prescription.

I take low doses of three non-narcotic meds for the following conditions (bad genes); hypertension, thyroid, and a hormone…fairly innocuous items, all typically requiring prescriptions from a doctor in the US.  (Other country’s laws may vary).

It was frustrating, taking photos through the fences, but these birds weren’t ready to return to the wild after their rehabilitation.

When I noticed my supply dwindled these past months, I decided to purchase over these next few months from ProgressiveRX, where I’ve been buying refills regularly over these past five years through their online service, comparable to buying from any online pharmacy in Canada.  

Easy as always? So I thought. This has never been an issue in any country in which we’ve lived over these past years. So I’d make the online purchase well before I needed them (slow delivery times) and have them shipped to wherever we may be at any given time. 

Although one shipment was lost while we were in Italy, the company happily replaced the lost items at no additional charge. Luckily, I’d planned the shipments months before I needed the pills and never missed a dose through the lengthy process of replacing the lost items.

Three Barn Owls at Zoo Ave, the bird and animal rescue facility in the Alajuela Valley.

While in Australia, for the sake of convenience, I received new prescriptions from a doctor we’d visited for physical exams while in Trinity Beach. But, unfortunately, I couldn’t get more than a six-month supply, which is typical, even through online pharmacies. 

Thus, again with a several months supply on hand, I ordered more from ProgressiveRX, which we had shipped to us in a box of supplies from the US from our mailing service.

I’d also considered making the purchases of a few month’s supply while here in Costa Rica since both of us must have physical exams no more than 60 days before the upcoming cruise to Antarctica. So we’d have the necessary exams and purchase my meds while here at any pharmacy.

Three Barn Owls were sharing a tree branch.

On Monday, the day of the rental car fiasco, I’d brought along the pills in the bottles with clearly marked labels to the Walmart Pharmacy. As it turned out, I’ll run out of two of the meds before the time we leave on November 22nd, thinking they could easily be replaced by some Costa Rica versions of the same frequently prescribed drugs for these conditions, common throughout the world.

Oh, foolish me. Walmart could not supply me with any of the three meds without changing doses and brand name components. One of the meds required the brand name when I tried alternates to no avail in years past.

After the pharmacist and I counted what I had left, we discovered I’d run out before leaving. “Local pharmacies don’t carry what you need,” explained the kindly pharmacist. So it’s a lost cause. I contemplated my options which included taking wrong doses and wrong meds and decided against it.

These birds were too high up to get clear shots without a tripod.

During the last month, when I’ll run out of two of the three meds, I’ll take doses every other day.  Doing so should not be life-threatening, although it may create some unpleasant symptoms. I’ve experienced worse. I’ll be fine.

In the interim, I’ll place an order from ProgressiveRX to arrive at our mailing service in September or October (at the latest) and have them shipped in a box of other supplies we’ll be sending to our hotel in Miami, where we’ll stay one night before boarding the 30-night cruise to South America.

How will we ensure the proper timing? We’ll have the shipment arrive from Nevada to Florida at least two weeks before our arrival on November 22nd. The hotel will hold the package for us until we arrive. 

Parrot sitting atop a perch at Zoo Ave (Ave means “aviary” in Spanish).

At that point, I’ll have enough to hold me for a few months until I place another order for a shipment to South Africa. That will work. We received a shipment while we were in Marloth Park in 2014 without incident.

The result…bring enough medication with you when you come to Costa Rica unless you’re confident you can purchase refills from a local pharmacy of the products/brands/doses you typically use. You are allowed to bring a regular supply into the country commensurate with your stay, plus extra for unexpected events.

Did I learn a lesson? I suppose regarding Costa Rica, I sure did. And, of course, in the future, I will check if there will be an issue receiving medication by mail from countries where we aren’t quite sure. But, after five years of world travel, this is the first time we’ve run across such a situation. 

A bit blurry from afar but a pretty parrot nonetheless.

But, like the rental car situation (BTW, we did get a refund from rentalcars.com for which we’re relieved and pleased), one never knows what may be encountered in unfamiliar territory. Neither of these scenarios would be an issue for a typical short stay by most travelers. 

Our unique nomadic lifestyle can be challenging at times. And we continue to learn as we go.

Be well.

Photo from one year ago today, August 30, 2016:

Shorter than he’d usually prefer, Tom’s buzz cut in Phuket Thailand held through the 33-night cruise, which began on October 31st. For more details, please click here.

Trip to the dentist in Curribatat…Good toll roads…GPS issues…

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Tom, walking toward the dental clinic. It didn’t seem to be in a great neighborhood with bars on windows and doors, but we felt comfortable.

“Sightings from the Veranda in Costa Rica”

We couldn’t see the eclipse of the sun here in Costa Rica, but we sure had a lovely sunset.

We’re never thrilled with the necessity of visiting a dentist. Who is? I suppose, in a way, we use our world travels as an excuse to postpone dental appointments based on the inconvenience of finding an English-speaking dentist and finding a clinic we find suitable. No doubt, it’s undoubtedly a case of avoidance in one way or another.

When we made plans to stay in Costa Rica for over three months, we knew we’d have a hard time coming up with an excellent excuse to avoid going to a dentist when this country is known for its good dental care at reasonable prices. So what reason would we have now?  None.

Shortly after we arrived three weeks ago today, we made our appointments with a dental clinic with nine highly trained and qualified dentists, most of whom were trained in the US and recommended by our property manager, Marian.

Two of the dentists contemplating a patient’s treatment.

Many foreigners travel from the US and other countries to have their dental work done at prices as low as one-third the cost in the US. This makes sense for seniors on fixed incomes, especially when flights are reasonable from the US to Costa Rica, along with affordable hotel rates and costs for meals.

No more than a minute after we arrived (early, of course) at the Costa Rica Dental Clinic Lab found at this site, we felt comfortable and at ease that we had come to the right place. 

We met an American from Texas who was completing an entire mouth restoration, priced at US $50,000 (CRC 28,823,500) for which he was paying only US $15,000 (CRC 8,647,050) at the Costa Rica Dental Clinic Lab. He’d been flying back and forth over the past many months to have the massive amount of work done and was thrilled with the quality work and competent dentists.

This is the dentist who did a fine job on my filling and cleaning.  I’ve always dreaded dental appointments but did fine without numbing injections.

A short while later, we met a woman from Maryland, US, who’d also been flying back and forth to have considerable work done at reasonable prices. In each case, the “tourists” enjoyed their time in Costa Rica whenever they returned for more dental work. This made sense to us.

The last time we had our teeth cleaned was on July 30, 2015, as shown in this post, for which we were content with the results. The pricing and details are described at the above link.

While in Maui for six weeks, we’d booked cleaning appointments for November 4, 2014, for both of us. Once we arrived at the facility, Tom felt surprisingly uncomfortable. Something just wasn’t right.  They’d moved our appointments around, requiring a long wait.  We canceled, unwilling to wait for the extended period, especially when Tom was so hesitant. See here for details.

This is the lovely Geovanna, who works with patients in the office, appointments, and billing and makes arrangements for hotels and transportation.

Later Tom had the abscessed tooth situation in Fiji in November 2015, requiring treatment on two separate occasions which resulted in the necessity of the tooth eventually being pulled in New Zealand in early 2016.  As a result of all of the above, we hadn’t had our teeth cleaned in 25 months, and it was long overdue. 

Yesterday morning after picking up the rental car at the outdoor cafe at the grocery store, Supermercado Coopeatenas, promptly at 10:00 am as Aad had arranged for us for a total of five days. Although we were a little surprised by the US $1250 (CRC 720,588) deposit required, the paperwork went quickly and smoothly. 

It seemed like a huge deposit for a five-day rental. However, with our appointments set in Curribadat for 1:00 pm, we accepted the terms and paid the US $167.50 (CRC 96,559) plus the deposit.

The dental office has a pleasant modern decor.

In no time at all, we were on our way, paper copies of directions in hand plus GPS directions on my phone using the SIM card. I don’t know if this has ever happened to any of our readers, but once we were within a few miles of our destination, the GPS kept changing, telling us to go another way, after another, and then another.

Poor Tom was driving and trying to stay calm. I’d say, “Turn left here! No, turn right in two kilometers at Calle 42!  No, turn right in 400 meters! No, make a u-turn now!” Later we discovered that google maps had an error regarding the clinic, showing it has two locations when it only has one. Most likely, that contributed to the crazy directions.

Oh, good grief, I don’t know how he maintained his cool while I went helter-skelter with the directions. The paper map was useless.  Finally, 30 minutes later than we expected to arrive, we found the dental clinic. Good thing we’d left as early as we did for the 1:00 pm appointments.

Geovanna stays busy ensuring each patient’s dental experience is top-notch.

In any case, the dentists were great, speaking excellent English.  The receptionist and dental assistant, Geovanna, was fabulous; warm, friendly, and inviting. The clinic was impeccably clean and organized, and from the two patients we spoke to, we were totally at ease.

I had one filling repaired, and both of us had our teeth cleaned with better results than either of us had ever experienced, even in the US. The total bill for both was US $250 (CRC 144,118), certainly much less than it would have been in the US or many other countries.

The drive back to Atenas was easy, and once we returned to our gated community, we drove up the mountains to see the many areas we’d been curious to see which were too steep to walk. This area is lovely, more than we’d expected from our comfy world in the exquisite villa overlooking the valley.

We ran into lots of traffic on the return drive.  Curridabat is close to the capital city of San Jose.

Today, as soon as we’re done uploading today’s post, we’re off to the market to get the remaining ingredients needed for tonight’s meal, Low Carb Chicken Pot Pie (please email me if you’d like the recipe), a favorite of ours and, to purchase groceries we’ll need for the balance of the week.

Tomorrow, after posting and weather permitting, we’ll be heading to an exciting and popular tourist venue. We’ll be back with more new photos.

Have a fabulous day!

Photo from one year ago today, August 22, 2016:

We took this photo at a local resort in Phuket. The placement of hands, Mudras, 
as gestures in Buddhism is explained here. For more details from that day’s post,
please click here.

All new photos of the interior of the villa…Making appointments and taking care of business…

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The view of the main pool from the master bedroom. These sliding doors and others on the adjacent wall open wide with fine screens to keep out insects. It’s such a treat for us to have screens! The louvered slats above the sliding doors allow cool air to enter the room when the doors are closed.

“Sightings from the Veranda in Costa Rica”

This morning at 6:00 am as the clouds continued to roll in.

Since taking the above photo at 6:00 am this morning, the clouds and fog have rolled into a greater degree and we can’t see across the valley at 7:30 am as I sat down to begin posting.  The temperature is in the low 70F’s, (21C) but the humidity is high and everything feels sticky.

Other than the moisture we feel under our feet while gingerly walking barefoot on the somewhat slippery-when-wet tile floor of the veranda this type of weather doesn’t bother us a bit. 

The sauna/steam room is accessible via a door in the master en suite bathroom which also has a door leading out to the veranda to the cold plunge pool.

We have much more to face in the way of inclement weather in the many months to come, particularly in Antarctica and Africa upcoming in the next many months. 

As we observe today’s date of August 9th, we predict we’ll be landing in Mpumalanga Nelspruit-Kruger Airport six months from today or tomorrow, depending on which flight we choose.

This short walk from the sauna/steam room toward to the cold plunge pool for a refreshing event after the heat.

Now, reveling in this peaceful, relatively uneventful period in Costa Rica, as we spend time bird watching over the lush canopy of trees surrounding us, we’re on a mission to get a number of tasks accomplished that we’ve put off for awhile. 

Although neither of us is procrastinators, the nature of our lifestyle often leaves us prioritizing based on its level of importance and/or urgency.  Spending the last over two months in the US, left us little time or motivation to work on some of the project’s we’re mentioning today.

Even this hallway between the living room and screening room has ample closets and decor.

In the past 24 hours, we’ve handled the following appointments:
1.  Friday’s upcoming phone meeting with our accountant in order to get 2016’s taxes completed before October’s due date (we had to get an extension when the box of our documents was lost and later found).
2.  Dentist appointments for both of us on August 21st (a 45-minute drive from Atenas.
3.  A car rental for five days beginning on August 21st enabling us to drive ourselves the long distance.
4.  Found a hotel for the 31-nights in Buenos Aires from December 23, 2017, through January 23, 2018, plus one additional night when the Antarctica cruise ends on February 8th (after which we’ll fly to South Africa as indicated above).

Once the hotel booking for Buenos Aires is wrapped up at the corporate rate, we’ll share the details and the excellent pricing in what appears to be an ideal hotel for our needs over this extended period. 

The villa is not only tastefully decorated but has many useful special areas.

We don’t love staying in hotels for a month or more but we needed to be able to store our luggage since the round trips flights to Ushuaia Argentina where we’ll board the ship, have serious weight restrictions (smaller planes).

As for the dentist appointments, they’re long overdue.  The last time we had our teeth cleaned and checked was in Trinity Beach in July 2015.  Since that period, Tom had an abscessed tooth pulled (a wisdom tooth) in New Plymouth New Zealand in 2016.  At the time we couldn’t find a dentist that did cleaning or we could have had it done then.

This courtyard creates a pleasing entrance to the property!

Not only do we both desperately need a cleaning but Tom’s lost two fillings and I’ve lost one.  Neither of us cares to have more dental crowns so we’re hoping they can refill the teeth. 

Yesterday, we called and spoke and spoke to an English speaking staff member who explained it would be no problem to refill/repair the broken fillings.  They have nine English speaking dentists in the clinic and are highly rated by the expat community in Costa Rica.  This was quite a relief.  We’ll report back how this goes.

Fountain in the center courtyard.

It feels good to finally be addressing these issues.  That’s not to say we don’t have plenty of work ahead of us to get these items wrapped up but at least the ball is rolling after a lengthy period of distractions.

At the moment, Tom’s sitting in the screening room watching US news he found on the TV while I’m comfortably situated outdoors on the veranda on this cloudy damp day.  Perhaps, I’m preparing myself for spending entire days on the veranda as we contemplate doing the same upcoming in Marloth Park.  Bugs?  Snakes?  Heat?  Humidity?  Bring it on, baby!

Plants and flowers in the entrance center courtyard.

Enjoy the beginning of a series of interior photos of this amazing villa in Atenas, Costa Rica!

Happy day to all!

_______________________________________

Photo from one year ago today, August 9, 2016:

Memorial markers at a local cemetery in Phuket Thailand.  For more photos, please click here.

Part 2…An inquiry from an old friend and long time reader…Artwork in Phuket house…

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This is my favorite piece of Thai art. It’s quite large placed above the TV in the living room.

In yesterday’s post we answered the first question posed by longtime friend and reader, Cathy in Minnesota as shown in a statement as below which she’d asked in a private message in Facebook.

With Cathy’s permission I posted her questions as follows:

Cathy wrote:
“So this is my question for you two. Honestly, have you ever gone someplace and after about a couple of weeks wish the stay was shorter? With your back hurting the way it does sometimes do you wish you were closer to a doctor. I just know how painful back problems are from experience.  I read your blog every day.”

As a result, yesterday’s post addressed the first question in detail, particularly as it applies in our current location: “Honestly, have you ever gone someplace and after about a couple of weeks wish the stay was shorter?”

Some of the art work is lopsided on the wall, but we didn’t want to straighten them for fear they’d fall off.

Today, we’re addressing the second question in Cathy’s inquiry: “With your back hurting the way it does sometimes do you wish you were closer to a doctor.”

We chose to break up these two questions, especially since this second question requires a certain amount of comment and reflection that we wanted to share with our readers, many of whom are in our age bracket subsequently more likely to require medical care.

Our reality when we began our travels was the fact that I have a serious spinal condition that is exacerbated by inflammation triggered by certain foods and chemicals. By changing my diet five years ago this month, within a period of three months I was pain free although I still have the condition.

Plus, I was pre-diabetic within months of requiring medication when I started this way of eating and now my blood sugar is normal with these dietary changes. Two major problems were solved by a change in diet. 

Many of these works of art consist of design and texture.

It was these massive improvements in my health that inspired us to travel the world, when prior to the change in diet, the possibility of travel was very limited when I couldn’t sit on a plane for two hours. In these past 46 months, we’ve experienced as much as a 34 hour travel period and though tired at the end as anyone would be, I did fine, pain free.

In the early part of June, slightly over two months ago, I injured my spine in the swimming pool in Bali while walking backwards in a particular exercise feeling fine and pain free. I was using the pool each day as a form of exercise with no health club in the area. 

In June, I accidentally walked into the sharp stone edge where the end of the steps meets the main part of the pool. The second I did this, I knew I was in trouble.  The impact hit me from my neck down to my tailbone. It felt as if I’d been in a car accident.

There is a pair of these, each slightly different.

At first I didn’t say anything to Tom hoping the pain would subside. I didn’t want to worry him. But, by the next day I knew was in big trouble when the pain was awful running from my neck down to my tailbone. 

Having heard stories of horrible medical treatment in the remote area of Bali, I decided to wait it out knowing it could be months until the injury would heal. My arms and legs were working fine convincing me I hadn’t injured my spinal cord itself. 

In time, the pain reminded me of when about eight years ago I had a compression fracture, compounding the pain I already had at the time. It took several months to heal. 

Recently with a lack of good medical care nearby, I made the assumption that again I had a compression fracture which is a very common condition for seniors, even those with less precarious vertebrae than mine.

This style of Buddhist statue is commonly seen in Thailand.

This statement is from a document at the following site from American Family Physicians :

“Vertebral compression fractures affect approximately 25 percent of all postmenopausal women in the United States. The prevalence of this condition steadily increases with advancing age, reaching 40 percent in women 80 years of age. Women diagnosed with a compression fracture of the vertebra have a 15 percent higher mortality rate than those who do not experience fractures. Although less common in older men, compression fractures also are a major health concern in this group. Because the age group of those older than 65 years is now the fastest growing segment of the U.S. population, the incidence of this age-specific fracture is likely to increase.”

Based on the fact that there was no need for surgery, I self treated doing the best I could. What would a doctor do, when only in very rare cases, there’s an impingement on the spinal column (which I didn’t seem to have) during which surgery may be required. 

Rest, hot and cold packs, limited movement with no bending, not spending days laying in bed and the fractures would eventually heal without further incident. Many times I had read that the pain could last for three months or longer in typical cases. I guess I’m a typical case. Had I not experienced this type of injury in the past, I may have been more intent on having x-rays, MRI or CAT scan.

Plus, I determined, that if the fracture was spotted in a scan, what would a doctor do anyway?  Prescribe narcotic pain meds? Not only did I not want to take narcotics for such an extended period I didn’t want to be hauling narcotic meds in our luggage as we travel in a variety of countries. 

This larger statue is located in the kitchen and dining area.

I had one old bottle of painkillers in my luggage with 30 pills (I’d never used any of them) in case of an emergency. During this two plus months I used 10 of the pills when I couldn’t seem to get the pain under control, especially when we were in Singapore and then on the Mekong River cruise, going out on tours. 

Tylenol, Paracetamol, Aleve, Motrin and aspirin haven’t helped at all, even after trying them for weeks. I take nothing now, instead finding a new way to sit, stand and rest using the ice and heat packs to relieve more painful periods. It’s getting better, now only painful during the second half of the day when I may have sat too long, bent over too much or walked too far. It’s a balancing act.

Back to Cathy’s question, “With your back hurting the way it does sometimes do you wish you were closer to a doctor.” 

My answer is clear.  Had we been living in the US I may have gone for an x-ray or MRI, but the ultimate treatment would have been the same except with the addition of pain relieving medications I’d surely have been prescribed of one sort or another. 

Interesting rendition.

Most likely physical therapy would have been prescribed once it healed, which is often postponed until after several months to avoid further injury. After years of experience with a variety of spine related physical therapy modalities, I feel confident once the pain is gone, I can begin walking more once again and incorporate light physical therapy type moves as I progress.

Once we arrived in Phuket I considered going to the local hospital for an x-ray but after reading many poor reviews about the local private hospitals, I decided against it. Finally, over the past few weeks, I’ve noticed a subtle improvement each day and feel confident that it will continue over time. 

Since the injury, I’ve managed the following:
1.  The four to five hour harrowing drive from Sumbersari, Bali to Denpasar Airport
2.  The flight from Denpasar to Singapore with considerable walking at both terminals
3.  The week in Singapore with several trips to immigration offices to acquire  the two visas
4.  The flight to Hanoi, the flight to Siem Reap, 18 days total touring Cambodia and Vietnam, including rides on non-motorized tuk tuk, motorized tuk tuk and a rickshaw along with many tours requiring lots of walking and stairs.
5.  Flight from Saigon (Ho Chi Minh City) with a layover in Bangkok, then another flight to Phuket.
6.  One hour van ride from Phuket Airport to vacation rental
7.  Lots of bouncing around in the less-than-stellar rental car over the past three weeks since our arrival.  Three weeks from today we depart Phuket.

This statue is located on the marble kitchen counter.

Over the next few months, we only have to get back to the airport in Phuket, with a layover in Singapore, then on to another flight back to Denpasar, an overnight in a hotel and then, the next day, the four to five hour harrowing drive to the villa. For sure, these next few months will be easier than the past two months.

I’m anticipating by the time we board the back-to-back cruise in Sydney, Australia after a seven hour flight from Denpasar (after one more four to five hour harrowing drive), on October 31st (our four year travel anniversary), I’ll be back to my “old self.” If not, we’ll carry on with our plans. I’ve proven to myself, I can do this.

Many people suffer with chronic conditions and maintain active and fulfilling lifestyles. Until such time as either of us cannot travel as such in the above listed points, we’ll continue to live life to the fullest, enjoying each and every day while dreaming and planning for the future.

May you do the same.

Photo from one year ago today, August 11, 2015:

It seems we awaken every morning at 5 am.  Tom gets up and I read in bed until I fall back asleep, usually until 7:00 am. Up so early he has an opportunity to capture these amazing sunrises. For more photos, please click here.

Dealing with life’s everyday challenged while traveling the world…

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A billy goat tied to a tree.

Finally, Tom is on the mend. After considerable research, we speculate that the abscessed tooth he had pulled may have resulted in the gastrointestinal infection that began to plague him 48 hours after the extraction, lasting for almost a week.

He suffered from severe gastric symptoms, fever, chills, body aches, and weakness. He took over-the-counter medications to alleviate the fever every four to six hours for the first few days until the fever subsided, sleeping most of the day on the sofa in the living room.

A bubbling brook.

The simple fact is that pulling the tooth released bacteria from the abscess in his bloodstream and stomach, resulting in what appeared similar to the bacterial infection I had in Marrakesh, Morocco after eating raw vegetables in a restaurant the first day of our arrival. 

After traveling for 17 months at that point, I should have known better. Now, we’re more cautious than ever in less developed countries. I had waited three weeks before succumbing to a three-day dose of Cipro which we’d brought along for exactly this reason.

Recently, we read a study that discovered the depth of the intellect of horses and their innate ability to connect with humans, even reacting to expressions on a human face.

Within hours I began to feel relief. In Tom’s case, we didn’t want him to take antibiotics a third time since his first dose for the abscess was in November, the second in January, on two occasions when the abscess flared up. Thus, he waited.

It wasn’t until he started feeling better yesterday that we conducted research to make the connection to the abscessed tooth extraction and the gastric. Had we suspected this earlier, calling the dentist to inquire, most likely he’d have recommended antibiotics, which we didn’t want Tom to take once again unless it continued for more than a week.

A creek we encountered on a drive.

Its in these types of scenarios that not having a “regular” doctor and dentist puts us in a tough position. In our old lives, if we were sick for more than five days we’d make an appointment to see the doctor often having tests and leaving with a few prescriptions. 

We don’t have this luxury now, 40 months after leaving Minnesota. For those family members and friends who are reading today…please don’t worry…if one of us exhibits life-threatening symptoms, we’ll immediately find our way to an urgent care facility or hospital. 

Even on cloudy days, the countryside has a special charm.

It may seem as if we’re often sick as we share the details of our daily lives. Most likely it’s no more than most of our readers. The difference is that few document each virus, infection, injury, and days of being under the weather. Most likely, twice a year we experience a malady of one sort or another.

After considerable discussion, we’ve come to the conclusion that moving from one location, one country to another, we have little time to build an immunity to local viruses than those who live in one location occasionally traveling who seem to build an immunity.

Stopping to admire cloud-covered Mount Taranaki.

On cruises, passengers are exposed to a variety of illnesses from living in tight quarters for a few weeks.  Luckily, we’ve never had Norovirus even during periods when there’s been an outbreak.

Although on four of our past cruises either one or both of us has developed the common “cruise cough,” the worst of which was on the cruise from Hawaii to Sydney with horrible symptoms lasting three weeks after the cruise ended. By far, that was the worst illness either of us has experienced since we left the US. 

Horses we encounter are animated and friendly.  Check out the cute pink spot on his nose.

When the ship disembarked we were so sick with a fever and a cough neither of us hardly recalls the time we spent picking up the rental car at the Cairns airport and finding the house in Trinity Beach.

We caught this awful virus toward the end of the cruise when a woman coughed on me in the elevator which, once my symptoms manifested, Tom was infected developing into the same whirlwind of awful symptoms.  

We each spent the last few days of the cruise in the cabin (it was an 18-day cruise) in an attempt to avoid infecting others. Otherwise, this was one of the most enjoyable of our 12 cruises to date, making many new friends with whom we’ve continued to stay in touch.

Another creek we crossed on a drive.

Most recently with Tom’s abscessed tooth, we ask ourselves what we may have done differently once the symptoms manifested. We were living in a remote area of Fiji. We visited a dentist within days of the first symptoms, taking antibiotics as prescribed. 

His second bout of symptoms occurred on the day we boarded this last cruise from Sydney to Auckland. The only solution was another round of the same antibiotics. As required in the case of antibiotics he continued with the full course of the medication. 

Once we arrived in New Plymouth, within two weeks of arrival, we were in the dentist’s office when at that time, no new symptoms were present. We feel we did everything we could. Then, he developed the awful gastrointestinal infection plaguing him for almost a week. 

A winding country road.

Now, he’s able to eat again, is feeling well and life will continue on as always, always, stress-free, filled with simple daily pleasures and the comforts of living in the countryside in this beautiful country. Soon, we’ll head back out to tour more of this exquisite location, sharing new photos along the way.

We feel blessed and grateful for each and every day of our lives. But, no one “said” life of world travel would always be easy.  It’s not. And, it’s the times it’s not easy that make us appreciate greater periods of good health and simple pleasures. Overall, we were very fortunate during these last 40 months.

Thanks to all of our readers for sharing this journey with us during periods of both excitement and the mundane events of daily life.

Be well.

Photo from one year ago today, February 13, 2015:

Thousands of feral chickens populate the island of Kauai. It is speculated that Hurricane Iniki in 1991 blew away hundreds of chicken coops, letting them loose to proliferate. It’s quite a sight to see! For more Kauai photos, please click here.

How much did we spend out of pocket for all the medical?…Haircut problems for Tom…Figuring it all out, one way or another…

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Its amazing how quickly it grows.

Yesterday morning, we both had final appointments with Dr. Konny at Apple Tree Medical in the town of Smithfield near the shopping center. Tom had his physical and according to what Dr. Konny could determine, he’s in excellent health.

He had his blood tests which will arrive by email in a few days. Once those have arrived, we’re done with the doctor. After Tom’s appointment, he headed to the lab located in the medical clinic while she and I reviewed my newly arrive test results.

Much to our delight, all is well. I have a clean bill of health. I must admit now that it’s over that the pain I had in Kauai was not a bladder infection after all. After we arrived here in Australia it started up again. It just wasn’t symptomatic as a bladder infection. 

The justcuts store is located only a few doors from the pharmacy, making it easy to find.

Over a week ago I had a CAT scan in Cairns as the pain had continued for days. We never mentioned the CAT scan here when we felt we should wait until we had results. I was upset about having to have the scan not wanting to pay thousands of dollars for the expensive diagnostic test.

We almost fell over when we paid the bill after the test was completed. It was AUD $365, US $269. As a matter of fact, Dr. Natasha had called four different diagnostic centers while I was with her to find us the best price. I don’t ever recall our doctor making phone calls for “deals” for us! The difference in pricing at various clinics was as much as AUD $1000, USD $738. We couldn’t express enough gratitude!

Keeping in mind we have no insurance to cover this when our insurance only covers hospitalization (hospital stays, surgery, and inpatient services) this was the full price, not a co-pay. I can only imagine the out of pocket cost we’d have incurred for such a service in many other countries.

Tom was reading a book on his phone while awaiting his turn.

Waiting for the results was angst-ridden. I was more worried about how we’d manage if I needed surgery or had a dreaded disease while on the move. One can do a number on oneself imagining the difficulty in these circumstances. But, we both held firm to a relatively positive attitude, and the days passed quickly until we knew the results.

As a result of a surgery over 20 years ago, I had adhesions in the left groin area (guys, figure that out on your own. Girls get it!) and a possible bit of diverticulitis. The pain from this can come and go and for now, it’s at bay once again. Reducing fiber intake seems to reduce all the pain. So for now, I’m on a low fiber, low carb, grain-free, starch-free, sugar-free, chemical-free diet. Good grief. 

Knowing it’s nothing more serious and not impeding upon any internal organs, it’s not worrisome. Occasional discomfort, I can manage. Worrying is eliminated. What a relief! As for the additional food restrictions, it’s no problem for me. Currently, I’m having low fiber veggies such as mushrooms, onions, leaf lettuce (no more cabbage), and a few others.

Tom’s former haircut gone wild.

As for all the other tests including tests for colon cancer, everything is negative. Now we wait for Tom’s results and we’re home free (literally and figuratively). Later in the week, when we grocery shop we’ll make our dentist appointments with a dentist located by the mall with a beautiful office and modern technology for teeth cleaning.

In the interim, Dr. Konny wrote my prescriptions for six months (all the law in Australia allows) for the few prescriptions I’ve taken for years, having recently eliminated one more due to good health. After the doctor appointments, we dropped off the prescriptions which will be ready by Thursday. With these, I’ll have enough on hand to last for the next 16 months. 

After three doctor appointments for me, one for Tom, multiple blood tests, and the CAT scan we spent a total of USD $$1075, AUD $1458. All that remains is is the cost for the three, six-month prescriptions which surely won’t be over US $200, AUD $271.26. Unreal. In the US, we’d have spent thousands for all of these out of pocket services. Once Tom’s results come in, we’ll report here, anticipating all will be good.

In no time at all, he was done. I particularly watched how Byron cut along the ears and back with which I’d had trouble. I can’t wait to try it again.

We were very happy with the level of medical care and service at Apple Tree Medical. If traveling to this area, one can rest assured they’d be in good hands with this clinic and with these fine doctors, including Drs. Natasha and Dr. Konny.

After the doctor’s office, the stop at the pharmacy, and Tom purchasing a battery for his watch which was a bit pricey at AUD $19.95, USD $14.71, we headed to JustCuts for Tom’s much-needed haircut. Why wasn’t I cutting his hair with our recently purchased hair clippers with the zillion attachments?

Simple answer. When we plugged it into our electrical adapter the noise was earsplitting and it quickly became overheated, approaching burnout. Apparently, these clippers won’t work in some countries but certainly not in Australia. My US purchased flat iron which uses more powers works without a problem. I offered to give him a scissors cut but he refused.

The bottom edge at the back had been tricky for me.  Now, I know how to do it.

The male pharmacist suggested we try his favorite haircutters, JustCuts, located a few doors from the pharmacy in the mall. Walking into the clean, modern, well-equipped hair cutting establishment made us feel we were in good hands. The stylist, Byron, a local guy did a fabulous job giving me tips for when I am able to cut Tom’s hair again. 

After a perfect cut along with an affordable price of US $14.71, AUD $23 we were thrilled. Hopefully, in Fiji, the hair clippers will work. If not, we’ll have to find a new haircutter before we head back to Sydney in January to board the cruise to New Zealand.

After all of our stops after the doctor’s visit including a trip into the grocery store for a few items, we were on our way, out to breakfast. Unfortunately, breakfast was over at the few restaurants we visited and it was too early for lunch.  With rain pelting down and preferring to avoid walking on the beach in the rain, we decided to head back home and go out to eat another day.

When we returned home, I collected all of our medical information and scanned every medical report saving it on our hard drive and the cloud we use, OneDrive, for which we pay a small monthly fee. We have almost one terabyte of data to save in a cloud and thus it requires a small fee for this amount of storage. We use the portable hard drive and the cloud for safekeeping in case our hard drive is ever stolen although I keep it in my possession at all times when we travel. 

Byron was a friendly and competent stylist suggesting a number of areas we plan to visit in the near future.

Tom’s test results will arrive by email by Friday. If all is well, he’ll have no further need to return to the doctor.  Once we receive them, they too will be stored on the hard drive and cloud. 

We’d received a DVD of my CAT scan which we plan to store at our box at the mailing service, along with accumulated receipts and our expired second passports which we no longer need but that I’d like to save as keepsakes. We’ll put together a small package of these items and send them to Nevada before we leave in September. More later on why we no longer need second passports but did when we originally began to travel in 2012.

That’s all the news for today, folks. Thanks for traveling along with us. We hope you enjoy reading the costs we bear along the way. We post them with the intent of informing travelers as to possible costs they may incur in their travels. If any of our readers have specific questions about any travel-related expenses we may not have included, please comment or send an email and we’ll happily respond.

Have a wonderful day!

                                        Photo from one year ago today, July 21, 2014:

A natural rock formation we discovered on a drive in Madeira. For more photos of that day’s road trip, please click here.

Results from doctor appointments…Tom’s appointment is next…Cruise updates…

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Nothing is as beautiful as a sunny day at the beach.

Alive and well after three years without having a physical exam, I am relieved most of it is over. Aside from a few remaining tests that we expect to be fine, I am thrilled its almost over and all is well.

A huge contemporary house near the beach.

On Monday, Tom begins the process, with his first appointment at the clinic. When all is said and done, including all tests the cost will be under US $800, AUD $1031 for both of us, not bad considering all is paid out of pocket when we only have major medical/hospitalization insurance.

Actually, our fixed monthly budget included a monthly estimate for medical of US $50, AUD $68 which we’ve never used except for the trip to urgent care in Kauai. When all is said and done all of these appointments and expenses are covered by that estimate, almost to the penny.

A contemporary house at Holloways Beach.

With continued good health, we plan to wait for another check-up in three years from wherever we may be at the time. Most likely, it won’t be in the US when we’re there in the summer of 2017. 

Another large home at Holloways Beach.

Costs of medical care are approximately four times higher in the US (out of pocket) as compared to what we’ve paid in Australia. There are good medical facilities in most areas of the world where we’ll be living in the next three years so we have no concern at this point.

Yesterday, when we arrived for my 3:00 pm appointment at Apple Tree Medical in Smithfield, I was disappointed to discover my last physician Dr. Natasha was out sick. Instead, I met with Dr. Konny Komlovari whom I found to be equally competent, warm, and friendly. Their onsite lab makes blood tests easy to arrange and process.

A small park at Holloway’s Beach.

Next month, we’ll make our dental appointments leaving all of this medical stuff behind. Thanks to all of our readers who encouraged us to get all of these done and out of the way. It was good advice.

As for the three cruises we reserved over the weekend, last night at 10 pm we spoke to our new rep at Vacationstogo.com, Brooklyn Earnhardt, who is highly experienced and capable. We both felt comfortable and assured that she’ll do a great job for us for these three cruises and all future bookings.

Double Island makes us curious as to what it would be like to visit.  Here are details of visiting Double Island.

We’d gone ahead and reserved the three cruises with Royal Caribbean over the weekend. Now, we’re in the process of transferring them over to our new agent, Brooklyn which can be done within 60 days of booking with the cruise line. 

In transferring the cruises to VTG we are able to use our own agent and agency for receiving various cabin credits that the cruise line itself may not offer. Plus, they receive their usual commissions. This type of loyalty is important to us. Relationship building is vital to our success in booking various aspects of our travels.

Tom looking out the sea undercover at the beach.

In yesterday’s post, we mentioned sharing a little info on our itinerary for these three new cruises which we’re summarizing here. Soon, as we’ve mentioned we’ll include our new updated itinerary

1.  Sydney to Perth: October 31, 2016, 16 days

2.  Perth to Sydney:  November 16, 2016 (back to back above the same cruise, same cabin number) 17 days

The above 33-day back-to-back cruise circles the entire continent of Australia, with multiple ports of call enabling us to see considerable sites along the way.

3.  Sydney to Seattle:  September 22, 2017, 24 days, crossing back over the International Dateline, arriving in the US on May 15, 2017

During these above three cruises, we’ll visit such new cities as:

  • Brisbane, Australia
  • Darwin, Australia
  • Benoa, Bali
  • Geraldton, Australia
  • Perth, Australia
  • Esperance, Australia
  • Adelaide, Australia
  • Melbourne, Australia
  • Dunedin (Port Chalmers) New Zealand
  • Akaroa, New Zealand
  • Wellington, New Zealand
  • Picton, New Zealand
  • Il Des Pines, New Calendonia (we missed visiting this port on our recent cruise due to rough seas)
  • Noumea, New Calendonia
  • Mystery Island, Vanuatu
  • Cross the International Dateline (getting our lost day back)

The last of the three cruises breezes through Hawaii on the way to Seattle, Washington, USA, stopping at Kona (Big Island, Hawaii), Lahaina (Maui), and Honolulu (Oahu). By that time, it will have been almost two years since we lived in Hawaii. 

Park at the beach with a covered area.

Besides these three above new cruises we booked in the past few days, we previously booked three other cruises in Australia, details of which we’ve shared online in past posts. A few of the ports of call are repeated on these other cruises but here are some of the highlights of the new locations we’ll have yet to see:

  • Hobart, Tasmania
  • Tauranga, New Zealand
  • Bay of Islands, New Zealand
  • Auckland, New Zealand (where we stay for 90 days in a nearby village)
  • Kuala Lumpur, Malaysia
  • Singapore, Republic of Singapore
  • Lifou, New Caledonia
  • Lautoka, Fiji

These 23 ports of call plus some repeats of others we’ll have previously visited  (not listed here today) are all new to us in our world travels. This gives us an additional opportunity to see as much as we wanted to see in the South Pacific in almost two years including this relatively short period of time of 97 days aboard ship on these six cruises.  

This house near the beach could be anywhere in the world, utilizing the benefits of solar power.

During these periods we’ll be housed, fed, and entertained aboard the various ships with the opportunity to socialize each and every day. By the time we head to Seattle, we’ll feel confident we’ve thoroughly scoured the South Pacific to our liking.

Over the next year, we’ll be deciding on how much time we’ll spend during our relatively short visit to the US in 2017 and begin booking vacation homes and cruises for our next foray to an upcoming new continent. 

As always, we’re excited as to our future choices while we’re thoroughly “loving the one we’re with!”

Happy Monday or Tuesday to all!

                                                Photo from one year ago today, July 14, 2014:

Colorful steps at an elementary school in Campanario, Madeira, Portugal, one year ago today. For details and more photos, please click here.

Counting down the days with a bit of trepidation…What do world travelers like us do without a primary care doctor?…This morning’s new photos….

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This Cattle Egret is sitting atop a tree in the backyard, a usual sight to see. Most often, they are on the ground near where there is landscaping, grading, and excavation in the process. They seem to know that such scenarios are excellent opportunities for foraging for bugs and worms.

After a fitful night of listening to science podcasts, at 6:00 am, I literally rolled off the edge of the bed, exhausted and wishing I could lay back down for a few more hours.

My mind was doing a number on me. I had to get up and try to call the doctor again with no response after yesterday’s call.  ER doctors don’t usually participate in any aftercare for patients they’ve seen on an emergency basis.

We no longer have a primary care doctor. It’s simply been too long since we last visited our former doctor in Minnesota, which was in September 2012, a month before we left. 

The egret couched down watching me open the door to take the photo.

I knew he wouldn’t participate in any health care questions at this late date when several months ago, I inquired to the Minnesota clinic with an online request for a relatively innocuous medication refill, never receiving a response. At that point, I knew he was no longer in our court. Too much time had passed. We get this. They have “rules.” 

Travelers maintaining a home base would have no difficulty contacting their primary care physician for advice.  Although in Hawaii, prescriptions can’t be “called in” from an out-of-state physician.

It’s a little late to establish a relationship with a doctor in a private office or medical clinic in Kauai. Besides, none of the testing equipment required for a diagnosis is readily available at any of the local clinics and a trip to the Wilcox Memorial Hospital in Lihue would be required. 

This morning’s view from our lanai while it rained off and on.

From what we’ve discovered most doctors refer patients to the hospital if their condition can’t readily be treated with meds. I suppose this is not unlike many clinics worldwide, let alone in the US.

Finally, this morning at 7:00 am I reached the ER doctor I’d seen on Friday asking for a different, perhaps more effective antibiotic. This is often necessary with a variety of infections, which don’t respond well to a particular drug which seems to be my case at the moment.

Ah, the perils of world traveling without a home base!  We knew this going in. We also knew that having only major medical insurance (which pays 100% of any hospital stays, doctors, tests, and medications rendered while in the hospital) would be a risk. 

I edited this photo to be dark in order to show the two rainbows that developed after the rain.

By purchasing the international policy, we chose the option of major medical only or paying outrageous fees to include doctor visits. However, if we had made a choice to include doctor/outpatient services, the policy still didn’t include any necessary medical care as long as we’re in the US, as we are now. 

Since Medicare doesn’t pay outside the US, we opted out of Medicare’s Plan B which pays doctor visits with a copay of as much as 20% for which most seniors purchase an additional policy. This would not be a sensible option for most senior travelers especially those who periodically return to a home base. They can easily purchase a specific travel policy for their trips, event by event.

This individual trip policy was also not available to us when our lives consist of one continuous “trip.” No such policy exists for us other than the 12-month international policy that we purchased almost three years ago and renew each year.

It was raining when we got this rainbow shot. If the hill and the trees hadn’t been in the way we’d have been able to see the end of the rainbow in the ocean.

When we consider the potential out of pocket costs for tests at a hospital, we cringe but fully accept that potential no matter where we may be. We’ve dodged a bullet to date but, we knew sooner or later the scenario could change on a dime.

In any case, the ER doctor refused to “call-in” a different prescription without my having additional tests. We understand her dilemma. As an alternative, I presented her a list of all of the antibiotics we currently have on hand and she suggested Cipro, the “big guns” for infections. 

She emphatically stated that if I’m not better 48 hours after taking Cipro which will be Thursday, we’ll be heading to the hospital for more tests. Both Tom and I agree that this is our only option. At that point, it will be only 10 days until we depart on the cruise. 

It’s hard not to appreciate the seeming magic of a rainbow.

What do ex-pats do in these cases? They either purchase insurance available in the country in which they live, purchase international insurance such as ours, or in some cases, pay for medical care out of their pocket when medical costs in some “retiree friendly” countries are surprisingly inexpensive. 

From what we’ve read online to date, a typical doctor’s office visit in Australia may be around US $50, as opposed to $100’s in the US. Once we arrive in Australia, we won’t hesitate to see a doctor if we deem it necessary at the time.

These berries on this plant remind me of Christmas.

If this illness had occurred a few months ago I would have followed the doctor’s instructions and not given it much of a thought. The current time constraint is weighing heavily on my mind at the moment.

My sister Julie worriedly reminded me of how many times we’ve been sick since we left the US, more often me than Tom. I must admit that at least twice a year I’ve picked up some type of infection, viral or bacterial.

With a history of inclement health for most of my life (mostly due to heredity and inflammation), my immune system continues to remain vulnerable regardless of how hard I’ve tried to offset it. It was equally precarious when we lived in Minnesota, still contacting some type of virus, sinus infection, or respiratory infection once or twice a year. 

Sunset from the front lanai.

Then again, how many of us don’t “catch” something once or twice a year? Tom would push through such conditions and continue to work as did many of the guys he worked with on the railroad, often infecting one another while working in close quarters on a train. 

Having a home base has what we now refer to as “luxuries” that come with it; easy access to medical care, cable TV, working cell phones, appliances such as a clothes dryer, quality Internet services, shopping centers, and grocery stores with familiar products and services.

We don’t share this personal story to elicit sympathy, although bless the hearts of many of our readers for sending their good wishes. We continue to tell our story for the purposes of sharing both the good and the bad of what it’s like to be traveling the world without a home base. 

And, we appreciate the beauty of flowers blooming in the treetops at a distance from the lanai.

The vulnerability we express here at times even surprises us when in our old lives, we only shared a degree of personal information with our close family members and friends.

How foolish we’d be to hide the realities of our daily lives only sharing the details of the most exciting of locations and adventures. With that, we’d only be a travel log, extolling the virtues of where we’ve been, and what we’ve seen, a place for a degree of braggadocio. The manner in which we share our lives is done so with a much bigger intent; truth and reality.  

We have no doubt that at times, some of our readers may become bored with our truth, reality and mindless drivel. Then again, daily life for most of us is mundane at times, isn’t it?

We’ve come to appreciate the simplest of life’s amenities, never taking for granted that which is available to us, including the potential of more medical care in Hawaii. If we must go, we will. If we luck out and I’m well again in a few days, it will be time to rejoice and start packing!

Have a superb day!

                                             Photo from one year ago today, May 12, 2014:

A year ago today, we were three days from leaving Morocco. We were definitely ready to be on the move. For details on that day, please click here.

Health concerns for travelers of any age…Questions and answers applicable to all…

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Sunday’s sunset from Jeri and Hans’ third-floor veranda, the last rain-free day.

The following comments are not intended in any manner to substitute for professional medical advice. This post is entirely based on our personal travel experiences regarding preparedness in the event of medical issues or emergencies.  Please seek the care of your medical professionals in regard to your personal healthcare.

Coupling our interest in health and well being with our worldwide travels has been important to us. Many seniors and younger travelers alike choose to address health concerns before traveling. Many others “wing it” hoping for the best, in many cases a poor decision or, simply a lack of a decision at all.

Checking online over the past almost two years, we have discovered a wealth of resources available that may be of assistance, too many to list here.

We’ve found that researching credible medical sites are crucial, not simply the opinions of a few travelers with a good or bad experience, often seeking a place to vent frustrations and unfortunate experiences.

Some of the questions we had and the answers we’ve discovered that have worked for us, that we’d asked ourselves when planning our world travels include and on an ongoing basis:

  • Will we get intestinal distress from eating uncooked fruits and vegetables? If so, how does one reduce that risk? Yes, illness is often a result of produce eaten raw. This risk does exist when non-purified water is used to rinse produce, which is then eaten raw, such as lettuce, celery, and fruit. Usually, cooking vegetables destroy most of the bacteria. We rinse all of our produce in a bowl of purified water, replacing the water as needed. Always remain mindful of cross-contamination of washed and unwashed produce. We washed all of our produce immediately before placing it in the refrigerator.  This may reduce shelf life, but our “shelf life” is more important.
  • Is it safe to drink the water? Before we arrive at each location we research to determine if the water is safe to drink.If not, we arrange for the property owner to have a several-day supply of purified water awaiting us to ensure we have ample time to get to a grocery store.
  • What about brushing our teeth? This is often a cause of illness. We keep small bottles of purified water in the bathroom for wetting the brush, rinsing our mouths after brushing and rinsing our toothbrushes. Daily, we brush with baking soda and then do a full 20-minute coconut oil gargle which kills bacteria in the mouth, spitting it out when done. Once a week we disinfect our toothbrushes (and my contact lens case) in hot boiled purified water.
  • What happens if get water into our mouths while taking a shower? Immediately, spit it out and promptly rinse the mouth with mouthwash, and brush our teeth following the above process using purified bottled water.
  • Can water be boiled to become safe to use? We don’t recommend this process. Considerable bacteria may remain if the water is not boiled long enough, 15 to 20 minutes, or more. This would only be done in the case of a dire emergency.
  • What about washing dishes?  Ideally, we could use purified water to wash dishes.  Unfortunately, the cost of bottled water is prohibitive and if done properly this isn’t necessary. Wash and rinse dishes, pans, and flatware in the hottest cleanest soapy water your hands can take. Drain on a clean cloth. Wipe dishes dry with another clean towel and leave out, not stacked, to further dry on the clean counter to ensure that no water molecules remain.  Wash your hand before handling dishes which we each do so often it’s ridiculous.
  • Do we need to take malaria pills or other prophylactic medications while traveling? Taking pills for the prevention of malaria depends on the location of your travels. Check with your local travel clinic for detailed maps and information for every country in the world. Other prophylactic medication? For us, we take a Bifidus Probiotic  (30 billion CFU minimum) supplement daily to keep the balance of good bacteria in the gut.  These may be purchased online or at any quality health store.  Research for a quality brand, most of which require refrigeration for freshness.  We have been taking multiple individual supplements for years.
  • What do we do if our luggage is lost or stolen containing all of our daily medications? Do we need to bring along copies of our current prescriptions, written letter explaining the use of medical syringes, if applicable, etc.? Yes! Yes! Yes! We have copies of all of our prescriptions and a doctor’s letter listing all of the supplements we use. Even so, we had trouble boarding a Carnival Ship in Belize (see the posts of April 9th and 10th, 2013 for details of our ordeal).  Also, we carry several Epipen syringes, in the event, we have an allergic reaction (anaphylaxis) to stings from insects or other substances, including a doctor’s letter of authorization.
  • Will our insurance pay if we become ill?  Do we need to purchase emergency evacuation insurance?  Is it costly? Every policy is different.  Check with your policy benefit well in advance of travel to determine what will or won’t be paid. Generally, Medicare usually doesn’t pay outside the US, but check on your supplemental policy’s terms and conditions.  Emergency Evacuation insurance is a must if you’re traveling outside your home country unless your regular policy provides this coverage. Check for specific details well in advance of travel.  On its own, emergency evacuation insurance usually is US $200 to US $300 per person for a two-week vacation. Keep in mind, that “travel insurance” and “emergency evacuation insurance may be entirely different from one another; one if in case of cancellation on non-refundable fares, etc. and, the other is for medical purposes. A few policies have both features combined. Check carefully for details.
  • Do we need vaccinations to travel abroad?  Again, check with your local travel clinic, a highly valuable resource when planning a trip abroad.  Countries in Africa may require proof of vaccination for Yellow Fever and other communicable diseases.  We keep a copy of our entire vaccination record (we had around 18 separate vaccinations) on the inside flap of our passport holders. We haven’t been asked to produce these records yet , but entry into a country can be refused if not provided.
  • How much in advance must we plan for the vaccinations? We both began the vaccination process 6 months in advance of our departure from Minnesota.  Many vaccines require waiting periods between boosters.  Many vaccines may be given at one appointment, which is not detrimental to their efficacy.  The question becomes…how will you tolerate multiple vaccines in one appointment? If dubious, space them out as I did with no side effects.  Many vaccines such as Yellow Fever don’t require a booster for 10 years.
  • Did our insurance cover the cost of the vaccinations?  At the time we had the vaccines, both of us were covered under Tom’s policy from work which much to our surprise, paid 100% of the cost.  With the number of vaccines we chose to receive, the total cost would have been over $1500 each.  If you have Medicare or under the new guidelines, this may not be covered. Please check with your company to determine what, if any is now covered.
  • Will the tours and excursions in which we plan to partake fit within the confines of our current physical conditions and limitations?  Most tour operators specific the “difficulty level” of each of their tours and excursions.  However, these are often minimized, leaving participants gasping for air and exhausted or perhaps at severe risk.  Read reviews and comments online at travel websites such as Cruise Critic and Trip Advisor.  These comments are often a better resource of “factual” information as opposed to the sales orientated tour companies and cruise lines.
  • Did we bring along extra prescription eyeglasses, contact lenses, and supplies, (and hearing aid batteries, if applicable).  What if we lose any of these?  How do we plan to replace them?  We both have our optical prescriptions with us, even if they expire.  In the event of a loss, most prescription eyewear and contacts can be replaced locally or through the mail.  Tom has three pairs of backup prescription eyeglasses and sunglasses. I brought along 24 boxes (6 packs) of contact lenses enough to last three years. I do purchase lens solution at a local pharmacy due to the added weight of the bottles which may be difficult to find in some locations (Belize and Italy).
  • If we use any particular medical supplies, what happens if they’re lost or quit working? Although Tom nor I use any particular devices, we suggest bringing a backup in the event of loss or failure.  We do have a thermometer, small blood pressure cuff, emergency suture kit, and emergency dental supplies (dental glue) in the event a crown or filling falls out or dislodges.
  • What over the counter medications did we include? We packed Aleve, Tylenol, Tylenol PM, aspirin, Milk of Magnesia and Benadryl, cortisone cream, antihistamine cream, antibacterial cream, and hydrogen peroxide.
  • What first aid supplies did we bring? Besides the above comments above, we have Bandaids, bandages, sterile gauze pads, sterile gauze wrap, ace bandage, liquid bandage, and Lidocaine patches.
  • Immediately upon arrival,l in a new location, what precautions do we take in the event we become ill or injured? Upon arrival at our new home, we ask the owner/landlord or property manager the location/phone of the best local hospital, medical clinic, physicians, and dentists in the event of any emergency. For example, here in Kenya, we have the phone number of a physician who will make a house call in the event of a non-life-threatening emergency.  Otherwise, there is a hospital within 10 minutes on the main road.

Yes, I know, this stuff is difficult to address. And for many of you who seldom travel it may be boring. But, for those who travel even short distances on a day-long road trip, being away from one’s home base can present challenging health concerns.

Years ago, I was meeting up with a bunch of girlfriends in Mexico for pre-arranged dinner plans. When they hadn’t arrived after a two-hour wait, I tried calling to no response. A day later, I received a call from one of the other friends in the group informing me that the friend had fallen into a hole under a “grate” on the sidewalk resulting in a serious compound fracture of the leg.

The only way to receive quality medical care was to return her to the US immediately.  With her not having emergency evacuation insurance and the requirement of payment in full in advance of the flight with the air ambulance service, the friend had no alternative but to ask family members for their credit card numbers to cover the then cost of US $25,000 when her own card had a US $5000 limit. Can you imagine the stress of returning home facing your own credit card bill, but also that of the cards of family members? That airfare was 30 years ago. Can you imagine how much it would be in this day and age?

This scenario remained stuck in my mind for 2 reasons; one, don’t walk on grates, wooden boards, or any potentially unstable surfaces on roads and sidewalks (in any location). Of course, Tom has adopted this practice also, as we’ve always alerted one another to possible hazards.  And, the second reason, always have an emergency evacuation policy in effect when traveling outside your home country.

Last night, we ventured out to dinner during a massive rainstorm that had started on Monday continuing all the way through today, Wednesday.  As is typical in Diani Beach restaurants, the walk from the taxi drop off area to the restaurant is long and treacherous with uneven steps, many often twice as steep as we’d expect, multiple tripping hazards, slippery surfaces, and the risk of falling tree limbs and coconuts.

Always carrying our LED mini flashlights has proven to be vital to our safety.  Last night, leaving the restaurant in torrential rains and gusty winds, luckily under an umbrella provided by the restaurant, I hung onto Tom for dear life.  If one of us went down, we both were going down. The long, steep outdoor steps were particularly hard to maneuver when their design was inconsistent and there was not a light or handrail at any point.

We both sighed with relief when we found Alfred, our trusty regular taxi driver, waiting for us and quickly jumping out to open the car doors as we handed off the umbrella to the restaurant server who escorted us. We were soaked all the way through to our underwear, but grateful to have made it to the taxi without incident.

No traveler can sit back and make the assumption that they are invincible and exempt from possible injury or illness when traveling.  With all the effort we’ve made, on a few occasions, we’ve fallen prey to unforeseen illness and injury. We can only hope and pray that we’ve exercised more than adequate foresight to guide us through those tough situations.

As they say on a mindless drivel TV show, Big Brother…” expect the unexpected.”  Doing so need not reduce the quality of our experiences or result in needless worrying.  But, preparedness, certainly minimizes the risks enhancing the quality of our experiences.

Oh, oh…Shipboard illness…We’ve been snagged…

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In the past several days we’ve cruised past Saudi Arabia, Sudan, Yemen, Eritrea, Somalia, and today Oman.  “Another safe, uneventful night,” says Captain Fleming over the loud speaker this morning.

Within the next 40 hours, we’ll cruise by Pakistan and Iran. Oh.

Washing our hands no less than 20 times a day has not protected us from catching the virus running rampant on this ship.

Tom succumbed nine days ago, starting with a tickle in his throat, progressing to a sore throat, runny nose and cough.  It was worse than a cold, more like a flu. In a matter of days, he went through an entire $18.95 bottle of Daytime Nyquil, purchased in the gift shop.

With the excursion to Petra scheduled this past Tuesday, he was determined to make the trip, no matter how poorly he felt I’m amazed how well he did on the tortuous three hour hike and four hour bus ride considering how he was feeling.

When Wednesday arrived, the day after Petra, I made a lofty assumption that I had dodged a bullet. With five days passing since Tom’s onset of symptoms, I was yet to have any indications that I’d caught the illness in our tight quarters or while exposed to hundreds of other sick passengers on the bus or in the dining areas.

Alas, late Wednesday afternoon, a tickle started in my throat, later that night to turn into a raging sore throat. As had transpired with Tom, it seemed to get better the second day, only to return with a vengeance on the third.

Now, four days after the tickle began, I’m a mess; achy, tired, raging sore throat, worse at night, with a disgusting useless cough. I’m refusing to see the doctor (I wouldn’t have in our old life). Tom has served me all my food in the restaurant to ensure I don’t touch anything, as I did for him when he was sick.

In the past, I would have done as most of us do, see it through, pampering ourselves as much as we can, hoping it will turn the corner to returned good health.

With no fever or apparent bacterial infection, what would the doctor do? Prescribe antibiotics, which only reduce one’s immune system with the potential for intestinal distress? Plus, as we all know, antibiotics don’t work for viruses, only bacterial infections.

Other possible doctor treatment? Over the counter medications that really don’t do anything other than to reduce the severity of the symptoms for a few hours. As lousy as I feel, I don’t want to sit in the germ-filled medical clinic where we’ve heard that one must take a number resulting in waiting for hours to see the ship’s doctor.

Norovirus has been rampant on this ship. Many passengers we’ve met have gone for treatment, including one of whom had to have IV fluids for several hours. So far, we haven’t been subjected to the ravages of that particular illness on any of our seven past cruises beginning January 3, 2013. With one more cruise scheduled for June 4th, hopefully, we’ll continue to be safe from this dreadful intestinal illness.

Tomorrow, we’ll pack again, to leave our bags outside our cabin door by 10:00 pm, to be picked up and held until departure on Tuesday morning. As always, we’ll carry our two laptop bags and the cloth bag with our prescriptions, utilizing one of our two wheeling carts for ease of movement.

Today’s a day of rest, staying in our cabin, reading, writing and using up the remaining minutes of the packages we’d purchased for the ship’s WiFi. 

Tonight is the final of three dress up nights aboard this ship, Royal Caribbean’s Mariner of the Seas. Having donated the balance of our dress-up clothes to the charity in Barcelona, we’ll be dressing “casual, dressy,” Tom in dress slacks and shirt with me in a long casual dress. It will have to do. 

On this ship, 75% of the passengers dining in the main dining rooms have dressed up for these occasions. At this point, we feel fine dressing casual. Our ease of travel is much more important to us than us showing off wearing in fancy clothing.

As we wind down this cruise, we look forward to our time in Dubai, hoping to add yet another rich experience to our repertoire of worldwide adventures.