Sick abroad…What wll we do?

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The dreaded Neti Pot!

Last Tuesday during the night, I wandered in and out of fitful sleep with my head pounding.  I never get a headache!

Dragging myself out of bed, choosing to ignore the heavy feeling in my head, I went about my day knowing something just wasn’t right.  This feeling continued all week long alleviated to a degree with various attempts: Tylenol, Motrin, and Aleve.  

Saturday morning, awakening with the worse headache yet, now with a stuffy sensation in my nose and head, I realized I had a sinus infection.  In the past, a sinus infection resulted in an immediate visit to the doctor or urgent care for an antibiotic prescription.  

Every few years in the fall, I’ve developed a sinus infection.  Whether it was due to an allergy from ragweed, prevalent at this time of year, precipitating an infection or merely a coincidence, this is a familiar plight.  Antibiotics always work within 24-48 hours, resulting in an enormous sense of relief.

Everything is different now. After the past two years of retirement and obsessively learning more about health online, we now both feel adamant that antibiotics should only be taken in a life threatening scenario.  

Generally speaking, for me, a sinus infection is not life threatening unless it develops into a more serious respiratory or otherwise infection. It is painful and annoying with pulsating headaches, congestion, sinus pain, trouble bending over and rampant lethargy.  It varies for the individual.  (No intention to offer medical advice here. Please see your medical provider for care.)

Why not give in and take antibiotics, I thought several times while bent over the kitchen sink, Neti Pot in hand, pouring warm salted water into one nostril and then the  other?  Yuck!  This is not fun!  

For us, it’s more than the desire to avoid antibiotics at all costs.  We must learn to cope with the inconvenience of minor ailments that we can easily attend to ourselves.

Many times over the years, I wearily visited the doctor, five days into the achy flu, the dry cough, the flaming sore throat, the sore elbow or the swollen knee, convinced that the ailment was only getting worse.  Leaving his office, prescriptions in hand, I already felt better and wondered why I hadn’t just “waited it out.”  Placebo effect, perhaps?  

Yes, it could be.  If so, why can’t “waiting it out” while taking advantage of home remedies, proven holistic and alternative remedies, plenty of rest, lots of fluids and a light diet provide the same end result?  In some cases it may.

So, here is my first illness since last fall, and I am trying it out.  Motivation?  To prove to myself, that while along the way in our travels when we are living on the island of Madeira, (for example) for three months, 1200 miles from the coast of Lisbon, Portugal that we can be proactive as opposed to reactive when it comes to our health.  

It’s about tolerance, creativity, patience and good sense.  Of course, we will seek medical care wherever we may be, if a situation is serious or life threatening.  I will post here with the results of this “experiment.”

The Neti Pot is calling me. I put it off this morning when I stumbled out of bed, head spinning, promising myself I’d do it at noon.  Well, noon has passed.  Here goes!

Smarter science…enjoying good health around the world…

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My neighbor took this photo of me this morning in our yard.

From a family with endless variations of heart disease, raging diabetes, rampant obesity, stroke-inducing hypertension, crippling spine and bone disorders and myriad autoimmune disorders, its been a lifelong battle for me to be healthy, slim and fit. My genes are against me.

It hasn’t been easy.  I started dieting at eleven, exercising at fifteen, feeling as if I were a hamster on a wheel, peddling faster and faster, never getting ahead of the curse I had inherited.  For many, this is not an uncommon plight.  Add raging hormones into the mix, and for many years, a long and healthy life seemed hopeless.  

My wardrobe consisted of clothing in sizes 2-14, my refrigerator stocked with foods for the latest fad diet promising a solution that would make this preoccupation with food and exercise gone for once and for all. I have tried them all.

Somehow, I managed to stay relatively slim and moderately fit, but not necessarily healthy. In all these years, I consumed no fast food, no fries, no burgers, no fried foods, and very few sugary snacks or desserts. Constantly hungry, always craving sweets and struggling with portion control, I blamed it on a my own lack of willpower.

Over the past 40 years, I blindly followed the “government’s” recommendation to eat a low fat diet with “healthy” whole grains, fruits, vegetables and lean meats in small portions.  Nothing improved. I didn’t use butter, mayonnaise or salad dressing fearing too much fat.  I ate six or more servings of vegetables per day and consumed plenty of fiber.  Nothing improved.

My cholesterol and triglycerides were high, my HDL too low, my weight teetered back and forth, I experienced constant pain often feeling weak and unfit. Yet I continued to “work out,” never less than five days a week, often for an hour and a half at a time.  I changed up the workout every month as “they” recommended.  

I walked, I lifted weights with a torn shoulder and arthritic knee, I stretched and I tried yoga.  A few years ago I invested in a BodyMedia device that I wore on a stretchy band on my bicep for two years, measuring all of my activities, aiming at a minimum of 10,000 steps per day. Most days it registered 12,000 steps. But, nothing improved.  NOTHING!!  

So what?  I was active, but my appetite increased the more I moved.  Should I be eating even less and exercising more to get to a level of fitness that would bring me some relief?  I was frustrated and stymied.

When I retired two years ago, I began spending most of my days when I wasn’t struggling at the health club, researching for a solution to the pain, the incessant hunger, the high blood sugar, and a failing exercise routine.  

My legs felt like lead and walking in itself, became almost unbearable. How would I continue working out?   Doing so gave me a few hours of pain relief when I was able to muster up a small surge of endorphins.

A year ago, I began to accept the reality that traditional medicine failed me and that I was doomed to a life in a wheelchair  In desperation, I sought the help of renowned, local chiropractor, Dr. Jamey Antione at the Minnesota Disc Institute, whom I had heard was a miracle worker.  

After reviewing my three MRI’s, indicating advanced joint disease, he suggested a treatment modality which included an inflammation-free diet.  He was adamant that I quit consuming grains, all grains, handing me printed literature about the diet from the famed Cleveland Clinic.

I was eating healthfully, so I thought: lots of whole grains, no white flour, no sugar, organic vegetables, fruits and smoothies made with protein powder, bananas and frozen strawberries. I purchased most of our produce directly from an organic farm during the summers.  It all seemed so right.

Eager to do anything to feel better, I began researching again, hundreds of studies, books, websites regarding anti-inflammation diets all of which led me to two life changing books: Wheat Belly by Dr. William Davis and, months later to The Smarter Science of Slim by Jonathan Bailor. 

Had I not meticulously followed the scientific research and resulting lifestyle changes presented so clearly in these two books, Tom and I would not be able to explore the world for the next many years.  Already slim, I discovered I was “skinny fat”.  Tom, sweetheart that he is, feeling burdened by some extra weight around the belly, followed along with me, subsequently saying goodbye to the debilitating symptoms of Celiac Disease and acid reflux.

Now, a year later, Tom has lost 30 pounds, I am no longer “skinny-fat,” instead feeling lean and fit for the first time. The pain is reduced dramatically, the cholesterol, triglycerides, are way down, the HDL way up (Tom has genetically great numbers. Lucky guy!), my muscles are more defined, my strength has increased 100%, I sleep better, I am never foraging for food an hour after I have eaten and no longer battling high blood sugar and hypertension.

Yes, it has been a huge commitment! Yes, saving one’s life is a huge commitment!   While going low carb, we chose to go wheat-free, gluten-free, grain-free, sugar-free and starch-free.  

We don’t eat any processed foods or corn, rice, potatoes, pasta, cakes, pies, chips or any fruit but berries.  We enjoy nuts, meats, healthy fats, organic, non refined coconut oil, non-starchy vegetables, coconut and almond flour treats.

We’ve learned “why not” of the foods we chose to eliminate by reading Wheat Belly by Dr. William Davis.  I could spend hours here explaining why not.  I won’t get on the soapbox.  I do that enough around my tolerant friends and family.  If you’re interested, read the blog, then the book.  

Then, the next miracle occurred in the search for great health. Months later, still frustrated with my seemingly useless exercise routine, I stumbled across The Smarter Science of Slim by Jonathan Bailor.

Everything changed.  This book is not a book of an author’s opinion (nor is Wheat Belly).  It is backed by 1100 research studies conducted by scientists at Harvard and other universities as to why our diet and exercise routine is not working and, the world is getting fatter and sicker than ever.

The Smarter Science of Slim by Jonathan Bailor provides the otherwise complicated studies (70 pages of references in the back of the book) to prove that “eating less and exercising more” is not working.  

In bite sized, manageable pieces Jonathan gives us an exciting and easy read, driving the reader to immediately jump up and start the amazing workout routine that truly requires only 10 minutes, two times a week.  Hard to believe! Backed by science! Endorsed by scientists at Harvard!

In the exercise world, it is referred to as HIIT, high intensity interval training. It’s a killer 10 minutes, I assure you, pumping your own natural under-used life enhancing hormones to run through your body producing a powerful euphoric and energizing sensation, lasting for days, working to grow and strengthen cells and muscles.

After only three short months of one 10 minute workout, twice a week, I am more fit, more muscular, in better overall condition than I have ever been in my entire life.  My pants fit better, I breathe deeper, I sleep more soundly and I’m able to prepare for our upcoming adventure, able to haul my share of the heavy bags, an impossible feat only months ago.

The food portion of The Smarter Science of Slim by Jonathan Bailor has been easy for me. I had already cut out, what Jonathan refers to as “insane” foods. And, most importantly, I discovered that a vital element was missing from our diet, enough lean protein sources and non-starchy vegetables.

By adding a healthy portion of cottage cheese and green veggies to my protein rich breakfast, protein and veggies snacks and meals and enjoying a giant bowl of plain Fage Greek Yogurt with nuts and berries for dessert at night, I have increased my protein intake from a meager 50 grams a day to 160 grams a day.

I am a new person at 64 years old. If I wasn’t already slim, I would definitely be losing weight. Instead, I eat nuts by the handful to maintain my current weight. For the first time, my metabolism is increasing. I am now able to consume at least 25% more food, finally feeling full!

Jonathan explains how we’ve been slaves to calories and how “a calorie is not a calorie.” There is required no-carb, no-calorie and no-point counting. This is not a quick fix diet. This is not a faddish tricky program that requires strict adherence to peculiar combinations or types of food. It is a simple concept, backed by science, to “eat more and exercise less” while enjoying short but intense workouts and healthy portions of nutrient rich foods as often as you are hungry.

Many who read this will say they can’t give up sweets, bread, corn and potatoes. My life depended on it. It is not a struggle. I am no longer hungry. Nutrient rich food is satisfying the hunger I could never seem to fill.

When man roamed the earth foraging for food, he hunted meat, dug up roots, picked berries and nuts while exploring vegetation fit for consumption. Our bodies are destined for this way of eating. For example, it is no different from our dogs who, by nature are designed to eat meat. Give them cereals, grains and corn in their food and they too become sick, sluggish and overweight.

The topic of this blog will not change to the topic of fitness. It will continue to be abundant in the realities of mine and Tom’s everyday life as we leave behind everything and everyone we have known and loved for all of our lives, as we travel the world for years to come.

It will include how we find foods we choose to enjoy to continue to maintain our health. Of course, wherever we may be, I will continue my two weekly workouts, 10 minutes each!It was important to share this piece of our lives with our readers to illustrate how more meaningful this adventure has become for us, having overcome enormous health obstacles, only possible with the years-long diligent research of a few highly knowledgeable and professional individuals dedicated to science.

We are wiser. We are healthier. We are grateful. We are now able to travel the world hauling way too many bags!

Final decisions on prescriptions dilemma…

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In my post of June 12, 2012 (please see archives), I discussed our concerns for bringing our medications with us while we live about the world, often in remote areas, far from a post office.

We’ve discovered that in certain areas, the receipt of packages is not only risky due to potential theft, but also inordinate delays. The thought of worrying every few months about receiving our refills will be an infringement upon our level of enjoyment.  What me, worry?

In the June post I explained that we had sent our prescription plan a comprehensive package of personal information, our itinerary, lists and reasons for medications, doctor’s information and a completed litany of forms, along with a detailed letter explaining why we wanted to take no less than 12 months of prescriptions with us.  

Thus, we began the wait for approval for our “vacation request.” Three to perhaps 10 years is hardly a vacation, as Tom often reminds me saying, “We will be living, not vacationing.”

In speaking with our doctor, we discussed an annual Skype appointment with him whereby he could “see” us in order to meet his ethical criteria of an annual appointment in order to write refills for yet another year. This was satisfactory to us.

I weighed the package, loading it with postage and left it for the mailman almost six weeks ago.  With no response, it was hovering in my mind to call and check on the status of the request.  Friday, I called.

An hour later, after explaining the story to five different employees, none of whom could find a record of my filing for the request, my temper began to flare. It is seldom that my feathers get ruffled.  But, I knew remaining calm would get better results than to expose my ire.

In a firm, yet pleasant voice, I explained to rep #5 that I needed to be sent to someone who would be able to find the file.  I was sent to the supervisor of the “vacation request” department, explaining a very shortened version of what we needed and focused more on the location of our file.  I looked at my cell phone. I had been on this call for one hour and five minutes.

The supervisor left me on hold, returning a full four minutes later to explain that she had found the file and our request was denied! “Where’s my denial letter?” I inquired.  No response. Finally, she stated, “Your insurance plan doesn’t allow for vacation requests.”  

“Why, may I ask,” again in a calm voice, “didn’t the agent tell me this was the case after I spent an hour on the phone in June asking them how to handle a vacation request and if we were potentially qualified?”

Why did he send me a packet of no less than 10 pages, explaining the process requiring me to include information they already had in their system, asking me to hand write in the forms on the few lines provided?” 

(No, I didn’t hand write in the forms!  I printed the 12 pages of information using our printer and paper, directly from their system!)  She apologized for my inconvenience. I hung up trying to mumble some sort of a thank you. (Can’t escape my ongoing effort to have good manners, I guess.)

Inconvenience? Ha! Doesn’t incompetence sound more like it? Usually, I am a very calm person. My heart was racing. I paced around the room, adrenaline thumping through my body, heading directly to my brain for a solution. I paced. I ruminated. I paced some more. I poured a fresh glass of iced tea. 

I had an idea! Why didn’t I think of this to begin with?

My simple idea was to pay for our own prescriptions out of our pocket! Forget the prescription plan!  Forget the co-pays! Find the best possible prices for a one year’s supply (the maximum time for which the doctor can ethically write)!

The comfy chair was calling me. Sitting down, with the frosted glass of iced tea in hand, I grabbed my laptop quickly bringing up our prescription plan records to determine the co-pays we had paid in the last 12 months. The total was $1542, the new number to match!

Now, the challenge was to find a way to buy all of our prescriptions for one year for as close as possible to this number, thus justifying buying outside of the plan.

My phone in hand, I looked up the phone number of the local Cub Foods Pharmacy and had the honor of speaking to Pharmacist Renee, a breath of fresh air after that grumpy “supervisor.” She confirmed that “yes” we could buy any amount of medications for which we had a prescription. She priced 365 days of each of our combined seven prescriptions. (Numbers coming here in a minute).

Next, I called Walmart Pharmacy. What about their $4 per month prescription? Wait a minute! The $4 theory went out the window when I received the pricing from their pharmacist for the seven drugs. Our drugs were not in the $4 plan.

Here are the cost comparisons for the two locations:

Cub Foods Pharmacy $2445.80

Walmart Pharmacy:   $3022.48

Hum, not good enough. However, Cub agreed to match the Walmart’s best price on any single medication, only a slight improvement in the total, bringing it down to $2390.45, still $848.45 short of our goal.
Gulp. Gulp. Gulp. More iced tea. Wheels turning. Here we go! 

What’s the commotion among senior citizens, without access to a good drug plan, buying prescription drugs from Canada?  I tried to picture myself bobbing up and down on a bus traveling to Canada with a bunch of seniors. 

Fingers flying across the keyboard, 1/2 hour later, web sites searched, reviews read, to discover that CanadaDrugs.com may be a partial solution.

(Please understand, we are not involved in this or any other companies in
any manner, and kindly ask you to do your own research as to what pharmacies/plans may work for you).

While considering the best prices at Cub, based on best prices at Walmart, matching the best prices at CanadaDrugs.com, I came to this conclusion:

We will buy some of the drugs from Cub Pharmacy and the better priced drugs from Canada which Cub can’t match. Considering these two combined costs, we are at $1749, only $207 more than we’ve been paying for co-pays on our current plan, now to pay in full for each drug out of our own pocket, no insurance plan involved.  (I won’t get into politics in this blog, but who’s making money here? Are our own seniors being robbed?)

Before leaving Minnesota, we will purchase our last three months of prescriptions, using the plan and then use the 12 months prescriptions between Cub and CanadaDrugs.com.

We won’t have to worry about prescriptions for 15 months out. Our doctor will write us new prescriptions in a year, while we still have three months on hand, plenty of time to repeat the entire process, while awaiting for the drugs to arrive. Both Cub and CanadaDrugs.com will mail to any address.

Moments later I was back at my laptop, sitting in my comfy chair, smiling from ear to ear, freshened glass of iced tea in hand, realizing that the New with Tags, 100% silk designer tie I was bidding on at eBay for Tom’s dressy cruise outfits, was now up to $2.10 with free shipping and, ending in three minutes.

I won.

1000’s of pills to go?…We’re not kidding!…

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We take vitamins. Do they work?  For us, yes.  How do we take them with us?

OK, here’s the deal.  Over the past several months I have shortened the list of vitamins and supplements that we have been taking, continuing to use those that credible scientific research has proven to be important for some people in some cases. That’s us.

Cutting out any questionable supplements (for us), we have been able to narrow down the list to the following.  (Please be aware that we are in no way suggesting that you take any of these supplements.  Please see your doctor for medical advice.  Supplements may interact with your current prescriptions).

1.  Vitamin C 1000 mg, timed released – Due to our low carb, gluten free, sugar and fruit free diet, we found that supplementing with this vital nutrient is important.  We don’t drink juice or eat citrus fruits.  Tom doesn’t like many vegetables containing vitamin C.  This was our solution over the past several years.  No scurvy!
2.  Vitamin K2 100 mcg – Good for building bone.  After two years, taking this supplement, my DEXA scan improved, taking me out of the osteopenia range and back to normal.  I am convinced this supplement was helpful. 
3.  Alpha Lipoic Acid 600 mg– An antioxidant with many benefits as we age.  
4.  Magnesium 500 mg – Often deficient as we age 
5.  Fish Oil 1200 mg – Tom doesn’t eat fish. Primary used for heart and blood vessels.  As one ages, it appears this may be valuable.
6.  Probiotics 35 billion live cultures – Probiotics can be helpful in boosting one’s immune system and in the prevention of stomach distress while traveling.
7.  Vitamin D3 2000 mg – Tom tends to avoid the benefits of this vital nutrient due to his Irish heritage and light skin.  We have both been supplementing with D3 for some time.
8.  Vitamin B6 50 mg 3 x day – Kidney stone prevention prescribed by urologist.  Seems to be working!
9.  Vitamin B12 100 mcg – Specific to one’s needs.  Worth reading literature.

Do they work?  Are they worth hauling a few year’s supply with us? The topic of supplements is controversial. As we know, the media rattles us with contradictory information; something is good for us, another is not, to later discover they have reversed the advice.  

How are we to know? Check with your physician.  Read the information provided by reputable unbiased medical sites:  Mayo Clinic, National Institutes of Health, CDC and our ability and choice to try what may work for us.

Yesterday, I placed an order for three years of supplements, considering that we also had enough on hand to get us through the next few months.  With free shipping, “buy 2, get 3 free” plus a 10% discount the total $301.51, a chunk at one time but another task out of the way.

Many will ask, “Why don’t you take the minimum with you and buy them abroad?” There are several reasons:

1. Safety – we’ve been buying from this company for years, feeling comfortable that they don’t contain dangerous substances. Supplement sales is a business wrought with illegal activities and ingredients.

2. Convenience – Every few months we’d be scrambling to restock our supply. We want our travels to be as stress free as possible. We won’t be receiving mail and if we did, we’d be paying international shipping costs from our pre-arranged mail service driving up the cost.

3. Peace of mind.

Next time, I will update you on our prescriptions dilemma for which we now
have a solution. Be well.

Responsibility travels well…

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Life is filled with responsibility.  There’s no escaping it.  It goes wherever we may go.  Self discipline is the driving force to commit us to responsibility.  

Some have asked if we will have a sense of freedom, leaving behind work, finally both retired, of the day to day responsibilities of the upkeep and maintenance of a home, a lifestyle we have clung to for decades and the love-centered responsibilities that come with the care and feeding of family and friends. 

Will we feel free and unencumbered by “stuff” that for us, as for most, dictates the tone of our daily lives?

The answers to these questions are yet to come from the upcoming experiences in our near future. It’s easy to speculate as to “how” one will feel when a certain scenario transpires. Anticipation in itself is often fodder for disappointment. How do we temper it?

Perhaps, by facing the responsibilities that will follow us around the world. These thoughts are not in an effort to dampen our enthusiasm. It is to maintain a level of reality that essentially will give us peace of mind that will ultimately enhance our experience.

Loaded with tasks to complete before we leave, we must gather the list of that which will carry with us, not in our overloaded luggage but in our minds and on secure Internet storage. Here are some of these:

  1. File income taxes each year in the same manner we have done while in the US.  Our long time accountant is prepared to do our taxes all via email and documents forwarded to him by our upcoming mail service with our direction.  He will file electronically (as we’ve done for years) and our refund will be deposited in our bank account.
  2. Handle all snail mail through our mailing service.  They will send us a daily list of mail and will scan and email anything of importance.  They will snail mail replacements debit/credit cards and packages for a small fee plus postage.
  3. Apply for necessary visas and maintain second passports. Second passports are necessary in order to submit a passport with each application for a visa.  We don’t want to be in a foreign country without passports in our possession at all times. Second passports must be renewed every two years in the US.
  4. File insurance claims and stay updated on policy changes as to coverage while out of the US.
  5. Handle prescription refills.  We are still awaiting a response for our prescription plan as to providing us with one year of refills at a time. 
  6. Stay updated on both business and personal email/Skype. Email and Skype will be the primary sources of communication with our family and friends. Tom and I are both diligent checking email and will continue to do so provided we are able to receive an adequate connection.  If we have a problem, we will seek out other local Internet resources frequently.
  7. Seek out health clubs at each location.  In Placencia, Belize, there isn’t a health club!  There are hotels with adequate facilities and also private trainers.  As soon as our bags are unpacked, I will be on a mission to establish a relationship with a facility to ensure I can maintain my current level of fitness.  The walking we will surely be engaging in will not be a strenuous enough activity for me, although it may be adequate for Tom.  
  8. Find a dentist every 6 months. Tom and I are diligent about daily flossing and having our teeth cleaned every six months.  As the time nears, we will ask the locals for reliable dentists in the area, paying out of our pockets. Our dental plan will be useless abroad.
  9. Arrange vision exams every two years.  Tom’s family history of serious eye disease and blindness require exams by an ophthalmologist every two years.  Overall, we will be living in remote areas around the world.   Taking the time and bearing the expense to seek out quality care will be a prerequisite.  My vision issues are typical age-related, remedied by mono vision contact lenses.  I have packed a two year’s supply.  Tom will have eye exams and new glasses before we leave the US.
  10. Family members birthdays. All these years we have given gifts to our grown children and grandchildren at the time of their birthdays.  For the future, our gift to our adult children will be occasional plane tickets to visit us for a “free” vacation.  As for the grandchildren, Amazon will be our friend and theirs, where we can purchase gift cards, allowing them to choose something fun from Grandma and Grandpa each year on their birthdays. 
  11. Trip planning.  We have yet to book beyond the arranged 949 days from October 31, 2012.  As the time nears, it will be necessary to book airfare, train travel, ferries and auto rentals. There are some holes in our itinerary that we are holding for the five cruises we want to book that are not posted as yet. Once we are a year out, we will be able to complete some of these bookings, sooner rather than later. Neither of us are “last minute” planners. (As you can see)!
  12. Food shopping. Our special dietary needs will be a challenge wherever we travel.  Finding gluten free, sugar free, wheat free, grain free, starch free, low carb foods will surely be a challenge. Here is another mission for us as soon as we unpack.  If we can find grass fed beef and pork, free range chicken and eggs, wild caught fish and organic vegetables, we will be able to enjoy our meals. We use Greek yogurt, almond flour, coconut flour, coconut oil, unsweetened coconut milk, real butter, spices and Stevia. If these items are available, we will be delighted!  
  13. The constant tracking of all of our expenses. Every receipt and all cash purchases will be logged daily in our expenses spreadsheet to ensure we are staying within our budget.  If necessary, adjustments will be made if we are over the budget to cut back and cover the shortage over a period of months if necessary.  If we are “under” we may choose to dine out more often or upgrade to first class when we have no alternative but to fly. (We are bringing a tiny portable scanner and printer in order to scan receipts, making it unnecessary to haul the receipts with us for years. The printer will provide boarding passes and other documents as needed).
Yes, this list could be overwhelming.  Here in the US, its familiar and a part of our everyday life. From afar? Maybe not. We can only look at these responsibilities with optimism and a sense of challenge, rolling it all into the adventure, chipping away at it, as we go.

As they say, “You can run but you can’t hide.” Hum…

Medical woes abroad?…

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The uncertainty of the quality of medical care in the many countries we will visit, undoubtedly presents us with cause for concern.  Overall, we are both in relatively good health after working so hard to improve it these past few years.

With our healthful, low carb diet of organic, grass fed meats and produce, exercise (mostly me), reduction in exposure to toxic chemicals in our home, low stress and a happy relationship, we feel we can manage our few complaints easily from afar.

Our doctor will be available via the Internet should we have questions and we’ll be well armed with a wide array of preventive and emergency medications should an illness arise.  In the past almost year, neither of us has had a cold, a virus or illness requiring a trip to the doctor.  

Our recent medical appointments have been for the sole purpose of reviewing our travel medications, receiving our vaccinations and having blood tests with an annual exam thrown in for good measure, all of which showed tremendous improvement from a few years ago.  We are hopeful.

Assuming we don’t get bitten by a snake or warthog, break a leg or have a sudden gall bladder or appendicitis attack, we should be fine. But, of course, we must plan for the possibility of illness in the following manner:

  • Emergency evacuation insurance
  • Supplemental insurance for Jess (Medicare won’t pay for any care out of the US). Only 60 at retirement, Tom will be covered by his regular insurance.  Proof of insurance documents.
  • Prescription processing from afar (as mentioned in prior posts, we’re awaiting a response from our prescription plan as to whether they will provide us with 12 months of prescriptions at a time).
  • Emergency medication for infections, bee stings and/or allergic reactions (EpiPen) and gastrointestinal distress.
  • Copies of all of our immunizations (proof of yellow fever vaccine required with passport upon entry into Kenya).
  • Copies of all of our prescriptions (in the event we are asked during customs inspections or going through security).
  • First aid supplies: Bandages, antibacterial and cortisone creams, alcohol, hydrogen peroxide (small bottles).
  • Over the counter medications.
  • Vitamins/Supplements we currently use.
  • Medical records for both of us (scanning these).
  • Optical needs: extra sets of glasses/prescription sunglasses for Tom,  three years of contact lenses for me. Both of us are yet to have our final optical appointments.
  • Final dental appointments and supplies: Our teeth will be cleaned two weeks prior to leaving the US, while visiting Las Vegas over Christmas. The past few years, we both had all the crowns done that we’d needed.  
  • Copies of our living wills and legal designation for medical advocacy in the event of an emergency.
A neat stack of medical forms and documents sits on our kitchen table with Post-it notes reminding me to complete the above tasks on the appropriate dates.  
This Saturday is the free shredding event.  After going through every file  folder, cabinet, drawer and piece of paper in our entire home, we are ready for the event.  No words can describe the freedom we feel from unburdening our lives with paper.  
Other than the required medical documents, passports and  travel documents we’ll need to have on hand, we’ll leave a “paperful” life behind us, instead relying on the latest technology to provide us access as needed.  Yeah for technology!  Without it, planning for this adventure would be more of a headache than it already is!   

The continuing prescriptions saga…

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On May 17, 2012, I posted concerns about our prescription refills when we are out of the US. As is the case with most insurance plans, the servicing mail-order pharmacy will not send more than three month’s of medications at any time.

Writing that post prompted me to contact the mail order pharmacy to request an exception, due to our unusual circumstances of our being out of the country for years as opposed to months.

Here was the conversation with them: 

“We’d like to request that we receive 12 months of prescriptions in October 2012 before we depart for our journey. A year later, we will ensure we are at a location with an address and have you mail them to us for another year. Our doctor has approved this.”

“Oh, we don’t send the prescriptions outside of the US,” he said with authority in his voice.

Hum…I mused to myself. My choice was either to alienate him by complaining about their policy which was surely futile or, give him a proposal. Here’s what I proposed:

“Sir, we will be getting a new address in the US when we establish residency in another state in December 2012.  Also, we will be obtaining the services of mail handling company in the same state.  Could you send the prescriptions, 12 months at a time, directly to that address?”

“Gee, I don’t know,” he quips, question marks flying around his head.

“Can you find out?”  I asked.  This was like pulling teeth!

“Uh, yea. Can you hold?”  The authority was gone from his voice.

On hold for 15 minutes, he returns with his answers. “Thank you for holding. We’ll be sending you forms in the (snail) mail with instructions.” 

“Oh, I have poor handwriting (true).  Can you email them to me or are they available online?”  I asked with the utmost of sincerity.

“No, they have to be snail mailed and completed by hand,” he says, sounding annoyed with me.

Good grief! Where’s my old typewriter?

Within days of my inquiry, we received a packet of complicated forms, stating not only our standard identification information (OK, I get this) including every word on our ID cards (they have this). We were asked to list one prescription per page, reasons for the prescriptions, how long we’d had the illness, the diagnosis and the prescribing physician’s information.  

With our regular daily prescriptions plus an additional prescriptions for preventive and emergency travel conditions, this would result in completing 20 pages!  It would take days.  

Yes, I could manually enter the repeated information, for example; ID information, addresses and prescribing physician information, etc. and then proceed to copy and print the 20 pages, subsequently, manually entering the requested lengthy medical information.  This still would take days!

Yesterday, I called asking to speak to a supervisor, asking that our conversation be recorded (it was) and documented (hopefully, it was) and here was my proposal:
1. Complete one page with the pertinent basic information.
2. Print all of our prescriptions directly out of their system. (They could have done this!)
3. Write a letter, signed by both Tom and I, explaining our circumstances, reasons for the request, including our itinerary for the next 949 days thus far.
4.  Staple this together.
5.  Snail mail.

The supervisor agreed to my proposal.  I reminded him to post it in the system as to his agreement with my proposal.  Otherwise, they will receive the packet, send it back to me, complaining I didn’t fill it out correctly and this entire process would begin again.  Of course, I made copies of everything.

Does this scenario sound familiar?   I’ll keep you posted on the end result.

Worrying about ice cubes…

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As I hauled out one box after another to our overflowing garbage and recycling bins today, a powerful sense of determination drove me to keep up the pace I had started on Monday.  

Yesterday, I had two more vaccinations; the first in a series of three rabies shot and a single Meningococcal vaccine.  The risks of serious side effects from either of these vaccines are fairly low, although approximately 50% of the population experience mild side effects, including flu like symptoms with a fever and/or redness and itching at the site of injection.

After Tom had these same vaccinations last Friday, he felt lethargic, achy and “out of sorts” (his words) over the weekend.  I guess I feel somewhat the same today.

In any case, I kept myself busy all day, making a trip to the auto repair shop to have a valve stem replaced on a tire, followed by a quick trip to Kohl’s to return an item I’d purchased online. While browsing the store, which I seldom do, I happened across a nifty item for our travels, buying two in the process.  Here it is:

Nifty 32 oz. BPH free drink holder
In looking on the inside of the bottle, there is a  1½” cylinder that holds a gel-like non-toxic item, that can be frozen to keep drinks cold.  While worrying about “safe” ice last weekend, I ordered four ice cube trays with lids to ensure we’d be able to make ice from purified water.  
In discussing our endless list of “habits” we’ll need to break living outside the US, we had struggled with the reality that clean, “safe” ice may be a commodity that we will be forced to include on the “goodbye” list.  

By bringing our own ice cube trays and getting settled at a vacation rental, we will fill them with bottled/purified water to make our own ice.  Every property has a freezer and bottled water for our use.

Also, the ice cube trays with lids will function as jewelry boxes for my earrings, bracelets and necklaces, preventing them from tangling. Since customs in some countries require prescriptions to be in the original bottles, we can each use a tray while situated to contain our weekly medications and supplements, thus preventing the necessity of bringing those bulky 28-day pill cases. 
When I had ordered the ice cube trays online last weekend, I had no idea I’d find these sports bottles that will serve us well for our daily doses of iced tea and water. The iced cube trays will be perfect for Tom’s cocktails.  I couldn’t get home from Kohl’s quickly enough to put the cylinders in the freezer so we could test them tonight with our iced tea.  It took about three hours for them to fully freeze.
Here we sit this evening, enjoying our new bottles of iced tea, knowing that we’ll need two more of these bottles allowing another to freeze while we are using one.  Back to Kohl’s in a few days.

The bottles originally cost $12.99 each.  They were on sale today for $5.99 each.  Today, Wednesday, is Senior Discount Day at 15% off, resulting in paying $10.18 + tax for two, as opposed to what would have been $25.95 + tax.  

While at Kohl’s today I also bought a pair of white KEDs and brown slide sandals.  The KEDs worked out great. But, when I walked around the house in the sandals, they hurt my feet and I will return them. 

The total bill for the bottles and the two pairs of shoes was $51.  Kohl’s was offering their “Kohl’s Cash” today, giving me back a $10 gift certificate that may be used for any purchase within a certain date range that happens to fall into next Wednesday.  

I will return to the store next Wednesday to return the sandals and, while there, use the $10 “Kohl’s Cash,” to purchase the two additional bottles for $5.99 each at a total of $10.18 + tax (once again using the Wednesday Senior Discount), use the “Kohl’s Cash,” pay the remaining $.18 + tax and bring home the additional two bottles.  That’s my kind of deal!

The continuing medical concerns…

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When meeting with Nurse Marcia a month ago at the Park Nicollet Travel Clinic, in St. Louis Park, Minnesota, we had discussed the rabies vaccine.  The cost is outrageous at $350 per person per injection, a series of three injections spread a month apart at a total cost of $2100 for both Tom and I. 


At the time, I suggested we hold off on rabies until further down the road. With only a little over five months left to departure date, the time had arrived to investigate this further.  I called our insurance company.  Much to my surprise, they will cover the cost in full! Thus, we decided to proceed with the rabies series.  My first rabies vaccine will begin on June 5th with Tom’s over the next few months.


We made this decision based on a few concerns; one; we will want to explore the bat filled caves in Belize (guano!) next February and two; while living among the animals in Kruger National Park in South Africa in December 2013 we will be exposed to a possible incident.  Surely, these two situations warrant a radical precaution such as the rabies vaccines.  


Is it likely a rabid bat will bite us while riding in an inner tube through the caves in Belize?  Highly, unlikely. Is it possible we will be bitten by a rabid wildebeest while lounging by the pool in South Africa?  Possible, yes. Likely, no.  


We have decided that any precautions we can take in the planning of our lengthy journey will be well spent both in time and in money. Unquestionably, situations will occur that we aren’t able to anticipate at this point, in regard to health and well being and their resulting costs.  


The more we prepare, the less likely we will experience angst and frustration. Remember, our journey…”wafting through our worldwide travels with joy, simplicity and ease,” requires as much preparation as possible.  Thank goodness, we’ve had the time and the determination to plan ahead to this extent.  


Yesterday, I had an appointment with our long time family practice physician, Dr. Dennis Showalter, a fine youthful doctor with a bright smile, kind and uplifting demeanor, sharp knowledge and a passion for his work.  

An advocate of main stream medicine, he and I have butt heads over the years with my penchant for alternative medicine and my obvious obsession with online research, (albeit reliable medical schools, universities and research institutes). All in all, Dr. S. always sought the best course available for any of our various ailments, real or imagined, and has provided the utmost of care.


Now, as our journey approaches, he and I discussed the challenges we may experience along he way, requiring medicine and/or medical care.  Here’s are a few of our concerns and possible solutions:

  1. Prescriptions:  Our insurance company only allows refills every three months with no regard to the willingness of the physician to write the prescriptions for longer periods.  With little access to mail as we flit about the world, receiving the prescription can be tricky.  Solution:  With our mailing service in the US, they can receive the prescriptions and forward them to us at the post office closest to our current location. We must ensure that we have an ample “extra supply of meds” to account for the extended mailing time. In the interim, I have requested a “travel waiver” from the insurance company which I will receive soon and process.
  2. Illness:  How often does one become ill at home in the US in 949 days?  For us, seldom, perhaps a cold or flu once every year for one of us.  Do we normally go to the doctor or get medication in these cases?  No. Tom and I seldom visit the doctor other than the required once a year exam in order to refill our medications. 
    Solution: Dr. S. can accommodate this requirement by conducting an online appointment with us as offered by our medical group. Should we require emergency medical care, we’ll seek out the closest, most highly recommended, medical facility within reach of our location.
  3. Emergency Illness:  Hopefully, we won’t require emergency medical treatment/surgery due to illness or injury. 
    Solution:  Many countries we will visit have excellent medical care and we’d go to the nearest hospital for care as one would here in the US.  If we are in a country with inferior medical care, we will use our then in-force Emergency Evacuation Insurance, a plan we have investigated and yet to purchase. (Many plans will not cover our extended period out of the US.  This particular company, requires an annual renewal.  However, they will provide coverage for us at about $100 a month per person, a cost we have budgeted).
  4. Preventive Medications:  As most of us, from time to time, we use over the counter medication that may provide temporary relief from annoying minor ailments which includes: antihistamines, aspirin, ibuprofen, antibacterial cream, cortisone cream, anti-itch cream, etc. 
    Solution:  Dr. S. and the travel clinic will provide us with prescriptions as preventive measures: Epipen (both allergic to bees), various antibiotics, allergy meds, anti-viral, ear patches (sea sickness, highly unlikely for either of us as long time boaters) cough medicine and other non-narcotic medications in the event we are far from medical treatment.   

In September, after having completed all of our vaccines with the travel clinic, we will book our final appointment with Dr. S. to review all of our medications, conduct last minute tests, perform our annual physicals, and send us off with his medical blessings for a safe and healthy adventure.  

Medicine from afar? Refill our prescriptions? Annual checkup?

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As a health and fitness buff most of my adult life, I have made every effort to stay healthy by eating good homemade food, exercising regularly and avoiding toxins in every way possible.  

Many of my efforts have failed me and I have been forced to succumb to traditional medicine and take a few prescriptions each day, as does Tom for a variety of conditions.  

Yes, I have tried over these past years to gradually reduce these few medications with the hope of stopping them entirely. For example; days later, my blood pressure sneaks up to a dangerous level, prompting me to begin the tiny dose once again, fearful of the consequences. 

For me, it appears my genetics is the culprit. Otherwise, there is nothing in my lifestyle, that I could discover from my years of research as to why I would be plagued with these few ailments. Its frustrating. 

Don’t drink, don’t smoke, don’t drink soda. I consume only organic produce and grass fed beef, avoiding all grains, wheat (inspired by Dr. William Davis’ book, Wheat Belly) starches and sugary food.  I haven’t had a sweet treat of any type in almost a year.  
Each day and night I wear a BodyMedia armband to ensure I get in 10,000 steps a day.  It tracks thousands of measurements including how much time I spend sleeping each night which s usualiy about 7.5 hours.  
I have exercised most of my life, regularly, faithfully and with vigor while currently obsessed with HIIT training as recommended by Jonathan Bailor, backed by 1100 medical studies, 10,000 pages of scientific research, endorsed by some of the top medical professionals in the world, many from Harvard Medical School and the Mayo Clinic.  A great read!

We miss doughnuts.  Years ago, on occasion,Tom and I experienced what we called “MD days,” meaning “multiple doughnut days” whereby we’d eat many doughnuts, watch movies and lounge all day. No more.  We haven’t done this in fifteen years.  I can no more imagine, lying in bed all day and eating doughnuts than going to the moon. (Actually, space travel is on my wish list).

A fast food item hasn’t crossed my lips in 25 years!  And what has it got me:
hypertension, thyroid disease, joint and bone problems and borderline diabetes, the bane of my ancestors, most of them inflicted with these conditions, many of whom suffered and died from these conditions!  
Am I sick? No!  But…I am a slave to these few prescriptions.  Am I slim, physically fit, strong and without any memory issues at my age?  Yes. So, I faithfully take those few little pills each morning, hoping for the best, hoping in time that I will discover a way to toss them all away.

Today, I called our prescription medication plan explaining that when we’ll be traveling for no less than 949 days (so far) asking if they can provide us with at least one year’s worth of the prescriptions to take with us when we leave in 5 months and 19 days.  (We’ll figure out something for the remaining period).  The answer was “no.”They will only do what they’ve always done: if the doctor writes a three month prescription, we only get three months of pills at a time!  I asked, “Are you willing to mail our prescriptions to: Kenya, Africa or maybe Marloth Park, Kruger National Park, South Africa?” There again, the answer was “no.” No mailing outside the US.
Will our prescriptions be mailed to Africa? No.

Tomorrow, I have an appointment with the family doctor, a great guy, who will most likely try to help us figure out a solution.  Yes, we will have a mailing a mailing service with our own address where any important mail will arrive and can be scanned and sent to us by email.  

The service will forward packages to us wherever we may be. However, some countries do not welcome prescription drugs entering the country.  We shall see what transpires and post the solution to yet another dilemma.