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.

Much to do…Retirement isn’t a free lunch….Photos from dinner in the souk…

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A complimentary bowl of spicy olives is served when dining at Arabe restaurant.
There’s never a day that passes that doesn’t require tasks related to our travels. In reality, it’s comparable to a full time job. Fortunately, we don’t mind doing most of the tasks. Although, it’s easy to lie in bed early in the morning thinking about everything that must be handled, we try not to make ourselves crazy or worried with the responsibility of accomplishing them.
The overlook to the shops below from Terrasse des Espices Restaurant.

Let’s face it. There’s no free lunch. We all have many tasks in our daily lives continuing well into retirement, if not until the end of our lives should we be so fortunate to be able to continue to do our own tasks. 

For most of our readers, daily household tasks and maintenance preoccupy a good portion of each day. Add the responsibility of handling medical insurance, medications, health appointments, paying bills, grocery, and other shopping, visiting family and friends who are ill or in nursing homes, and entertaining family and friends, it is exhausting.

Complimentary bread sticks are provided at Arabe restaurant.  The price of cocktails is high in Morocco, as much as US $10 per cocktail. As a result, Tom doesn’t bother to drink any alcohol. With us dining out three or four times per week, him not drinking could easily be saving us over US $100 per week.

Although we have eliminated some of the above items from our “to do” list, since we no longer have a home, we have other tasks to perform that replace them, mostly wrapped around our continuing travels.

In other words, being retired is not being “retired’ from anything other than going to an outside job each day. The perception that many younger still working people may have is that life is free and easy. Ha! It’s hardly the case.

A pigeon we spotted while dining on the rooftop.  Their cooing sounds permeate the air in the riad each day, along with the crowing rooster who crows every 5 or 10 minutes.

Although at times I consider myself in the retired category, I am far from retired. I work half or more of each day with our website, writing, editing, taking photos, and generally being continually aware of the creation of the inspiration for the next story. That’s hardly retired. The fact that I enjoy doing so is incidental.

Add the financial management, record keeping and the daily task of handling of the budget, logging each penny spent, my days are full, leaving a little time for playing Gin with Tom, watching a few shows and of course, getting out to explore.

This is the usual crowd we must maneuver each time we go out to dine, get cash from an ATM, roam around the Big Square, or to exit the Medina in order flag get a taxi. 

This morning I spent an hour placing our few pills into our pill cases. Tom’s case holds two weeks of pills. Mine holds four weeks. The end result is that I have to do pills every two weeks. Now, this should be an easy task. I take a few prescriptions and Tom takes one. Adding the few vitamins and probiotics we have left and it seems that it shouldn’t take so long.

But, as time has moved on, we’ve used all of our US prescriptions and are now into the one year’s supply of the those we’ve purchased from ProgressiveRX, a reputable online pharmacy company. (They don’t take insurance).  Each pill they dispense is individually wrapped in foil requiring a huge amount of time to get each pill out of the right wrapping.

As we dined at Le Jardin, Mr. Turtle stopped by, hanging out for “crumb patrol.” Of course, we complied with his request for vegetable tidbits from our plates as he stared up at us, which he savored with delight, quickly snapping them up. He rested between bites at my feet.

Today, I unwrapped over 100 pills for the six weeks total of pills I placed collectively in the little cases. As I’ve aged, good grief, I’ve noticed my fingers are not as adept as they may have been 40 years ago. Small handiwork is not my forte. 

Also, several years ago I had surgery on my right thumb and it’s basically useless. Try unwrapping those tight little tin foil packs when right-handed and the right thumb doesn’t work. What a time consuming ordeal.

Mr. Turtle and his companion, another male, scour the floor of the restaurant all day, as customers come and go. The staff feeds them their usual diet of fresh greens but they particularly seem to like the cooked vegetables from our plates.

After performing this task this morning, I thought, “Why don’t I unwrap them all and put them in the plastic bottles I saved from the old pills?”  Simple reason. As we are stopped by airport or cruise security, we’ll fare better with them in the labeled foil packs than in the white plastic bottles I saved that I plan to toss before we leave Morocco.

This morning, I performed the pill task earlier than usual after being awakened at 5:00 am by the crowing rooster next door. He’s obviously going nuts now that its spring, continuing to crow throughout the day, until dark. 

Fresh produce is offered for sale at Le Jardin including these pretty oranges.

Looming in our minds has been the car and flight we still need to book for leaving here in 27 days which invariably proves to be a lengthy process when making every effort to get a good deal. We postponed booking these two items as we considered the possibility of leaving a few days earlier. Now, that we’ve re-framed our thinking, we’re content to stay until our departure date of the 15th of May.

In addition, we still have four more family members to book for Hawaii as we continue to watch rates on a daily basis. We plan to have their bookings completed by the first week of May.

Notice the two buds growing behind the flower.  Photo taken from a tree in Le Jardin a restaurant we’ve found that stays open at all hours.

Yesterday, we created a detailed spreadsheet listing all the places we’d like to visit in the next year including prices and details of possible cruises and the flights to travel to those locations, the cost of rent, rental cars, and other expenses. As a result, we created a budget for the next year. It feels great to have accomplished this task.

When realizing that the cost of our “wish list” was more than we’re comfortable spending, we knew that the next step in the process was to whittle it down to an acceptable level. That it itself is a time-consuming process.  However, that business-related part of me still enjoys creating and updating spreadsheets. Good thing. It’s definitely not within Tom’s skill set or desire to learn.

A hand-carved head on display at Le Jardin.

Assigning tasks to each of us helps to avoid redundancy. At the moment, Tom is researching future travels while I document his research. This works well for us. I’m researching the remaining flights for our family, while Tom keeps checking our booked cruises for rate changes. (If prices drop, we get the benefit of the lowered price, if done so prior to 90 days before sailing).

As a result of the division of tasks, neither of us, ever feels there is an imbalance in responsibility, very important in keeping peace when together around the clock. Resentment over the balance of responsibility is often a source of disharmony in relationships which has never been an issue for us.

As I shot this photo of this parakeet in a cage at Le Jardin, she shook her tail feathers.

Without a doubt, I spend more time “working” each day as I write and post photos. But, the fact that it is a pleasant task, doesn’t make it feel as if it’s work.

As much as life for retirees may seem like a walk in the park, most of yours and our days are filled with tasks and responsibilities, none of which we can easily ignore or postpone.

This guy refused to awaken from his nap while I took these photos.

Maybe next time our hard-working, still working, family members or friends comment about the “easy” lives of retirement, they can ask us how we spend our days. Then, perhaps, they may realize it is not as simple or easy as it appears. Sadly, they eventually find out how difficult it is when we get so old that we can no longer perform our own tasks, and they have to take over.

It’s for all of the reasons we must grab at every moment we can, finding joy, pleasure and meaning in our lives.  And, it’s for this very reason, that we find ourselves in Morocco in spring of 2014, living life to the fullest, the best way that we can.
                                              ______________________________________

Photo from one year ago today, April 18, 2013:

Photo Tom took from our balcony at sunrise, as our ship made it’s way to Sam Juan, Puerto Rico where it spent the day. For details of this date, please click here.

The trials and tribulations of taking prescribed medication while traveling the world….

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The comments here today are in no manner intended to be any form of medical advice. We are not medical professionals. Please see your medical professional for advice and consultation.
Decorative doors in Morocco are common. Some believe symbols and a beautiful door may drive away evil spirits.
Where do I begin? Here we go, me doing my best to describe a situation that easily may become a dilemma for seniors or those taking medications while traveling. No matter how hard I’ve tried I am plagued with hereditary health issues. Since I was 16 years old, I exercised, watched what I ate, stayed slim (except for a few short periods which I later remedied), and lived a healthy lifestyle. 
I was motivated by fear, watching family members fall prey to diabetes with subsequent amputation and untimely death, morbid obesity, heart and arterial disease, thyroid disease, and the painful condition I changed a few years ago by changing to my restrictive diet.
With my efforts all these years, I have no alternative but to take a few medications, one for high blood pressure. But, let’s face it, millions of seniors over 65 take medications for this and other conditions. It’s not unique.
These doors have similarities that many who designed the riads found particularly appealing.
Over the years, I’ve read how to reduce the necessity for medications for hypertension and have made huge efforts to eliminate the need for the medications to no avail. Invariably, the symptoms stayed steady and I was merely kidding myself that I could function without them. 

Luckily, almost three years ago, I stumbled across a doctor who steered me in the direction of this strict anti-inflammation diet that I’ll follow for the remainder of my life, that that has changed the quality of my life, now living pain-free (except for the occasional pain in the bum right shoulder which I’ll gladly live with). Without this change, we’d never have been able to travel for a two-week vacation, let alone travel the world for years.

In some of the narrow alleys, we could only take photos from an angle as shown.

After the first six months on the restrictive diet, all of my lipids dramatically improved from bad to normal. But, the high blood pressure, entrenched deep within my genes, remained. I have no choice but to take medication, most likely for the remainder of my life.

As described in this site many times in the past, taking medication while on a vacation/holiday is not necessarily an issue. It’s imperative to bring more medication than you’ll need in the event of delays, with the medication in it’s original labeled bottles along with copies of your prescriptions in the event you are questioned. Only once have we been questioned about non-prescription and prescription medications except in Belize. Long story.  Here’s the link.

Two interesting doors..
We’ve posted many times as to how we decided to purchase our few medications through a reputable online pharmacy, a year’s supply at a time, to be shipped to us wherever we may be. When down to a remaining four months of a drug, we place our order.

Alas, an order of a few months ago that we received in South Africa via snail mail, had a problem. Before sending the medication, they contacted me by email, explaining the dilemma. The pharmacy company, ProgressiveRX was unable to correctly fill the blood pressure medication.

The drug in question is Lisinopril with Hydrochlorothiazide.  The pharmacy company only had the drug Lisinopril by itself without the Hydrochlorothiazide, a diuretic used to reduce fluid in the body and subsequently in the blood vessels (simplification). They didn’t have access to the combination drug or the two drugs separately. The combination of these two medications, available in a single pill was the only drug that worked for me after trying many combinations years ago. 

We also noticed exceptional doors while we were living in Tuscany last summer.

What was I to do?  Find a doctor to write a separate prescription for the required 12.5 mg dose of Hydrochlorothiazide and then take the two pills together?  Worrying about running out entirely, I advised them to send the 10 mg. Lisinopril by itself and I’d figure out the rest. I didn’t want to go to a doctor’s office in Africa unless it was an emergency with fears of communicable diseases in such a place.

Taking my copy of the prescription to a pharmacy in South Africa provided no options. hey didn’t carry the drug or a reliable equivalent. Knowing that I’d run out of my old supply in the first few weeks in Morocco, I realized I’d have no choice but to try taking the Lisinopril by itself and see what happens. Within three or four days, I could feel that my blood pressure was high. Many do not feel any symptoms from hypertension making it important to have it checked from time to time.

A serious kitty nap at the base of a tree.

I know many of you will write to me suggesting I don’t self treat. Medical care in many countries is sketchy at best, especially with the language barrier. That’s why we have emergency evacuation insurance. 

In fairness to medical professions in every country, surely, there are fine doctors in most countries. Finding one’s way to them is tricky, can be costly and time-consuming. We didn’t determine this dilemma to be a medical emergency at this point.

With Spring Break on the horizon, yesterday the souks weren’t as busy as usual.

Taking a copy of the prescription with me as we wandered through the souks and Big Square on several occasions we stopped at a few pharmacies, none of which could understand the dilemma. Alas, on Monday, before we started our sightseeing tour, Samir directed Mohamed to take us to a certain pharmacy, outside of the Medina.

The pharmacist spoke excellent English. We left her with a copy of the prescription and a short time later she called Samir, explaining she could supply the separate drug, Hydrochlorothiazide in 25 mg pills which I could cut in half and add it to the Lisinopril dose each day. 

(Oddly, I had packed a pill cutter. We’d never used a pill cutter until our precious dog Willie was diagnosed with cancer in 2011 for which we were giving him Morphine, cutting the stronger doses in half over the few weeks until he left us.  If you’re a dog lover, you may enjoy reading the first blog I’d ever written, during his last days of life, written from his perspective. Please click here for the link. Please scroll through the archives to read from the beginning. Get out your hanky).

Occasionally, we’ve seen a modern-looking spa-type store in the souk, often selling the popular Argan oil, thought to be highly effective in treating the skin and hair.

We ordered a year’s supply to supplement our year’s supply of the Lisinopril and we’re good until we’re in Hawaii next March. Today, Samir dropped off the prescription order for which we reimbursed him. Heartfelt thanks to Samir for his assistance in this situation.

The entire cost for the years supply was US $33.20, MAD $270. I can only imagine the cost of this drug in the US for a year’s supply, perhaps as much as 10 times more. (I could drag out the soapbox for that discussion but I won’t at this time)!

Had she only been able to get the combined drug, I’d have no use for the year’s supply of Lisinopril for which we’d already paid the online pharmacy. Luckily, it all worked out well. 

The rooftops in Morocco are also similar to those in Tuscany.

An interesting fact that we’ve discovered in many countries including Morocco, is that pharmacies don’t necessarily require a prescription for many drugs. However, this could make replacing a drug one accidentally left at a home time consuming and frustrating. Also, some narcotic drugs (none of which we take) may be acquired in some countries without prescriptions which ultimately could result in an arrest if one didn’t have an accompanying verifiable prescription on hand. 

I ask myself, “What could we have done differently to avoid this situation?” Not much, really. Now, feeling like myself again after the addition of the second drug and the recovery from the recent illness, we feel we did the right thing.

The last archway we enter on our long trek to Pepenero.

Traveling long term has its challenges. We don’t have all the answers since we, like many of you, learn as we go. Hopefully, today, if one of our readers gleans a morsel of information from us sharing this story, our efforts are well spent.

Tonight, we’re dining in after a fabulous dinner yesterday at our favorite, PepeNero. OK, we’ll admit it, we’re already doing repeat restaurants. But then again, Madame Zahra’s amazing dinners are surely repeats that we can’t resist.

Tomorrow, we’ll share photos of artifacts from the interior of our riad that we’ve found rather interesting.  Hopefully, you will too!
                                                ______________________________________

Photo from one year ago today, March 27, 2013:

Our veranda in Belize was located at the left edge of this sidewalk.  We couldn’t have been closer to the Caribbean Sea than we were.  For the post from that date, 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, packages didn’t arrive!…Are we running out of time?…

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The four of six boxes we received from the pharmaceutical company. We’re awaiting the two missing boxes, hopefully to arrive or be replaced before leaving Italy in less than two weeks.

When living in the US we rarely gave a thought to our few prescriptions.  Ordering online through Medco it was a relatively painless process with the large white plastic bags arriving about a week after placing a refill order.  Once a year we visited our doctor to get newly written prescriptions to comply with insurance requirements.

Now, traveling the world, taking literally everything we own with us everywhere we go, all of our supplies, prescriptions and otherwise, take on a new meaning. It’s not to say that we’re preoccupied with these items. However, we must stay mindful and proactive to ensure that we have everything on hand as needed, avoiding a crisis and its resulting stress.

Early in July we ordered a year’s worth of prescriptions for both of us through ProgressiveRX, a reputable, prescription required, highly rated BBB online pharmacy with the best prices we’ve found so far.

Between us, we take a small handful of medications. Running out of them could be a problem. Having purchased enough to last us the first year in our travels, now  gone since Halloween, 10 months have passed.  We’d have run out while in Kenya.

Tom’s vitamin and pill cases.  Originally, we had four of these cases, allowing me to restock them once a month. Having to ditch two of these to make more room, I now have to refill them every two weeks. Mine is similar. We carry on all of our meds and few vitamins after the incident in Belize when security confiscated all of our vitamins for 24 hours. Lesson learned.

After considerable research and reading online posts, we felt it was too risky to receive a package through USPS while in Kenya with its reported high risk of never arriving or of getting caught up in customs, all of which is less of an issue in Italy. Ordering in July, with our plan to leave Italy on September 1st, made all the sense in the world. 

Unfortunately, ProgressiveRX process is to send a variety of the prescriptions in a variety of small boxes.  With us needing more Z-Pak (antibiotic) since I’d used one in Dubai when I was so ill, extra malaria pills and our few combined prescriptions, six small boxes were due to arrive. 

Two weeks ago, four of the six boxes had arrived, leaving two missing. “OK,” I said, “Let’s give it a little more time.” 

Becoming concerned last week, I contacted the company by email, receiving a prompt response. They suggested we give it a little more time.  By the end of last week, the two missing boxes had yet to arrive. The rep at the company asked that we wait until today to put in a request that the two boxes be replaced and shipped the quickest method available. With only nine business days until we leave Italy, this plan in itself is risky.

Yesterday, I went through the four boxes that each contained a variety of the medications counting every pill, all individually wrapped in childproof shrink wrap plastic packages, to determine exactly what we’re missing. Once completed, I checked the stock against the original order coming up with a list of the missing items.

As suggested, I sent them an email with this list this morning, suggesting that they quickly resend the missing meds. We shall see how this rolls out over the next several days. In my email this morning, I suggested that if the boxes, missing and new, arrive before we leave, we’ll either return the extras or pay for them, preferring to keep them, thus avoiding the necessity of finding a place to mail them.

We have no complaint with the company. They are responsive, providing quality products. This company was recommended to us by the wife of a delightful mature newlywed couple (they hooked up on Facebook after having dated in high school many moons ago) that we met the day after their wedding while in Belize.  She had a home in San Pedro, Belize  but they had decided to have their honeymoon at our resort, LaruBeya in Placencia. Gee, we loved that place. 

In any case, I took her recommendation for the online pharmacy seriously. As an American citizen, she too required a handful of meds having found ProgressiveRX to be ideal for ordering from afar. 

The names of the prescriptions, although containing the exact same ingredients, are different in some cases.  This is important to know to ensure a patient knows precisely which named prescription replaced the familiar name to avoid incorrect dosing.  Should any of our readers’ order through this company, please be careful in observing the named differences. Their website is helpful in defining these different names.

With the time differences in between Italy and the US, it may be hours before we hear back as to what they will do to get the missing meds to us as quickly as possible. We’ll report back here once we know.

Today, our plan was to grocery shop. After looking in the refrigerator and freezer noting the additional meat products we have on hand and seeing our delicious leftovers for tonight from last night’s dinner of Chicken Breasts stuffed with homemade pesto (from the garden on the patio), Parmesan cheese, wrapped in Prosciutto, we’ve decided we can wait until Wednesday. We’ll recalculate our grocery list to get us through 11 more days, instead of the original 13 days.

Perhaps today, a little refining of our items to be packed is in order, a task I thoroughly dread, among other “moving” tasks.”  Oh, I can’t wait to be sitting on the large veranda overlooking the gardens at the house in Kenya; the packing, the excess baggage fees, the three flights, the trip from the airport to the house in the middle of the night and the unpacking will all behind us. 

Prescriptions are on the way…Best pricing ever!…Gift from Santina, with photo…

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Santina cleaned our house this morning, bringing this fabulous plate of “torte” she’d made. How thoughtful she is! With the pie crusts made with flour,  I won’t be able to take a taste, but Tom will definitely try all three of these.  There’s no doubt they are delicious.  I will savor them via my eyes, otherwise known as being a “food voyeur.”

It’s hard to believe that almost a year ago that we purchased a year’s supply of prescriptions, the few we take, to get us through the first year of our travels. By the end of this month, we’ll have been gone for nine months.


Realizing months ago that getting mail in Kenya was going to be sketchy at best, we knew we’d have no choice but to order our prescriptions while still in Italy. 

Keeping in mind that the only way we’ve received mail thus far has been through our mailing service in Nevada (with similar such mailing services all over the US).

Luckily, we were able to make arrangements with the owners of our house here in Boveglio, Italy as to how we’d receive the multiple packages being sent to us from the mail-order pharmacy.  By using our address in Boveglio and the owner’s name on the packages, we were assured the package will arrive at our door.

While posting when still living in the US, we made many references as to how we’d receive a year’s worth of prescriptions.  Our doctor wrote the prescriptions for one year, leaving it up to us to pay for the upcoming full year out of our pockets without using insurance.  The insurance company wouldn’t approve more than three months at a time.

Ironically, the cost of the full year’s of medications was actually less than a full year of co-pays we’d paid for the same prescriptions, each of the prior two years. Hum…

As we priced, our prescriptions using this “new to us” online pharmacy, we were shocked that their prices were $200 a year less than the amazing deal we received from our local pharmacy in the US almost a year ago.  Our local pharmacy had agreed to beat any of the local prices we found at the time, including Walmart. Now, at less yet, we’re thrilled.

For those of you wanting to use this online pharmacy, you need only produce copies of your prescriptions that you may either snail mail or email to the company.  You can do it for one month to three months.  They allowed the 12 months of prescriptions for us, due to our travel schedule which we provided.  They ship free anywhere in the world with a $20 extra fee for the expedited per package. Their customer service is excellent with them quick to respond to email inquiries. I never had to speak to them on Skype.

If one is paying too much for prescriptions, it is certainly worth a few minutes to check their online pricing. Also, this company made the process so easy.  If one doesn’t have the actual prescriptions, they will accept photos of the prescription bottles. This company is approved by the Better Business Bureau and others.

The only hitch for us, we need to be here when they arrive since they’ll be left outside the door.  The anticipated arrival time for us in our remote location could be up to 21 days, which we’re counting off on the calendar.  If ordered in the US, the package(s) will arrive in a few days. Outside the US, it may be a few weeks, requiring one to order well in advance of running out. 

Their website allows for automatic refills which we didn’t do since we’ll need to figure out a new mailing address next summer while in Madeira, Portugal, or Marrakesh, Morocco. 

So often, I’ve talked to seniors frustrated over the cost of their medications. We don’t have to sit back, a captive audience for the prescription plans we are familiar with. It’s imperative in these tough economic times that we reach out for other options to save as much as possible along with convenience.

If you have any further questions, please feel free to post comments or email me directly at jessicablyman@gmail.com. I’m happy to help. Their website is user friendly, so easy to use, even if you aren’t an avid online shopper.

Another consideration at this time is the fact that we’ve yet to hear about what happens with the rental car that we’ve been informed has been sold. We’ve been told to “stand by” for instructions as to when and where the car will be swapped out. 

This definitely limits our previously arranged and later canceled plans to travel for a few days. If they say they are coming to Boveglio on a certain day and we’re staying in a hotel in another remote location, this creates undue stress for us.  The language barrier further adds to the complexity of this situation.

Plus, the six prescriptions we’ve ordered (including more Malaria pills and antibiotics after I’d used a Z-Pak in Dubai needing to replace it) will arrive in six separate packages, possibly on separate days beginning in two weeks. At the moment we feel we must stay put.

Actually, we don’t mind staying put for now. We have much travel ahead of us. The pleasant and fulfilling routine, we’ve established in Boveglio, is all we could ask for at the moment.

We spend most of each day outdoors on the shaded veranda with expansive views in front of us.  Our evenings are full and rewarding. Sleep is comfortable in our bug-free bedroom with the fan quietly cooling us as we languish in the comfortable bed and covers. Our meals are fabulous, mostly easy to prepare. Plus, Tom does the dishes.

Tonight at 9:00 pm, we’ll walk to the “square’ for the weekly gathering at Bar Ferrari making our way back home a few hours later, uphill all the way. The locals, used to the climb, don’t seem to huff and puff as they maneuver the hills. I hope before we leave here in less than six weeks, that we’ve built enough stamina to do the same.

Tom’s day for tests…

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Most often I write the post for this blog every other morning.  This morning, as typical for medical procedures, we must be out the door before 8 am.  Tom is having both his colonoscopy and endoscopy, the final medical tests before we leave the US, four weeks from today.

Yesterday, was “clear liquids only” day.  He amazed me how well he did without a single complaint about hunger.  Since we’ve been on our low carb, gluten-free diet, either of us is seldom hungry, certainly never ravenous. It’s ironic how, when you feed your body what it needs, whole nutritious food, it sends out a few hunger signals.

Recently, we decided to stop eating based on the clock. Could we get our appetites in sync eating whenever we felt hungry as opposed to the time of day? Did the caveman watch a clock and go out and kill his meal in time for lunch or dinner? 

Hardly.  Most likely he hunted and gathered food for himself and his family, preparing it quickly to prevent spoilage which they consumed until stuffed, perhaps not eating again for another day or two.  Maybe we are meant to eat the same way to a degree. 

It’s not so much about hunting for our food in this modern world, but gathering our ingredients to create a healthful, nourishing and delicious meal to be fully enjoyed, eating again only when we’re hungry.  Both Tom and I love this concept.  Over the past several weeks, we’ve had dinner at varying times, huge breakfasts, and no dinner later that day, and now, for the first time, no real food all day.

So, yesterday, when “my hunter” was unable to hunt, I decided that I too would follow along and consume only simple liquids.  In this temporary home, smaller than that which we are used to,  there would be no place for me to eat without him smelling and seeing the food.  His gentle soul encouraged me to have whatever I wanted and he’d be fine. Instead, I decided to join him in this one day fast.

I considered making myself liver and onions, which he dislikes, but figured the smell might be intolerable on an empty stomach.  Instead, we ate a few sugar-free Popsicles, chicken bouillon, sugar-free Jello that I’d made the night before and plenty of iced tea and purified water.  We made it through the evening, hardly giving it a second thought as the day wore on.

At 5 PM he drank the first of two 6 ounce bottles of the prescribed SUPREP (with a ridiculous retail price of $75.  We paid a $25 co-pay) mixed with 10 ounces of water and the same again this morning at 5 AM, each time followed by an entire quart of water within an hour. 

He managed to chug down the 16 ounces of nasty tasting liquid along with the required quart of within an hour.  Nonetheless, it worked. Surprisingly, he slept through the night to be awakened by my cell phone alarm clock going off at 5 AM.  After the same drinking process again this morning, the results continued. All in all, the prep was relatively easy. 

If you have hesitated to have a colonoscopy due to fear of the prep, please reconsider.  A day at home watching mindless TV, lots of liquids, a few minutes of chugging a foul-tasting drink, multiple trips to the loo, and the first phase is over.
 
So, this morning we’re preparing to go out the door for the appointment soon for the second phase.  We’ll be reporting back here later today with what we hope and pray will be great results…that all is well and we may proceed with our plans to travel the world for as long as we want, as long as our health holds out until we get tired until we are sick of our bags or until we find a place along the way, that we mutually agree is truly where we’ll call “home.”  One never knows.

11:15 AM – We’re back from Tom’s test.  His signs of Barrett’s esophagus are gone!  He has no polyps!  The visible signs of irritable bowel are gone!  Dr. Larry Pass, here in Scottsdale, tells Tom to keep “doing what you’ve been doing!”  Our healthy diet has paid off in only 16 months. 

We hoped for this good result since Tom’s acid reflux disappeared within 30 days on this way of eating:  low carb, grain-free, wheat-free, starch-free, and sugar-free (no corn, no rice, no beans, no grains of any type). Plus, he’s lost 50 pounds of belly fat since August 2011!

We’re free to breathe easy knowing we can continue with our plans to travel the world. We are grateful.  We are relieved.  Perhaps, now, we can begin to allow ourselves the privilege of getting excited without trepidation and without hesitation. 

Now I must jump over to Dr. William Davis’s blog and thank him for the great inspiration he offered us when we read his book, Wheat Belly so many months ago.  Thank you, Dr. Davis!

Our final doctor appointments…

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With a degree of angst we headed out yesterday afternoon with empty stomachs in preparation for blood tests to our last doctor appointments, Tom’s and mine scheduled together for a full hour.  I imagine that most people don’t enjoy going to the doctor, but for me it is a dreaded experience.

Doctor, dentist, Ob-Gyn and optometrist all fall into the same category. I don’t like it, don’t want it, don’t want to take my clothes off, don’t want anyone looking in my mouth or other such places and don’t want to stand on that disgusting scale. No, no, no!

We had to go. Yes, I know, it would be our last appointment for a long while (hopefully). Obviously, I have some type of “issues” around this, a mixed bag of good and bad.  That which makes me diligent, impatient, goal orientated and downright persistent adds to my ability to spend endless hours planning our year’s long world adventure. 

On the flip side, it makes me feel “out of control” to have a stranger poking and prodding at me, obviously looking for something wrong as opposed to something right.  Perhaps everyone feels the same way.  Perhaps the only difference is that I am more vocal about it.

So, off we went to our long time physician Dr. Dennis Showalter of Park Nicollet, a youngish (40″), kind, physically fit and smart man, for our final appointments (except for one more travel clinic appointment for each of us, Tom’s later this week, mine in early October).

Greeted with, “Do you have your insurance card and ID?” as opposed to  a cheerful “hello” never ceases to amaze me. I suppose the job of doctor office assistant is demanding, wrought with frustration.  Answering the endless array of the same questions over and over, accompanied by grumpy comments from ill patients (who also don’t want to be there), pushes them over the edge. 

When calling for an appointment they grumble their name immediately asking, “What’s your name and date of birth?”  I cringe while giving them my age, something I am otherwise not ashamed of, having posted it many times in this blog.  I literally cringe.  Knowing their job is thankless, I go overboard with kindness and thoughtfulness, complying with their every wish.

I refused to go on the scale.  Tom was standing right there, edging me on.  I have weighed myself in front of him at home.  I’m skinny, but still, as a woman, I have the same insecurity about “the number.” 

Tom jumps on the scale with an enthusiastic bounce.  I remind him to take off his “three pound tennis shoes.”  He laughs and says he doesn’t care. Oh, yeah, he’s a guy. His weight was five pounds more than at home naked on the digital scale; heavy jeans, tee shirt, keys in pockets, wallet and those shoes.  “OK, maybe the home scale is accurate after all,” I think.

We’re escorted to a room, blood pressures checked by another rushed assistant and left alone.  Tom squeezes my hand aware of my discomfort. He tells me a joke.  I didn’t get it, a guy joke but I laughed anyway. Maybe I wasn’t paying attention.

Moments later, a light knock on the door and in walks the tall, slender doctor, an example of robust health, warmth in his eyes, hand extended. 

An hour later, a year’s worth of prescriptions on hand to be mailed to CanadaDrugs.com (please see my post as to how we’ll handle prescriptions from afar) for the best pricing. (Tom went from four prescriptions down to one from our low carb, gluten-free, sugar-free, grain-free, starch-free diet over the past year). Doc was impressed at his weight loss.  He didn’t ask me why I didn’t get on the scale.  He knows. 

We meandered off to the  lab down the hall to have “every blood test known to man” for one final check before we go on our year’s long worldwide adventure. One test that we determined to be crucial, in the event of an emergency, was blood typing. This information wasn’t in either of our charts.  Good information to know, just in case.Holding hands, Tom and I left the clinic, smiling from ear to ear, me relieved it was over, Tom was anxious to get home to enjoy the remainder of the day he had taken off work for this appointment.  

Thank you, Dr. S.  Hopefully, in a year, we’ll have our online Skype appointment with him to review of our health and refills. Perhaps, we’ll use our portable travel scale and maybe, just maybe, I’ll weigh myself on it!

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.

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!