The continuing medical concerns…

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.  

Just booked cruise #6…

Planning our itinerary so far in advance has prompted questions from our friends, family, and readers.  Why book so far ahead? There are reasons for planning ahead: 

1. Favorable Rental Rates: Booking vacation rentals utilizing some type of contract between the parties; us and the property owner/manager, for a predetermined price, allows for a “locked-in” rental amount without consideration for inflation. One would assume the benefit is all ours, but in reality, this greatly benefits the property owner as well.  
Should the economy continue to dive (as anticipated), it could result in a decline in travel. With a contract, a deposit, and a commitment from us for no less than one month and for as long as four months, the owner is provided a modicum of peace of mind knowing their property is rented in the future to responsible, mature travelers.
2. Favorable Cruise Pricing: Our cruise agency and it’s amazing cruise agent, Joaquin Contreras, not only provide for discounted cruises, membership discounts (such as AARP, military, organizations), and past customer discounts. As I’d mentioned in a previous post, they guarantee the lowest prices up to 90 days prior to sailing. Thus, if we book a cruise for 2014, if and when the price goes down, we get the benefit of the lower amount. To avoid their customers waiting until the last minute to book cruises, this benefit ceases at the 90 days from the sail date.   
Yes, we could wait to book cruises until they offer the lowest possible pricing during the last 30-90 days, perhaps saving a few hundred dollars. However, as we carefully peruse the 1000’s of cruises posted on their website, we notice many cruises are sold out. We’d prefer the peace of mind knowing that we have avoided airports, luggage restrictions, bad airlines, long overnight travel, and jet lag, an annoying consideration that is all but eliminated in the gradual course of a cruise.
3.  Using Cruising as a Mode of Transportation: We will need to book no more than three flights for the 926 days we have planned thus far. If we could avoid these flights by cruising, we would. The difficult, if not impossible locations to reach by cruises are:   
a.  Kenya (due to piracy in the seas) 
b.  South Africa (still awaiting cruises to be posted for 2014)
c.  Madeira (a remote island 1200 miles from Lisbon, Portugal for which there used to be a weekly ferry.  Cruise ships only come to Madeira at certain times of the year) 
Today, we booked our 6th cruise. When we arrive in Barcelona on May 1, 2013, our plan included getting off the ship hauling all of our “stuff” and take a cab to the port of the ferry line to get us over to the island of Mallorca for our pre-planned one month’s visit. We would have spent hours awaiting the next ferry and hours traveling by ferry to the island.  

A few days ago a new cruise was posted. The ship on which we will arrive in Barcelona, Spain, The Norwegian Epic, a repositioning cruise, will leave for a four-night cruise, stopping off in Mallorca the second to last day. The cruise line has agreed to “drop us off” at Mallorca and continue on without us.  

Today we booked our same cabin on the same ship that brought us to Barcelona, Spain, allowing us to continue on to our next destination. Of course, there is an additional cost, around $1100 for both of us, in the same cabin with a balcony. This is called a “back to back.” 

The cost of the ferry would have been around $300 plus food for both of us. What are we getting for our additional $800? Room and board on a fabulous ship for three additional nights, great food, beautiful seas, and romantic walks along the promenade with my honey.  

Adding the cost of the combined fifteen days of cruising from Miami to Barcelona and then, Barcelona to Mallorca, our average cost is $205.97 per night (for both of us) including taxes, port taxes, meals, and entertainment (tips are extra). In looking online for the rates at a local Holiday Inn, 20 minutes away, mid-range, the cost with taxes would be $147.70 per night not including meals and entertainment.  

Now tell me, which sounds more appealing???