Family Health Magazine - PREVENTION
Health Tips for Snowbirds
Staying healthy in warmer climates
In Western Canada we know that winters can be long and harsh. Just as birds head south for warmer climates before winter settles in, many of us feel the urge to escape to warmer areas when winter is most intense. Some go south so often in the winter that they are known as “snowbirds”.
Many go to warmer parts of the United States including California, Arizona, Texas, Florida, Hawaii. Others go further into Mexico or Central America. Travels may be for a month or extend up to four or five months.
Are you a snowbird? If you are, you likely understand that humans should plan their migratory flights a lot more carefully than birds do. Especially when your health is concerned, preparation done before you travel can help prevent serious problems in another country.
Tip 1: Have a complete physical check-up before you leave including dental and eye examinations.
If you have a chronic health condition such as diabetes, heart problems or respiratory illness, talk to your doctor about situations that may cause problems for you. For instance, if you cannot walk up a flight of stairs without feeling short of breath, you should have oxygen available for plane travel. Your doctor can make those arrangements with the airline.
If you have severe allergies, particularly to foods or insect stings, your doctor can prescribe medication to carry with you. If you have asthma, you should carry an inhaler, even if your last attack was years ago.
Tip 2:Plan what you need to take with you.
- Carry enough to last for your whole trip plus an extra week. Medications should be in their original pharmacy containers, properly labelled.
- Ensure you have a written prescription so your medication can be replaced if necessary.
- If you need syringes for a medical condition such as diabetes, it is important that you take enough for the length of your stay.
- Take with you a letter from your doctor that lists your medications, (both the generic and trade names) and explains that they are for your own use.
- Make sure you have your doctor’s name, as well as office and emergency phone numbers.
Some over-the-counter medications may not be available in other countries. Take with you any that you use routinely or if you anticipate any of the following situations:
- pain and fever – analgesic such as ASA (Aspirin™, not recommended for children), acetaminophen (Tylenol™) or Ibuprofen (Motrin™, Advil™)
- allergies – antihistamine such as Benadryl™ or Reactine™
- itching – calamine lotion such as Caladryl™
- motion sickness – anti-nausea medicine such as Gravol™
- stomach upset – antacid such as Diovol™
- diarrhea – anti-diarrhea medicine such as Pepto Bismol™, Imodium™
- serious diarrhea – a three day prescription of antibiotic, usually a quinolone such as Ciprofloxacin™
- cuts and insect bites – antibiotic ointment such as Polysporin™.
- If you have a medical condition, wearing a Medic-Alert™ bracelet is strongly recommended during travel. This could save valuable time in an emergency. In Canada you can phone Medic-Alert™ 1 800 668-1507 or find it on-line www.medicalert.ca. In the United States, contact the Medic-Alert™ Foundation: 2323 Colorado Avenue, P.O. Box 1009, Turlock, California, 95381-1009, or phone 1-800-432-5378.
- If you have severe medical problems, ask if your doctor can give you the name and phone number of a medical doctor at your destination. IAMAT (International Association for Medical Assistance to Travellers) provides a directory of English-speaking doctors worldwide. If you plan to be in several countries, an IAMAT membership may be worthwhile. Their headquarter address in Canada is: 40 Regal Road, Guelph, Ontario, N1K 1B5, phone (519) 836-0102, or their website www.iamat.org. In the U.S., the membership office is: 1623 Military Rd. #279, Niagara Falls, NY 14304-1745, phone (716) 754 4883.
- www.internationalsos.com (International SOS) provides international emergency assistance and medical services.
- Carry spare medical items that might be difficult to replace. These include eye glasses, contact lenses, and batteries for hearing aids or blood glucose meters. If you wear glasses, carry a copy of your current lens prescription.
- If you wear contact lenses take enough cleaning solution for your whole trip.
- A basic first aid kit will help care for minor emergencies.
- assorted bandages, tape
- scissors, tweezers (or Swiss Army knife) (in your checked luggage)
- moleskin (for blisters)
- antiseptic towels
- topical antibiotic ointment
Tip 2:Supplemental health insurance is crucial*
Do not rely on your provincial health plan to pick up the tab if you get sick or are injured in a foreign country. At best, your health plan will cover only a portion of the bill. It is your responsibility to obtain and understand the terms of your supplementary insurance policies. Some credit cards offer their holders health and travel insurance. Do not assume the card alone provides adequate coverage. Remember, too, that even while traveling in other parts of Canada you may need additional health insurance.
Be sure to ask whether or not your policy:
- pays foreign hospital and related medical costs. If so, does it pay ‘up front’ or expect you to pay and be reimbursed later?
- provides for your medical evacuation to Canada.
- pays for a required medical escort (doctor, nurse or companion) to accompany you back to Canada.
- excludes pre-existing medical conditions. If such conditions exist, notify your insurance company and get an agreement in writing that you are covered for these conditions. Otherwise, you could find your claim null and void under a ‘pre-existing condition’ clause.
- covers premature births and related care for newborns. You may be covered, but is your baby covered if the birth occurs while you are away?
- allows for cash advances if a hospital accepts only cash in advance.
- pays for the preparation and return to Canada of your remains if you die while travelling.
Carry details of your insurance with you. Also, tell your travel agent, a friend or relative at home and your travelling companion how to contact your insurer.
Remember to always submit original receipts for any medical services or prescriptions you received while travelling abroad. Most insurance companies will not accept copies or faxes.
If you need medical care, get a detailed invoice from the doctor or hospital before you leave the country you have been visiting. There is nothing more frustrating than trying to get the proper paperwork from thousands of kilometres away.
Tip 2:Remember that old saying, 'An ounce of prevention is worth a pound of cure.'
Your doctor can help you with your existing medical problems before you travel. If your destination presents special risks, a travel health specialist is your best source of information. A travel clinic offers complete information and immunization service to all travellers, whether your destination is Arizona or India. For information on the location of travel clinics in your area visit the Public Health Agency of Canada’s Travel Health website at www.travelhealth.gc.ca.
Before you leave, ask yourself the following questions:
- Is your tetanus and diphtheria (Td) vaccination up-to-date (within the last 10 years)? If you gash your leg while travelling, adequate Td protection beforehand is preferable to facing an injection in another country.
- Have you had your influenza vaccination (flu shot) for this year? This is free for all seniors and anyone with a chronic health problem. The vaccine is available starting in early October every year. The pneumococcal (pneumonia) vaccine is also free for all seniors, as well as for those with certain chronic health problems. One dose of pneumococcal vaccine is enough to provide lifetime protection for most people.
- If you are travelling further south to Mexico or Central America, you should protect yourself with immunization against diseases carried in food and water. Hepatitis A is a liver virus that is carried in contaminated water and food (especially raw or undercooked shellfish). It causes jaundice, nausea and severe fatigue. Hepatitis A is one of the most common vaccine- preventable diseases acquired by travellers and is easily prevented with vaccination. Hepatitis B is another liver virus that is spread through contact with blood or body fluids, including sexual contact and the use of unsterilized equipment in hospitals or doctors’ and dentists’ offices. You may want to consider immunization for both of these diseases with Twinrix™ (combination of hepatitis A and B vaccines). If your travel south of the USA involves going off the beaten track or is longer than a month, you should consider typhoid vaccine as well. If you are a frequent user of antacids, which lower stomach acidity, typhoid vaccine is especially important.
- If you eat in restaurants, you are at the mercy of someone else’s kitchen. The safest foods are those that are freshly cooked and served hot. Beware of undercooked protein foods such as poultry and shellfish, or cooked foods served at room temperature. Creamy foods containing mayonnaise, cream or eggs should be avoided as they cause travellers’ diarrhea. Uncooked foods like fruit and vegetables can be risky if other people have handled them. Although restaurants in Mexico may look modern, travellers’ diarrhea, often known as Montezuma’s Revenge, is common and a sure sign that sanitation is often substandard.
- Make sure that everything you drink is clean. Tap water usually is not clean enough to drink or even for brushing your teeth. Drink bottled water or water that has been boiled. Remember, too, that ice cubes may be frozen tap water and so should be avoided. Tea and coffee are usually hot enough to be safe, and commercial bottled beverages are safe.
- If you will be preparing your own meals, food safety is easier as long as you have proper facilities for washing, cooking and refrigeration.
- Washing hands often and carefully is a hygienic measure that is often forgotten. Use soap and water or a waterless antibacterial handwash such as Purell™ or One Step™.
- If you do get travellers’ diarrhea (TD), make sure you drink enough fluids to avoid dehydration. The medications in your first aid kit (Pepto Bismol™, Imodium™) usually help reduce symptoms until the bug clears your digestive system. Occasionally, TD is more serious and may need antibiotic treatment.
Most travellers’ diarrhea gets better by itself but it certainly does not enhance any holiday. It can cause serious problems for older people or those with health problems. There is now a vaccine called Dukoral that protects against one of the most common bacterial causes of TD. While not 100 per cent effective, it can be useful for some travellers.
- Travel to countries south of the American border may also carry other health risks. Dengue fever is a virus carried by daytime biting mosquitoes. It is found in some parts of Mexico, and throughout Central America and the Caribbean. Cases have even been reported in Texas, since the mosquito is migrating north.
There is no vaccine against dengue, commonly known as break bone fever. Remember that mosquitoes are often disease carriers. Protect yourself with insect repellents (30 per cent DEET) and clothing such as long sleeved shirts and long pants that cover your skin.
A night-biting mosquito carries the parasite disease malaria. If you will be in Mexico or Central America find out which areas are risky. In malaria-risk areas you must be particularly careful with mosquito precautions, especially while you are sleeping. Choose a room with air conditioning or screened windows or use mosquito nets which have been treated with the insecticide permethrin. (These can usually be purchased in Canada from travel clinics.) You may be advised to take antimalarial pills.
- Take your time adjusting to a hot climate. Expose yourself gradually to sun, and avoid too much heat. As you age, you are more at risk of heat stroke. Drink plenty of water to avoid dehydration. Do not wait until you feel thirsty. Drink enough to keep your urine a pale colour and remember that coffee and alcohol can worsen dehydration.
- Sun effects can be deceiving. Avoid sunburn by wearing a good sunscreen of at least 15 SPF (sun protection factor) with UVA and UVB protection, and by wearing a sun hat and sun glasses. Stay in the shade during the periods when the sun is most intense (11 a.m. to 3 p.m.).
- It is great to be away from the snow, but unless you are used to regular exercise, increase your activity gradually.
- Be cautious when travelling in a foreign country. Make sure that you observe and follow local laws and customs.
- Road safety is important. Wear a seatbelt, if one is available. Hire a local driver or ask your hotel to recommend a reliable driver or taxi service. Avoid travelling on overloaded minibuses, or at night, if possible. Don’t drink alcohol and drive, or drive with anyone who has been drinking. Try to travel with others rather than travelling by yourself.
- There can be a tendency at all inclusive resorts to think, ‘it’s all paid for so I’ll eat and drink everything.’ You still need to think about the safety of everything you put into your mouth.
Does all this planning and preparation make you wonder why you want to travel? Is being a snowbird with a plan worth the effort? It most certainly is! There can be a lot to consider about your health, but with a travel clinic and your family doctor to help you, this planning can be done efficiently. You can then wing your way south, confident that you have done everything you can to ensure a healthy winter.
*The information in the section Supplemental Health Insurance (TIP 3) is based upon “Bon Voyage, But… Tips for Canadians Travelling Abroad. It is produced by the Department of Foreign Affairs and International Trade and is available from the passport office, or on line www.voyage.gc.ca.
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2015, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 2S6 [PR_FHd08]