Traveling in good health

When you pack your bag this summer, don't forget to plan for medical emergencies and everyday needs. Summertime is travel time for many folks. Trips can be fun,

Tuesday, June 20th 2000, 12:00 am

By: News On 6

When you pack your bag this summer, don't forget to plan for medical emergencies and everyday needs.

Summertime is travel time for many folks.

Trips can be fun, but there are health risks, especially for the unprepared. Carefree, safe travel requires planning for medical emergencies as well as everyday health needs.

The following summer travel guide will help ensure you have a hassle-free summer adventure.

Advance planning

Anticipate potential problems before you leave.

Keep a file detailing dosages, warnings and other information on all prescriptions and over-the-counter medications. This will make a handy, comprehensive reference during travel planning.

Review dosage schedules with your doctor or pharmacist before your trip, especially if you'll be crossing time zones. Allergies, heart conditions, high blood pressure and diabetes may require modified daily regimens.

Check labels for warnings or ask your doctor/pharmacist how medicines may increase your sensitivity to the sun, heat and fatigue, especially if you're pregnant or have a chronic health condition.

Obtain written prescriptions in the event you lose your medications or need a refill. If you purchase medicine while traveling, read the label and follow directions carefully. Ask your pharmacist to translate prescriptions in the language of any country you will visit. Before opening any medication, check for signs of tampering.

Get a letter from your doctor explaining any existing medical condition, treatment or procedure you need to follow. Make sure airline or cruise personnel are aware of any special medical needs.

Make sure your health insurance and information card is up to date.

Emergency medical care/evacuation

Never assume a remote locale or foreign country will offer health care services equal to those you receive at home.

Keep vital health insurance and other medical data on your person, not in checked luggage or in your hotel room. Purchase traveler's health insurance, if necessary.

Carry a list of all your prescription and over-the-counter drugs, vitamins and other dietary supplements with you.

Carry emergency phone and fax numbers of your primary care doctor and pharmacist, as well as of clinics, hospitals, pharmacies and physicians in the locale you're visiting. Also carry the addresses and phone numbers of embassies and consulates along your travel route.

Wear an I.D. bracelet with vital emergency information if you have a chronic or life-threatening condition. Some medical I.D. companies offer wallet-sized cards with your complete medical file on microfilm or a computer chip.

Consider purchasing a medical evacuation policy if traveling abroad, especially in regions with poor or uncertain communications, transportation or medical facilities.

Major "medevac" organizations such as MEDEX and International S.O.S. Assistance have branches worldwide. Check the MEDEX Web site at http://www.medexassist.com or call (888) 633-3900 and the International S.O.S. Assistance Web site at http://www.aeaintl.com/company or call (713) 521-7611 or (215) 244-1500.

Checkups and immunizations

Get medical and dental checkups before leaving on a lengthy trip.

Get required immunizations if traveling overseas. For the latest information, check the Centers for Disease Control and Prevention Web site at http://www.cdc.gov or call (404) 332-4559.

Packing "smart" and safe

Make sure to pack an adequate quantity of prescription and over-the-counter medications. Availability and formulation may differ between countries.

Keep medicines in their original containers. If you take several drugs and use a pill-dispenser, take information regarding dosage, instructions and warnings for each medicine.

Do not stow medicines in checked luggage, and keep at least a day's supply of crucial medications with you when out and about.

Store medicines in a cool, dry place. Heat and humidity can alter their potency.

Keep all medicines out of the sight and reach of children.

Sun Safety

Summertime travel and outdoor fun exposes your skin to several kinds of attacks ranging from merely unpleasant to downright deadly. The key culprits include:

Sunlight: The sun's ultraviolet rays not only can cause painful, blistering sunburns, but can prematurely age the skin and lead to various forms of skin cancer.People with fair complexions and all infants age 6 months and younger are at highest risk. To protect your skin:

Avoid the sun as much as possible between 10 a.m. and 4 p.m.

Seek shade when you're outdoors.

Wear protective clothing including a broad-brimmed hat.

Apply generous amounts of sunscreen rated at SPF 15 or higher to all skin exposed to the sun. Sunscreens higher than SPF 30 are fine but provide only marginal additional benefit.

Use sunscreens containing zinc oxide or titanium oxide, which block most UVA and UVB light, the sun's most damaging radiation.

Put sunscreen on at least one-half hour before going outdoors; reapply often after swimming, heavy sweating and during peak sunshine hours.

Never use sunscreen as a substitute for avoiding the sun if you're at high risk for malignant melanoma, the deadliest form of skin cancer.

Eyecare: Prolonged exposure to direct UV radiation can harm your eyes just as much as your skin. A single unprotected day in a strong summer sun can burn your corneas, the outermost, clear "window" of the eye. Long-term exposure over many years can lead to cataracts or clouding of the eye's lens as well as damage to the retina itself. Eye specialists advise that you:

Wear UV-resistant sunglasses that block 99 percent or more of both UVA and UVB rays.

Shield your eyes from glare. Sunglasses with polarized lenses eliminate most glare.

Pack an extra pair of prescription eyeglasses, sunglasses or contact lenses. Take a copy of your eye prescriptions.

Insect bites/stings

Bees and wasps can be dangerous, even deadly. Ants, ticks, spiders, gnats, mosquitoes and other critters can cause serious pain or infections requiring a doctor's care.

To keep bugs at bay:

Avoid heavily scented toiletries, including shampoos, perfumes and aftershave lotions.

Cover food containers and beverages tightly when outdoors.

Ask your doctor to prescribe an epinephrine syringe kit if you or a family member is prone to life-threatening allergic reactions to stings.

Wear light-colored clothing, and avoid bright colors, such as white, blue or yellow, and flowery prints, which attract bees and other insects.

Walk away slowly and calmly if bees or wasps come close. Don't swing at them wildly, which may provoke an attack.

Sleep under netting.

Check skin, hair, clothing, shoes and bags after a hike in the brush.

Cover as much skin as possible when biting bugs are at their worst.

Apply insect repellent containing DEET on exposed skin. Spray clothes, too, for extra protection. The product should contain at least 25 percent DEET which repels for up to six hours. If you're concerned about using a chemical, try a repellent that has citronella as an active ingredient.

If bitten by a tick:

Do not scratch the affected area. This can lead to infection.

Use tweezers to remove a tick imbedded in the skin. Grasp the tick's head and pull outward without twisting or crushing until the entire tick is removed. Wash the area, apply an antibiotic cream and cover the wound.

If you're attacked by bees:

Run. Don't swat them or jump into a pool or pond. They will wait for you. Keep running until they break off the chase. Cover your head with clothing but leave enough room to see. Seek shelter in a car or building where bees won't follow you.

Remove a stinger as soon as possible. Venom can flow for up to 10 minutes if left in the skin. Use a fingernail, blade or credit card in a sideways motion. Squeezing or pinching the stinger's free end can cause the venom sack to squirt more toxin into the body.

Apply an ice pack to reduce swelling, and a topical cream to relieve itching and pain. Calamine lotion is a popular remedy for reducing inflammation and itching.

Watch for signs of a severe allergic reaction such as tongue swelling, hives, shortness of breath, dizziness or unconsciousness. If necessary administer epinephrine (adrenaline) from a sting emergency kit. Seek immediate medical attention, especially if someone has multiple stings or a history of allergic shock.

Poisonous plants

Poison ivy, oak or sumac are found in every state except Alaska and Hawaii. All three emit a toxic oil called urushiol that covers the stems, leaves and roots.

About 75 percent of the population is allergic to urushiol, which causes a red, itchy rash that appears within several hours to days. The affected area soon swells and develops pimples that merge into fluid-filled blisters. These dry up and become crusty. Untreated, the condition clears up in 1-2 weeks, although severe cases may take more than a month to heal.

To avoid contact:

Learn where these plants are likely to grow and what they look like.

Wear long-sleeved shirts and long pants when hiking off-trail.

Be careful touching tools, gear, clothing or pet hair that may be contaminated. Thoroughly wash them. Don't burn dried poisonous plants. Vaporized urushiol in smoke can irritate your eyes, skin or lungs.

If you come in contact:

Wash the exposed skin with soap and hot water. Cleansing within the first six hours often can avert a rash or minimize its severity.

Do not scratch the itchy rash. Do not break the pimples or blisters.

Apply calamine lotion or hydrocortisone cream to help stop the itching.

Fungal/bacterial infections

Fungi (i.e. athlete's foot, ringworm, jock itch) and bacteria (boils, folliculitis, carbuncles) thrive on skin that's warm, moist and prone to chafing such as spaces between the toes, skin folds in the groin and armpit areas.

Prevention is your first line of defense:

Don't walk barefoot on wet bathroom floors or around swimming pools.

Avoid borrowing towels, combs and hair brushes.

Change socks, underwear and shoes often. Wear cotton socks to absorb sweat or open-toe sandals if your feet perspire a lot. Wear loose-fitting clothes.

Liberally apply anti-fungal powder to feet and other body parts that sweat profusely.

Get lots of rest and eat a balanced diet. Fungal infections tend to strike when your resistance is low.

Treat a superficial fungal infection with prescription anti-fungal cream such as nystatin or tolnaftate. Oral anti-fungal medication may be needed for infections affecting large areas.

Motion sickness

If flying, sailing or driving gives you that old queasy feeling here's what to do:

Consult your doctor about prescription and over-the-counter aids for controlling motion sickness. One of the most effective prescription drugs is scopolamine hydrobromide (SCOPACE). A typical dose is 1-2 tablets taken an hour before travel. A long-acting patch also is available.

Antihistamines including Antivert (meclizine hydrochloride), Benadryl (diphenhydramine hydrochloride) and Dramamine (dimenhydrinate) also can be effective in preventing or relieving motion-induced vertigo and nausea.

Sit in the most stable part of a vehicle such as the front of a car or train, or the middle of a ship or airplane.

Keep your head as still as possible. Avoid bending over to fetch something, then sitting up abruptly.

Focus your eyes on a stable object in the direction of travel. On a ship, look at the horizon or land rather than rolling waves. Don't read or watch television or a computer monitor.

Get plenty of fresh air. Open a car window, go up on deck or aim an air vent in your face.

Eat a light meal about three hours before departure. Stay away from high-calorie, fatty, salty or high-protein fare.

Altitude sickness

If your trip takes you to places more than 5,000 feet high, you may feel the effects of thinner air. Symptoms include headaches, shortness of breath, nausea, dizziness and fatigue. People with asthma, anemia or heart trouble may suffer the most. If you're eager to take the vacation high road:

Ascend mountains no faster than about 2,000 feet per day.

Don't over-exert yourself during your first few days at higher altitudes.

Check with your physician before leaving if you have a breathing or cardiovascular problem that could be affected by altitude.

Get a prescription for acetazolamide (Diamox), a diuretic that helps prevent and relieve symptoms of acute altitude sickness.

Jet lag

Crossing several time zones quickly confuses the body's internal clock. Your wake/sleep cycle gets thrown out of sync. Many travelers become sleepy, stressed out, headachy, inattentive and have unpredictable bowel movements and hunger pangs.

To prevent or reduce jet lag:

Slow down. Drive or go by ship or train. Normally people can adjust their internal clocks as they travel eastward across time zones by one hour per day and westward 1.5 hours daily.

Schedule an early morning flight if heading east or a late flight if heading west. You can more easily stretch your body's natural cycle to the longer day resulting from westward travel than compressing it to fit eastward travel's shorter day.

Adjust your eating, sleeping and working schedule several days before your trip.

Drink lots of fluids en route (avoiding caffeine and alcohol); eat light, easy-to-digest fare; wear comfortable clothes; do periodic isometric exercises in your seat; stretch and take walks in the aisle.

Gastrointestinal distress

It goes by many names -- "Montezuma's revenge," "runs," "turista," and "Delhi Belly." No matter what you call it, traveler's diarrhea can make you miserable. Usually it's caused by drinking bacteria-contaminated water or eating raw or undercooked food.

To keep Montezuma away:

Don't drink or brush your teeth with local water from a tap, well or stream unless it has been purified by boiling for at least 10 minutes or by adding substances such as tincture of iodine or water purification tablets (available at camping stores).

Avoid beverages containing ice made from local water or fruit juices that may be diluted with local tap water.

Drink bottled water, bottled carbonated sodas, wine or beer.

Assume that any well-cooked food is safe, but stay away from raw food, including lettuce and vegetables in salads. Peel fruit and vegetables immediately before eating.

Stick to restaurants with reputations for safety; don't buy food from street vendors.

Thoroughly wipe down eating utensils before dining as they may have been rinsed in tainted water.

If precautions fail:

If you must take something, take Pepto-Bismol