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mnjodette
01-07-2007, 06:50 AM
My husband and I have been discussing taking a vacation this summer (I was too sick to do much of anything last summer.) All depends on how I'm doing, of course. It would involve going out of the country. I'm a little concerned - and my husband is, too - about traveling, particularly out of the country. We worry about what would happen if I suddenly got 'sick.' Have any of you done much traveling since you've been sick? How do you plan for that? What precautions do you take?

Saysusie
01-07-2007, 09:19 AM
My husband and I travel relentlessly (lol). We are almost NEVER home!!
If your travels are confined to the United States and/or our territories, you should fist find out where your HMO has affiliate facilities in whatever states you intend to visit. If you are not a member of an HMO, you need to find out what doctor's and hospitals your insurance will cover in the states that you intend to visit. Locate these facilities on a map prior to leaving on your trip. Make sure that your doctor knows of your trip and how you will be traveling. Also, make sure that all of your prescriptions are re-filled (most doctors will allow this even if you are not due for a refill, if you let them know that you are going on vacation!). Always take a copy of your prescriptions and their instructions with you (along with your prescriptions of course. I always take an extra five days of medications when travelling - just in case of delayed or canceled flights, or when I need to adjust my medications for immediate relief, etc.). Map out your itenerary, if you are doing a lot of driving, and map out reasonably priced hotels/motels along the way in the event that you have to stop to rest (this was a Godsend for us when we took a road trip to Canada - when I began to feel as if I could not sit up any longer, we knew where the nearest hotel was, how much further we had to travel to get there, called ahead and just stopped and spent the night so that I could take my medications and rest).
Pack hats and sunglasses and lots of sunscreen and always drink lots of water!! I also kept babywipes with me as well as a battery operated mini misting fan (wow, that was also a lifesaver!).
Here are some tips if you are planning to travel outside of the country: The most important thing that you should do is to determine what your medical insurance coverage's policy is on treatment out of the country. Learn what medical services your health insurance will cover overseas. If your health insurance policy provides coverage outside the United States, REMEMBER to carry both your insurance policy identity card as proof of such insurance and a claim form. Although many health insurance companies will pay "customary and reasonable" hospital costs abroad, very few will pay for your medical evacuation back to the United States. Medical evacuation can easily cost $10,000 and up, depending on your location and medical condition. Then, you need to contact several rheumatologists in the country you plan to visit and find out what their policy is for treating Americans with american medical insurance. A U. S. consular officer can assist in locating appropriate medical services.
A listing of addresses and telephone numbers of U.S. embassies and consulates abroad is contained in Key Officers of Foreign Service Posts. This publication may be obtained through the Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402. Also available from the Government Printing Office is Health Information for International Travel by the Centers for Disease Control and Prevention (CDC). This contains a global rundown of disease and immunization advice and other health guidance, including risks in particular countries. The CDC maintains the international travelers hotline at 1-877-FYI-TRIP (1-877-394-8747), an automated faxback service at 1-888-CDC-FAXX (1-888-232-3299) and a home page on the Internet at http://www.cdc.gov.
It is very important for you to establish health care providers prior to going abroad. For detailed information on physicians abroad, the authoritative reference is The Official ABMS Directory of Board Certified Medical Specialists published for the American Board of Medical Specialists and its certifying member boards. This publication should be available in your local library. U.S. embassies and consulates abroad maintain lists of hospitals and physicians. What I just learned is that many major credit card companies also can provide the names of local doctors and hospitals abroad.

I hope that this has been helpful!! Perhaps someone else will have some more traveling tips for you!

Peace and Blessings
Saysusie

mnjodette
01-07-2007, 09:47 AM
Invaluable information, Saysusie! I didn't mention this, but the trip is a cruise, so there is at least a basic medical facility on board. If we go we intend to purchase comprehensive travel insurance, and if I remember from past trips medical evacuation should be included in that coverage. I will do all of the preparatory things you suggest. Research, research, research! Adds a new dimension to travel, doesn't it? But, if it's a great trip it'll be worth it! Thanks again.

Jody

Missy
01-07-2007, 10:16 AM
I haven't been on a cruise since I've officially had Lupus, but have been to Europe twice and Mexico twice. I went on three cruises before I had Lupus, but one of them came while I was sick with Mono/Paratitis that very well could have been a Lupus flare.

I always rest when necessary on vacations (this has meant skipping fun activities we already had planned), bring extra Prednisone, and discuss with my doctors beforehand. I'm actually going to Mexico again in February, and trying to work out whether I can/should bring antibiotics for stomach problems.

Anyway, if you have questions about cruising, let me know. I've been on two 4 nighters and one 7 nighter with Royal Carribean. They were great! I would bring lots of wet wipes and hand sanitizer to ward against Norovirus.

Have fun!

MARYCAIN
01-07-2007, 10:55 AM
My job used to involve a lot of national / international travel- my husband's still does, and we've done quite a bit of travelling even after my illness. With all the new security restrictions on flying, getting through the airport screening process seems to be the biggest hassle, so be sure to plan for it beforehand - know what you can and can't take with you, and wear shoes you can slip on and off easily. If you have anything that will show up on a x-ray, like a steel plate or rod in a fracture, be sure you have a letter from your doctor documenting that it is a medical implant. Some thing for diabetics who need to carry glucose or insulin syringes, or anyone who carries injectable meds like an epi-pen - have a letter on your doctor's letterhead documenting your medical condition. Some international air carriers like British Airways have more severe restrictions on carry-on luggage, so check the website of whichever carrier you choose to find out if they have any special restrictions. As far as medicines, you have to be sure all your prescriptions are in the original containers, not in a pill organizer, and it's safest to keep them with you in your carry-on luggage if possible in case your luggage is lost. If you're planning a trip to somewhere exotic, you may need immunizations before you go, or malaria prophalaxis. You can find out about any travel warnings for particular countries by going to the US State department's website -www.travel.state.gov - or the CDC website. Always make sure your tetanus and other immunizations are up to date before you go -diseases like mumps and measles are still very common in most non-European countries. I always take a "first-aid kit" with things like band-aids, antibiotic wipes, ibuprofen, a digital thermometer, and antidiarrheal and nausea medicines with me rather than try to locate them in a strange place. I also take a letter from my doctor briefly outlining my medical history, allergies, and any special things that need to be done in case of an illness or emergency. Depending on where I'm going, I may also take a list of emergency addresses like the US Embassy or Consular offices for wherever I'm going, and a list of English speaking doctors if I'm going somewhere like Egypt where I know getting medical care could be a problem. Remember if you are taking prednisone, imuran, cellcept or any immunosuppressive meds - you are much more vulnerable to disease and infection, so you don't want to choose a travel destination where something like TB is endemic. Your doctor should know if there are special concerns or precautions for a particular area, or again, you can find that out on the State Dept. travel website.

Most diarrheal diseases are transmitted through water, so it's not a good idea to drink tap water anywhere - don't even use it for brushing your teeth. I use bottled water for everything including tea and coffee even in "western" hotels. I have a little thing called a shower ball that is is a portable water filter that attachs to the shower head or bath tap to purify the water. Depending on the destination, I may also take a small water purification kit because I've been places where bottled water wasn't available, and boiling water isn't always feasible. I also don't eat anything from outdoor markets or street vendors, or any type of soft fruit that can't be peeled, and no raw or uncooked vegetables of any kind, even salad, no raw milk or dairy products or soft cheeses - even in European countries. If you eat meat (I don't), make sure it is thoroughly cooked - no tartare. "Smoked" meat and fish like salmon is NOT cooked and it can still harbor parasites. I know the different food is part of the adventure of traveling, but finding medical care outside the country is an adventure you don't want. And when your immune system is suppressed, something that wouldn't affect a healthy person can make you very sick indeed. These are food safety guidelines for people who are immuno-compromised - you can ask your doctor for a copy or print something off the internet to take with you.

Remember that as of 1/23/07, you have to have a valid US passport for almost any international AIR destination, including Canada, Mexico. the Carribean, Bermuda, Central and South America, etc. You don't have to have a passport to leave the country, you do have to have one to re-enter by air. So even if you're planning a cruise or land travel, it's a good idea to have a passport anyway, in case there's an emergency where you need to fly back to the US.

If you're not travelling with an organized tour group (and I never am even on vacation), it's a good idea to register with the US Embassy or consular office in the country where you are visiting. That way you can be contacted if there is an emergency, or if there were to be a disaster of some sort (like the tsunami or the hurricanes in Mexico), they can help you evacuate. Most tour agencies register their trips through the State Department, but it's a free service for any US citizen, and a little extra security. Just go to the travel registration website - https://travelregistration.state.gov/ibrs/ - or register when you arrive. Then if something happens that might affect your potential safety in a country, you will be notified. It's sad you have to worry about things like that, but the world is a lot scarier place than it used to be, and there are a lot of places now where Americans aren't that welcome. But there are still a lot of really wonderful places to visit - do you have any ideas about where you plan to go?

MARYCAIN
01-07-2007, 12:04 PM
I posted my response before I realized you were planning on a cruise. I would still recommend getting a passport if you don't have one, because you would need it if for any reason you have to fly back into the US. And starting next year you will need a passport to re-enter the country at all, even at a border crossing.

I love cruises - they are one of my favorite ways to travel for fun. Fortunately I don't get seasick even in bad weather, Michael does - so he starts taking ginger capsules a couple of days beforehand and also uses "Seabands" for motion sickness. I went on cruises a lot more pre-marriage and kids, but they are still fun. I liked the Bahamas and the Cayman Islands back in the days when I could still swim and sun, but nowadays I like the cooler destinations better. My favorite cruise of all time was coastal New England and the Canadian Maritimes on Holland America - we went in fall and the foliage was gorgeous. Alaska and British Columbia are wonderful, especially on the smaller ships that can get to more of the ports, but some of the wildlife areas like Denali aren't easily accessible, so you have to add a land trip to really see everything. I'm an animal person - I'd rather see wildlife than cities, so I used to love adventure tours, but I don't think I'm up for them now! :)

mnjodette
01-07-2007, 01:18 PM
You are all such a wealth of information! My husband is a big jazz fan and we're talking (just talking yet...no commitment) about taking a jazz cruise on Holland America. It includes the North Sea Jazz Festival in Rotterdam in the Netherlands. We'd also be seeing Copenhagen Denmark, Gottenburg Sweden, and Berlin. And we'd do some scenic crusing around Oslo and Hamburg (on the Elbe River.) It's a big deal, so we're still in the dreaming stage. There are a great number of big jazz performers who would be on the cruise performing every day, not to mention the 4 days of the festival in Rotterdam. More jazz than I probably care to take in, but my husband would be in hog-heaven. I think available medical care in those big European cities would probably be very good, but I want to be so overprepared that I won't have to worry about it. I'll keep you guys posted. We might decide it's all just a little too much (too much worry...and too much money!) :)

Saysusie
01-09-2007, 05:41 PM
AHA!! A CRUISE! I LOVE CRUISING. I think that my husband and I have been on, maybe, 11 cruises (from 4 days to 14 days) :lol:
To me, with this illness, it is the best way to vacation. You have no unpacking and repacking...you can go to your room whenever you need to and rest. You are not obligated to do anything at anytime and, whenever you are in the mood to do something, there is always something to do!! Room service is 24 hrs/day and FREE (as are all meals, except those in the specialty restaurants!). I have always contacted the cruise line prior to departure to advise them of my special diet. I have taken a folder of recipe's with me on the cruise, met the Chef personally and given him the recipes. The Chef's have ALWAYS been wonderful about preparing my meals. They've even enjoyed it because it gave them an opportunity to be creative!!! Everyone at my table is always jealous of my special meals..the Chef's work wonders with my limited diet!!
Shore excursions are up to you (for me, that is the best time to stay on the ship and sit by the pool - everyone else is gone and it is so quiet and peaceful). The excursions can be expensive if you take the tours/excursions the ship offers. But, you will find that, at every port, there are local tour groups that will take you on a tour for much less and they will show you much more local sites. Make sure that you only take those tours that are right there at the dock. I would not suggest that you hire taxis!
A word about medical facilities on the ship....they charge you an arm and a leg for their services!! And don't tell them that you have any signs or symptoms of fungal, bacterial or similar illnesses...you will be confined to your stateroom for the duration of the cruise (lol). Been there, done that..NOT FUN!! It is advisable that you let the cruise line know, prior to departure, that you may have special medical needs!!
Your dream cruise sounds absolutely wonderful!! I know it is expensive..that is always a draw-back. But, believe me...you may find that it is well worth the money.
Because cruising is so stress-free, I have NEVER had any medical emergency. In fact, I always feel better on a cruise because I spend so much time just relaxing, lying around, reading, sleeping or just enjoying the music and the people.
Whatever you decide....I do hope that you have the most wonderful trip!
I would love to see pictures should you decide to take the cruise!

Peace and Blessings
Saysusie

MARYCAIN
01-09-2007, 09:06 PM
You can get a free book from the National Institutes of Health called "Lupus: A Patient Care Guide for Nurses and Other Health Professionals". It is a fairly thorough overview of lupus, its symptoms, possible complications, and information about all the medicines and treatments. You can order a print copy from the NIH for free, or print off a copy directly from the website -

http://www.niams.nih.gov/hi/topics/lupus/lupusguide/outline.htm

I take a copy of this with me anytime I go on a trip, in case I do get sick and end up dealing with a doctor who doesn't know anything about lupus, which has happened a couple of times.

Missy
01-10-2007, 10:19 AM
I agree with Saysusie - my cruising friend and I always would skip the excursions, but walk around for a little while, then spend the day on the ship when everyone else is off the ship. It's a great time to find a chair by the pool, explore the ship, or chat with the crew.

I think cruising is very stress free. However, I think most vacations are stress free, because I'm just so dang happy to be on vacation and I have a great travel partner in my husband (or my best girlfriend, with whom I have traveled extensively).

MARYCAIN
01-10-2007, 10:52 AM
Even though it costs more, I prefer the small ship cruises the best, especially if I'm going somewhere where the destination is really the point of the trip, like Alaska. I've done the cruises on the monster ships that hold 2,000+ people and have casinos and restaurants and vegas-style shows - they are fun when you just need to get away, but I still prefer the small ships, where you get to know everyone on board, shore excursions are part of the trip and you don't have to pay extra, and they go to the smaller destinations that the big ships just can't reach, and can change course easily if there's something interesting, like a pod of whales, or a glacier calving. The amenities aren't as much or as fancy, but the level of service is awesome, and you can really get to do some fascinating things that make for lasting memories. And the dress is always casual, which makes packing a breeze.

mnjodette
01-10-2007, 06:28 PM
We're getting more serious about the trip. It sounds like it may be 'do-able.' Saysusie, I will definitely share pix when/if we go. If we don't do this particular cruise this year, we will absolutely do it next year. (I'm leaning towards this year!) :)

Marycain, we hope to do an Alaskan cruise in the next year or two, and I think you're right about the small cruise ships for that kind of trip. I've been reading about some specialty cruise lines that have all balcony staterooms and travel the inside passage. Some also have land packages available so you can see more of the country if you want (or just hang out in the hotel!) 8) That's what we're hoping to do.

So many places to visit! I'd love to hear about vacations any of you have taken that were really great. Cruises or anything else. My husband retires in 6 months and I'm working part time (and can take off most any time I want to) so we're hoping to really ramp up to some serious travel. (Keeping my fingers crossed for good health!)

Jody

Saysusie
01-11-2007, 10:34 AM
I'd have to say that, of all the cruises/vacations that we've taken, my favorite was the 14 day cruise to Rio. This was on the Celebrity cruise line. We flew to Buenos Aires and boarded the ship there. What I loved about this cruise was that the ship sailed at night and every morning we woke up in a new port. But, the highlight of the trip was Carnivale in Rio. The ship docked in Rio for 3 days and it was our hotel while there. Now, Carnivale is a 24 hour tcelebration that goes on for two days..it never stops! Celebrity crusie line had a reserved section in the SambaDrome (the stadium where Carnivale is held) and buses that took you to the stadium, brought you back to the ship and back to the SambaDrome as many times as you wanted (the buses ran every hour!). Carnivale is a sight to behold...Nothing at all like Madi Gras! The costumes are much more elaborate and each school had at least 1,000 people (and I believe there were over 100 schools). The colors, the music, the singing, the dancing....It is truly hard to describe!
We have talked, often, about taking that cruise again! I have only wonderful memories :lol:

Peace and Blessings
Saysusie

Missy
01-11-2007, 10:56 AM
Even though I live far north, I have never been to Alaska. The weather is such a bummer here, I always want to go south for vacations!

A lot of the Alaska cruises leave from the Seattle area, and I live just an hour or so north of Seattle. I think many also leave from Vancouver, BC., which we are an hour or so south of.

However, the regular Alaska ferry leaves from our city and travels the inside passage, so a lot of people travel to/from Alaska here. My dad used to go to Alaska every summer and after we moved here, he took the train from Oregon up here then took the Alaska ferry throught the inside passage to get to his destination (he had always flown from Oregon before). Traveling the inside passage was something he had always wanted to do and even though it wasn't like the cruise you are going to do, he had a fabulous time. My dad is legally blind and only has partial vision, but still enjoyed the views more than anything. He is so proud of the photos he came back with. I know he would recommend any travel plans that included going that way.

The 3 cruises I have been on have included two from California down the Pacific coast, stopping in Mexico (my favorite place in the world, so far) and one from Florida that covered many ports in the Western Carribean.

Good luck and happy travels!

MARYCAIN
01-11-2007, 11:58 AM
The best Alaska trip we took was Cruise West - a small ship (fewer than 110 passengers), but very nicely outfitted - wonderful food and the staff were awesome. There were lots of shore excursions included in the price - flight-seeing and sea-kayaking for the adventuresome, but also things like a pontoon boat trip to a sea otter colony. . The small ship could get through the narrower passages and ports that we never even saw on the big Royal Carribean ship. And the staff really tried to customize the trip as much as possible - if one of the local fisherman radioed about a pod of whales or something interesting, the captain could vary the route so we could get up close, and the small ship didn't bother the wildlife. The only downside to an Inside Passage tour from Vancouver is not enough time in Vancouver - it's a beautiful city! On our first trip we added the Alaska land trip so we could go to Denali - the second time, we added on extra days in Vancouver at the end of the trip, instead of the Alaska land tour, and it was perfect. There's so much to do and see in British Columbia, it's a great destination in and of itself. And I've never seen such beautiful gardens - if you love flowers, you can spend a whole day just looking at gardens.

mnjodette
01-11-2007, 06:42 PM
Wonderful trips - I'm adding them to my 'wish list!'

About two years ago we took a 12 day cruise that took us through the Panama Canal (into Lake Gatun and and then turned around again to go back out to the Caribbean.) It was wonderful - we visit Costa Rica and did the rain forest canopy tour. We visited Cartegena, Columbia and toured a wonderful old fortress there. The time in Panama was really amazing - visited the San Blas Islands, and did a hike through rain forest there. The canal itself was incredible, too. We went on an Italian cruiseline, MSC Cruises. They've been in the commercial shipping business for many years and recently got into the passenger cruise ship business. Very nice, mid-sized ship. Not for those who want non-stop entertainment on the boat, but it was beautifully appointed, and the crew went out of their way to make you feel pampered. We loved it.