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Ask Fathom: I'm Sick. What Now?

by Dr. Mark Melrose

Photo: US Army Africa / Flickr

Dear Fathom: I'm sick. And I'm away from home. What should I do?

When you're traveling, the last thing you want to do is get sick. But new climates, new cuisines, and stale airplane air can bring you down, to say nothing of skiing mishaps and ankles twisted on cobblestones. As for pre-planning for medical care, who does that? We usually think of doctors and hospitals when it's too late. We asked Dr. Mark Melrose, co-founder of Urgent Care Manhattan (and frequent surf traveler), for the medical 411 (and 911).

When do I go to an emergency room?

A health emergency exists when there is a sudden and unanticipated change in your usual state of health due to illness or injury that may cause harm to life or limb if not evaluated and stabilized promptly. Use your best judgment; it is always better to be safe than sorry. You just may need to wait if the staff at the emergency facility don't agree with your urgency. (Bring a book or electronic devices for a pleasant diversion.)

For minor emergencies and other immediate health-care needs (I forgot my medication, Do I have strep?, I might have a UTI), look for an urgent care or other walk-in, immediate-care medical practice.

Can I trust a hotel doctor?

Hotels that have a recommended house physician have usually vetted their medics in the same way they would investigate any high-profile employee. Since hotels are not primarily in the health-care business, they are not interested in losing you as a client if the medical service/care is of questionable quality. In general, the quality of the doctor is a reflection of the quality of the hotel. In-room consultations are usually pricey and most often require payment in cash or with a credit card at the time of service.

Are there simple measures I can take before I leave that can my life easier in the event of a medical issue?

Here are six steps to prevent medical problems when traveling:

1. Carry medications in their original bottles and a list of medications and dosages with you at all times. Bring extra, and keep them in two separate, safe places in case you lose your luggage or carry-on.

2. Carry a list of any medical conditions and surgeries and your doctors' telephone numbers.

3. Pack a simple first-aid kit:
- bandages in various sizes
- antiseptic
- antibiotic ointment
- tweezers for splinters
- ibuprofen (Advil) or acetaminophen (Tylenol) for pain or fever
- antihistamine for allergies
- motion-sickness tablets
- anti-diarrhea medicine
- A prescription from your primary care doctor for a broad-spectrum antibiotic to cover skin infections, UTIs, or upper respiratory infections, or traveler's diarrhea will be useful in a pinch.
- While not strictly medical, you'll be glad you packed condoms, sunscreen, and a spare pair of perscription glasses just in case.
(To buy everything, visit FATHOM's First Aid Kit Shop.) 

4. Don't sit in one place for too long (train/bus/plane) to avoid deep vein thrombosis (blood clots in the legs).

5. Make sure your accommodations are user-friendly if you have disabilities or physical limitations.

6. Check the CDC website for travel health alerts and immunizations that might be required for countries on your itinerary.

Will my insurance work when I am overseas?

Check your policy, as well as premium credit card membership privileges, for overseas health coverage benefits before you go — and before you purchase duplicate coverage you may not need.

Should I buy travel insurance in case of medical emergencies?

This depends on your personal willingness to assume risk, your medical history, and the nature of your voyage. If you will be ice climbing in the Andes or scuba diving with great white sharks in Cape Town, or going to a remote location, then travel, health, and medevac insurances are a fine idea. Ditto if you have a chronic medical condition that could confound local doctors.

Would you give the same advice to people who go on active vacations (say, ER doctors who love to surf in Mexico) as you would to people who go to Paris for a leisurely weekend to eat too much?

Find out the local resources before you travel. If you are on an outdoor adventure trip, the guides will often be trained in advanced first aid as EMTs or paramedics. Do your  homework before you travel, and stash local contact info for a hospital or a recommended doctor or two with your other important documents.

SHOP IT

First Aid Kit Essentials 

YOUR TURN

Have a travel question that you can't figure out? We're here to help. Drop us a line at askfathom@fathomaway.com.

Dr. Melrose, the co-founder of Urgent Care Manhattan, has practiced emergency medicine for more than 20 years, and was named one of the area's Best Emergency Physicians by New Jersey Monthly magazine in 2008 and 2009. He travels to surf and in search of uncrowded waves.

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