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How to prepare for getting sick on a summer vacation

Written by Ben Allen, General Assignment Reporter | Jul 24, 2014 4:00 AM

(Harrisburg) -- The health care system can sometimes be described as a tangled maze, a labyrinth, or maybe even a puzzle. So, what happens if you get sick while traveling?

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Photo by Ben Allen/witf

Pinnacle Doctor John Goldman leads the Travel Clinic at its Harrisburg office.

It’s vacation. The car is all loaded up, DJ Jazzy Jeff is playing, the windows are down, and the sun is shining. In other words, life is good.

And then, like a record scratch on the turntable, the last thing you want to happen, happens.  You get sick.

"I think it gets exacerbated, because obviously, if you're at home and you get sick and "Ooooh I have to call off work, big deal'," says Dominic Salvatori, who’s from Pittsburgh and visiting Gettysburg.

"But when you’re on a vacation, it’s like 'Hey I’m on vacation I want to enjoy myself' and then it can really interrupt your routine."

While Salvatori didn’t get sick on this swing through Gettysburg, he has needed medical attention on previous vacations. Fortunately for him, his wife is a nurse who recognized the problem and got him help.

Preventing sickness before leaving

Pinnacle has been running a Travel Clinic for at least 20 years. It’s inside the a nondescript office off Union Deposit Road in Harrisburg, and looks no different than any other doctor’s office. The topic of conversation isn’t quite the usual doctor’s visit chatter.

"We will do counseling. We'll do things on how to avoid mosquitoes, particularly for diseases like malaria. How to do good food and water precautions so that you don’t end up getting simple things like travelers diarrhea, or more exotic things such as typhoid or Hepatitis A," says Doctor John Goldman, Director of the Travel Clinic at Pinnacle Health.

Goldman says the key is to get to the clinic 2-4 weeks before taking a trip. That gives the vaccines time to take effect.

Getting care while on the trip

There are a couple different options.

First of all, if visiting family, it might mean seeing their primary care physician.

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Photo by Ben Allen/witf

A U.S. Ranger talks to a tour group at the Gettysburg National Military Park.

But in the event that a doctor is unavailable, urgent care centers have become more and more popular.

"We see European visitors, Asian visitors. Often the Asian visitors are visiting family, Europeans visitors are often here touring the United States. It's not infrequent at all. Probably 5 to 10 people a week at least in that category," says Doctor John Surry is Medical Director at Patient First, an urgent care center in Mechanicsburg, Cumberland County.

The number of patients is relatively steady throughout the year.

But with foreign patients comes different challenges. Translation services are available at Patient First, and also staff has to decode some terms that no translation service could figure out.

"There a few drugs that are not even available in the United States, so we have no knowledge on those, and that’s probably the most challenging group. The other drugs, it’s just a matter of the nomenclature. So you have to decipher what they’re using it for," says Surry.

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That’s when Google is Surry’s best friend. He’ll often look for any medical roots in the drug name and go from there.

Penn State Hershey Medical Center deals with similar issues. Call it the "information gap".

"When you have a patient who may have a large complex, medical history and they’re from many states away and out of town and they don’t carry their medical history with them, it's always a challenge to get that information in a clear and concise way," says Dr. Chris DeFlitch, an Emergency Physician and Vice Chair of Hershey Med’s Department of Emergency Medicine.

He says it gets more critical for information when an emergency comes up.

DeFlitch says carrying a one sheet medical history is a good idea. You can add prescription drugs you’re currently taking too, so doctors can assess any reactions you might have.

The follow up

Walking out of an urgent care center or a hospital is a good first step. But those in medicine preach continuity of care. Going to a place far from home requires a couple more steps to make sure your family doctor is informed.

Says Doctor Surry: "The ones that I worry about are the ones we see tonight and then the next day, they’re taking a plane home. So we have to make sure they understand it’s critically important to follow up with their family physician."

He says print out a sheet of the diagnosis and treatment to send home with patients.

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At Penn State Hershey, DeFlitch takes it a step farther: "We have a pretty robust way to distribute this information, electronically after the patient leaves, even if the patient’s primary care physician is states away."

That means zipping it off to a doctor through the Internet, or by fax if that works better.

Coordinating with insurance

The best advice is to check with your insurance company. There’s traveler’s insurance, which is highly recommended by health care professionals. 

"Well the program is called Blue Card Worldwide. It assists blue plan members traveling or living outside the U.S., Puerto Rico and U.S. Virgin Islands, in obtaining medical services," says Barb Maclay at Capital Blue Cross.

There are some hoops to jump through: you have to make sure you’re eligible for the coverage, sign up before a trip, and then coordinate with Blue Card staff when abroad. But Maclay says that’s for good reason.

Adds Maclay: "What we're trying to do is not imposition the members. What we're trying to do is give them assistance in finding the quality of care and knowing that they're going to be taken care of well. Give them clinical expertise. A clinician is involved in the coordination of the members care, so that’s a benefit to the members."

In the end

From Pinnacle’s Travel Clinic to urgent care to Penn State Hershey to many other hospitals, the biggest issue might be something that isn’t top of mind, says Doctor John Goldman.

"They spend a lot of time worrying about exotic diseases, but the standard, run of the mill, car accidents, trauma, heart attacks is what people typically get in trouble with."

Vacations can sometimes add stress: making your plane on time or finding a nice hotel. But at least if you ever get sick, you’ll have a game plan, and can let the music play on.

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