Tolnaftate

To facilitate the packing of your medical supplies, .1 present an updated version of the previously published article "Suggestions for Your Medical Travel Kit" (July '97, pg 128).

WARNING

Since interactions between drugs can occur, and not all medications are suitable for each person, 'be, sure' to check with your physician and/or pharmacist regarding the appropriateness and dosages of the remedies mentioned below.

The notation (Rx) after any of the following drugs means that the medication is available only by prescription (at least in the U.S.).

ITEMS TO TAKE WITH YOU IN YOUR CARRY-ON

Under this heading, I list all the. items that would cause you to be thoroughly inconvenienced (to say the least) if your luggage were lost. The list can be amended, in accordance with the region in which you will be traveling.

1. Documents

Take with you a list of your health conditions--any allergies you may have, which medications you take and any known drug conflicts or interactions--just in case you are not awake to answer these questions.

Carry a copy of your most recent EKG, as well as the prescriptions for your eyeglasses and/or contact lenses.

Several companies store your vital information and will forward, it on a 24/7 basis to any health practitioner or authorized relative worldwide. Among them are the following:

* MedicAlert[R]

One of the oldest companies in this field, MedicAlert[R] will provide you with a wallet card and a bracelet engraved with emergency information. For more information, call 800/863-3427 or visit www.medicalert.org. org.

* Global MED-NET[R]

This is a personalized emergency medical information service that stores, updates and sends your medical history directly to medical emergency facilities. For more information, call 800/650-7283 or visit www.goeken.com/ mednet/index.asp.

2. Medications

A. Prescription medications (Rx).

Leave these, in their original packaging in order to avoid Customs inquiries. (While this is prudent; I personally never do this and so far have not run into "any problems. If you, repackage your drugs, use a pen with indelible ink, to mark the name and dosage on the label; masking tape works very well.)

Carry separately a list of your medicines' brand names, generic names and dosages.

B. Nonprescription medications that you regularly use.

3. Painkillers for short-term pain relief

I recommend the following (consult a doctor. if distress persists or gets worse):

* Acetaminophen generic. This is used to mitigate pain and reduce fever.

* Acetaminophen with codeine. Not everybody gets relief from codeine and your doctor may have to substitute a derivative of codeine, such as oxycodone.

* Ibuprofen 200 mg. This alleviates menstrual cramps and moderates dental and muscular pain. The dose is listed on the bottle.

Ibuprofen belongs to a class of medicines called. Nonsteroidal Anti-inflammatory Drugs (NSAIDs). If you already take an NSAID, do not add ibuprofen to' your medical kit.

Note that NSAIDs are not innocuous drugs. Among their many side effects are gastrointestinal 'bleeding and/or perforation without warning.

4. Antihistamine

Take an antihistamine with you (even if you have no known allergies) just in case you suffer a sudden allergic reaction. It also will help runny noses.

Carry a once-a-day nonsedating anthistamine, such are Claritin 10 mg (Rx) or the virtually identical Clarinex[R] (Rx)

5. Antidiarrheal medication

Carry both of the following:

* Imodium(r) (over the counter) or generic loperamide (Rs). The latter medication, available in 2mg capsules, often will get rid of your diarrhea completely or, at the least, will make you more comfortable. Be sure to follow the instructions on the bottle.

* Pepto-Bismol[R].

This works both as a preventative for diarrhea and as its treatment. For dosage, read the label: Pepto-Bismol[R] also counteracts the loose stools that so often accompany the use of antibiotics. (Take two tablets with each dose of antibiotic.)

6. Laxatives

7. Antibiotics (Rx)

Ask your doctor or a travel medicine specialist which antibiotic you should take along for sinusitis (if you are prone to this) and which one for diarrhea not responding to Pepto-Bismol[R] or loperamide.

8. Eye drops

* Take artificial tears for dry eyes, often manifested by discomfort, itching or watering. (Yes, a dry eye can cause an eye to be watery. An explanation is beyond the scope of this essay.)

* Polytrim[R]

This is generically available, as a mixture of polymyxin B sulfate and trimethoprim sulfate (Rx), for a red, infected eye. The drops usually are effective in bacterial, but not viral, infections.

9. Motion sickness medication

* Bonine[R] or Dramamine[R].

10. Skin ointments

* Hydrocortisone 1.0% cream for rashes and stings.

* Polysporin ointment for minor skin infections after cuts.

11. Foot powder

* Tolnaftate cream against athlete's foot.

12. Birth control pills (Rx) and/or condoms

13. Spare contact lenses, contact lens fluid and/or glasses and sunglasses

The latter should have 100% UVA and UVB correction.

14. Sunscreen

The strength should be greater than factor 19. Make sure the cream contains no PABA.

15. Disposable needles and syringes You should carry these when you go to countries that don't use disposable needles (in the event that you need to have blood drawn or need injections). If you take syringes, it is a good idea to have a letter from your doctor stating that you can legally do so. (The FAA does permit syringes to be carried on board, with documented proof of medical need.)

16. Altitude-sickness medications

Check with an expert in the field.

17. Hearing aid paraphernalia and batteries

ITEMS FOR YOUR CHECKED LUGGAGE

The items below 'can be packed in your checked luggage:

1. Lip balm

2. Insect repellent

One containing at least 30% DEET, such as Deep Woods Off[R].

3. A water-purifying chemical

You can use an iodine-based water-purifying chemical, such as Potable-Aqua, if no safe drinking water is available and if boiling the water, which is best, is not an option. This product, which you can find in camping stores, is also available as the Potable Aqua Travel Kit, which, besides the iodine tablets, contains a collapsible one-liter bottle and an ingredient to remove the iodine taste.

Note that iodine does not kill Cryptosporidium, a parasite found in contaminated water, which often causes a self-limited diarrhea in otherwise healthy persons.

4. Throat lozenges

Pack theses in case of a tickle in the throat with or without a mild cough.

5. Miscellaneous

* Moist towelettes. The cheapest and easiest-to-use package that I have found is Nice and Clean[R] at K-Mart.

* B and-Aids[R], adhesive tape, bandages and gauze pads.

* Elastic bandage for strains or sprains.

* Swiss Army knife with scissors and tweezers (the latter for splinter or stinger removal).

* A small, pocket-sized magnifying glass, which also, aids in sliver extraction.

* Moleskin (at drug stores), or 2nd Skin[R] Dressing. (Spenco Corporation) for foot blister treatment (at camping stores).

* Thermometer.

6. Include a copy of "The Pocket Doctor," third edition, by Stephen Bezruchka, M.D. (1999, The Mountaineers, 1011 SW Klickitat Way, Ste. 107, Seattle, WA 98134; phone 800/573/8484). The cost is $6.95.

7. An excellent booklet, the "Personal Health Guide: Put Prevention into Practice,", is available free of charge from the government and can be ordered at www.ahcpr.gov/ppip/ppadult.htm#add or by calling the AHCPR Publications Clearinghouse at 800-358-9295.

PILL CONTAINERS. HOW? WHAT? WHERE? WHY?

* REI (Recreational Equipment, Inc.; an outdoor company; phone 800/426-4840) sells assorted screw-top bottles and round flip-top containers eminently suitable for carrying pills. The round ones even hold liquids. For years, I have carried a tooth retainer submersed in water in one of 'the smaller boxes. without any fluid ever spilling or the receptacle accidentally opening while in my pocket.

* For drugs I have to take on different days of the week, I use the following approach:

On a computer I type the dates on which I have to take my medications. I make sure the type is compact enough so that, after printing and sizing the paper, the numbers cover the back of the bottle only. I attach this to the bottle with. 2-sided tape.

Then, each time I take a pill, I cross out the date. Here's an illustration of what I type:

Aug 1 3 5 7 9

13 15 17 19

23 25 27 29

BEFORE YOU LEAVE

* Make sure your vaccinations are up to date. And get tetanus shots every 10 years, even if you don't travel. Inquire about needed immunizations or booster shots well ahead of time.

* Consult your local health department or a travel health clinic or call the, Centers for Disease Control & Prevention (CDC) at 877-FYI-TRIP, or 877/394-8747. Its toll-free fax number for requesting information is 888/232-3299. (Note: any information available by fax is also available on its. website, www.cdc.gov.)

* Ask your doctor for the appropriate antimalarial drug.

TELEPHONE HELP

As I have indicated in previous articles, it is vital that you know the location of the nearest phone in the place where you spend the night. You also should have the coins or a telephone card specific for that phone. If an emergency should occur, you will be happy that you will be able to call for help.

Bon voyage, and happy and healthy travels.

Dr. Wagenaar welcomes questions but may not be able to answer them individually. Write to him at 6556 50th Ave. NE, Seattle, WA 98115; e-mail pwagenaar@qwest.net.

COPYRIGHT 2002 Martin Publications, Inc.
COPYRIGHT 2002 Gale Group