Tips to keep unexpected health issues from throwing your overseas vacation off ... - Calgary Herald

An international vacation typically involves months of advance planning, from renewing passports to finding flights and booking hotels. But even the most carefully planned itinerary can be knocked off course by an unexpected health problem.

If you're travelling in a country where you don't speak the language and your insurance isn't accepted, even a basic errand like filling a prescription can become a complicated ordeal.

Here are some tips on getting the medical care you need, no matter where your travels take you:

PRESCRIPTIONS: It's far easier to bring an ample supply of medication from home than to refill it overseas.

If you're going to be travelling for a few weeks, most pharmacies will give you an extended supply of medication if you show them your travel itinerary. All prescriptions should be kept in their original bottles that clearly display your name. This is important when travelling through foreign customs where your baggage may be searched.

"Generally speaking, any medication that is prescribed to you must be identified as such and be in the properly marked bottles," said Dr. Sal Pardo, vice chair of emergency medicine at the Long Island Jewish Medical Center. "That's the most reasonable and fail-safe way to travel with medicine."

If you have any kind of narcotic-based pain medication, for example codeine, you may want to check with the your. embassy in the country you're visiting to make sure the drug is not considered illegal. A list of Canadian offices abroad can be found at http://www.international.gc.ca/ciw-cdm/embassies-ambassades.aspx.

If you lose your medication or need a new prescription abroad, most pharmacies will honour a fax or email from a foreign physician. However, some countries do not even require prescriptions for common medications. In Mexico, for example, antibiotics, pain medications and other common pharmaceuticals are dispensed at the pharmacy without a prescription.

DOCTORS: Sometimes you'll need more than a prescription refill to get your trip back on track.

Let's say you're swimming on a beach in Ecuador and get stung by a jellyfish. A small rash develops into a larger infection and you want to find an English-speaking doctor who can diagnose the problem and prescribe the best treatment. Your health insurance does not cover overseas travel and your Spanish is limited.

Fortunately there are several organizations that offer free help finding qualified physicians.

The International Association for Medical Assistance to Travelers maintains an online database of licensed, English-speaking doctors in 90 countries: http://www.iamat.org/doctors_clinics.cfm .

Concierges at most major hotels keep a list of English-speaking doctors in the area. In some cases, they'll have a doctor on call who can see you in your room.

Doctors recommend that travellers with chronic conditions, allergies or rare blood types bring a form with their medical history. The American College of Emergency Physicians offers a medical history form on the website www.er101.org, and your doctor can help you figure out what to include.

This is something you will want to keep in your wallet or purse, not in the luggage that stays in your hotel room.

INSURANCE: Most government and employer-based health plans do not cover medical care overseas. For this reason, many travel agencies recommend customers purchase some sort of travel health insurance.

Along with covering the cost of cancelled trips or travel delays, several insurance companies like Travel Guard, http://www.travelguard.com , provide a range of health coverage options, from basic medical expenses to medical evacuation.

Depending on the country and the condition of the patient, an international medical flight can cost $50,000 or more, making an insurance policy a smart financial decision. Adventure travellers who face a serious risk of harm can even be covered for the repatriation of dismembered limbs and other remains, according to Laurene Taylor of Liberty Travel, a New York-based travel agency.

Travel insurance prices vary depending on the cost of the trip and the age of the travellers.

Dr. Pardo recommends such policies for both older patients with established health issues and younger patients.

"Most of the time the people who get into trouble are those that don't think about it: the young, healthy group that travels abroad for three months and can't anticipate anything ever going wrong," Pardo said. "Suddenly they're in a situation where they really need these services."

Maine Voices: Co-ordinate care for mind and body - Press Herald

Yesterday at 12:00 AM

Separating medical treatment from behavioral health gets in the way of ensuring people receive the care they need.

By JEANNINE D. LEPITRE

SACO - The British scientist and writer C.P. Snow said in a now-famous lecture that Western society was split into two cultures -- the sciences and the humanities -- and this cultural split was a major hindrance to solving the world's problems.

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People with severe mental illness die 20 years earlier than the general population because of physical illness that is difficult to treat due to their mental condition.

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Health care in the United States is also split into two cultures -- medical and behavioral -- and that split is proving to be a major hindrance to solving the problem of health care integration. And it is a serious problem.

People with severe mental illness die, on average, 20 years earlier than the general population. In most cases their terminal illnesses are related not to their mental health issues, but to their physical health problems. People with mental illness are much more likely than the rest of us to die from heart disease, respiratory disease, cancer and diabetes.

Conversely, many people with acute physical problems, especially those who show up with great frequency in our hospitals' emergency rooms, have injured themselves or made themselves physically ill because of their mental health or substance abuse issues. 

MODERN RESEARCH

The idea that mind (mental health) and body (physical health) are separate entities has been promulgated in Western culture since the 17th century. But modern scientific research has demonstrated how deeply entwined the mind and body are, resulting in increased public awareness and ambitious state and federal efforts to implement a more holistic, integrated health care system.

It would appear that medical practitioners and mental health practitioners are natural partners. And we are, in theory. But in practice the situation is much more complicated. For decades we've hardly talked to one another, although we are all dealing with the same thing -- human health.

To give just one example, some physicians simply do not want to deal with mentally ill patients, because they can be challenging -- they may act out in waiting rooms, exhibit bizarre behaviors, abuse prescription medicines, miss appointments or refuse to comply (or not be mentally capable of complying) with medical instructions.

On the behavioral health side, therapists often feel like second-class citizens. Many distrust the "medical model," which they feel is prescriptive, cold and mechanistic, rather than warm, personal and humane -- values they advocate and practice.

Fortunately, my agency belongs to a mental health network (Maine Mental Health Partners) and a health care system (MaineHealth) that are committed to integrating physical and mental health, and that has instituted a number of initiatives to achieve this goal. A program already in place provides easy access to mental health services by placing therapists in the offices of primary care physicians.

We also are exploring the reverse approach: placing medical professionals in a mental health setting. This makes a lot of sense, as mentally ill people are often uncomfortable doing anything outside of their practiced routines, like going to see a doctor. In this scenario, they can be examined for physical problems in a place they feel safe and comfortable.

Unfortunately, even with this commitment, we've experienced our share of challenges. And what we've accomplished is far from the norm in the general health care world. As a state and a nation, we have a long way to go to reach what we can legitimately call "integrated health care."

Recognizing this challenge, Maine, other states and the federal government are introducing new, innovative ways to integrate health care.

NEW INITIATIVE

Those of us in the behavioral health world are eagerly awaiting the introduction of Maine's Behavioral Health Homes initiative, which will provide a range of coordinated services to high-frequency users with significant mental health and chronic physical health needs. The concept for this team approach began with the recognition that the integration of physical and behavioral health is a critical feature of a high-performing health care system.

This is an enlightened approach to coordinating total health care, and one that should realize significant cost savings while improving health outcomes.

If we were to dismantle our nation's health care system and start from scratch, we would certainly do things a lot differently. But we obviously have to work with the system we have and change it incrementally. At the same time, we need to be innovative and we need to be bold.

Sometimes the common-sense approach is the best. If improved overall human health is our goal, then let's treat medical care and mental health care as the natural partners they are and bring them together, where they belong.

Jeannine D. Lepitre is CEO of Counseling Services Inc. in Saco.