A Traveler’s Medicine Chest


Travel Medications and Being Prepared

Our first line of defense is improving our immune system before we get sick and that starts with vitamin C. Several weeks before a trip we start taking it.

Around 1970, Nobel prize winner Linus Pauling (chemistry and the Peace Prize) popularized the theory that vitamin C helps treat colds. He published a book about cold prevention using megadoses of vitamin C. Multiple controlled studies have examined whether vitamin C had any effect after coming down with the common cold and, while the results have been fairly disappointing, it has been established that a regular supplemental regimen of vitamin C has several benefits. It includes reducing the symptoms of a cold and making it less severe. It also reduced duration and increased recovery time by about 8% in adults and 14% in children. Some studies also indicated a supplemental dose of 1–2 grams was enough to shorten the duration of a cold by 18% in children. Other studies with adults found 6–8 grams per day to be effective. Vitamin C in large doses comes packaged as Emergen-C and Airborne.

Another item we carry with us is zinc. One popular form is Cold-Eeze and, while it hasn’t been found to be a preventative, it has been shown that zinc lozenges can reduce the duration of a cold, perhaps by a day or more and also reduce its’ severity. Sucking on zinc within the first 24 hours after symptoms start and continuing to take it as long as your cold lasts will help shorten your cold and sometimes help with the flu. According to the Mayo Clinic, zinc may keep cold viruses from multiplying and taking up residence in your nose and throat lessoning the severity but there’s no evidence it’ll actually prevents getting a cold.

Two Prescription Medications

While we haven’t been very successful in convincing our doctors to provide us with prescriptions just in case, we’ve met a number of people that have. There are two specific prescriptions that can be helpful if you do come down with something but there are serious cautions in their use. The major issue is understanding when their use applies. Is the illness viral or bacterial is the biggest question to answer because antibiotics are of no use against a virus.


Determining The Culprit


Viral and bacterial upper respiratory infections have very similar symptoms. Lab testing or a clinical diagnosis is the only way to know for sure, but this can be costly, time consuming and at times not available on a cruise ship. Some symptom differences can help alert you to whether you have a viral or bacterial infection, so pay attention to a number of things.

First be informed about what is “going around”. Flu outbreaks sweep the country in waves so it isn’t uncommon to have them show up on your cruise. Usually the news will provide clues to what the current contagion is. Also you may hear that a couple of other passengers have been specifically diagnosed with the flu or a cold.

Viral infections are milder than bacterial infections, and they tend to last longer. With a virus you will usually feel very sick for 1 to 3 days and then you will start to feel better, though some of your symptoms may linger. Symptoms that linger for ten days or more are likely to be a virus. Over time, viruses can also lead to things like sinus infections or increased risk of middle ear infections which result from developing an additional bacterial infection.

When you blow your nose or cough up mucus, pay attention to the color. While it may be indelicate, color can be an indicator of whether you have a viral or bacterial infection. Thin and clear mucus is more likely to be a viral infection. Greenish mucus is more likely to be a bacterial infection. Keep in mind mucus color is not a completely accurate indicator of a viral or bacterial infection. Make sure you consider additional factors.

Pay attention to your throat. A sore throat is common for both viral and bacterial infections and checking for a sore throat is the most common thing a doctor will evaluate to determine if you need antibiotics. Certain types of sore throats can indicate a bacterial infection. For example, white spots are generally caused by bacteria as well as a sore throat without other symptoms such as a runny nose or sneezing, often indicating a strep throat.

Fevers can present in both viral and bacterial infections but fevers differ with different types of infections. In bacterial infections, fevers tend to go higher quicker. Also, with a bacterial infection, fevers often get worse after a few days but if you improve in a few days it’s likely a viral infection.


Medications

The two prescription medications most often carried when traveling are Z-Packs and Tamiflu® with one used for bacterial infections and the other for virus.


Doctors vary on if they should provide prescriptions to their patients for infections while traveling outside the country. Most resist but it is a case worth discussing with your doctor. If you are traveling there are over the counter alternative sources along with some mail order pharmacies.


The Z-Packs

First, Z-Packs are easy to use and they’re cheap. They come as a pack of five pills, which you take two on the first day and one daily over the course of the next four days, and they’re highly effective. Azithromycin is well-absorbed when you take it orally, easily enters your body tissues, so it can fight the bacteria causing your infection, and stays active for a long time.
Again An Important Note: Z-Packs have no effect on virus infections but are effective against:


1. Strep throat. Azithromycin is approved for treatment of strep throat. Especially if you are allergic to penicillin, which is usually the first choice of treatment, and a Z-Pack is still a good option.

2. Skin and soft tissue infections. Infections of the skin or soft tissues — like muscles and tendons — commonly caused by Staph and Strep bacteria can be treated with Zithromax. A typical prescription consists of either 500 mg daily for five days or a single dose of 2 grams.

3. Community-acquired pneumonia. Meaning mild to moderate cases of pneumonia that are acquired outside a hospital, Z-Packs are a useful option.

4. Acute bacterial bronchitis. In folks with chronic bronchitis or other underlying lung disease, acute bacterial bronchitis can be treated with a Z-Pack.

5. Chlamydia. For the sexually transmitted disease, Chlamydia, a single one-gram dose of azithromycin is the recommended treatment. Just one dose and done.

6. Traveler’s diarrhea. Azithromycin can effectively treat traveler’s diarrhea, aka dysentery or bloody diarrhea, caused by the Shigella and Campylobacter bacteria. This makes the Z-Pack a handy companion to bring along on international travel.

7. Nongonococcal urethritis in men. A single 1-gram dose of azithromycin can treat certain urethra infections in men. Again, one and done!


Tamiflu


The antiviral drug oseltamivir (Tamiflu®), helps your body bounce back faster from the flu.
Researchers find that taking oseltamivir within 48 hours of symptom onset can shave approximately one day from a typical seven-to-10-day illness. A more recent study showed that in patients 65 years old and older without other health conditions, up to two to three days could be shaved off using oseltamivir.
Oseltamivir interferes with the proteins the flu virus uses to reproduce, giving your immune system time to destroy it.


If You Don’t Have Perscription Medications (Or Even if You Do)


If you come down with something and don’t have access to those prescriptions, here’s your best course of treatment:
1. Stay hydrated.
Drinking water and juice to stay hydrated can help cut down on symptoms like a sore throat and stuffy nose. Steer clear of alcohol and super-sugary drinks to help prevent dehydration.
2. Gargling with salt water.
To combat a scratchy throat add half a teaspoon of salt to a glass of warm water. The salt draws out excess water in your throat’s tissues, reducing the inflammation, and clears mucous and irritants from the back of the throat. The rinse also flushes out bacteria and viruses, which may help whether you’re getting a cold or want to prevent one in the first place.
3. Keep your nose clear.
Using a sterile saline nasal spray right after cold symptoms first appear may reduce their impact by moisturizing dry nasal passages and loosening mucous caused by colds. Taking a hot shower allows the warm moisture to clear nasal passages.


OTC Medications


Theraflu

Theraflu is basically a dose of acetaminophen along with several other anti-cold ingredients. It does carry a warning about the risk of liver damage if you take more than the recommended dose or mix with alcohol or other acetaminophen-containing products. Maybe take ibuprofen or acetaminophen alone and brew yourself a hot cup of tea. You’ll get the warm, soothing fluids without the risk of those extra drugs.
Pain Relievers
A pain reliever may be the first thing you reach for when you come down with a cold. Pain relievers for coughs and cold can be very effective. They can help with fever. Anti-inflammatory meds like Advil or Motrin (ibuprofen) or Aleve (naproxen) have the advantage of reducing tissue inflammation, but you should take Tylenol (acetaminophen) instead if you’re taking blood thinners
NyQuil And Other Cold & Flu Drugs
This is one of the more popular OTC drugs but it is also one of the most dangerous when abused. Check the indications, side effects and warnings. You need to check to make sure that it is safe for you to take NyQuil (acetaminophen, dextromethorphan, doxylamine, and pseudoephedrine liquid).
Other choices with similar cautions include:

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Some are usually available in the ships store and a trip to a pharmacy when in port can also provide something suitable. Read the recommendations and watch out for high blood pressure cautions regarding other conditions.

What’s In Our Travel First Aid Kit
Just like our collection of batteries, chargers, cables and adaptors we carry a collect of just in case medications. As always we focus on size. We carry NyQuil but only in capsules along with zinc, C, anti-diarrhea and ibuprofen. We also carry a few bandaids, antiseptic wipes, and packets of Neosporin.

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