I’d rather wake up in the middle of nowhere than in any city on Earth. Steve McQueen
I have always been an independent sort. As I kid, I often ‘ran away from home’. I never went very far –usually exploring the outer reaches of our 25 acres. Many times, I had my school backpack and stuffed it with a sleeping bag, snacks and a book and had a good day. Summers were great as I often set up a tent somewhere on the property and was ‘away’ for a few days at a time. A couple of times, I built a little raft a floated it on the creek pretending to be Tom Sawyer. As a child, my fondest wish to be a boy scout. Our town didn’t have a girl scouts, but that didn’t stop me from checking out books in the library on ‘wilderness survival’. I taught myself cool things like how to build a fire, how to set up a tent, and how not to get attacked by bears.
Up until my mid 20’s I considered myself to be pretty outdoorsy, enjoying to spend as much time outside and under the sun as possible, hiking, biking, communicating with nature and all that crap. But somewhere along the line, things changed. It’s hard to put a finger on exactly when this happen, but I think it had something to do with getting my first big girl job. Working 6 days a week with minimal vacation time sucked the life out of my soul, and after about 2 years, I couldn’t do it anymore. It had been 2 years since I’d had a vacation so just after my two year work-anniversary, I took off to the North Carolina’s Outer Banks.
The Outer Banks is awesome. The northern half where Cape Hatteras Lighthouse is by far the more popular part of the Outer Banks. Ocracoke Lighthouse is gleaming white. It was built in 1823, the second oldest still in use in the nation. It’s not a tall as Hatteras or as famous but nevertheless it is an awesome site!
Ocracoke Island sits 23 miles off the North Carolina coast and a quarter mile south of Hatteras Island. It usually measures 17 miles long and a mile wide. The deserted, windblown beaches of the Cape Hatteras National Seashore make up the northern 90 percent of the island, and a small village of hotels, restaurants, shops, homes makes up the southern 10 percent. It’s a great place to get away from it all.
Going to the Outer Banks helped me re-assess my priorities in life. Did I want a life of relative security and stability? Did I want a life where taking a vacation was more of a headache than a means of relaxation? Hell no. I didn’t want that when I started, and after two years I didn’t like where that life was leading. Subconsciously I guess I realized how unhappy I was with my life, and deep down I was yearning to get back to my childhood roots, and to the last time I was really happy with life. I needed to get dirty, sleep under the stars again, and paddle about around on a body of water on a regular basis.
And where did I have this profound, existential realization? In a tent, under the stars off the coast of North Carolina in an area where the one of the most infamous pirates in history roamed.
I sure know how to pick my moments.
There is something incredibly cliche, but true about laying out under the stars, way out in the middle of nowhere, hearing waves crash on the shore that triggers some scary deep thoughts, right? Right? Please say this is not just me.
Seeing the sun rise over the ocean…
watching dolphins play in the ocean…
observing patterns in the sand…
These were the kinds of moments I had been missing over the past few years. Taking a step back away from all the craziness, all the rush, all of the stress that is involved with chasing the “American Dream” and realizing that simple, peaceful quiet moments abroad are often the most meaningful and profound. I exited the rat race at that moment [even thought it still took a while to start chasing MY American Dream].
It’s been 8 years since I’ve had that revelation. In that time I’ve traveled to more than 40 countries. I’ve had short adventures and long ones. I’ve become a registered nurse. I’m on my way to becoming a nurse practitioner. As I paddled around and explored the barrier islands off South Carolina’s coast, I felt the stress of the last few weeks melt away. I was light years removed from the stress of the last few weeks. With each stroke of my kayak, I felt so far removed from the hustle and bustle of life, I could feel a smile creep on my face for the first time in a while.
Conde Nast Traveler has once again posted their Top 25 cities in the world. And while I haven’t visited them all, I do have a few in the top 25 covered, and I am proud that a city from my state is rated as one of the top 25 city IN. THE. WORLD.
25. Barcelona, Spain. Haven’t been there, but want to go.
24. Venice, Italy.
23. Melbourne, Australia. Want to go. Had a pen pal from there as a teenager and currently work with a guy from there.
22. Paris, France. Went on a world-wind tour on New Year’s Eve/New Years Day. I didn’t love Paris, but I’m willing to giver her another chance.
21. Lebanon, Beirut. Intrigues me, but I wouldn’t want to travel solo there.
20. Seville, Spain. My favorite professor in college often told me Sevilla was “la ciudad mas bonita en todo el mundo.” It was her hometown, and I’ve heard several wonderful things about it. I can’t wait to go to Spain.
17. Santa Fe, New Mexico, USA. Seems like a cool town, but my southwest experiences are quite limited.
17. Sydney, Australia. Want to go here to. Australia is SO. FAR. AWAY.
17. Victoria, British Columbia, Canada.
16. Krakow, Poland. I visited Krakow last January, and was it ever frigid. But it is a cool city.
15. Prague, Czech Republic. Same as above. I went in January and snow covered Prague is magical.
What I am about to say might be considered blasphemy to some… I didn’t travel the yellow brick road to see the land of Oz and meet the Wizard until very recently… as in I read the books Wicked and Son of a Witch before I ever knew of Dorothy and crew.
I KNOW… what can I say? I missed out on a lot as a child by not having a TV or living in a town without a movie theatre.
So not being a huge fan and being an infant when it closed, I hope I can be forgiven for never having heard of Autumn at OZ. In its heyday the Land of Oz could attract 20,000 visitors a day, but now the neglected Yellow Brick Road is missing some bricks, the Wicked Witch of the West’s castle is empty and the Emerald City has all but disappeared.
Truthfully, it’s a little bit creepy.
Local actors dress up as characters from the book/movie. Kids [and some very strange adults] dress up in costumes. Parents take pictures of kids with Dorothy and crew as if they were Santa Claus.
What it is: From 1970-1980, there was a Wizard of Oz theme park not too far from where I live now. It’s located in Beech Mountain, NC and is open to the public for one weekend only… usually the first weekend in October, although that varies as they are having a few more events for the general public. [This year is was open on Oct 3 & 4]. I say open to the public because it’s current owner is Emerald Mountain Properties and they rent out the cabins, property, ect to people who want to have private parties at the land of OZ.
If you want to go: Ticket usually go on sale in the beginning of August, and sell out quickly. This year they sold out in just TWO short Weeks. I’m not saying go or not go, but if you do, be aware that this isn’t a theme park by 2015 standards, or even 1975 standards; it’s a quirky, weird little park best suited to real, devoted Wizard of Oz fans.
So here’s the thing. DJ and I are both registered nurses. We met while working at the same hospital, her as a RN, me as a respiratory therapist. The timing of this trip was such that both of us should have graduated (me initial RN; her BSN). We almost screwed that up–me by breaking the bones and pushing back my externship for a block, and DJ is actually taking a chemistry class as we travel that will be her last class. So–as part of out London tour, we had to visit the Florence Nightingale Nurse’s Museum. We went to the museum right before the Miss America pageant aired. One of the contestants, as her talent, performed a soliloquy in her scrubs talking about her job.
She was mocked endlessly by talking heads for wearing her ‘doctor’s stethoscope’ and just talking. As a person who has worked in healthcare better part of 10 years, I can definitively say that being a nurse [or respiratory therapist] takes talent. It takes skill to take care of sick babies. It takes skill to insert an IV on someone who is dehydrated. It takes talent to make someone comfortable when they are not in comfortable situations, and it takes talent to help someone die with dignity and grace. While certainly an unconventional talent, being a nurse [or any health care provider really] is most definitely is a skill and a talent and not everyone can or will do it.
She did not win.
But from pageants to TV shows to corporate sponsors, nurses have been in the news in the last two weeks more than possibly at any other time in recent history. And that’s good for nurses. It’s good that the public at large are getting to see what nurses do. I worked for ten years as a respiratory therapist before I became a nurse and people know even less about that profession than they do nursing. Anyway… as luck would have it, I have been spared most of the nurse drama because I was in London, visiting the nurses’ museum… oh the irony.
How can I say this nicely? The nurses’ museum wasn’t my favorite. It is small. It costs 7.50 [many of London’s museums much bigger, better, and are FREE], and doesn’t do the best job of depicting nursing. It’s mostly historic, but unlike the Old Operating Theatre, it’s not full of many artifacts. It consists mostly of photographs… displayed much like they would be if you were looking at microfiche [I am so old]. The Fleming Museum consisted of his laboratory; the Semmelweis museum (in Budapest) is located in his former family home. Those are all much better scientific/historic museums.
What I would have like to seen is a small section focused on Aunt Flo, a small section cataloging the history of nursing, a small section of historic nursing artifacts, and maybe an interactive ‘can you be this patient’s nurse’ set-up using a current model of a hospital room or ICU room. That would have made for a rocking nurses’ museum.
It did have the lamp, which is a pretty important part of the graduation ceremony [or so I’m told. I skipped my graduation…remember broken arm, broken ankle? yea, I didn’t get to graduate with my original class and was in the new class for only the internship part…which didn’t really foster warm, fuzzy feelings towards my new classmates… anyway…]
I wonder what the design thought was in using fake grass to adorn the walls, or if there even was one.
My first visit to Budapest was a frosty sojourn where I tried to be either inside or in the toasty warm thermal baths at all times. I learned a lot about Budapest’s cafe culture, walked around the city with my head wrapped in hats and scarves, learned to use Europe’s second oldest subway efficiently, attended some grade A classical music concerts, and made a lot of mental notes to ‘look up’ the significance of what I saw, and explore more in detail should I ever return.
I have returned.
One of the things that I saw on my January walk along the river, was several pairs of cast iron shoes pointing towards the river. Interesting, yes, but what is it’s significance.
I only snapped the one photo because…cold, and frostbitten fingers were a very real possibility.
Interesting…curious….something I’d like to investigate further. It’s hard to look at a monuments like this–sometimes called ‘dark tourism’–especially in areas where life has gone on, but I think it’s important to look at them, ponder the significance, and reflect on the meaning. Budapest, in 1944 was not a place you wanted to be if you were Jewish. But then again, most of central Europe was not a place you wanted to be either.
Rusted cast iron looks like real, used leather, and these shoes in all shapes and styles represent some of the victims of the Holocaust. In the winter of 1944, several Jews from Budapest were rounded up and stripped completely naked on the banks of the Danube River. That would have be torture enough. January in Budapest is not balmy. Trust me, I was there in January and nearly froze to death despite my wool hat and coat. These Jews–men, women, and children– were told to face the river. A firing squad shot the prisoners-of-war at close enough range so that their bodies would fall into the icy Danube and be washed away from the city. If the gunshot didn’t kill them, the river most certainly would.
Leather was such a precious commodity that even shoes were taken from the victims. After the victims fell into the river, the shoes were rounded up, either re-distributed or the leather re-worked into something else. Today there are 60 pairs of cast iron shoes modeled after 1940’s footwear lined up on the Pest side of the Danube. The memorial was commissioned in 2005.
The monument is located on the Pest side of Budapest, Id. Antall József rkp., 1054 Hungary.
Days 2-4 in Budapest... Current event will tell you there is a refugee crisis in Budapest. Current events are not wrong. Refugees are pouring in to the country at such a rapid pace that officials can’t keep up; however, refugees are being contained to one are of the city. So there’s that.
Let’s go adventuring, shall we, but first, a little history lesson. Budapest is a fascinating historical city separated into Buda and Pest by the Danube River. This area represents the Hungarian part of the Austro-Hungarian Empire which fell at the beginning of WWI. After WW2 in 1949, Hungary was declared a people’s republic and was ruled by communism. The iron curtain fell in 1989 but when touring Budapest, you will see that there are reminders of the Communist regime scattered throughout the city today.
Today, Hungary is part of the European Union which is part of the reason it is facing its current refugee crisis. DJ and I narrowly escaped Budapest ahead of Hungary closing its borders in an attempt to stem the influx of these invaders. Authorities in Budapest are trying to help the refugees [migrants, illegals, ect] by providing shelter, water, and facilities at the train stations, but the migrants want more. More handouts from not-exactly-wealthy governments. More demands from people not vetted by any type of security. It’s quite the sticky situation… but I digress…
One of the few remaining Soviet Monuments is Liberty Statue on Gellert Hill. This statue was originally erected to honour the Soviets who sacrificed themselves to free Hungary from the Nazis occupation. As we all know, that liberation came with a price and the Soviets ended up locking out the Western world. The statue was damaged in the 1956 Hungarian Revolution, and in 1989 after the fall of communism, the statue was kept to honour all those who gave the ultimate sacrifice for Hungary. An inscription in the statue states: To the memory of those all who sacrificed their lives for the independence, freedom, and prosperity of Hungary.
Ruin Bars are a popular spot that came out of the fall of communism. These are trendy hipster pubs that are decorated with retro furniture and have a very cool vibe. Known by locals as ‘romkocsma’ (ruin pub in Hungarian), these pubs have been a part of the drinking culture for over a dozen years. Each one is unique but, more often than not, a ruin pub in Budapest will have a rundown and slightly sketchy exterior that completely contradicts the vibrant colours and unique ambiance you’ll find inside. Filled with second hand furniture and nearly anything funky picked off the curb, these formerly abandoned buildings are now pretty integral to Budapest. And it all seems to have started in the city’s 7th district.
The neighbourhood was largely damaged and neglected after World War II and it’s said that ruin pubs are what changed the district’s future for the better. Where many saw abandoned factories and deteriorating apartment complexes, the people behind Szimpla saw potential. Over the years, the transformation of these buildings (and now others across the city) led to an entirely new concept in Budapest that super cool.
Budapest is in a major transition right now and an interesting part of traveling there is that you can see a contrast between the communist era and the modern day society of today. Communism is very much a part of the conversation in Budapest. People that are the same age as I am remember growing up during the regime. It has been slower to develop than other communist cities due to lack of funding, but this has allowed it to stave off the dreaded gentrification that is affecting so many cities today. It won’t be long until the West invades though, even now you will find McDonald’s and Starbucks. As a matter a fact, Budapest was the first city in the Eastern bloc to open a McDonald’s. They had a more relaxed form of communism than other countries, giving it the nickname Goulash Communism. They enjoyed a certain freedom and amenities that weren’t available to other countries in the Eastern Bloc.
Definitely the fancy one
Our train to Prague was nearly 2 hours and 45 minutes late getting in last night. It originated in Budapest, then went to Prague. For the first time in 10+ years of traveling, the police boarded the train at the Czech border, and checked passports. It reminded me a little bit of when I was hanging out in Zapatista territory– at least these police didn’t have machetes attached to their hips.
The migrants are now, shall we say, pissed. They are now attempting to block trains from coming and going by standing on the tracks unless they are allowed on them… without a passport… Without a ticket… without any type of security checks. And they all want to go to Germany. Germany. Does. Not. Want. Them. and neither does anyone else after these antics. To riot against the very people who have literally given you shelter, water, and a place to pee because you did get want you “want”, is a bit like cutting off your nose to spite your face. It makes no sense. They are acting like children who got their candy taken away.
What’s the answer? Idk, but Greece and Italy can’t patrol all the islands that all the refugees are arriving to. Hungary put up a razor wire fence on its border with Serbia but it can’t cover the railway which is being used as a highway. Romania isn’t strong enough to police it’s borders. The Austria/ Hungary border is ground zero. Refugees are trying to get into Austria by any means necessary since they see it as the gateway to Germany. And people are dying–hiding in truck shells. And sealed refrigerators.
This adventure has been a long time in the making and it’s nearly polar opposite from what I usually do or how I normally travel.
More than a year ago, my work mate DJ said “I want to go to Europe with you” and like everyone who says that I say OK and figure absolutely nothing will happen. Because nothing ever does. So I was somewhat surprised when she brought it up again, and this time my response was ‘where do you want to go?’ because if someone only wants to go to Rome or Paris, I’m not the person they should go with.
Her response “I don’t know… I’ve never been to Europe…” Great… I have got a geographically challenged person with no idea of what they might like to do. Europe is pretty big, I say. It include Istanbul, Greece, London, Moscow, Stockholm, Barcelona, and many places in between. I begin to think that this may not be happening.
Over time, DJ and I become good friends. She cons me into running a 5k at home and a 10K in Charleston; I conned her into staying in a hostel while running said 10K. And driving. It was a wash. Eventually we decide on summer 2015 as when we should go. My vote was May or September (shoulder season and not 1000 degrees); her vote was July or August, based on kid’s school schedules (hers, obvs). We finally decide on last week of August and first week of September. I should mention that I’ve never been to Europe in the summer and what I know I know from reading and talking to others.
We probably did about 50 trip combinations before settling on out actual route. She wanted to go to the beach; I wanted to go somewhere I haven’t been before. Croatia, Italy, and Spain were some of the finalists, but in the end, the planes, trains, and boats just wouldn’t work out financially. DJ really wanted to go to Barcelona, Paris, and London; I explained that those cities were probably the most expensive and with the budget we were working with, we could do one, maybe two, but not all three.
I got an email alert for a really good price on a flight to Budapest. Normally, I fly into one city and out of another, but this time, we did a round trip for <$700 in August/September. I call that a win.
Now from Budapest, we could go south, or north. I was pushing for South… Serbia, Croatia, Montenegro, Albania, Greece. DJ was deterred by the lack of tourist infrastructure and the Cyrillic alphabet so we went North. We eventually settled on Budapest–>Vienna–>Prague–>Berlin–>Copenhagen–>London–>Budapest circuit over three weeks.
I was a little bummed to be missing out on Spain… yet again, but London for the 5th time was an acceptable substitute.
Because London is awesome, and no matter how many visits I have, there will always be more things to do. And Berlin is awesome too. So I knew that at least those two cities were going to be OK. The other cities were a toss-up. Even more interesting would be the accommodations. I’ve always stayed in hostels and if I am really feeling flush, I’ll get a private room. DJ was a hotel girl. We settled on guesthouses and apartments plus a hostel in London with two beds and a bathroom.
Different styles… different expectations… let’s hope the friendship survives.
Parts 2 and 3
Three flight delays from Greenville, a close call in Washington DC, an uneventful overnight flight to Munich, a much-loved [and craved] pretzel during the Munich layover, a short flight to Budapest, a visit to passport control, and DJ has her first ever passport stamp. Currency exchanged [dollars to fornits], train tickets purchased, subway passes bought, and a 15-minute walk while carrying our luggage in the 100 degree [no exaggeration] heat, we’ve arrived at our first stop.
I’m always nervous booking places on-line. Now for me, my expectations are low, and whatever the place looks like, as long as there are no visible bugs or drug needles, I am generally OK with it. DJ’s standards were a bit higher. Luckily, my first guest house was a winner… two beds, and in-room bathroom, and a central location. What’s missing is air-condition. Now, while I expected this, I did not expect it to be 100 degrees. DJ is dying; I’m surviving but only barely. Thank God for the small, but powerful fan inside our room.
For our first meal in Budapest, DJ wants to go to… McDonald’s. For a cheeseburger. No street food for that girl. No sidewalk pizza will do. A plain cheeseburger. We traveled 6000 miles for McDonald’s. [me… shaking head in disbelief] Luckily, I have been here before. I know there are multiple McDonald’s in Budapest, including one just a five minutes walk away, but that’s not the one I suggest we go to. Budapest has quite possible the world’s nicest McDonald’s [or at least the nicest one I’ve ever seen] inside the Nyugati train station. I discovered this gem when I was in Budapest in January 2013 freezing my ass off. [Irony upon irony: first visit to Budapest I nearly froze to death; this visit I may die of heat stroke] I was just looking for some heat when I happened upon this mirage inside the train station.
DJ agrees. And it has air condition. I am a hero… At least for a little while.
Michelle in Budapest. Never mind the bra showing through the t-shirt. Or the purple hair. The FitBit said we had done more than 30,000 steps, and I was celebrating by eating a deliciously (cold) coffee flavored gelato.
Tybee Island is one of the few places in the world [London is another place, but it requires an airplane ticket as it is much further away] that I return to on a regular basis. In the last 20+ years, I’m certain that I’ve covered the entire island on foot. The boyfriend and I have been there a few times… once in winter, twice in spring, and once when it was a miserable 110 degrees and the sand was too hot to walk on. I’ve taken family trips there. I’ve been to Tybee on Spring Break solo. It’s a perfect beach for me. Not crowded. Not commercialized. And close to one of my top 5 favorite cities in the USA.
Tybee Island’s Landmarks
The fishing pier
Tybee has a fantastic fishing pier. Sometime people even fish from it. I , like many other couples I’ve seen, have made out with my boyfriend at least once on the pier. I’ve hung a hammock from the underside and watched waves roll in. And I definitely have used it as a guide when I’ve gone kayaking. Tybee is a great place to learn ocean kayaking. The waves are never to rollicking and the currents are usually gentle.
Tybee Island Lighthouse
There’s also a lighthouse on the north end of the island. You can tour the grounds and even climb up the 143 steps to the top. I’d recommend not doing that in August, when it’s over 100 degrees though. That’s what I did, and I almost passed out from heat exhaustion.
Looking up at the lighthouse gives an idea of just how tall it is
There’s another lighthouse on the island too…Cockspur Lighthouse. As far as lighthouses go, Cockspur is quite tiny, measuring only 46 feet from base to the top of its cupola. But this structure is no slouch; it has endured high tides, hurricanes, waves from ever-growing container ships, careless individuals, vandals and – for a deafening 30 hours – the bombardment of nearby Fort Pulaski during the Civil War.
Remarkably, the lighthouse suffered little or no damage during the April 10, 1862, Union bombardment of Fort Pulaski. Crews manning 36 guns on 11 batteries stretching along the western end of Tybee Island likely used the lighthouse for sighting as they pounded away at the fort located about 1 mile beyond.
The Cockspur Lighthouse is one of the five surviving historic lighthouses in Georgia. It was re-lit in March 2007.
Fort Pulaski National Monument is located on Cockspur Island near the mouth of the Savannah River. Fort Pulaski was constructed between 1829 and 1847 [Robert E Lee was one of the principle engineers] to defend the port city of Savannah from foreign attacks and invasion. However, early in the American crisis that became the Civil War [or as some say–The War of Northern Aggression], Georgia state troops seized this masonry fortification.
On April 11-12, 1862, [exactly one year after the events at Ft Sumter] events at Fort Pulaski forever changed defensive strategies worldwide. Union forces deployed bullet-shaped projectiles from rifled artillery batteries on Tybee Island. After only 30 hours of bombardment the 7.5 foot thick brick walls of the fort were breached and the Confederates surrendered.
Today, the fort is a remarkably well preserved example of 19th century military architecture.
The Tybee Sea Turtle Project is a conservation project on the island. Its goal is to ensure hatchlings on Tybee have the best chance for survival. The average length of incubation is 60 days and so observation of the nests becomes a part of the daily dawn patrol. As a nest’s hatching time approaches, cooperators are assigned to “nest sit” during the night until that nest has hatched and the hatchling turtles make their way to the ocean. Loggerheads are the most numerous turtles on the east coast, but their population is still in decline. Nothing makes me happier than to see hatchlings headed towards the sea.
Disclaimer #1: I am not a doctor, but I do work in a hospital in the USA; I have graduated nursing school [just last week!], have examined my fair share of poop and snot, and have volunteered/visited several health clinics in my travels. I DO consider myself an expert on all things related to green snot.
Disclaimer #2: I do not advocate unyielding doctor avoidance or rampant self-medication. Sometimes, there can be something seriously wrong that you can’t fix on your own, but quite often, there are simple ways to treat what ails you without spending piles cash on tons of medicine either at home or abroad.
Without further ado: an around-the-world traveler’s guide to poop, parasites, pulmonary related issues, pokes, motion sickness, headaches, birth control and women’s health, cuts, breaks, sprains, scrapes, burns, and all things snot related.
At home, I am a healthy, but clumsy individual. I attribute it to all the time spent around snot-nosed kids who happen to be sick and in the hospital. My immune system is in overdrive. All the time. Flu-schmu. I almost never get sick beyond a simple sore throat and cough. But when I travel, it’s a difficult story.
Evidence #1: Every time I change environments, this guy sets up in my chest [or more accurately, my nose]. I don’t freak out, run to the nearest pharmacy, or anything out of the ordinary. He just has to run his course.
Evidence #2: While living in a low-malarial risk area [and on prophylaxis] I inexplicably caught malaria. Even though mosquitoes rarely bother me at home. I thought I might die. It was really that bad.
Evidence #3: This little guy must live on my passport. He’s responsible for all things related to excessive poop. He always follows me out of the country. Even to Canada. Even though I carry a supply of metronidazole with me at all times.
[a member of the Giradia family]
Evidence #4: I have had stitches and broken bones in five separate countries [USA included, but also Mexico, Peru, England, and Russia.]
Evidence #5: A particularly nasty little bout of excessive poop acquired in Mexico robbed me of my will to live.
All of these incidents occurred outside the friendly confines of my home state. So I know a thing or two about travel related maladies. For #5, I called my boss [who was a Mexican doctor] and he called a friend of his who lived in the city I was visiting who brought me some oral re-hydration solution. That saved my ass — quite literally. It’s no fun pooping mucus. Take it from someone who knows.
So after you have traveled all over creation, battled a few bugs, completed two health care degrees, got accepted into a health graduate program, worked in a hospital for a few years, worked and volunteered in hospitals and clinics all over creation, you come to know a few things. Or at least you think you do. Or at least your friends and family think you do. And they ask questions.
So here goes–a list of common travel illness scenarios, where they are likely to occur based on my limited experience, how you might want to treat what is going on, and some secrets on how to acquire drugs inexpensively.
Problem #1: My snot is lime-jello green.
What it is: More than likely it is a sinus infection.
Where it often happens: In public places, touching stuff and not washing hands afterward. In large, heavily polluted cities. Anywhere air quality is poor.
What to do: After 7-10 days with no improvement, go for a round of an antibiotic like Amoxicillin. Amoxicillin [for sinus infection] is currently out of fashion in the US, but it is cheap and easy to get in most of the world. [Do not take if you are allergic to any of the -cillin family of drugs]
My disclaimer about antibiotics: I try to avoid taking antibiotics if at all possible because they kill all the bacteria in your body [not just the bad bugs]. Additionally, over-prescription of antibiotics in recent years has helped lead to drug-resistant strains of bacteria such as MRSA and VRE.
Problem #2. I’m pooping all the time! (and it brings its friend–vomit)
What it is: More than likely it is traveler’s diarrhea. [or vomiting]
Where it comes from: Most cases come from an intestinal bacteria or viral infection. It could come from food, water, dirty glasses, pretty much anything.
Where and when it happens: Countries throughout Latin America, South America, Asia, and Africa.
What to do: Avoid getting sick, but if you do get sick, try the following: Treat the emergent: You are about to board a night bus for _____. You have a queasy tummy. You know bathroom breaks will be few and far between. Take loperamide[Immodium] or diphenoxylate/atropine[Lomotil]. But not both. Or your intestines will turn to cement. Crisis averted for the next few hours.
Address the cause: If you have bad traveler’s diarrhea doesn’t go away in a day or two, it’s likely you’ve got a bacterial or viral infection. I always carry a supply of Ciprofloxacin [Cipro] or Azithromycin [Z-pak] — an antibiotic easily found almost anywhere in the world cheaply — as my first line of treatment. Often, you’ll see your body recovering in 24-36 hours. However, once you begin taking an antibiotic, you MUST take the full course. Never stop after you feel good. This also contributes the the multi-drug resistant bacteria surge.
If you can’t keep anything down, including medications–hydrate, hydrate, hydrate: Don’t drink plain [bottled or boiled] water, but find yourself some packets of hydration salts, make your own using this formula, or buy some Gatorade and cut it with water. This will help replenish your system with salts, sugar, and minerals that your body has violently kicked out. It’s all too easy to end up in the hospital from dehydration. [I would have–twice–if I didn’t know how to start my own IV and carry a saline bag with me. I don’t always do this, just to remote places]
If you have a virus, antibiotics will not help you. Period. If it lasts more than a couple of days without improvement, suck it up and go see a doctor. They are almost always cheaper than in the US. Especially if you have travel insurance.
Problem # 3 My burps smell/taste like rotten eggs.
What it is: When you’ve got a case of burps that smell and taste like rotten eggs or sulfur, there’s a good chance you are dealing with a water-borne protozoa like giardia.
Where and when it happens: Latin America/South America, Asia, Africa–any where that can’t purify the water system.
What to do: Take a full dose of Metronidazole or Tinidazole(4 tablets at the same time). If you have this particular parasite, the burps will go away and you’ll feel better pretty quickly. If they don’t, get yourself to a doctor. As a bonus, Metronidazole can be used to treat bacterial infections in the genitals. [should you need treatment for that sort of thing]
Problem #4 I can’t poop! [or my poop is really hard]
What it is: Constipation
Where and when it happens: USA/Canada… Pasta belt in Europe… Dumpling Belt of Central/Eastern Europe… anywhere where there is heavy food
What to do: Back off the pasta, dumplings, bread, and cheese. Eat as much fruit, greens, and water as you possibly can. If that doesn’t work, bring out the big guns and eat a bag of prunes (with another few liters of water).
Problem #5 Jackhammers are being used inside my skull.
What it is: Depending upon the intensity and location of said jackhammer, you could be experiencing a garden-variety headache or a migraine.
Where and when it happens: After a series of overnight buses with blaring music and jerky stops. Sleeping in cheap hotels with giant pillows. People yelling outside your room ALL. NIGHT. LONG.
What to do: For regular headaches, Tylenol or Advilwill usually do the trick. For tension headache/migraines, try Tylenol with caffeine. And quiet. And darkness. And not moving.
Problem #6 I don’t want to get malaria.
What it is: A parasitic disease transmitted by the bites of infected mosquitoes
Where it happens: Africa, parts of Asia, select parts of Latin America, the Caribbean
What to do: Once you have an itinerary, consult the CDC malaria map to determine malaria risk for the regions where you are traveling. Two things will matter most: where you are going and in what season. Not all malaria is created equal, so you’ll need different medication for different parts of the world. [I contracted P. vivax malaria in the Amazon even with Chloroquine–so take this advice with a grain of salt]
Doxycycline: Insanely cheap when purchased locally and fairly cheap in the USA. Two things to note: doxycycline tends to make people more sun-sensitive. It can also conflict with some birth control pills. It’s also an antibiotic.
Malarone: It’s insanely expensive, but its chemistry supposedly messes with your mind and body less than larium or mefloquin.
Chloroquine: Not really cheap. Chloroquine tablets have an unpleasant metallic taste.
On the cutting edge of malaria remedies is the Chinese artemisia plant (or qing hao, “sweet wormwood” or “sweet annie”). It appears to be commercially available from Novartis as the drug Coartem (Artemether 20 mg, lumefantrine 120 mg). It’s now on the WHO essential medical list. [2018 update: Coartem is in in Peace Corps med kit for treatment of malaria so it is now a pretty standard drug].
Problem #7 I don’t want to catch Dengue fever/Typhoid fever.
What it is: A viral infection transmitted by A. aegypti mosquito [dengue] or a bacterial infection caused by Salmonella typhi [typhoid].
Where it often occurs: sub-tropic regions such as Indonesian archipelago into northeastern Australia, South and Central America, Southeast Asia, Sub-Saharan Africa, and parts of the Caribbean [dengue] Most of the world except USA/Canada/Australia/ Western Europe. [typhoid]
What to do: There is no prophylactic medicine for dengue. The best thing you can do is avoid being bitten. These are the ones that come out during the day. There is a vaccine available for typhoid, and it can be treated with good old Ciprofloxician. And wash your hands. Frequently. Like become OCD obsessed with it.
Problem #8 I’m going to vomit on this bus/boat/plane/donkey cart/ect.
What it is: Motion sickness
Where and when it happens: On windy buses in the mountains of Ecuador, Bolivia, Peru. In a donkey cart in Guatemala. On a research boat headed to the Galapagos Islands in a storm.
What to do: Option #1–If you’re prone to motion sickness, keep a stash of Dramamine or my personal favorite Bonine (aka Antivert, Meclizine) handy and take it 30 minutes before departure. If you take it once you’re on the road, it’s too late. As a side benefit, Dramamine will usually knock you out so you don’t have to watch the death defying acts of the bus driver.
Option #2: Purchase a pair of pressure point wrist bands (usually go by the name of Sea Bands). Not sure if their effect is psychosomatic or real, but some people swear by them.
Problem #9 . I’ve gone too high. My head is going to explode.
What it is: Altitude sickness.
When and where it happens: Hiking or walking anywhere above 2500 meters, particularly if you’ve just arrived by air, train, or bus. The worst I have ever experienced was taking a bus from sea level in Ecuador up to Quito. I felt as if my head was going to blow right off. La Paz, Bolivia and Bogota, Colombia were no picnic either.
What to do: If you can, take altitude slowly, acclimatize. Outside of that, try local remedies like coca leaves (recommended in the Andes, chewed or in served in coca tea) before resorting to traditional altitude sickness drugs like Diamox [which is a diuretic].
Problem #10 . I’ve got blood spurting from somewhere it shouldn’t.
What it is: Scrape, cut, gash, road rash.
Where it happens: Being smashed into rocks when trying to learn to surf in Peru. Falling off the sand board in Chile. Getting too close to the reef in the Caribbean. Running into trees while skiing. Ect.
What to do: I always carry an assortment of band-aids, bio-occlusive dressings, gauze, steri-strips [for wound closing], ACE bandages, hydrogen peroxide, neosporin, saline, and iodine. And Cortisone cream–for rashes and bites. I may be going overboard, but then again, I am pretty clumsy.
Problem #11. I do not want to get pregnant and/or a souvenir I can’t get rid of…
What it is and where it happens: Me hopes you should be able to figure this one out on your own. But beaches, booze, and bathing suits are a heady combination.
What to do: Contraception options are many, but if you choose to take birth control pills, here’s some advice: Before you leave home, ask your doctor to put you on a pill with a hormone formula that is more universally known. Drugs are known by different names around the world, so write down the commercial name of the drug as well as its chemical and hormone structure. Condoms are available [can be expensive], but especially if you need the non-latex variety, bring some from home.
In my experience, many countries outside of North America and Europe (and I assume Australia) will sell birth control pills without a prescription. Along your journey drop into pharmacies and ask if they carry your particular pill. Birth control pills are rather expensive (especially by local standards) and choices are limited in many Central and South American countries. However, they were relatively inexpensive and easy to find in Argentina. So, when you find yourself in a country that carries what you need for a good price, stock up.
How do you get all these drugs on the road?
Most pharmacies outside Europe, North America and Australia will sell you whatever you need without a prescription and at a much lower cost than you’ll find at home. My advice: if you’re going on a long journey, travel first to a country where prescriptions are not required for basic medications.
Prescriptions: not necessary.
Prices: much cheaper than back home
Medicines (at least based on my experience): the real deal
I have only had to buy medicine in countries where I speak the language, but knowing the generic name for a drug will help immensely. Write down the chemicals (and percentages if you can find it) that go into the medication you need instead of just the commercial or generic name of it. The chemical names translate roughly the same in all languages even if the medication is called by another name in that country.
There it is. My best advice for staying healthy on the road. Take it or leave it knowing that I have had my fair share of sickness on the road, but it has kept me alive and mostly healthy.