During the last two years, Tamara Brattoli of Tinley Park has spent New Year’s Eve in a Sacramento emergency room; Christmas Eve in a Sacramento urgent care center; and the majority of one weeklong visit holed up in her in-laws’ guest room.
Family vacations, so much anticipated, turned into family fiascoes because of her two children’s severe ear infections and a case of the chicken pox.
Sound familiar? Illness often becomes an uninvited traveling companion on family vacations–just ask the approximately 90 million adults who will take a family vacation this year.
But illness doesn’t have to ruin–or even intrude on–your family vacation. Planning ahead and being prepared will help protect you from many travel-related problems.
These are the most common discomforts and illnesses families encounter and what you can do to prevent and treat them:
Sunburn and sun poisoning
Getting a sunburn is a quick way to spoil a vacation. Too often, that happens on the first day of a trip. “Once you’re burned on vacation, you’re pretty much done,” says Dr. Robert Citronberg, associate director of Infectious Diseases and the Travel and Immunization Clinic at Lutheran General Hospital in Park Ridge. “You’ll have to either stay out of the sun entirely or cover everything up.”
Protection is pretty simple: Slather sunscreen of at least SPF 15–preferably SPF 30–that protects against both UVA and UVB rays all over exposed skin, including the often-forgotten tops of the feet and ears and the back of the neck. Choose a waterproof sunscreen if you’ll be swimming or sweating, and use a PABA-free product for children, as PABA can cause rashes. Apply sunscreen 30 minutes before heading outside so the skin can absorb it, and reapply frequently.
Keep babies younger than 6 months covered with clothing or in the shade. If that’s impossible, you can apply minimal amounts of sunscreen to small areas, such as the baby’s face and the back of the hands.
Stay out of the sun when it’s strongest, from 10 a.m. to 2 p.m.
Wear light-colored clothing, covering as much of the skin as possible, and a brimmed hat to protect the face.
Stay out of the sun if you’re taking a medication that causes photosensitivity, such as tetracycline antibiotics, sulfa drugs, thiazide diuretics and oral contraceptives.
Cool, moist compresses help reduce pain and heat from minor sunburn. So can moisturizing the skin with baby lotion or cold cream. Topical preparations for sunburn can relieve swelling and pain, and aspirin or ibuprofen can relieve inflammation.
More serious than sunburn, sun poisoning can require medical attention. Be on the lookout for red, swollen skin and a rash or blisters, fever, nausea and vomiting, diarrhea, delirium, seizures or lethargy. If you have any doubt about the seriousness of any symptoms, see a doctor.
Gastrointestinal problems
About half of all international travelers experience “traveler’s diarrhea,” whose uncomfortable and inconvenient symptoms probably require no further explanation. Prevention is your best weapon against this bacterial illness. First, eat yogurt before you travel. Studies have shown that daily consumption of a pint of yogurt that contains live, friendly bacterial cultures (Lactobacillus bulgaricus and Streptococcus thermophilus) helps guard against unfriendly bacteria. While you’re away, drink only bottled water, even for brushing your teeth, and avoid fresh fruits, vegetables, salads or anything that could have been washed in local water.
“The basic rule is boil it, peel it, cook it yourself or don’t eat it,” says Dr. Mary MacGregor, a specialist in infectious disease and medical director of the Travel Medicine Source in Morton Grove. “And don’t eat food from street vendors who have no sink to wash their hands.”
Mexico and other exotic locations are not the only place you can pick up diarrhea–causing bacteria. You can get an intestinal parasite called Giardia lamblia by drinking water from a mountain stream in Colorado, says MacGregor, or food poisoning from improperly cooked meat. Avoid eating any raw foods, such as oysters in New Orleans, says Citronberg, and make sure that any meat you eat is brown all the way through and steaming hot. And if you’re packing a picnic lunch, keep it on ice. Mayonnaise-based salads and eggs can harbor organisms that will grow when not sufficiently cool.
Being careful can’t prevent every diarrhea-causing situation. A Disney World vacation for the Motel family of Lincolnwood last spring included a tour of many of Disney World’s restrooms when 10-year-old Seth developed a reaction to an antibiotic he had started taking before they left home. Relief at being on the road to recovery before the trip quickly turned into misery a couple days after they arrived. After a call home to their doctor, the Motels started Seth on the BRAT (bananas, rice, applesauce and toast) diet to try to quell the symptoms.
“It really cramped our style, pun intended,” says Seth’s mom, Louise. “They don’t have that kind of food there. All of a sudden, the whole world is fried, and you’re looking for a cracker.”
Jet lag, altitude changes and changes in diet can also cause traveler’s diarrhea. “If you normally eat a healthy diet and then bombard your intestines with a fat load on vacation, you can develop diarrhea,” says MacGregor.
If someone in your family experiences diarrhea and cramping, an anti-diarrheal medication such as bismuth subsalicylate (Pepto-Bismol) or loperamide (Imodium) can help. Follow the BRAT diet and be sure to drink enough fluids to more than replace those that have been lost. Oral rehydration packets can be added to the fluids to replace lost minerals. Prolonged (more than 4 days) or severe (bloody stools, foul-smelling gas) symptoms may require antibiotics, so you’ll need to find a physician.
Motion sickness. That queasy feeling can overcome you in any moving vehicle. It’s caused by a disturbance in equilibrium and can make you feel nauseous, dizzy and fatigued; vomiting is also common. To help prevent motion sickness:
– Always face forward.
– Look out the window but keep your eyes focused on the horizon or on some distant stationary point.
– Sit in the most stable section of the vehicle. In a car, it’s the front seat. (Children too young to sit in front should sit next to the window and stay as still as possible.) In an airplane, it’s over the wings, on a boat it’s midship and on a bus, it’s just forward of the middle.
– Eat lightly and drink plenty of fluids. Adults should avoid drinking alcohol.
– Don’t close your eyes.
– Don’t read.
– Try over-the-counter medications such as dimenhydrinate (Dramamine) or antihistamines. Ginger root, ingested as tea or taken in pill form, may also be effective and has fewer side effects.
Ear pain and infections
Although research doesn’t support them, many parents are convinced that air travel can initiate an ear infection. A child who boards a plane without any sign of an ear problem suddenly has one 24 hours after deplaning. “An ear infection could be brewing and not be symptomatic, and the plane ride makes it worse,” says Citronberg. That’s especially true if a child has a respiratory infection, even one that’s undetected.
That was the case for the Ebach family of Wrigleyville on two visits to relatives in Florida. Two years ago, both kids, then 4 and 2, came down with ear infections within a couple days of arriving. This year, their son got an infection the day after they got there.
Even if there’s no ear infection, air compression changes can cause discomfort. Parents should give babies bottles to drink on take-off and descent; the act of sucking and swallowing helps keep ears clear. Older children and adults can chew gum, yawn, or hold their noses closed and blow to clear clogged ears. Decongestants do not help.
Swimmer’s ear. A bacterial infection of the outer ear and ear canal, swimmer’s ear is associated with frequent swimming, especially in fresh water. It is fairly common among people who use group hot tubs because the high temperatures foster bacterial growth, especially if the water is improperly chlorinated, according to Citronberg. The bacteria also can cause skin infections that appear as red, raised bumps in areas that had direct contact with the water. To help prevent swimmer’s ear, dry the ears out with a towel after each swim. People who have frequent ear infections should wear ear plugs when swimming. Treatment for swimmer’s ear includes keeping the ear dry and using antibiotic drops.
Tick and mosquito-born illness. Ticks and mosquitoes aren’t just annoying bloodsuckers. They can give you some pretty nasty diseases. Ticks can leave you with Lyme disease and Rocky Mountain spotted fever, while mosquitoes can deposit any of a number of strains of encephalitis, as well as Dengue fever and malaria. To help avoid their bite, wear an insect repellent containing DEET. For children, choose an insect repellent designed for kids that contains no more than 10 percent DEET; adults should use products containing 30 percent DEET. Like sunscreen, insect repellent needs to be reapplied after swimming or excessive sweating. And, if you’re using a sunscreen, be sure to apply it first, allowing it to absorb into the skin before you apply the repellent. Wear long pants and socks with shoes and long sleeves with shirts tucked into pants in areas known to have ticks and mosquitoes. Avoid bright colors and jewelry. If you’re camping, use a product containing permethrin to treat clothing and bed netting; it will repel both crawling and flying insects.
Even with these precautions, you must still inspect all family members for ticks. They are very tiny and can be tricky to remove. Use a pair of blunt tweezers and grasp the tick firmly, gently pulling upward. When the tick has been removed, apply an antiseptic.
Altitude sickness. A good percentage of people who go abruptly from sea level to high altitudes (8,000 feet or higher) suffer from altitude sickness. Caused by a decreased amount of oxygen in the air, symptoms include headache, fatigue, dizziness, nausea, shortness of breath, sleep problems and rapid heartbeat with exertion. To prevent altitude sickness, allow your family to gradually adjust to higher altitudes. Diamox, a prescription medication to prevent altitude sickness, can be taken for a couple days before your trip, says MacGregor. She also recommends staying well hydrated and avoiding alcohol. If your child becomes confused, has a severe headache, vomits more than a couple times or has labored breathing, descend immediately to a lower altitude and get medical attention.
ROUTINE SHOTS A PRETRIP MUST
No matter where you’re traveling this summer, be sure to update your family’s routine immunizations before you leave.
Adults need a diphtheria-tetanusbooster every 10 years. If you cut yourself while you’re away, you’ll be glad you were inoculated.
HOW TO FIND COST-EFFECTIVE MEDICAL HELP WHILE ON THE ROAD
The worst has happened, and you’ve got a sick family member who needs a doctor. Do you know where to go?
Before you leave homemake sure you know where you can find medical help. Check directories for local hospitals and urgent care centers near where you’ll be staying, find out their hoursand ask whether they accept your insurance. Also, check to see which pharmacies will accept your prescription card, or you’ll waste precious time or face paying exorbitant prices for medication.
Know, too, that emergency rooms may cost you more than urgent care centers, even if they take your insurance, and the wait can be interminable. Tamara Brattoli learned that the hard way: A late-night visit to the ER in Sacramento cost her more than $400 and many hours in the waiting room. “The sicker the person, the more likely I’d recommend an emergency room,” says Dr. Mary MacGregor, medical director of the Travel Medicine Source. “But for most medical problems, an urgent care center is more than adequate.”
If you’re staying with relatives, they can usually recommend a doctor. Otherwise, ask your hotel manager, resort directoror a local pharmacist. Although the quality of the health care won’t be guaranteed, a recommendation is usually better than the Yellow Pages.Check to see which pharmacies will accept your prescription card, or you’ll waste precious time or face paying exorbitant prices for medication.
WHAT TO TAKE IN ADDITION TO THE SAND CHAIR AND BEACH TOWEL
It’s 2 a.m. and your child awakens in a strange place with what feels like a 103-degree fever. You don’t know for sure, though, because you don’t have a thermometer, and you’re helpless because you forgot to pack the Childrens Tylenol.
Don’t be caught off guard on vacation. Take the following along:
– Adhesive bandages, different sizes; adhesive tape and gauze
– Antibacterial gel (for handwashing without soap and water)
– Antibiotic cream or ointment
– Antidiarrheal medicine
– Antihistamine
– Anti-itch preparations, such as After Bite or a hydrocortisone cream.
– Antiseptic solution
– Cold/hot pack
– Fever and and pain relievers, such as acetaminophen and ibuprofen for adults and children
– Insect repellant
– Medications: take adequate amounts of any medicines family members use Prescriptions: just in case you lose your medicine or don’t have enough
– Scissors
– Sunscreen
– Thermometer (oral and rectal if you have small children)
– Tweezers (for removing ticks and splinters)
