Travel Medical

My right upper deltoid is sore because I've just gone through another round of travel immunizations with my new travel doctor.  I wanted a second opinion because I found conflicting advice and didn't feel I received adequate explanations.  So I searched for someone who has had experience "in the field" and hit the jackpot. 

Even though you assume all doctors ought to have the same book knowledge, real experience does stand out.  She was able to list all the recent travel health notices, anticipate my questions, understand my concerns right away and could help me anticipate for the future.  Having recently returned from a 3 month mission in Asia was just the bonus.  That alone was worth many times the second consult fee.  Outside of the rabies vaccines, I am now ready for the developing world!

You'll read a lot of varying opinions on the merits and costs of travel medication and immunization.  A lot of people complain about the cost.  My tally so far is around $500.  And surprisingly our extended health insurance covered about 2/3rd of it. Wasn't expecting that.  Last time I went for shots (Yellow Fever and Typhoid), I hadn't even bothered to submit a claim as I assumed it fell in the category of elective procedures.  A lot of other people complain about potentially disastrous side effects.  Friends of ours feel so strongly against it, they won't immunize their children.  It can be a touchy subject, that's for sure.

I think of it this way:  Drugs and immunization has helped more people than not.  Considering the flight alone cost more than our new washer and dryer, what's $500?  How much is my life worth to me?  How much risk do I want to take on physically and mentally?  How keen am I to want to be looking around for a qualified doctor and clinic solo in a country where I don't speak the language and where I may be hundreds of miles away from anything?  Some countries will require proof for entry.  Yes, you can choose to not go.  That's where D stands and it works for him.  No hassle then.

You can apply the above thinking to the topic of travel insurance.  We have coverage through our travel credit cards and through D's work which we've paid extra for. And silly me has been travelling without really knowing the absolute direct number to call as I've been complacent with the places I've gone to.  Even when I knew I was going to Greenland I felt secure that I would receive good care should something happen.  Having gone, I would say -- Know your policy and make sure it covers the activities you plan on undertaking as well as emergency evacuation for the country you are visiting.  Plans often have their own definition of what a "risky" activity is (ie. dogsledding, camel riding). 

Levels of medical facilities and care in the developing world can be real scary.  In the "I would not allow them to put an IV in me" (and hopefully I'd be lucid enough to say that) sense because of incidences of re-using needles even in hospitals and prevalence of HIV etc.  For example in Cambodia, the level of care is basic enough that should anything moderately serious happens, you will want/need to be medically evacuated to Bangkok.  And seriously, the Only Thing remotely exciting about that would be the potential helicopter ride...and even that isn't always as straightforward as described in your policy.  Have a read of this post. 

So make sure your policy really will get you out of there if need be.  Know where your home country's Embassy is (There isn't one in Cambodia for us Canadians -- We have to go to the Australian Embassy).  And talking to agents at an insurance call centre isn't all that fruitful as they aren't always able to tell you much outside of what you are able to read anyways.  And being told "You'll be covered..." when they can't get over the concept why you'd go to places where there is no running water, cell phone coverage or a hospital hasn't been all that confidence boosting.  Talk to someone in the actual claims department if you can.  Or buy extra insurance from a company that does lay it all out and have experience in certain types of travel.   Unless I get better answers, that's what I'm going to do. 

On a real positive note about travel, my flights in April have been changed by the airline fairly significantly.  It wasn't such a great itinerary to begin with (3 hops each way with an 11 hour layover in Seoul on the way home) but I was making the best of it -- 5 hour free transit tour and time at what is supposed to be an incredible airport!  The email came barely 2 weeks after I purchased the ticket.  I panicked because it made things even more uncomfortable on the way there and back, increasing my average layover to 4 hours and the one return layover in Seoul to 13+ hours. 

So I called and got someone right away.  He was fantastic.  Didn't explain any rules or anything to me when I asked what my options were.  Just asked me if I had to connect through Seoul?  When I said 'no', he proceeded to find me flights that were so good, I almost giggled out loud. 

Not only do I no longer have to make 3 hops each way, I am now able to make it home on the same day I left.  It's still going to take about 30 hours but psychologically it feels better, like I've cheated time or something.  And the kicker?  When D called (because it wasn't available to be purchased online and having seen what I've come up with for that trip, has decided he might want to join me after all...) to see how much it would cost to take the same flight?  $4200..... Score!!!  And that's for economy....

Munich x 3

This was our 3rd time visiting Munich.  Twice to take in their Christmas markets and once at the start of Biergarten season (May). 

Here are some of our observations this time around:

• Increased numbers of people (especially young adults) smoking -- Disturbing considering all we know.
• Road rage from Audi drivers!  Not sure what is going on there.  Normal vehicular experience is quite quiet due to the type of cars on the road (mostly luxury sedans vs scooters and small cylinder vehicles in say, Paris or Rome) so honking really stands out.
• Increased numbers of beggars -- Non German.
• We found it overall to be busier than last year.
• Popular street food trends this year include the crepe and flatbreads with various toppings.  We stuck with the traditional German selections such as Reiberdatschi, lebkuchen, spatzle, knodel, schupfnudeln, leberkase etc. etc.  We were surprised to see a plethora of places offering Currywurst as well.
• Noticed prices have gone up slightly compared to last year.  Each snack/item/alcoholic drink costs in the 4 - 5 Euro range this year.  A plate/entrée (still talking street food portions here) will be in the 8 - 10 Euro range.  Small bottle of water 2 Euro+ depending on where you are.  And you won't find people drinking water either, which is totally opposite from Canada.
• We continued to stand out amongst everyone else because we shared dishes and drinks.  People just don't do that.  I can't imagine eating or drinking one of everything on my own as there is just too much food to choose from and to do so would mean gaining many pounds.  Considering how many hours of walking we did each day, I still managed to gain a pound. 
• It took us a couple of days of visiting and tasting various markets treats to develop a list of favourites (and about 3 days before we were thinking in basic German -- pretty pathetic, I know).  I can't imagine being there for 2 weeks.  Just too much food!  Temptation is everywhere!  I think 4 - 5 days is the ideal length of time to hit all the highlights and to go nuts trying everything. 
• From a food allergy perspective, this was my best trip.  No nasal congestion or itchy eyes post wheat/egg/sugar/dairy exposure as I didn't hold back.  Just noticed a drop in energy.  I will take it as a sign I am healing.  Good thing as we will be spending New Years in France (last minute bonus trip courtesy of sheer luck with finding decent flights and Skymiles).
• Did you know their Ice Tea is sparkling?
• Few things help complete a meal laden with meat (mostly pork) better than a skewer of dark chocolate covered strawberries.  D really took to the chocolate covered grapes (yuck -- not for me).  Tasted so refreshing.  I also enjoyed the dark chocolate covered hazel and macadamia nuts.  Most people walked around snacking on candied nuts of one sort or another.
• If you enjoy looking at and buying beautifully displayed gourmet food, head to Dalmayr -- Simply gorgeous store.  Reminded us of the food floor at KaDeWe in Berlin.
• If you like riding style leather boots, you will find a lot to chose from -- Won't come cheap.
• We loved how if you order a fresh waffle with chocolate, one side is actually dipped in a chocolate that dries/hardens so when the cherries and whipped cream is added on top, it prevents the warm waffle from becoming soggy in a hurry -- So Smart!
• It still hasn't failed to surprise us just how quiet the Munich airport is.  It is literally almost silent.  People are so respectful.  Love it!
• Speaking of airports, AMS and MUC are offering real food for "good" prices.  Airports are notorious for bad quality food at high prices.  I actually had an organic hamburger made fresh with salad and fries for 10 Euro in Amsterdam!  Usually I am paying 17 Euro for about 8 pieces of sorry looking sashimi and a bad green tea or 6 Euro for a small freshly squeezed fruit juice.  That was just earlier this year too.  And in MUC, you can get a plate of leberkase, potato salad and a Weissbier for 10 Euro!
• Another point about European airports -- WiFi has improved in AMS and MUC.  If you do not have a data plan for outside of your home country, be cautious as roaming fees can be exorbitant.  Check with your provider as to how to disable roaming on your phone.  Case at point -- My new android phone uses more data than my old BB.  I was able to email D from Hawaii over the 2 weeks I was there and incurred only about a $4 charge (no package).  In Sept, when I was in Bar Harbor, I noticed a "R" by the bandwidth strength sign up top but not before getting charged for roaming -- $7.03 for 2.34 MB (think I just managed to receive 2 emails and was starting to check the weather)!  My new phone needs to be in flight mode as well as disabling the data while roaming and mobile data settings in order to be able to use WiFi without roaming.  Found this out in AMS after a few minutes of surfing...We'll see if I'm dinged anything shortly.  I had time to burn as we got there 1 hour ahead of schedule (due to high winds).  Add to it our usual 1 hr 40 min layover between flights and 1 hour subsequent delay as the winds were wrecking havoc for other planes. 
• Starbucks is serving up an Orange Mocha coffee this season in Europe...Too sweet for me but I had to try.
• We discovered a really fun store -- Manufactum.  There is this toy horse I wanted for myself --  Video below. (Turn your sound on)
• Should you find yourself with extra stomach room and energy to burn after regular market hours, head to Tollwood as the fun there goes till 1 am daily.
• I'm going to take this opportunity to Wish You All a Merry Christmas & A Happy New Year!!! May your lives continue to be better than you imagined.

Munich Facades

 

 

It's Time

For the last decade and a half, especially the last 2 years, I've been travelling to explore some of my dream places.  

Now that my work schedule is comfortable and my psyche has had a chance to decompress from what feels like decades of "torture", it's time to start travelling for a larger purpose than myself.  I'll still incorporate some fun stuff but there is something I've wanted to do since I was a teenager:

To give back in a more personal way than money.  I want to experience viscerally what it is like in true adversity, not the "first world problems" that I contend with here.

Here's what's been on my reading list lately and the subject matter has made my gut feel very uneasy and has negatively affected my sleep.

• Notes From My Travels:  Visits with Refugees in Africa, Cambodia, Pakistan and Ecuador --  Angelina Jolie
• I Have Seen The World Begin:  Travels Through China, Cambodia and Vietnam -- Carsten Jensen
• First They Killed My Father:  A Daughter of Cambodia Remembers -- Loung Ung
• Cambodia Calling:  A Memoir From the Frontlines of Humanitarian Aid -- Richard Heinzl

In order to do the types of things I would like in the places that are needed, I have to get over myself. 

I have to be able to brave heat, bugs, potential disease, cultural shock, mental angst, emotional overload, safety concerns, long transit hours, disease, delays, frustration, potentially appalling levels of hygiene and public health standards, overwhelming sadness and despair...To rise above discomfort and still be productively helpful.

Will I be able to do it?  I honestly don't know but I would like to give myself an opportunity to find out.  To go beyond my current limitations and open myself to be changed forever.  I know I would have lots to offer if I can manage all the noise that comes with a more extreme environment.

Should I discover I don't have what it takes or am truly not cut out for this line of work, then I'll be satisfied with continuing to donate money.  But if there is a chance I can adapt and participate with my own hands, I will. 

This is the focus of my initial travels for 2014.  I'm seeking first to understand so haven't signed up for a solid commitment of any sort, as tempting as it is -- I don't want to let anyone down should I have a "breakdown".  I would like time to acclimatize literally and mentally/emotionally. 

It will be a challenge as I currently exist in a pretty controlled, clean, safe and manageable environment and it has taken a long time before finally feeling ready to take this on.  D will be the first to tell you that I'm not a huge fan of change in my everyday routine.  Not to mention mosquitos love me and heat and I have not traditionally gotten along too well. 

He'll also add that he simply choses to not go to places where there is so much to deal with but has been surprised with my persistence and how much I've been putting into my preparations.  I'm hoping a strong enough purpose will make all the difference.

Until then, I will allow myself to revel in the safety of a country that is at the opposite end of the spectrum.  A place where I'm free to wander at my leisure, where spirits will be high.  We're returning to Munich to bask in their Christmas Market culture.  Back in about 1 1/2 wk.