In general, always take your "regular" medicines with you, especially those you have needed over the last six months. ( for a Urinary Tract Infection for example). Always try to take a list of your current medicines and the "chemical" name of the medicines. Make sure any allergy you have for medicines is printed out. ( If there are any doubts, consult your doctor! )

Take a thermometer with you.

The main health problem travelers have is DIARRHEA sometimes with vomiting. So you should have medicines to help these problems, and replenish fluids.

1. KALBETEN ( Pepto-Bismol overseas ). Tablets and Liquid. This is the "healthiest" medicine for diarrhea. Always use this before other anti-diarrhea medicines. Dosage: One dose after every bout of diarrhea, up to seven times a day. Side effect: Colors stool black ( and may color tongue black too! ) .

2. IMODIUM ( Stopit; Loperid ). Capsules. Not as healthy as Kalbeten, but more effective. Use when you have to stop the diarrhea as soon as possible. May cause more stomach cramps. Dosage: Two capsules together to start, continue with another capsule every six hours as needed. Avoid Milk and milk products.

Avoid Caffeine ( Tea, Coke, Coffee ). You should try to eat, your intestines are sick and will "get better" sooner if you eat ( Even if you have lost your appetite ). Chicken soup, or any broth is good ( a source for fluid, salt and protein ). Instant soup "cubes" or packets are a good idea. A special "anti-diarrhea" diet does not have a major effect on the illness. It generally lasts for about 12 hours of vomiting at the beginning, and then up to 5 days of diarrhea.

ANTI-VOMITING

3. PRAMIN Tablets, Syrup, or Suppositories. Suppositories are the best ( If you don't have diarrhea ). BUT they may get soft in heat ( If they do - put them (still in their plastic wrapper ) in ice water or in a freezer for 15 minutes ). Suppositories are not pleasant, but you won't throw them up! Dosage: One Supp. Or tablet up to 4 times a day . Side effect: may put you to sleep. Take after the second time you vomit.

4. ORAL REHYDRATION SALTS are very important to replenish loss fluids and salts. We avoid dehydration, and may avoid being hospitalized! Useful also on hot trips to avoid dehydrating. Many products are available as "Sport" drinks such as ISOSTAR, or GATORAID. HYDRAN, REHIDRAT, and ORSET are powders to prepare a "isotonic" drink. These are available by prescription ( so they are less expensive ). ( Hydran prepares a liter, Rehidrat 250 cc, and Orset 60 cc per tablet ) It is important to use the exact amount of water to prepare the "isotonic" solutions.

5. Many tourist guides recommend bringing an antibiotic to be used for DYSENTARY. ( A bacterial infection with fever, severe diarrhea ( sometimes bloody ) and vomiting. ). It is best if you consult a doctor before starting antibiotics ( even by phone if you can't get to a doctor ). ZINNAT or CIPROGIS ( CIPROXIN ) are both good options, and also are useful in other infestions. Dosage: One tablet twice daily for 3 days. ( 500mg is generally needed per dose ).

DEHYDRATION IS THE MAIN DANGER OF THIS ILLNESS. TAKE IT EASY UNTIL YOUR STOMACH GETS BACK TO NORMAL. TAKE A FEW DAYS OFF. AVOID STRENUOUS ACTIVITIES FOR A WEEK AFTER A BOUT OF DIARRHEA.

AND IF IN DOUBT - CALL ME or SEE A LOCAL DOCTOR!!

The second common health problem is SKIN INFECTIONS. Skin sores get easily infected overseas. SO…. WASH EVERY CUT and ABRASION IMMEDIATELY WITH SOAP and WATER! ***Take a small bar of soap and a "emergency" water bottle in your day pack for emergencies. It is a simple and very effective method of avoiding infections.

6. POLYDINE is a disinfectant. It is useful, so take a small plastic bottle. It has NO USE as an anti-biotic cream, so the cream "form" shouldn't be used. Use soap and water! It in doubt, use a few drops of Polydine. If an infection develops ( red area around the sore, or pus ) use a good antibiotic cream:

6. BACTEROBAN ( or MUPIRICIN - TEVA ) or FUCIDIN are the best creams. ( They work better than the older creams many people have been using for years. ) Spread a small amount three times a day for a few days. Remember that minor cuts can get infected in foreign coountries, so don't ignore them.

7. AGISTEN or DAKTARIN are common anti-fungal creams. Take one with you if you have a tendency ( foot fungus "athelete's foot" or groin rashes ). Women with a tendency for Vaginal Candida should make sure they have their usual treatment with them.

8. ZINNAT or MOXYPEN are good broad-spectrum antibiotics. They are taken orally. Moxypen three times daily, Zinnat twice a day, after food. ( Zinnat has a common side effect of Vaginal Candida so make sure you women have treatment and take a "probiotic" like the BIO yogurts). One should take antibiotics for a minimum of 5 days, and you should always consult your doctor before starting, to make sure you're on the right course. Remember, wherever you are, your doctor is only a phone call ( or email) away !

If you have a fever and a sore throat ( and no other "cold" symptoms like cough or sneezing ), or a productive cough and fever, or a urinary tract infection, it's a good idea to have antibiotics around…

9. OPTALGIN ( Dipyrone or Novalgin in Europe and South America ) is a very useful anti-pain and anti-fever medicine. It is not available in USA. There one can use one of the many Ibuprofen brands ( Advil, Motrin, Nurofen ) instead. Optalgin can be used up to 5 times a day, although if you need that much you should probably…. ( call your doctor ! ).

10. Nose spray or drops - Especially if on a long flight. If your nose is stuffed, or gets blocked, make sure to use a nose spray an hour before landing ( when the plane begins to descend ) Otrivin or Vibrocil are two options.

11. Anti-allergy pills ( Lorastine, Loratidine-teva, Histazine) or others are very useful for allergic sneezing, "Rhinitis", or itching, or insect bites. Once daily, these latest "generation" of anti-histamines are usualy non-sedating ( won't make you tired ). An anti-histamine gel like:

12. Fenistil Gel is a good thing to have for itchy bites. If you tend to react badly to insects a steroid cream like:

13. Hydrocortisone or Neriderm or many others is a good thing to use. Three times a day ( can be used intermittently with the Fenistil) .


MALARIA PREVENTION Go according to the "traveler's clinic" recommendations and the CDC site. Malaria is a very serious and unpleasant illness. It is very important to take the full course of the correct preventive medicine. Personally I think the "simple" once weekly Lariam (or Mefloquine as the generic is called ) is the best option ( IF IT COVERS THE TYPE where you are going to be ) . Contrary to rumors ( including internet sites ) It has very infrequent side effects.

REMEMBER!

Always leave medicines in their original packages. Police and Customs officers get upset at a bag of pills… Print a list of your medicines ; keep copies in a few places. Make sure you know the "chemical" name of your medicines. If you have a involved medical history - print it out in English. When in doubt - contact your doctor!

PLEASE Visit the CDC site ( the American Center for Disease Control ) while planning your trip. They are the world's experts and source of information for traveler's medical advice. The site is very clear and has updates on recents outbreaks of illnesses. www.cdc.gov

Most hospitals have TRAVELERS MEDICINE clinics. The Ministry of Health also runs one. You must consult one before travel, as soon as you can, in case you need a series of vaccinations before travel. Books, friends, travel guides, and even your own very clever doctor are not the correct source for up-to-date recommendations. It costs about 250 NIShekel, but this is not the time to save money!

Some options:
1. Ministry of Health , Remez Street, Rehovot Phone: 08-9485815
2. ICHILOV Hospital , Tel Aviv 03-6973557
3. TEL HASHOMER Hospital 03-5303456

The hospitals have a discount program with the Kupot Holim. Check with your Kupah's secretary to find out where they recommend you go. It may not be worth the small discount to go out of town.