Cruises make traveling easy: The captain does the driving, the waiters serve the food, the cabin steward makes your bed, and counselors babysit the kids. And if you fall ill, onboard doctors and nurses will take your temperature, bandage a cut, or give you a course of antibiotics.
Cruise ships that carry a few hundred passengers or more all have onboard medical clinics staffed by doctors and/or nurses. If you want to visit the doctor for a non-emergency issue, like a bad cold, muscle strain, or scrape, passengers can stop by the clinic when it's open (typically for a few hours in the morning and a few more in the afternoon). The rest of the time, a ship's medical center focuses on taking care of the crew. If there's a dire emergency (ranging from acute appendicitis to a heart attack), you can reach the ship's medical staff 24 hours a day by phoning the front desk.
Generally, the ship's medical staff will try and stabilize a gravely ill patient until land-based medical care can be reached. Minor surgical procedures, such as suturing of wounds, are routinely performed at sea; major surgery, such as an appendectomy, is not typically performed aboard a cruise ship because an operating suite, an anesthesiologist, and a surgeon aren't available. Depending on circumstances, an air lift to the nearest reputable hospital might be arranged (at the patient's expense). Helicopters can land on the foredeck of some large ships or hover above and lower a stretcher to hoist up the patient.
Though it's comforting and convenient to know medical care is available on board just in case, it's always a good idea to be prepared. If you can try to take care of your own minor medical needs when possible, you can avoid waiting in line at the ship's clinic and paying for medicine and the consultation itself (which typically costs about $100). These fees are charged to your onboard cruise account, payable at the end of a cruise via a credit card or cash. Health insurance cards cannot be submitted on the ship, so you'll want to save the bill and file any insurance claims once back on land.
How to Pack a Travel Medical Kit for Cruises
A few staples can go a long way, especially if you plan on exploring in port on your own. If you take the ship's organized tours, the guides typically bring along basic medical supplies.
Before you leave home, you can buy ready-made first-aid kits in many drugstores, or you can easily make a basic kit yourself. Always include insect repellent, sunscreen, and personal prescription medications (which you should keep in your carry-on luggage if flying to the ship). It's a good idea to pack some adhesive tape and gauze pads, adhesive bandages, an elastic ankle sprain bandage, Imodium to treat diarrhea, and some seasickness medication. Include antihistamine cream for itchy bug bites, Benadryl for allergic reactions, Neosporin ointment for infected areas, and moleskin adhesive cloth for any blisters you may get from long walks or hikes in port. A small pair of scissors and a pair of tweezers are also helpful. Keep the whole kit, except for prescription medication, in your checked luggage because the various creams and liquids may not make it through airport security checkpoints.
If you forget anything, like sunscreen or aspirin, you can buy the basics from the ship's shop. However, remember that onboard shops are closed while in port, and keep in mind that products purchased aboard the ship will usually cost more -- prices are sometimes more than 50 percent higher -- than if you bought the item at your local drugstore or while in port. If you're in a bind, the ship's medical clinic also sells essentials but may not stock your favorite brand.
"Over-the-counter medications are available in the ship's medical center and do not require a physician consultation. Prescription medications do require a physician consult," says Dr. John Bradberry, medical director for Carnival Cruise Lines (www.carnival.com). Dr. Bradberry also points out that some prescription-only medications in the U.S. are available over-the-counter at pharmacies in some ports of call. Technically, these prescription-only medications cannot be brought back to the U.S. without a valid prescription.
How to Avoid and Treat Seasickness
With more than 100 cruises under my belt, I've only felt seasick twice, so succumbing to mal de mer is not a foregone conclusion. But just in case it strikes you, there are a variety of effective prescription and over-the-counter motion sickness medications.
"Meclizine is overall a good choice and Dramamine is effective, but tends to be quite sedating," says Dr. Bradberry, who spent 10 years at sea as a cruise-ship doctor. "The scopolamine patch is also effective, but potential serious side effects can occur. Medical studies have not shown the wrist ban to be effective."
If you're prone to seasickness or worried about getting it, book a mid-ship cabin on a lower level.
"At that location, the front-to-back, up-and-down 'seesaw' motion is minimized, and so is the side-to-side sway motion," Dr. Bradberry says. "Standing, keeping one's eyes open, and fresh air seem to help some people who are experiencing motion illness symptoms."
How to Ward Off Stomach Bugs
Another cruise bugaboo is the flu-like gastrointestinal norovirus that occasionally plagues cruise ships. More common than the common cold, it typically runs its course over a couple of agonizing days of vomiting, stomach cramps, and diarrhea. The best way to avoid the highly contagious virus is by washing your hands frequently and avoid touching railings and door knobs. If you have symptoms, notify the ship's medical center right away.
Consider Getting Some Shots
If cruising to exotic locales in the Far East, Africa, or South America, for example, definitely take a look at the Centers for Disease Control and Prevention's (CDC) travel advice website (www.cdc.gov/travel) to see what shots and other prophylactic measures are recommended.
At the end of the day, it's a personal decision whether you get all of the CDC's suggested inoculations and medicines for travel to particular countries. Some meds, like certain anti-malarial drugs, for example, have substantial side effects, so I personally don't take them and rely on topical mosquito repellents instead. On the other hand, I always make sure my tetanus and various hepatitis boosters are up-to-date as I frequently travel to tropical places and developing countries where hygiene and drinking water standards are often not up to snuff.
Be Prepared
Chest pain is the most common serious emergency aboard cruise ships. "Anyone with a history of a cardiac problem should ideally travel with a copy of a prior EKG, which can be used by the ship's physician to compare with an EKG taken on the ship," Dr. Bradberry says.
Keep Common Sense in Mind
As Ben Franklin once said, "an ounce of prevention is worth a pound of cure." To avoid getting ill on board or in port, Dr. Bradberry advises passengers to wash their hands frequently, especially before eating or applying makeup. Use sunscreen, and wear a wide brim hat and adequate clothing.
While in ports of call, avoid close contact with stray animals that might carry rabies. Dr. Bradberry says it's advisable to avoid mopeds, but at least wear a helmet if you choose to ride one. Other tips: Wear seatbelts in taxis and rented vehicles. Do not display expensive jewelry that may prove an attractive target to a thief. Drink alcohol in moderation, and observe standard food precautions: stick to bottled beverages to be on the safe side and avoid food from street vendors.
Surprisingly, Dr. Bradberry says motion sickness rarely requires evaluation and medical treatment, so it's not the most common ailment treated by most cruise ship doctors. What does bring passengers most frequently to cruise ship clinics are upper respiratory infections -- most patients were symptomatic before the cruise, according to Dr. Bradberry -- along with stomach aches, skin rashes, and minor sprains, strains, and abrasions sustained onshore.
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