Dr. Eric Anderson, a charter diplomat of the American Board of Family Practice and a former president of the New Hampshire Academy of Family Physicians, is a regular contributor to Travel Tips 'n' Tales. He is widely traveled and published, having written a travel health column for Travel 50 & Beyond and a weekly online column, Ask The Doctor, for The New York Times Syndicate.

Dr. Anderson invites you to send your questions regarding travel health issues to ericmd@lorrypatton.com

Dr. Eric Anderson

Question: I think our personal physicians could do more to help us enjoy our travels, yet, some doctors don't seem all that interested in our vacation plans. What can we do to get more value from our doctor visits before we leave?

This question came just as the newspapers carried the story of a combat medic who flew from Texas to visit his mother in San Francisco and had problems on the return flight. Security screeners confiscated wire clippers he was carrying for a possible medical emergency. He had been shot through the jaw in Afghanistan in April 2002 and surgeons had wired his jaw shut. He had been given wire clippers to cut the wires (to avoid choking) if he started to vomit. Clearly he needed the wire cutters and the security action was unfortunate. A combat veteran is an unlikely terrorist but, as an airport spokesperson said, flight crew could have kept the clippers for him - "if, for instance, he had presented a doctor's note."

Why didn't he? I have no idea; however, medical care is a two-way street involving both doctor and patient and I have to admit I'm a bit defensive about your question. Today's medical care has become so complicated doctors are now being taught in medical school that, if they expect to get satisfactory results with patients, especially those with chronic illnesses, they have to educate patients to show more responsibility for their own care.

What does that mean? I believe it requires a special visit to the doctor before any involved or unusual trip especially for an older patient or one with a significant chronic illness, but please don't add complicated questions to regular office calls such as a recheck blood pressure visit where, perhaps, only a little time has been allocated for the encounter. Intricate discussions can't be piggybacked on to a quick visit yet sometimes patients bring up those very problems as the physician has a hand on the door to leave. Physicians call this being "door-knobbed." It sometimes seems patients will spend several thousand dollars on a cruise or trip but not bother to spend a little more for a pre-vacation health discussion that might make the trip more enjoyable. Wow! I am defensive! Sounds as if I'm hustling for work!

First, the patient should control the content, have a clear idea of the degree of activity or exertion required on the trip and the destination's altitude. ( Even cruises can be complicated. For example: shore excursions and pre- or post-cruise add-ons can be challenging to some patients, as they are not all at sea level). And if traveling to the Third World, check with the Centers for Disease Control and Prevention and our General Tips page to see if there are special needs for the destination. If there are, arrive at the office with a print-out and ask specific questions.

One: Can I handle this height, this hike, this adventure?

Tell the doctor how active you've been in conditioning yourself in preparation for the trip in the last few months. If you've done nothing and you're heading for the Andes, expect a frown.

Two: Ask for a copy of your EKG and any recent lab work or physical exam. You can get the EKG miniaturized and laminated, or you just ask the nurse to cut it into its 12 parts and staple it for your wallet.

Three: Ask the doctor or nurse to print on some official-looking stationery a list of the medications you take regularly and if they would be kind enough to print a brief summary of your health on a prescription sheet. It doesn't need to be a long story, a simple list of diagnoses may be adequate.

Four: Ask your doctors if they have any small sample bottles of medications you take regularly. Such sealed bottles pass airport security scrutiny better than what you normally carry. And don't weigh so much.

An unrelated point is to visit your physician when you get home if you had to see a doctor on vacation. Resort physicians, especially ships' doctors, often remark that after they've treated a person, the patient disappears as if into a Black Hole so the doctor never knows the final result. Ask your personal doctor to scribble a brief update for you to send to the vacation doctor. The message gives closure to what may have been a worrying event for both the vacationing patient and the far-off doctor.

NOTE: Lorry Patton's Travel Tips 'n' Tales would like to remind you to always consult with your personal physician before following any medical advice and to please read the Travel Tips 'n' Tales "Terms of Use" found on the bottom of each page of this website. Dr. Anderson's opinions are not necessarily the opinions of Lorry Patton or Travel Tips 'n' Tales.