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February 26th, 2010
07:59 PM ET

Happy person makes for a happy heart

By Elizabeth Mo
CNN Medical Intern

I have little to smile about when it comes to my morning commute in the New York City subway system. It’s crowded, it’s dirty and it’s stressful. Some people read to pass the time, a few sleep, and others sing (I really wish they wouldn’t). I, like the majority, stay aloof. Occasionally, someone passing between carts will interrupt my blank staring with, “Why the long face?” Well, I simply don’t feel like smiling.

But maybe I should try.

A recent study published in the European Heart Journal found that a good mood can have a positive affect on your heart. In 1995, Dr. Karina Davidson of the Columbia University Medical started following 1,739 Canadians who had no heart conditions. More than 10 years later, 145 people had developed heart problems.
After examining the data, Davidson found that happier people are less likely to develop heart conditions such as heart disease.

Happier people tend to lead healthier lifestyles including smoking less and exercising more, which decreases the risk of heart problems.

"If you aren't naturally a happy person, just try acting like one," Davidson says, “It could help your heart.”

There is a strong relationship between stress or depression and heart disease. Stress releases hormones that ultimately damage cardiac muscle. Certain genetic factors related to heart disease can also play a role in developing depression. However, can acting happy help your heart? Will smiling when I don’t feel like smiling help my heart as much as when I smile naturally?

“There is evidence that trying, for a day, to 'act' happy leads to higher ratings of daily satisfaction at the end of that day,” Davidson says. It is this increased level of daily satisfaction that might improve heart health. She notes that this was an observational study and didn't address causality. She is interested in doing a study that would determine whether acting happy actually prevents heart problems from developing.

Now, I sit on the subway and wonder whether Canadians are more prone to happiness. Between the Olympics and maple syrup, it’s very possible. I think of what 1,700 Canadians descending on New York subway system might look like and I laugh. Then someone passing from cart to cart screams, "What’s so funny?" and continues past.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

 


February 25th, 2010
04:27 PM ET

IVF increases risk of stillbirth – or does it?

By Miriam Falco
CNN Medical News Managing Editor

(CNN) - A Danish study suggests that women who have undergone in vitro fertilization or Intracytoplasmic sperm injection to get pregnant, are four times more likely to have their child stillborn, compared with women who conceive naturally or use other types of assisted reproductive technology.

In a study published in the journal "Human Reproduction," researchers looked at more than 20,000 pregnancies and found 742 babies were conceived using IVF, where a woman's egg is fertilized in a petri dish and then placed in a woman's uterus,  or ICSI, where a single sperm is injected into an egg and after a few days the fertilized egg is placed in the woman's uterus (Editor's note: thanks to readers like Kate and Jamie, this sentence has been corrected).  Among the 742 IVF or ICSI pregnancies there were 12 stillbirths.

Researchers emphasize that the overall risk for a stillbirth is still very low. What causes some pregnancies to end prematurely is still unknown and the researcher believes it is linked to treatments. Dr. Kirsten Wisborg, a neonatal consultant at the Aarhus University Hospital in Denmark, the lead author of this new study, said in a press release, "Hopefully the results from our study emphasize the need for continuous follow-up of the outcome of fertility treatments."

However, a Swedish study, published earlier this month, looked at more than 27,000 pregnancies and did not find an increased risk for stillbirths. Dr. Karl Nygren, one of the authors of the Swedish study says in a statement, "We found no increase in stillbirths from IVF/ICSI treatment in this larger group, and this contrasts with the Danish study that found a fourfold increase in the risk of stillbirths between the IVF/ICSI pregnancies and spontaneous pregnancies."

All this information can be very confusing and scary for couples trying to become parents and who are turning to the most invasive reproductive techniques to help them start a family. Dr. James Goldfarb is the director of Infertility Services at the Cleveland Clinic in Ohio. He's also the president of the Society for Assisted Reproductive Technology . Goldfarb tells CNN that regardless of IVF or natural conception, having a stillbirth is always devastating when it happens, and doctors want to know what causes them. He says infection, chromosomal problems, and the placenta separating from the uterus are some known causes, but "most of the time we don't know what caused the stillbirth."

Goldfarb also points out that "it should not surprise anyone to learn that patients getting infertility treatments have a more difficult time conceiving, carrying and delivering health children. That difficulty is what defines the disease of infertility and led those patients to seek treatment in the first place."

So do IVF and ICSI really increase the risk for stillbirth as the Danish study suggests? Goldfarb isn't convinced. "While this is an intriguing paper, it's important that the findings be kept in context. Other studies, even very recent ones from very similar countries, have not found this large an increase in miscarriage rates for IVF pregnancies.”

Goldfarb says in the IVF world, the biggest concern isn't stillbirth – it’s the birth of multiples. Although Nadya Suleman, also known as the Octomom, represents the most extreme case of having multiple babies at once , more twins and triplets have been born since the first IVF baby was conceived 32 years ago. That’s because doctors have been implanting multiple embryos in the hope that it will lead to a pregnancy. When a woman carries multiple fetuses, the risk of complications goes up, including premature birth, which can lead to the babies’ having underdeveloped lungs, brain, and other organs. They may also have difficulties fighting off infections. Limiting the number of embryos being implanted per IVF cycle greatly reduces that risk, Goldfarb said.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


February 25th, 2010
02:33 PM ET

When will we see a herpes cure?

As a feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

From Lloyd Bartley, Bowling Green, Kentucky

“How close are scientists to developing a cure for herpes, figuratively speaking will we be seeing a break through in 10, 20, or even 30 years?”

Answer:

Well, Lloyd, there is good news and bad news on the herpes front. The good news: Researchers have made serious strides and now better understand the mechanism behind herpes outbreaks. The bad news: There is very little funding for that research.

After receiving your question we reached out to a leading herpes expert, Bryan Cullen, the director at the Center for Virology at Duke University. Cullen is hopeful that a cure for herpes could come within 10 years, once funding hurdles are crossed.

Nearly one in five people over age 12 in the U.S. is affected by herpes. It is caused by a virus - either the herpes simplex virus type 1 (HSV-1) or the herpes simplex virus type 2 (HSV-2). Both strains can cause genital herpes, but HSV-1 usually infects the mouth and produces cold sores.

Despite funding challenges, Cullen and his team are inching closer to a cure. They conducted a study recently that identified the pathway herpes takes as it infects. They now know how herpes embeds itself into the cells and how it eludes treatment. Now that they have honed in on the physiology of the disease - and its triggers - researchers believe they are steps closer to creating drugs that could cure herpes.

While we wait for a cure, there are drugs out there that can at least suppress herpes. Three antiviral drugs: acyclovir, valacyclovir, and famciclovir are commonly recommended to quell outbreaks. A physician might recommend taking these drugs when an outbreak occurs to quiet symptoms; or taking them continuously to reduce the likelihood of an outbreak.

And of course the best way to avoid spreading herpes is to abstain from sex, but if you are sexually active, engage in safe-sex practices such as using condoms.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


Filed under: Expert Q&A • Sex • Virus

February 23rd, 2010
06:36 PM ET

Hospital-acquired infections lead to substantial loss in life, and waste billions

By Miriam Falco
CNN Medical News Managing Editor

Researchers believe 48,000 deaths could have been prevented and $8.1 billion dollars could have been saved in the United States, if patients hadn't gotten infections after being admitted to a hospital. (Watch Video)

Previous research has shown an association between deaths and hospital infections, but according to a new study, it's difficult to figure out whether the patient actually got the infection in the hospital.

In the study, published this week in the Archives of Internal Medicine, the authors set out to find out how many patients died because they got infected in the hospital.

"Just the way we know that there are 15,000 people who die every year in this country because of HIV, we should know how many people die because of infections they got in the hospital,” says Ramanan Laxminarayan, a senior fellow at the social sciences think tank Resources for the Future. He and his colleagues wanted to find out how many people became sickened by pneumonia or sepsis (a life-threatening infection that has spread throughout the body) while they were hospitalized. They looked at 69 million hospital discharge records from 40 states between 1998 and 2006. In an effort to rule out patients that already had infections or were so sick they would not have survived even without a hospital-acquired infection, researchers considered only patients who went in for elective surgery, not because of an emergency.

"These were people that the surgeon would not have operated on if they showed any signs of infection and not being well," Laxminarayan explains. He says that judging by the number of patients who then got an infection as opposed to those who didn’t, there were an estimated 290,000 cases of hospital-acquired sepsis and 200,000 cases of hospital-acquired pneumonia in 2006. Further, he said, "48,000 sepsis and pneumonia deaths can be attributed to hospital-acquired infections every year."

In addition to the loss of life, these infections add to health care costs. The researchers estimate that the extra hospital days lead to $8.1 billion in added costs.

Laxminarayan says there are multiple reasons for patients getting an infection.

"You could have a surgery and the wound is not dressed properly or the operating room is not scrubbed properly or someone didn't wash their hands."

Laxminarayan says some hospitals are starting to standardize procedure to reduce the spread of unnecessary infections. Probably best-known in the medical community is Johns Hopkins physician Dr. Peter Pronovost, who developed a five-step checklist for doctors to follow when inserting a central line or catheter in a patient: wash your hands using soap or alcohol prior to placing the catheter in the patient; wear sterile gloves, mask, hat, gown and completely cover patient with sterile drapes; avoid placing the catheter in the groin if possible; clean insertion site of patient’s skin with chlorhexidine antiseptic solution; remove catheters when they are no longer needed

Pronovost’s checklist caught the eye of the hospitals in Michigan who asked him to help them reduce medical errors in their intensive care units. More recently, surgeon and author Atul Gawande developed a checklist for surgeons. But the majority of hospitals still don't use checklists yet. Which means mistakes can still happen.

Nancy Foster, the American Hospital Association's vice president for Quality and Patient Safety Policy, tells CNN that this new study confirms what they have known from previous studies but it doesn't show the progress hospitals have made since 2006, which is when the last data were collected for the study. "We at AHA are working with Peter [Pronovost] and others who are expert in infectious disease to help hospitals implement those strategies all over the country," says Foster.

She points out that many hospitals now have prominently placed hand gel dispensers everywhere. They are also encouraging patients to ask hospital personnel if they washed their hands. But more needs to be done to make systemwide changes. To help make that happen, two years ago, Foster says, the AHA received funding from the Agency for Healthcare Research and Quality for programs to prevent infections in hospitals in Michigan and 10 other states. "Just last year, we received additional funding from the stimulus package to roll out the project nationwide," she says.

Study author Laxminarayan believes hospitals need financial incentives to make changes. He points out that last year Medicare, the federally funded health insurance program for retirees, stopped paying hospitals in some cases, if preventable infections occurred. He thinks this should be done on a broader scale. Until that happens, Laxminarayan thinks there are at least three things hospitals could do now that don't cost them more money but could save lives: improve hand-washing; adopt checklists; and screen everybody who comes into the hospital for germs that could infect somebody else. He says they need to be tested if they are colonized with bacteria – not necessarily infected – because they could be inadvertently transmitting bugs that could infect others already in the hospital.


February 23rd, 2010
05:27 PM ET

Keep fighting despite the losses

By Dean Hanan
CNN Fit Nation Triathlon Challenge Participant

A few months ago, before I ventured onto CNN.com’s Fit Nation Web site and got myself into this amazing triathlon training experience, I woke up and ran into the kitchen, prepared some coffee and went outside on the balcony to smoke a cigarette. That had become my morning ritual after September 11, 2001.

CNN Fit Nation Challenge participant Dean Hanan.

CNN Fit Nation Challenge participant Dean Hanan.

I stared at the Coney Island beach and remembered how I used to run the beach when I was a lifeguard. How easy it was to effortlessly run a mile in seven minutes. And how I used to swim, gliding through the water like a seal.

Being in shape seemed so easy back then. But then you experience life. You suffer setbacks, you lose a relationship, a friend, a job, or money becomes tight. Sometimes it’s a major loss. For me it was losing my aunt at age 8, moving to Florida during my senior year of high school to care for my sick grandparents, losing friends, and almost losing the love of my life on September 11, 2001 when, as a New Yorker, and an American, our hearts were broken.

We all suffer setbacks. Some of us eat a little more, drink a little more, smoke cigarettes or worse. Sometimes we let others down. The hard part is to break down the walls of feeling guilty. Guilt is not what we are supposed to learn from our flaws or mistakes. Life molds us. We can take the good from it and move forward or we can focus on the negative and keep it in us to paralyze us from moving forward. My mom and dad always said obstacles are the things that help us realize how strong we don’t know we really are. They were right. We all suffer setbacks. We all lose jobs, money, loved ones, and things we care about. We all go through the good times and the bad times.

But it’s not about how many times life kicks you down to the ground into the dirt. It’s about having enough guts to turn around, look life back in the face, and tell yourself you are worth it! I cannot give up! I will always fight! No matter how much it may hurt or scare you. No matter how many people think they know you and what you are made of! It’s about getting back up off the floor, dusting yourself off and looking into your own eyes in the mirror and making a decision that we are all capable of: To never give up! To take that small amount of spirit left in your body and to realize that after everything you have gone through…YOU ARE STILL HERE!

You are not alone! You ARE still here! Go get ’em!

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


February 23rd, 2010
02:11 PM ET

Before you send your child to the doctor

By Sabriya Rice
CNN Medical News Producer

Prosecutors announced Monday that a grand jury has indicted Delaware pediatrician, Dr. Earl Bradley on 471 felony counts in the alleged sexual abuse of his patients. Bradley has practiced in Lewes, Delaware, for more than 10 years, and is now facing charges which include, rape, sexual exploitation, endangering child welfare and assault.

How could this happen? Most physicians don't get involved in criminal activities, however sometimes a bad apple can fall through. According to the Federation of State Medical Boards, approximately two hundred of the 735,000 actively licensed doctors in the United States have been found guilty of criminal acts.

In many cases they continue to practice; in some states a license can't be revoked until a witness has testified and the physician is found guilty of the charges. Patients have no way of knowing unless they do their own research.

Parents, here are some things you can do:

1) Find out if your pediatrician has a criminal past:
To find out whether your doctor has been disciplined by a state medical board, here's a state-by-state directory of medical boards.

2) Check your pediatrician's national profile:
Some states explain why a doctor has been disciplined while others don’t, so just searching in your state might not reveal a doctor's history of problems elsewhere. You can also get a national profile on your doctor for just under $10 by searching on the Federation of State Medical Boards website.

3) Get a good recommendation
You can view the American Academy of Pediatrics’ list of recommended pediatricians on their website.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


February 22nd, 2010
05:48 PM ET

Report: Hypertension a neglected public health issue

By Ashley Fantz
CNN.com Writer Producer

High blood pressure is killing more Americans than ever, but it's being neglected as a public health issue and doctors are not adequately diagnosing it, according to medical experts who worked on a new report issued Monday by the Institute of Medicine, an independent, nonprofit organization based in Washington, D.C.

High blood pressure is a major contributing cause of heart disease, the nation's leading cause of death for men and women. Cancer ranks second. Heart disease killed 631,636 people and cancer killed 559, 888 people in 2006, the most recent year the Centers for Disease Control and Prevention has data available. Hypertension is the second leading cause of preventable deaths; smoking is number one, according to IOM.

The 155-page report, sponsored by the CDC, says that currently one in three people have high blood pressure - measured at 140 over 90 or higher. The figure of one in three people is an increase from 2005 when one in six adults suffered from high blood pressure, according to Dr. Corinne Husten.

An increase in blood pressure translates to a hefty price tag for health care. Hypertension prevention and control is only one of a number of programs competing for $54 million last year in the CDC’s entire Heart Disease and Stroke Prevention portfolio, the report states. The American Heart Association recently reported that the direct and indirect costs of high blood pressure as a primary diagnosis was $73.4 billion in 2009.

The former chief epidemiologist and acting director of the Office on Smoking and Health at the CDC, Huston was part of a 10-person panel of medical doctors, epidemiologists and Ph.D.s who took roughly a year to review more than 100 existing studies on high blood pressure. Many of those studies included comprehensive information from national surveys that reviewed patient medical records, she said.

"We looked at how many times a patient had been to see a clinician, and [in those instances] when high blood pressure was recorded but those patients were either not given treatment or medication, or nothing, in general, was done," Huston said.

It's unclear why doctors are not following guidelines on how to treat hypertension, panel members told reporters Monday. "A lot of people who have hypertension don't know it because clinicians aren't telling them that their numbers are high," according to the epidemiologist.

Why are more Americans suffering from high blood pressure?

"We can blame our high intake of sodium in the food we buy at grocery stores or eat in restaurants, our lack of potassium in our diets, that we don't get enough exercise," said Husten.

An adult should be consuming a teaspoon of salt a day, said David Fleming, chair of the IOM panel and the director of King County public health in Washington state. The elderly or someone already suffering from high blood pressure should get no more than two-thirds of a teaspoon of salt each day. But measuring that is, practically speaking, extremely difficult.

"One has to remember that the food you buy already has sodium in it before you use your salt shaker," he said.

The report recommends ways to address the increase in high blood pressure, including a familiar call to eat more vegetables and fruit, work out more and ask a restaurant exactly how much salt meals contain.

The CDC should also work with schools to encourage them to strengthen or implement physical fitness programs and work with food industry professionals to tamp down on the amount of salt put in food, the report advises.

The report also suggests requiring providers to allow patients to make smaller co-pays in order to get medications and have doctor visits. Another option would be to require providers to issue more rigorous treatment guidelines to doctors.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


February 22nd, 2010
05:44 PM ET

2009 H1N1 flu strain will be in next season flu vaccine

By Miriam Falco
CNN Medical News Managing Editor

The 2009 H1N1 flu virus, which has been circulating since last spring, sickened millions and killed at least 15,000 people worldwide, will be included in the next seasonal flu vaccine when it becomes available in the fall, health experts in the United States decided Monday.

Every February, the Vaccines and Related Biological Products Advisory Committee advises the Food and Drug Administration on which flu strains to include in the next flu shot or spray.

The committee is following the recommendations of the World Health Organization, Dr. Jerry Weir, the FDA's director of the Division of Viral Products, told CNN.

"This is the same process we go through every year," Weir explained. The selection is made early in the year to give flu manufacturers enough time to make enough vaccine by September or October, when health officials recommend people get vaccinated. Pharmaceutical companies need so much lead time because it's takes a long time to grow vaccines in eggs, currently the only licensed method for making flu vaccines.

"The new H1N1 strain didn't exist last February," said Weir, which is why health officials couldn't consider it for the flu vaccine for the current flu season. Once it was determined that this new type of H1N1 flu strain was circulating around the country and the world, flu manufacturers were asked to develop an additional flu vaccine to fight this virus.

The most recent estimates from the Centers for Disease Control and Prevention suggest that between 41 million and 84 million people in the Unites States have been infected with 2009 H1N1 since last April. The CDC also estimates between 183,000 and 378,000 people were hospitalized and between 8,330 and 17,160 people died from this flu since it emerged.

The agency says its estimate vary widely because not everyone who gets sick goes to the doctor, and not everyone who is hospitalized was tested for this flu and because health officials believe hospitalizations and deaths are under-reported.

The following three virus strains will be included in the 2010/2011 seasonal flu shot:

- an "A California viru," which is the pandemic virus H1N1 virus that caused so much illness in the past 10 months;
- an "A Perth virus," which is an H3N2 virus
- a "B Brisbane virus."

Weir says now that the three specific strains have been selected, manufacturers can now begin producing the new batch of seasonal flu vaccine.

For those concerned about getting the flu now, the CDC continues to recommend getting the separate H1N1 vaccine which is now widely available.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


February 22nd, 2010
10:41 AM ET

Pediatricians group issues anti-choking guidelines

By Jennifer Bixler
CNN Medical Executive Producer

Spend time with a baby or toddler and you learn that one thing is nearly universal: They love putting things in their mouth. It's one of the ways they learn about the world around them. But sometimes, curiosity can be dangerous. A study that appeared in the New England Journal of Medicine found a child dies every five days from choking. Now the American Academy of Pediatrics is calling on food manufacturers to require warning labels on foods that can cause children to choke. According to AAP, choking is the leading cause of death of children under age 3. Hot dogs, hard candy, even peanut butter are among the culprits.

“No one wants to see kids suffer,” says Dr. Gary Smith, author of the AAP’s new policy statement. (link here). “We need as a society to provide them with safe environments. There’s not a food manufacturer out there that would disagree with that.”

Smith and his colleagues are also asking food manufacturers to avoid making food in shapes and sizes that may cause children to choke. (So far, the Grocery Manufacturers Association has not commented on the recommendations.)

Smith says hot dogs pose the greatest danger. He says their shape and compressible texture will seal off a child’s airway and are hard to wedge out. Peanuts and raw carrots are also dangerous, but for a different reason. Toddlers typically don’t have molars, so they can easily choke on chunks of those hard foods.

So parents, what should you watch out for? Smith says it’s always best to err on the side of caution, but if you are going to feed your child hot dogs, for example, be sure to cut them in extremely small pieces. Also, doctors suggest waiting to introduce things like raw carrots and nuts into a child’s diet until their teeth are fully formed.

Smith hopes the food industry will take a cue from the automobile industry and make these changes. “Safety sells,” says Smith. “ You can take something like this and see it as an opportunity and not a burden … watching kids die, that’s not acceptable.”

em>CNN's Caitlin Hagan contributed to this report.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


February 19th, 2010
08:20 PM ET

Even on a grand adventure, take care of your health

By Rebecca Leibowitz
CNN Medical News Intern

Imagine waking up in a hospital in excruciating pain, barely able to breathe, swallow, or speak. Sound scary? Now imagine you’re in a foreign country, surrounded by doctors and nurses you cannot understand, thousands of miles away from your family and friends. My friend Sam found himself in this terrifying situation during his semester studying abroad in Prague , Czech Republic.

Sam had come down with strep throat, mononucleosis, and tonsillitis all at the same time. An eight-day hospital stay later, he was still so ill he was forced to return home to St. Louis, Missouri, two weeks before he had originally planned. Sam is fine now, but as I prepare for my own study abroad trip to Buenos Aires, Argentina, his story has left me wondering: What should I – and others planning a trip out of the country – do to protect our health and safety while abroad?

Before you buy your plane ticket: Have a conversation with your primary care physician. Tell him or her where you plan to travel, and any activities (like hiking, biking, or mountain climbing) you want to do that may affect your physical health. Make sure you are healthy enough to travel, and that you heed your doctor’s advice that may be based on your personal health history.

A month before you leave: Get vaccinated! Check the cdc.gov Web site for a list of vaccinations you’re required (or encouraged) to get based on the parts of the world you plan on visiting.

Call your insurance company and find out what its policy is for covering members traveling outside the United States. Ask specifically what they do and do not cover. (Hospital stays? Medical procedures? An early plane ticket home?) If you feel it is necessary, you can purchase supplemental insurance.

A week or two before you leave: Do your research. The State Department’s travel.state.gov and the country’s own embassy Web site are great resources. There, you can find out all the information you need – from what happens if there is an emergency in the country to what to do if you’re the victim of a crime. Don’t forget to check whether the water is safe to drink!

If you take any prescription medications, make sure to obtain enough to last you for the entire time you’re abroad. Many overseas pharmacies will not fill American prescriptions. While you’re picking up your medications, purchase over-the-counter remedies for cold, flu, and traveler’s diarrhea to pack with you.

While you’re abroad: Be sensible. Take the necessary precautions if you’re travelling to areas that appear unsanitary or where certain diseases are endemic. Carry your health insurance information with you at all times, and make sure you know how to contact your insurance company if you have any medical issues.

In the unfortunate event that you do get sick abroad, seek medical attention immediately. In Sam’s case, he ignored his cough and stuffy nose for about a week before his symptoms became far more serious. He got caught up in the excitement of his international adventure and in the process lost sight of his health. Don’t make the same mistake!


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