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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!


February 19th, 2010
10:10 AM ET

Get in the zone for your triathlon training

By Laura Cozik
Athletic Director, CNN Fit Nation Triathlon Challenge
CEO, Team Lipstick Triathlon

There are seven common training zones. The most utilized for triathlon racing is Zone 3, or your Tempo Zone. This is the zone you will race in, so it’s also where you should spend a lot of your training time. Zones 6 and 7 are not often visited by triathletes, as they are really your short burst of power efforts, lasting no more than 20 seconds to about 3 minutes in length. There are, however, benefits to applying them from time to time.

· ZONE 1 – Active Recovery – You can spend all day here!

Active recovery is easy, so easy it can be hard to maintain without going overboard. This level is not for training endurance but for recovering tired legs after hard training or racing. No significant effort whatsoever.

· ZONE 2 – Endurance – This is also an all-day pace or classic long/slow distance training.

This is a no-frills effort where most athletes spend the majority of their training rides – base training, easier intensity, low-level leg fatigue, breathing is more regular than at Level 1, but continuous conversation is still possible. It remains a completely aerobic effort.

· ZONE 3 – Tempo – This is our triathlon race pace.

A medium/hard level aerobic exertion, slightly more difficult than endurance level. This will require more concentration to maintain the effort and conversation will be difficult.

· ZONE 4 – Lactate Threshold – This is time trial pace, or your best 20-minute effort.

Lactate is a byproduct of anaerobic metabolism within the muscle, although lactate is produced continuously, even at rest. As exercise intensity increases, more lactic acid is produced in the muscle and is released into the blood. Lactate Threshold, or LT, is the point at which muscle lactate production into the blood is higher than the rate at which the body can metabolize it.

· ZONE 5 – VO2 Max – This effort lasts 3-8 minutes in duration.

Everybody has a physiological limit to the amount of oxygen that can be transported and utilized, which is the VO2 max or maximal oxygen consumption. This is the largest volume of oxygen your lungs can consume and the highest end of aerobic training. Strong to severe sensations of leg effort/fatigue. Conversation not possible due to labored, ragged breathing. These are hard efforts that teach an individual how to suffer!!

· ZONE 6 – Anaerobic Capacity – Up to 3 minutes sustained, high intensity effort.

This level is above aerobic exertion and must be performed in short 30-second – 3 minute repeats at the highest intensity one can maintain for those time periods. This is a very intense exertion and is typically not repeated consecutively, as recovery is needed. For example, a 1-minute interval generally takes about 3 minutes to fully recover from. Severe sensation of leg effort/fatigue, and conversation impossible.

· ZONE 7 – Neuromuscular Power – 20 seconds or less!!!

Strength! As hard as you can push the pedals for a very short time – 20 seconds or less. This level has short, maximal efforts without specific parameters. Greater stress on musculoskeletal rather than metabolic systems. Complete recovery needed.

Next week we’ll discuss the benefits of each zone.

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.


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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.

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