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!

January 11th, 2010
12:50 PM ET

Dangerous drives

By Rebecca Leibowitz
CNN Medical Intern

Talk about an "I-told-you-so" moment. On the night before my drive from my Atlanta school to home in Washington, D.C., I had a conversation with my dad that he won’t soon forget. “Becca,” he warned, “You shouldn’t leave tomorrow. It’s supposed to snow, and driving could be very dangerous.” “Dad, I’ll be fine!” I yelled, ignoring his advice. “Don’t worry about it! See you tomorrow night.” Fat chance.

I left Atlanta on Friday, December 18th, the day the 2009 blizzard began to pummel the southeastern United States. The snow began falling about two hours into my drive, changing very quickly from a pretty distraction to a blinding and dangerous terror. Around 9:30 pm, after pulling off the highway to get gas, I re-entered I-81 in southwest Virginia to find traffic at a standstill. Not crawling – completely stopped. We did not move again until 10:30 am the next morning. My passenger and I had no choice but to sleep in my car – rolling all the windows down in order to avoid carbon monoxide poisoning and covering our bodies with whatever we could find to keep warm. When we finally got moving, we were told that the highway was closed in several places farther north. I checked into the nearest motel and collapsed there for the next 24 hours. When I finally left for home the next day, I passed dozens – maybe hundreds – of disabled cars.

The drive from Atlanta to Washington is supposed to take 10 hours with “normal” traffic. It took me three days.

Although I did make it back in one piece, there were many things I could have done differently to protect my health and safety along the way. What should you do to prepare yourself for a long drive? How can you minimize risk when confronted with difficult driving circumstances?

1. Invest in a car cell phone charger. Since most phone batteries don’t last for more than a few hours of talk time, this is indispensable.

2. Bring the essentials – and keep them in your car. You should have a blanket, non-perishable food, bottles of water, an ice scraper and flares in the trunk of your car at all times. You never know when you’ll need them.

3. Know that the GPS can help you, but it can also hurt you. Certain features of my GPS helped me out when I got into trouble, but it also led me into trouble in the first place by instructing me to take a more hazardous route. If snowfall is expected along your trip, take a major highway. They tend to be much better plowed and easier to drive on.

4. Don’t let your car’s gas gauge fall below a half a tank, and if you’re stopped in traffic for a long time, turn off your lights. You don’t want to run out of gas or drain your battery!

5. If you drive into inclement weather, don’t panic. Put on some relaxing music, drive cautiously and take deep breaths. If you feel uncomfortable or unsafe at any time, do not hesitate to pull over.

6. Avoid trucks and tractor trailers, as their large wheels can splash blinding slush and snow on your car’s windshield. Drive in the middle lanes of the highway, which tend to be better plowed, and avoid reckless drivers.

7. If you see someone in a bind and you have the time, help them out – but don’t put your safety at risk. I don’t know what I would have done if not for the generous strangers who helped push my car out of a snow bank or the friendly motel concierge who drew a map of how to avoid unplowed highways on the final leg of my trip.

Adverse driving conditions can materialize without warning. Just hours before I left Atlanta, forecasters predicted only moderate snowfall along my route. Ensure your health and safety as well as that of your passengers – prepare for the worst when embarking on a long road trip. Don’t make me say “I told you so!”

How do you prepare for an upcoming long drive? Have you been faced with a difficult driving experience? How did you cope?

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.

November 27th, 2009
11:42 AM ET

Alzheimer’s changes family ties

By Rebecca Leibowitz
CNN Medical Intern

It all started one afternoon. “Grandma,” I asked, “how did Karen like my hand-me-downs?” “What?” she responded, “I didn’t know what those clothes were doing in my trunk. I gave them to charity.” We all knew immediately that something was wrong. And there was more to come. Once a skilled, careful driver, my grandmother terrified her passengers when she blew through a stop sign as if it didn’t exist. I would catch her staring at me in confusion, often calling me by the name of my cousin or aunt. My grandmother, like her own grandmother, two brothers and a first cousin, has become one of the estimated 5.3 million people in the United States living with Alzheimer’s disease – the most common cause of dementia.

Our family has learned what many other families know well: Alzheimer’s disease is devastating. We’ve seen our loved ones change into someone entirely different. According to the Alzheimer’s Association, a person develops the disease every 70 seconds in the U.S., and the amount of people living with Alzheimer’s is expected to double every 20 years. The illness’ economic costs are nearly as distressing as its emotional toll. Each year, an estimated $148 billion is spent on Alzheimer’s, including direct costs of Medicare and Medicaid and indirect costs to businesses. This figure, like the burden of Alzheimer’s disease in the U.S., is expected to only get worse.

Alzheimer’s has no cure and its damage can begin decades before symptoms are apparent. The exact cause is still unknown, but tangles and plaques in the brain are thought to lead to symptoms like memory loss, poor judgment, changes in mood or behavior. Without a cure in sight for this disease, what can people like my mom, who is approaching the age when the disease could already be developing, do to prevent or slow the onset of this debilitating illness?

Researchers are convinced that mental activity and socialization can help. Reading, playing board games, playing musical instruments and dancing have all been shown to decrease the risk of contracting any form of dementia. Engage your brain, build up your social networks and you’ll put off getting the disease or possibly avoid getting it altogether.

Other studies have found a link between unhealthy living and increased Alzheimer’s risk. A study earlier this month in the Archives of General Psychiatry concluded that for people with a family history of the disease, high blood pressure in middle age is a significant risk factor for Alzheimer’s in old age. So, what can you do if Alzheimer’s is prevalent in your family? Don’t smoke, eat a well-balanced, heart-healthy diet, stay stress-free and exercise regularly. Not only will these measures decrease your risk for Alzheimer’s, they will improve your overall quality and length of life.

Unfortunately, this information wasn’t around when my grandmother was growing up. But for my mom, her siblings and myself, (as well as the millions of other Americans with a strong family history of the illness), there is hope. Not only can we decrease our Alzheimer’s risk by maintaining a healthy and active brain and body, but researchers are constantly discovering new things about prevention and treatment of the disease. Perhaps one day we will even find a cure.

Do you have a history of Alzheimer’s disease in your family? Are you taking any measures to try to keep from contracting the disease?

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.

November 2nd, 2009
12:30 PM ET

Deciding whether or not to get the H1N1 vaccine

By Rebecca Leibowitz
CNN Medical Intern

I had H1N1. It started with a cough, which quickly progressed to a headache, body aches and a 102-degree fever. A rapid flu test came back positive, confirming my diagnosis. Although this nasal swab test for H1N1 is not very reliable, so much so that it is no longer being used, I had all of the symptoms of the flu. H1N1 was pretty much the only strain circulating in late August, so chances are very high that I did indeed have it. I spent the next three days isolated in my apartment, pumping my body with vitamin C and chicken soup. Then I was fine. I felt great and I was no longer contagious; I could go to class, to the grocery store and to the gym without fear of infecting others. To my friends, I was finally “swine-free.”

My decision whether to be vaccinated against H1N1 has been made for me. Since I most likely already had H1N1, and therefore have built up immunity to the virus, I will not be getting a vaccination. However, millions of Americans are facing the decision of whether to vaccinate themselves and their children against the novel influenza A virus.

The Centers for Disease Control recommends the following high-priority groups get vaccinated: pregnant women; people who live with or provide care for infants younger than six months; health workers; people aged six months to 24 years old; and people 25-64 years old with certain pre-existing conditions.

So, when my mom told me that her doctor recommended she not get the H1N1 vaccine, I was confused. As a chronic Lyme disease sufferer (who is well under 64) and a social worker who works with very young children, my mom fits into one of the high-risk groups. Why, then, did her doctor advise her against getting it?

As I later discovered, there are several reasons why people are apprehensive about getting the H1N1 vaccination. My mom’s doctor told her that he did not see the evidence that the H1N1 inoculation protects one from getting the virus, a concern he also raised regarding the seasonal flu vaccine. This contradicts what the CDC has been saying for weeks. CDC Director Dr. Thomas Frieden recently told reporters that the vaccine should work very well because “it is an excellent match with the strains of the virus that are circulating.”

There is also widespread concern about the safety of the vaccine. During the 1976 swine flu epidemic in the United States, those who received the vaccine for that strand of swine flu were proven to have an elevated risk of contracting Guillain-Barré syndrome. Guillain-Barré syndrome is a disorder in which the body’s immune system attacks part of its nervous system. The most common complications from Guillain-Barré syndrome are breathing-related, and patients are often placed on respirators. The majority of people who contract the disorder recover, but it can be fatal.

The CDC says that it expects the H1N1 inoculation to follow a similar safety profile as the seasonal influenza vaccine, which has not been associated with increased risk of Guillain-Barré. Officials also say that this new pandemic vaccine is much “purer” than the 1976 inoculation. The expected side effects from the 2009 H1N1 vaccine are similar to those from the regular flu shot, including soreness or swelling at the point of injection, low-grade fever and body aches. The CDC and the Food and Drug Administration will be closely monitoring the safety of the immunization. The Vaccine Adverse Event Reporting System exists so that health care providers can report vaccine concerns directly.

And then there are those who think natural immunity is better and safer than any vaccine and are suggesting “swine flu parties” are the way to go – get yourself infected with H1N1 and your body will build up immunity. Most doctors and the CDC strongly advise against this method of protection.

What factors have influenced your decision whether or not to get the H1N1 vaccine? What advice has your doctor given you? Have you come to a decision whether to vaccinate you or your children?

About this blog

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.