I would love to be able to share that we have done all of these world adventures without getting sick. That's not the case, but to be fair we also have several stories of being sick in the US on vacation too. The big difference is that in the US there is likely a CVS near by with everything you could possibly need and urgent care facilities. It's never completely ruined a vacation but it certainly puts a damper on it for a period of time. Being less prepared makes it a bit harder.
Moctezuma's revenge, the Nile's runs, Delhi belly... the list goes on. In 2008 we traveled to China to visit friends who were living there. It was overall a fantastic trip, except the day trip to the Great Wall. There is nothing quite like starting to feel that sensation like your insides are going to explode and looking out at the majestic sight of the Great Wall of China. I had woken up feeling fine that morning at our hostel in a back alley of Beijing. By the time we traveled to the Wall and had hiked the hour or so up to the Wall itself, it started to hit. I had to run while on the top of the wall to find a bathroom. There is a video somewhere of me puking on the Great Wall because my husband saw the potential for this story living on. We found some squatty potties nearby, which was probably worse than accepting nature as a toilet. We made it back to the hostel in less than ideal fashion. I was down for about 24 hours but recovered. We didn't have all the meds we normally would and were not well versed to track them down in Beijing. From then on we had plenty of traveler's diarrhea medication and recovery tools with us at all times!
We've also had our kiddos get sick, but not from food. Our ear infection prone son got a throat infection right before we left for a trip to Costa Rica when he was 2 years old. Urgent care in the US gave us basic antibiotics which we took on the trip with us, along with children's Motrin and Tylenol to handle the symptoms. Unfortunately, a few days into our trip it became clear that the antibiotics weren't working. We were in La Fortuna, Costa Rica and the only doctors I could find online was several years old and about missionary doctors. We called the pediatrician in the US to get a name of an antibiotic that we should go ask a pharmacy for in Costa Rica, but they only responded "don't take any medication from outside the US." Super not helpful. Thank you, US legal system. We had some international assistance numbers that we had from our insurance company so we called that. They didn't have any doctors on file to connect us with but what they did was call our hotel's front desk. Our hotel had a doctor they would call if a guest got sick. (Lesson learned: We could have done that ourselves, had we known it was an option!)
This young, local doctor came to our hotel when he returned from a helicopter trip where he was taking a patient to the hospital in San Jose. He was incredibly friendly, he was totally caught off guard by our son's tubes in his ear (he had learned about those in medical school but never seen them), and gave us antibiotics from his bag, which we had to mix (don't I need a degree for this?). We also had run low on Motrin/Tylenol and the pharmacies didn't have the same children's medication as the US. The doctor gave us suppository acetaminophen, that was a new experience too, and worked fabulously. The antibiotics worked too and we were able to enjoy the rest of the trip with a more joyful toddler. The doctor visit set us back about $200, and it had to be cash which was a different challenge (will have a post on money for this one), but well worth it. From now on we bring unmixed children's antibiotics and plenty of children pain medications.
So these experiences, along with a couple of others, greatly informed my traveling pharmacy mindset. Here are my lists, which I remove items from depending on location. (e.g. I don't take most of these medicines with us to Europe).
Pain Medication.
Children's Tylenol and Motrin - I always bring full bottles, not just a few pills because you may not be able to buy these in developing countries.
Adult Tylenol and Motrin
Excedrin - My go-to for migraines which are exasperated by lack of sleep.
Traveler's Diarrhea Medication.
Tums - For the simple issues.
Pepto Bismol - Pill form so that they can be carry on.
Loperamide - Anti-diarrheal in case we get hit.
Charcoal pills - I feel like the science is not clear on the effectiveness of this but we have them.
Probiotics - We start taking a couple of weeks before to hopefully at least prep our guts to fight off some bacteria.
Prescription Antibiotics - For the adults we have azithromycin and cipro prescriptions. For the kids, we have had unmixed azithromycin - you can get your doctor to request that they don't mix it. Instructions to only take it if it's really bad.
Rehydration mixes - Powder Pedialyte to replenish our hydration levels, if needed.
Allergy Medication.
Benadryl - Because you never know what could cause an allergic reaction.
Hydro-cortisone cream - For the bug bites and any skin rashes that pop up in new environments.
Claritin - Because we have seasonal allergies in the family which may be better/worse in the new environment.
Clotrimazole - Anti-fungal cream, because you just never know.
Sleeping Medication.
A basic sleep aid for adults - For the plane ride.
Sleep gummies for kids - Melatonin gummies for the plane ride and to help adjust to the time zone changes.
Dramamine - Actually for boat rides or twisty roads but it definitely knocks us out too.
First Aid Kit.
Band aids in variety of sizes and some water proof. Extra care for cuts in when swimming in questionable rivers/lakes.
Neosporin - infection prevention taken to next level.
Tweezers/pins.
Miscellaneous.
Thermometer - It's always good to figure out how bad the fever is.
Malaria pills - Depending on travel zones.
High altitude medicine - We got this once, it didn't seem to help.
The traveling pharmacy bag has come to the rescue many times. When we have needed to seek some sort of medical care, the hotels/lodges we have stayed at have been extremely helpful. In Ecuador, I had another episode (notice the trend). This time a hotel doctor in the Andes who we communicated with via Google translate gave me a shot in the butt to stop the vomiting. I didn't even know what it was, and quite honestly didn't care. Butt it worked. And was free. Another major thing that US travelers don't know is that many countries don't require prescriptions. Pharmacies will provide medications to you if you just talk to the pharmacist about what's going on, making getting what you need faster and easier. In comparison, I've also gotten sick on a work trip in the US. The care and helpfulness of the big fancy hotel staff was less so than in developing countries. They did bring me a $60 bowl of room service chicken noodle soup though.
We would ideally like to avoid anything that requires hospital/trauma care. We do purchase medical evacuation insurance for all our trips to developing countries. The idea being if something bad did happen, we have coverage to get either back to the US or a more medically advanced county. I hope to never have a blog post to explain lessons learned with this.
Overall, we've had very healthy and safe vacations. The small percentages of times that we have been sick do tend to get remembered very clearly. This is the one area that I don't skinny down on in packing and it helps put my mind at ease and helps deal with some of the bumps in the road that have come along.
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