A Nurse’s Guide to Staying Healthy While Traveling

Getting sick while traveling is the worst! You save your money, get time off work and then get stuck in your hotel room feeling miserable or even worse, need to visit a hospital. You need to do whatever possible to stay healthy while traveling and I am here to help. Why am I qualified to give out advice on this subject? I am a nurse practitioner with two masters degrees in nursing along with both primary and critical care experience for over 10 years. I won’t give any advice that isn’t based on good medical principles.

1.   Get Travel Insurance

If you can afford to travel, you can afford travel insurance. It is necessary unless you have some amazing policy from your employer that covers you in other countries. Definitely worth looking into. There are many good companies out there but I use Allianz. Emergency health services are covered along with many other things. I buy their yearly policy.

2. Optimize Your Immune System 

This is a big one and I’m going to spend some time here. This is the reason all things go wrong in our bodies when it comes to acquiring infections while traveling. Traveling can be stressful (navigating the airport can make me homicidal) and stress of any kind weakens your immune system.  Airplanes are notoriously dirty. The tray tables, the armrests, the remote controls, and other things are never sanitized, nor even wiped. Not to mention, you are trapped in this big tube with hundreds of other people, many who may be sick, coughing, and lacking some basic hygiene and etiquette! I’ve seen people put their hands in body parts they just shouldn’t while in public.

Let’s now add jet lag, change of diet, lack of sleep, disruption of fitness routine, exposure to new and different foods and this just adds to the body’s propensity to become ill. A strong immune system is your best weapon against all these pesky germs we encounter whether it be on the plane, from other travelers or from food in foreign countries.

Think of it as a 2 pronged strategy:  Strengthing Immunity and Decreasing Exposure to Germs (aka bacteria and viruses)

What can you do?

• Don’t Smoke (this impairs your body’s ability to heal and fight off infections)
• Stay hydrated
• Get enough sleep
• Maintain a healthy weight and fitness
• Diet high in fruits and veggies
• Adequate vaccinations. CDC website has all the info you need.
• Alcohol in Moderation (this is hard, I know. The struggle is real)
• Frequent Hand Washing  This is probably the most important. I can’t emphasize this enough. When traveling and away from a sink, bring Purel or an alcohol-based hand sanitizer in your bag and always have it with you. Do not use the fancy smelling ones with antibacterial ingredients in them. These only kill certain bacteria and allow others to flourish on your skin. Gross! Also, when confronted with a sink that does not have hot water or just a nasty bar of soap, DON’T USE THAT SOAP.  Friction is the most important part of hand washing. Use cold water, no soap and just spend at least 20 seconds rubbing your hands together vigorously, getting all the nooks and crannies.

For more advice on how to strengthen your immune system, I will direct you to the experts at Harvard University for further reading on this subject. 

Here Are Items I Travel With:

Hand Sanitizer

Disinfectant Spray

Let’s stop for a minute and talk about something trendy…using herbals and organics instead of chemicals. I’m all for it…usually. Let’s get serious. If you went to the operating room to have surgery and they told you instead of the industrial strength mega-virus and bacterial killing chemicals they usually use to sterilize the equipment, the ones that are known to kill 65 different organisms including HIV, Hepatitis and Herpes, today they were using lavender oil because it “kills some germs” and is more “natural”, would you be ok with that? Uh huh. So…don’t give me crap about using some stuff with “harmful chemicals” because if you want the nasty virus on your tray table gone so you can have fun in Bali, you need to take it seriously. That’s why I don’t mess around and use this travel-sized Lysol disinfecting spray on everything I touch in my airplane seat. Usually, my fellow passengers are begging me to disinfect their area as well.

Water Purification

If you are hiking or camping or traveling in a place where clean water will not be available, this will be your best friend.

3. Clot Prevention

On long flights or any long period of immobility, you are at higher risk for a blood clot to develop in your lower legs. This is because the blood in the veins cannot pump as well and the blood pools because of gravity. If you are dehydrated, this risk is increased. If you are over 35 years old, on the birth control pill or a smoker, you are at higher risk.

On long flights, stay hydrated, move as much as you can, consider compression socks, and pump your feet up and down a few times every hour or so to keep the blood moving. I actually take a baby Aspirin for these flights, but I would check with your doctor before doing this. If you ever have calf pain, redness, heat or swelling in the lower legs after a flight or long drive, seek medical attention quickly.

4. Gastrointestinal Issues

This may be the most common traveler complaint. Traveler’s diarrhea can affect up to 30% of travelers in foreign countries. This is due to contaminated food or water. Never drink tap water in other countries until you have researched whether or not it is safe.  This is usually not life threatening but very unpleasant. If you are unlucky and get a bug, it’s best to let it work itself out of your system. Meanwhile rest your stomach with easy to digest foods like rice, bread, bananas or yogurt. In medicine, we call this the BRATTY diet (Bread, Rice, Applesauce, Toast, Tea and Yogurt).

Stay hydrated! Coconut water is a great help in this situation. If after a couple days it isn’t better or you have a fever, you should probably seek medical attention. If you feel nauseated or have vomiting, follow this same advice plus adding ginger beverages or ginger tablets.  Consider traveling with ginger tea. Easy to pack and great for digestion, nausea and many gastrointestinal maladies.

For more information and lists of countries where the tap water is safe to drink, here is link to Center for Disease Control

5. Urinary Tract Infections (UTI)

Unfortunately, these are quite common especially for the ladies because of anatomical differences.  Being dehydrated, frequent sexual intercourse and low immunity are risk factors. These infections sometimes will go away on their own after a couple days but you will be a bit miserable, with frequent urge to urinate and burning upon urination, even bloody urine.  Hydration is essential. There is no evidence that cranberry juice is better than water but if you have it available and like it, it is a fluid after all.  There is an over the counter medicine called Azo that really helps with the symptoms while you wait for it to go away. I don’t know what the foreign counterpart is so I suggest traveling with it or asking a local pharmacist in whatever country you’re visiting.

If after a couple of days, symptoms are worse or you have back pain or high fever, you may need antibiotics. Everybody knows Cipro but there are lots of Cipro resistant UTI’s out there. Bactrim is a good cheap antibiotic, but you can’t take if you are allergic to Sulfa.  Macrobid (also called nitrofurantoin) is another one that is cheap and effective. You can ask the pharmacist if they have either of these. I try to have one of these before a trip and take them with me just in case.

6.  Hangovers

Is there anything worse than a hangover?  I will admit, I’m usually a healthy person but sometimes I think I’m still 18 and try to party like it. Sadly the hangover reminds me that I am much, much older! Essentially your body treats alcohol like a poison that must be detoxified by the liver. It blocks the release of vasopressin, a hormone that promotes water absorption in the body. So much of the body’s water goes directly to the bladder and gets flushed out instead (we all know this from our frequent bathroom trips while imbibing) and you end up severely dehydrated. This leads to the dry mouth, nausea, fatigue and throbbing headache.

Hydration is paramount. Again, I think coconut water with its natural electrolytes helps a lot. Pedialyte or similar children’s electrolyte solutions are great. Ginger drinks help the upset stomach. Watermelon water is also a great new item to try.  I avoid Gatorade and sports drinks because of the high sugar content.

Definitely, consider ibuprofen or acetaminophen (Tylenol) for the headache.  There are prescription anti-nausea drugs you can request your doctor to prescribe and take with you on your trip. Phenergan (comes in both pill and suppository form) or Zofran (comes in pill or orally dissolving tablet).

There is a vitamin supplement called Drink Wel that contains several key ingredients for hangovers. One of these is N-acetyl cysteine (NAC, a precursor to glutathione. Glutathione is a substance produced by your liver to help neutralize acetaldehyde, a toxic by-product of alcohol metabolism. When you drink too much, the liver can’t keep up. This is why the sleep you have with alcohol is so crappy and you feel so fatigued and malaised the next day. Give your liver a little help with this!

7.  Common Cold or Flu

The cold and flu viruses are just ridiculously easy to get. Keeping your immune system strong and hand washing are the best defense but sometimes it still happens. These are both caused by viruses and therefore antibiotics do not work. Taking antibiotics is actually bad for your immune system and bad for your GI tract (your stomach).

There are many misconceptions and old wive’s tales about these things. Cold weather, wet hair, sleeping with a fan, etc DO NOT CAUSE infections. Viruses and bacteria cause infections.

Cold vs. Flu can be tricky. Both have similar symptoms: sore throat, fatigue, muscle aches, fever, chest discomfort. With the flu these are always more severe, particularly the muscle aches and fever. Only a lab test can tell you for sure. With, the flu sometimes, if severe, you need a doctor who can prescribe Tamiflu.

The average virus lasts 9 days. Could be less, could be longer. A viral bronchitis (nasty cough) can last a month. Very annoying.

I sound like a broken record, but stay hydrated. Fluids make all the functions of your body operate at peak levels, including your immune system. Eat a healthy diet. You need your proteins, vitamins and minerals to aid in the healing process. Do you need vitamin C supplements or echinacea? I don’t believe so and no research proves that it helps, however, it doesn’t hurt.  Should you make foods high in vitamin C such as oranges, tangerines, mangoes, papaya, leafy greens, broccoli, and tomatoes, a part of your diet? Absolutely.  Not to mention that leafy greens such as spinach and kale have anti-inflammatory qualities which means that it helps your immune system and helps fight off the muscle aches you may have.

It’s good to know generic names of key ingredients when you visit pharmacies in foreign countries. Here are some helpful pharmaceuticals you may need:

• Tylenol (acetominophen) will help with sore throat, fever or muscle aches as will aspirin or ibuprofen (Advil or Motrin)
• Pseudoephedrine with or without an antihistamine (loratadine or fexofenadine) can help with sinus congestion and a runny nose.
• Guaifenesin (found in many over the counter cold medicines) can loosen up thick secretions and mucus and help with chest congestion, coughing and sinus congestion.
• Dextromethorphan (also found in many cold medicines) is a cough suppressant.
• Codeine is a very effective cough suppressant to use at night, since it may cause sleepiness. Some countries this is available without a prescription, but not in the United States.

8. Homeopathic and Other Natural Remedies

This type of treatment is not well researched in western medicine but I do believe there are lots of good treatments for various problems out there. I would love to hear from you in the comments below so share your tips. 

Stay healthy my friends, stay healthy.

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