It’s May, and so the end of school isn’t far away. Many of you are thinking about summer vacations with your families. You might be thinking about a grand expedition across the country, or to Europe, or some exotic location... or simply a weekend or two at the beach enjoying the matchless Oregon coast scenery. Whatever your plans are, it bears to do a bit of advance thinking about how travel might affect your child’s health care needs. Here’s a list of tips that you might find helpful, both in the planning phase and once you get out on your travels.
Are you traveling to an unusual, far-away, or exotic location? You and your offspring may need either additional immunizations prior to the trip, or, in certain cases, special medications to fight off infections during your travel. Your best resource online is the CDC; their website has a user-friendly travel section. In general, tropical locations have increased risks for mosquito-borne illness, while travel to undeveloped countries carries an increased risk of catching nasty things through contaminated food or water.
Are you traveling to a destination with an outbreak of a vaccine-preventable disease? Measles has cropped up in New York, in California, in Texas, and in both the UK and many parts of continental Europe. Healthy travelers who have had both doses of their MMR should be protected. Since we don’t usually give the second dose of MMR until the four-year checkup, children between the ages of 13 months and 4 years may qualify to get that dose early if you are planning travel where there is an outbreak. There needs to be a minimum of one month between the two doses; the first dose is usually give at 12 months at our practice. In the case of travel to areas with a high incidence of measles, the first dose can be given a few months early (but it doesn’t ‘count’ and must be repeated at one year). Obviously, everyone in the family should be up-to-date on the rest of their regular vaccines before travel.
Does your child take any prescription medications on a regular basis? It sounds silly, but remember to take them! Every summer we have to help frantic families by sending a new prescription to a pharmacy at their destination, and no one wants the expense and hassle of having to do that. Pack medications in carry-on luggage, and pack them early on in the process. Remember that there are restrictions on liquid medications on aircraft. Keep liquid medications in their original packaging with the patient label clearly showing. Consider asking for a note from our office if your child takes critical liquid medication such as meds used for seizures or heart conditions.
Consider your destination and method of travel. Small children grow bored on airplanes; take plenty of amusements. Car travel allows for more flexibility and greater comfort but watch out for those twisty-turny roads on the way to the coast! They are famous for upsetting little kids’ inner ears and bringing on car sickness. Over-the-counter motion-sickness remedies can be helpful and there are chewable forms suitable for the little guys. Other strategies: lots of water, light and non-greasy food, plenty of fresh air, and encouraging them to play games that involve looking out the window rather than staring at books or tablets. If someone feels queasy, pull over as soon as traffic conditions allow and give the victim a rest for a few minutes, with a brief walk if possible. Get bad smells out of the car right away and keep the temperature on the cool side.
If an unexpected illness does strike, try to plan ahead a few steps. Is there a drug store/pharmacy near where you will be staying, in case you need acetaminophen, ibuprofen or Benadryl? Is there a store that sells Pedialyte or Gatorade? Most acute pediatric illnesses don’t need anything else. If you are going to be in one location for several weeks, or if you have a child with special health care needs (or little Johnny has a track record of getting strep throat every time you go to Disneyland), it’s worth knowing about your other local resources. Is there a pediatric practice nearby that is willing to see a ‘guest’ patient in a pinch? Is there an urgent care nearby? Where is your nearest hospital? Make sure you have our phone number with you, as we can advise you and help you find local resources such as physicians and pharmacies.
Be aware of what we can and cannot do for you. We can help you replace a lost or left-behind prescription for a non-controlled substance -- but your insurance may not pay for the new batch. We can advise you whether or not to seek medical care at a local office, urgent care, or ED, and can often help you find one. We can try to problem-solve with you to make your child comfortable until you can get to definitive care. We can get on the phone with local doctors and answer their questions about your child’s health record and needs. We CANNOT diagnose conditions over the phone. We won’t be able to call in prescriptions for antibiotics without seeing your child; that’s no different than if you were home. We also cannot call in orders for lab tests or x-rays. If your child is sick enough or injured enough to need labs or x-rays, then they need to have Someone Local checking them out.
So there you have it! Have fun working on those summer vacation plans, and remember to ask us for help with any of the issues discussed above.