Let’s take drugs!

No, wait…that’s not right. Let’s talk drugs—our travel medicine cabinet, to be specific.

In our pre-retirement vacation travel days, we quickly discovered the advisability of scoping out the nearest pharmacy shortly after unpacking. We were young, our prescriptions were mostly for allergies, and we never had to carry more than a couple weeks’ worth of essential medicines—you know, like Liverite for combatting hangovers. If we caught more than just the sniffles, we’d just toddle on over to the nearest green-crossed drug store to pick up whatever we needed, essentially making it our own giant medicine cabinet.¹ Those were innocent times.

Skip ahead 30 years, and I can’t imagine how we made that work.

These days, we have an entire Dopp kit devoted to just our prescriptions, a soft-sided lunchbox for “essential” medicines, and yet another Dopp kit for what I like to euphemistically call “backstock,” which really just means whatever we can’t squeeze into the other two. Obviously, the inventory expands and contracts over time, but generally speaking, pills take up nearly a quarter of one of our suitcases.

Prescriptions

First, let's talk about prescriptions. We left San Diego lo! those many moons ago without a clue. The assumption was that, in a big, beautiful, globalized world, we'd be sure to find replacement prescriptions when needed and probably cheaper, too!

That was incorrect. Or, at least, mostly incorrect.

We quickly learned that even with international insurance coverage, you can’t just call up your GP back in Seattle for a replacement refill of that allergy spray you used up. Nope. Instead, you need to find a local GP² who’s willing to see you, willing to speak English, and willing to write the scripts you need.

Assuming, of course, they have the medicines you need in whatever country you’re in. Because guess what? They might not! Each country has its own formulary. Some drugs are simply not available—or maybe they are, but the local medical establishment refuses to dole out the kinds of things our doctors treat like candy.³

Or, worse, they have medicines that are oh-so-slightly different versions than their American counterparts. For instance, Geoff uses two allergy sprays that, in Australia, are combined into a single bottle. Brilliant! But because we don’t have that in the U.S., it doesn’t appear on our insurance company’s list and is therefore not reimbursable. Or as another example, in Australia they sell you codeine and ibuprofen for extra pain relief. But in the U.S., we only sell codeine and acetaminophen, so Blue Cross won’t pay for the Australian version, pretending that it is instead some Frankenstein drug that doesn’t deserve to exist. We’ve paid a fair amount of money for prescriptions that “fell through the cracks” between the delivery systems.

And don’t even get me started on the endless horrors of filing claims for prescriptions with our insurance carrier back home. You need to file an individual receipt for every prescription, and that receipt, we learned the hard way, has to be the "tax form" or "long form" from the pharmacy in addition to the register receipt. Meaning that the receipt must contain not just the medicine information and cost, but the pharmacy name, address, and phone; the dispensing pharmacist’s name; the prescribing doctor’s name and contact information; the full name of the drug and the name of the generic equivalent; the dosage, amount, strength, and days-of-use—for every single prescription item purchased. You can't see me, but I am rolling my eyes so hard right now. A 30-minute pharmacy run often resulted in a three-hour e-filing nightmare for yours truly.

Hmmm…it looks like I got myself started. Oops. Anyway, the solution is to think ahead. I know, so boring. But we discovered much later that you can get up to a year's worth of your prescriptions. Your doctor will happily request the override for "extended travel refills." There will likely be some phone calls and finagling with your insurance company. So don't think you can just have your doctor write you a 12-month script and you'll be home free. But it's eminently doable.⁴

It'll be expensive because you’re paying your deductible for 12 months of drugs all at once, but it’s worth it. And remember to pack your new prescriptions in their original prescription bottles. Don't think you'll save some space by consolidating or dumping your pills into Ziploc bags. The TSA doesn’t require it, but other countries just might. And some prescriptions here are considered controlled substances elsewhere. Safest to have everything in their own bottles so it doesn’t get taken away or you spend a night in the cooler.

Non-prescriptions meds

Okay, on to non-prescription medicines—which are equally important, sometimes. We keep a sufficient quantity of critical over-the-counter meds to survive—and this has happened to us—when we get sick simultaneously. Ugh. Nobody wants to run to the drugstore when you're sick.

Remember how we’d map out the nearest pharmacy on our early trips? Knowing where the pharmacy is can be a whole different kettle of fish than navigating that pharmacy. Especially if your head is fogged by illness.

Many places—including but not limited to Australia, Hungary, and Mexico—put all the most valuable and essential over-the-counter meds behind the counter. There are no brightly lit super-sized pharmacies with open floorplans like at home where you can browse the aisles comparing 42 different versions of pain reliever to find the one that’s just right. Oh lord no!

Instead, everything’s lined up in boxes on shelves or under glass. You have to stand in line until you can talk to the pharmacist and ask for what you want. And you need to be fast and clear because everyone else is standing in line behind you.

Which is all well and good because you do know what you want. The sweating starts when you realize that the lovely young thing behind the counter does not, in fact, speak any English, and the thing you've asked for doesn't exist, as such, here. Do you know how to ask if there's something similar? If there's a less expensive generic version? What's the strength? Do you have a larger box? Do you have it in pills? Tablets? Caplets? I'm telling you, it’s a nightmare. And god forbid you’re looking for something like Imodium, but you can't see any on the shelves so you have to suddenly figure out how to ask for something like that without airing all your dirty laundry, if you will, for the entire cast of characters lined up behind you with nothing better to do than listen to your babbling. Good times, good times.

All of which is why, despite the weight and volume, which is anathema to our larger packing goals, we carry a butt ton of the drugstore staples we like from home.

Here’s what’s in our medicine cabinet:

1. Alka-Seltzer. So old school, so useful. Nothing, and I mean nothing, quenches heartburn like this staple from the ’50s. And we have not found it outside the U.S. Buy it before you leave home.

2. Aspirin. Yes, other countries have aspirin. Usually in blister packs of 20 tablets. For $8.50. Seriously? That'll get me a thousand tablets and two hot dogs for lunch at the Seattle Costco.

3. Bandages and Band-Aids. Because when you need one, you don’t have time to get to the store.

4. Benadryl. It saved my sanity after I was devoured by a swarm of “no see ‘ems” in Australia. It is not marketed as “Benadryl” in Australia, of course. *sigh* I am also 99% sure Benadryl is unavailable without a prescription in Australia and probably elsewhere.⁵

5. Bonine. This is the best anti-nausea drug we’ve ever found to combat seasickness and motion sickness—with no side effects! I can’t recommend it highly enough. But it’s hard to find and expensive overseas.

6. Caffeine. Geoff steadfastly refuses to acknowledge the efficacy of caffeine in pill form, but when we run out of coffee in the morning, I have to take one to avoid withdrawal, fatigue, and muddled thinking.

7. Colostrum. The #1 best preventive for gastrointestinal issues from nose to butt, and a first-line curative in larger doses. We carry it by the jug, take it for every conceivable symptom, and have stopped needing Imodium. Research it.

8. Cough drops. You have no idea how vile and ineffective foreign cough drops are. Please don’t put yourself in the position of buying everything on the shelf in desperation, hoping one of them will work. Buy American and bring them with you—in bulk! A two-week flu will decimate all but the largest of stashes.

9. Gas-X. Foreign foods cause some pretty robust, um, gas attacks. ‘Nuff said.

10. Ibuprofen. See Aspirin above.

11. Imodium. Not big on colostrum? Then you’ll definitely want this in your kit. Just don’t expect it to be marketed as “Imodium” anywhere else, so how would you find it? I don’t think I need to go into why this is essential to life and health for all world travelers.

12. Lactaid. So far, this has been relatively easy to find everywhere, though it is more expensive than at home.

13. Migraide. Geoff occasionally gets migraines, and this homeopathic under-the-tongue pill works like a charm.

14. Melatonin. Surprisingly, melatonin is available by prescription only everywhere we’ve been outside the U.S. And it is spendy! If you use it, buy it at home.

15. Mucinex. We’d buy cough syrup Robitussin at home for those chesty cough situations. But the same active ingredient, “guaifenesin,” is available in pill form, and you’ll need dozens of the sizeable 12-hour variety to get two people through the flu.

16. Neosporin. You do not want foreign bugs getting into a cut.

17. Nicotinamide (aka, expensive vitamin B3). The Aussies proved this to be effective in reducing skin cancers. And they’d know.

18. Omeprazole. For heartburn. And contrary to their marketing materials, it works immediately, so you can take it when the heartburn starts.

19. Pepcid. Also for heartburn. Are you seeing a theme here? This also works immediately, so you take it when your heartburn starts, too.

20. SleepCalm by Boiron. They are the best homeopathic go-to sleep pills I have found.

21. Sudafed (aka, “red pills”). The good stuff, not that crappy phenylephrine replacement—which has literally been proved by the FDA not to work. You’ll need some of the 4-hour and 12-hour variety. These are as difficult to obtain overseas as in America, so get them at home and stock up.

22. Tums. For, you guessed it, heartburn! But also upset stomach. It's bulky but also works as a pseudo-sleeping pill if you need help at night. Buy the rare sugarless variety, and you won’t wake up with a fuzzy mouth.

23. Thermometer (old-style glass). We had a fancy electric one but had to jettison it for the space.

That's the scoop, folks. Rick and Geoff’s medicine cabinet recommendations for world travel. I think you can begin to see why we carry so much luggage and why we recommend that you do, too.

Geoff: Buongiorno.

Pharmacist: Prego.

Geoff: Parla inglese?

Pharmacist: A leetle.

Geoff: Uh oh. Um…well, do you have anything for a cold sore?

Pharmacist: *cocks head quizzically*

Geoff: Erm, a canker sore?

Pharmacist: *raises an eyebrow*

Geoff: Oh, ugh…*points at angry cold sore*

Pharmacist: Oh! HERPES!

You should have seen his face, struggling with the choice between acknowledging that, yes, he did have herpes (“but not THAT kind of herpes!”) and getting the medicine he needed.

2. And heaven forbid you need a specialist. In most other countries, you can't just call a specialist and make an appointment. You need to see a GP first and go through a couple rounds of GP-based treatments before they'll refer you to a specialist—all of which typically takes waaaaaay longer than the month we usually give ourselves in any given place. As you might imagine, this especially galls Geoff, who mostly disdains GPs, preferring instead to employ an army of specialists, because “they know what they’re doing.”

3. I’m looking at you, sleeping pills!

4. It may, in fact, be a compelling reason for us to come home once a year!

5. I know I keep talking about Mexico and Australia, but we had similar experiences in England and Scotland. And, believe me, no one can read any of the ingredients in Hungarian—we had to ask friends there to buy stuff for us and schedule appointments. Dubai pharmacies were small and uber-expensive. There is no pharmacy on the cruise ship, and visiting the infirmary was breathtakingly expensive.