Medication Management on Long Trips in Europe

If you’re going to be away from the US for more than three months, you’ll have to give some thought to how you’re going to get your maintenance medications refilled. What doesn’t occur to you until you get sick overseas is the need to give some thought to your usual OTC remedies.
Together, Linda and I take four maintenance medications, and I managed to get them synced up so that the refills all occur at about the same time. Generally, with mail order pharmacies, you can ask for a refill two-thirds of the way through the prescribed quantities (e.g. after 60 days for a 90-day refill).
Mail order pharmacies won’t ship overseas, so you’ll need a stateside helper for this.  For some plans that permit it, it might be easier to get 90-day refills at a local pharmacy rather than the mail order one. This will reduce wait times by a few days.
Once your helper has the meds, they can be repackaged in a small box or envelope if necessary. We sent the four prescriptions to Europe (once to Ireland and twice to the UK) for $13.50 each time, and it took 5 to 9 calendar days to be delivered. On the customs declaration, we put “prescription refills” and a value of $25, and there were no problems, at least in these countries.
Because of the shipping delay, you will need to identify a place where you can receive the item, and where it might arrive before you do. I asked our pet-sitting hosts for their postal address and permission to do this, and it all worked out well.

By the way, lens.com will send contact lenses overseas for $30, and without having to check with your eye doctor. They have a UK branch so it might be quicker to get them that way, or even to pop into a local optical shop. But they might not have your brand in another country.

What about OTC items?

We were planning a trip of seven months, and that meant about 400 multivitamin tablets, 400 fish oil capsules, and 200 glucosamine tabs. I brought a full bottle of Sam’s Club vitamins (350, I think), the 200-count bottle of fish oil with almost 1000 mg of omega-whatevers, and the remainder of my big bottle of glucosamine. These are fairly big bottles. In Europe, you will not find huge bottles of any medication, and I did not find fish oil with much over 400 gm of the omega oils. I knew I could get these at Boots, though, and decided to settle for those. Sending refills of these in separate shipments would be more expensive, and because of the quantities might not be permitted. By the way, everything should be sent in its original labeled container.
But wait: what if you get sick? What do you use? Most of it is hard to find in Europe, where they customarily use different medicines. You might want to think about:
• Acetominophen (Tylenol): it’s called paracetamol in Europe, and is available only in small quantities (30-60) at a wide variety of prices.

• Ibuprofen (Advil): it’s called ibuprofen or a variation of that, and also available in 30-60 packs at more than you’d expect to pay.

• Decongestant: we use pseudoephedrine (Sudafed) which (in the US) you now have to buy from the pharmacist and give your name, etc. This is to prevent its diversion to the manufacture of meth. In Europe, they don’t sell the pure form, it’s already blended with paracetamol or ibuprofen and usually liquid.

• Antihistamine: they have generic Zyrtec, which goes by a variety of names, and is inexpensive.

• Cough suppressant: There’s no pint bottle of Robitussin like we buy at Costco. I have found tablet dextromethorphine (DM). There are syrups but the taste will not be familiar, to say the least, and the active ingredient is something else. I don’t like to experiment when I’m not feeling well. Bring some DM.

• Expectorant: In the US, this is guiafenesin, which is the main ingredient in Robitussin and Mucinex. Not generally available, although they knew what it was. They offered a tablet equivalent, called ambroxol, which we found just as effective and it’s a much smaller pill.

• Low-dose aspirin: Remarkably, aspirin is a prescription drug a lot of places. There is controversy about whether a daily aspirin is a good idea or not. Bring the 250-count bottle from Costco if your doctor has you on these.

• Melatonin: I’ve seen it, but not with the dosage varieties we have in the US. I’d bring it.

• “Advil PM” or “Tylenol PM”: these sleep aids are either acetaminophen or ibuprofen with Benadryl, whose generic name is diphenhydramine. Not available, although straight diphenhydramine is.

Pharmacies in Europe

On the continent, anything that goes into your body and isn’t food has to be bought at a pharmacy. These vary from tiny to medium, but there is nothing approaching a Walgreens. In cities, there will be at least one pharmacy open at all times, usually on a rotating schedule, and in some countries, like Italy, there will be a sign in the window of the closed pharmacy telling you where the nearest open one is.
In the UK, you will find some OTC meds in larger grocery stores, but any of the ones mentioned above will still need to be bought from a pharmacy. The biggest one is Boots, and they are even in very small villages.
We have always found the pharmacists to be very well qualified. They are permitted to give a little more medical advice than US pharmacists, and some can even prescribe. Almost all spoke enough English, whatever the country. Take the package from whatever you need more of.

Bring your pill-cutter if you have one.

 

Home from Maui; off to Europe

We flew home from Maui.  So sad to leave.  Just like this turtle who is going back out to sea in this photo I took. We said Aloha to the wonderful island and came home to 91 degree temperatures.DSCN4261  DSCN4271  When we got home we decided to go back to Europe this May.  It would be easy to just slip back into living at home and doing everyday things that keep you busy.  But we are not getting any younger and so we need to push ourselves to travel again this year.  Our son will be staying in the house with his spouse and they will take care of our sweet doggie, Mac.

So we have booked a trans Atlantic cruise for the end of April and will be in Europe in the beginning of May.  We are working on lining up some pet and house sitting gigs in England and Ireland for the first months.  We met such nice people last year and took care of some wonderful pets that we are looking forward to doing it again.  I will be posting as we get ready, so if you want to follow along just hit the “follow ” button on top of the blog and add your email addy and you will be notified only when I post. I am so excited to experience more adventures.  Now to pack…..

St. Ives; a lovely Cornwall harbor town

We took the train to St. Ives in Cornwall from Truro, it only cost about $5 each for us to go to the beach and to return to Truro.  Here is an old fashioned signal box house for those of you who are railroad fans that is still operating in the Truro train station. truro signal box small The train goes to St. Erth where we got on the St. Ives train.  This train only goes back and forth to St. Ives.Truro train smallSt. Ives is a seaside town on the western edge of Cornwall.  It is a popular summer resort.  We went on one of the few days of sunshine that we experienced in Cornwall and it was crowded.  Here is a photo of the beach.St Ives beach 5x7 smallMany people put up wind breaks and small pop up tents.  There is a lovely harbor where the local kids jump off the pier to go swimming.St Ives pier jumpers small There is a picturesque Lighthouse on the end of the pier.St Ives lighthouse small  And some local seals patrol the harbor walls hoping some of the fishing boats might lose some fish.st Ives seal head small We did get some fish and chips in a fun restaurant on the harbor front.  Here is a photo of David looking happy after eating salmon. St Ives David fish and chips small  It was a wonderful day train trip.

I have been captured by the Olympics

We are taking care of 2 lovely dogs in Truro, Cornwall.  Here is a picture of them having fun.

dog friends play small

We have been walking these babies 2 times a day in a lovely field nearby.

But we have not done any sight seeing because….I love the Olympics.  All my favorite sports come in the first week.  Swimming, volleyball and gymnastics are the big three for me.  The problem with being in England is that the swimming finals are live  here at 1-4 am because the the time difference with Rio.  Oh no…..my normal schedule runs until 1 am everyday but this is really making my clock crazy.  Luckily, next week we can see some of lovely Cornwall and I will put up some lovely photos for you.

Here is the view from our pet sitting home, so lovely.

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Oh and go USA!

England; rain and flowers

It is summer here in England but sometimes it is hard to tell.  There has been more rain than sunshine during our visit.  For someone from Southern California it is an amazing amount of water from the sky.  The wonderful part of all of this rain is the glorious flowers that bloom here.  I have been going crazy taking photographs of some of these lush blooms.  I thought I would share some of them with you.  A bouquet of English blossoms for you to enjoy. wells flower pink yellow smallflower purple smallflower white green smallpink flowers A  smallflower pink purple smallChartwell flower back smallJanet pink bells smallcambridge flowers 5x7flower pink spikes small

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We discover how the National Health Service works

Well, we have been lucky so far with our travels and except for a terrible cold and some allergies have not had any health issues.  That was until Tuesday.  David had hurt his big toe when he accidentally dropped a suitcase on it a week before.  It had been healing until Sunday night when it started to bleed and to hurt.  David's toe 7 2016By Tuesday , we knew we would have to see a doctor.  What do you do when you are in a foreign country?

Well, here in the UK they have the National Health Service (NHS, free coverage for all of their citizens and indeed anyone from the EU). After a little Googling, we followed what they ask you to do when you need help.  David called the NHS hotline (111) and spoke to a nurse who advised him to go to the ER near where we are staying.  (A little surprisingly, there are Walk-in Centres (kind of like US Urgent Care) only in more rural areas.)  So we took the #2 bus, which conveniently stops 100 feet from our door, to the hospital and waited for about 1.5 hours to see a doctor.  The doctor was very nice and after we all talked about it , we decided that the toe nail had to come off. Here is a photo of nursing assistant  Lauren, who did all the hard work and helped the doctor take the nail off .lauren the nurse small

We got the toe bandaged up and went home on the bus with a round of antibiotics to take. We changed the dressing Saturday and the toe looked good.  Today it looks normal and a regular bandage is enough.  We were thankful for the NHS assistance and the good work done in the Cambridge Addenbrooke’s A&E.IMG_20160729_150723

By the way, we immediately confessed to being visitors from the US, and the word “insurance” was not heard, nor was there any request for payment. They even waived the co-pay for the medicine, which is normally £8.40. They did take our address, so perhaps the final outcome will be different. but right now we think this care was free. The NHS website seems to say this is the case for emergency care when you’re not admitted to the hospital.

Also by the way, there is a full complement of reality TV in the UK just like in the US. It includes police (highway and city), border control (from the UK, Canada, Ireland, US, and Australia), lifeboat rescue, and yes, medicine (both emergency and GP (general practice, you local family doctor).

 

Life in Glasgow’s Tenement House

We spent six days in Glasgow after our two-week pet sit in Edinburgh (I still miss Jodi the dog).    One of the places we visited there left a big impression on us.  It was the Tenement House.  This was a upper working class tenement home of one Miss Toward and her mother Mrs. Toward.  They lived in this one bedroom flat from the early 20th century until 1965.  Here is her  story from the exhibit.glasgow tenement house ms toward smallglasgow miss toward bio small It was being able to see how a single working woman survived in the 20th century that was so affecting.  She rented her apartment, like most people in the city.  She was very thrifty and saved whatever money she could.  Here is a layout of the apartment she and her mom lived in glasgow Miss Toward's tenement floor plan smallShe and her mom slept in the double bed recess in the kitchen and rented out the bedroom to a boarder to save money.  The kitchen would have been the warmest place in the house to sleep in those cold Scottish winters.  The docent told us that the bathroom was very luxurious in 1911 because it had an indoor toilet and hot and cold running water.  There was a shared wash house in the back of the building in which everyone had a day to use to do their washing.

Here is a photo of a photo of her kitchen ( I was not allowed to use a flash and it was not bright enough for a photo from my camera) glasgow tenement  house kitchen smallThat is a coal heated stove and oven. Above the the oven she had a drying rack that pulled down to hang clothes and up to dry them. Miss Toward did not want to pay for electricity to be put in for her landlord’s benefit, so she made do with gas lights and no refrigerator.  She did break down and converted to electric lights in 1960, but the stove was still working so no replacement was needed.  She left the flat exactly the way it is now when in 1965 she went into the hospital.  Not having a refrigerator was not as hard as it seems.  The door in the  upper right hand of the photo opened into a cold larder.  A shelf room that had holes drilled into the walls that kept everything as cold as outside, which in Scotland is pretty cold.

There was even a bit of elegance in this hard working woman’s life.  It was the parlor. glasgow tenement house table smallThis room was only used for company.  Here is the table as it would have been set for tea.  In this room there is also a stand up piano that both Mrs. and Miss Toward used to play.  No electricity meant no radio and no TV .

Remember she worked long hours being a typist including Saturday  (they eventually got a half day off on Saturday).  There were no grocery stores, you had to purchase food almost every day from separate stores (groceries, produce, meat, etc.) and prepare it from scratch.  It must have been an exhausting life, but she and her mom kept their standards and  their sense of dignity.

She spent ten years in the hospital before she died in 1975.  Her apartment was rent controlled at around 30 pounds a year and she kept paying for it the entire time she was in the hospital ( I supposed hoping someday to get to return home).

After her death the house was left in her will to the church which intended to sell it to raise funds. It was only on inspection of the flat somebody noticed its potential as it had remained completely unchanged from the olden days and decided to preserve it.  That lady purchased it and lived in it for 9 years before selling it intact to the National Trust for Scotland.  They reinstalled gas lights and made it as close as possible to the way that Miss Toward lived there. (##budget travel tip:  If you have an English National Trust card you can get into any of the National Trust of Scotland properties for free).

We both found this testament to a thrifty hard working woman to be uplifting and beautiful.

Creepy old graves & body snatching in Greyfriars’ graveyard

The last blog was about wee Bobby the dog and his loyalty to his master.  This was the lighter side to Edinburgh’s Grey friars’ graveyard. Now we move from a Disney movie to the Body Snatchers movies.  Grey friars cemetery started out life as a Franciscan herb garden for the infirmary that the monks ran from the middle ages.  The monastery was dissolved in 1559 and the garden was turned into a graveyard in 1561.  The oldest graves have a distinctly decrepit look. greyfriars skull 5x5 bw They seemed to like all kinds of variations on skulls and cross bones, possibly to make sure they remembered that death from disease, famine, or religious disagreement was always imminent.  Greyfriers grave 1 small This particular medieval monument would keep me on the straight and narrow .  greyfriars dark angel 5x7.jpgAnd even an angel keeps a skull on her knee in case you thought about sinning.  But the decorations are just the beginning.

There are some really creepy grave monuments like these; Greyfriars bw grave 5x7 small Here is a husband and wife united in death ; holding hands under that famous skull.greyfriars 17th cent grave small

Edinburgh had a progressive and excellent medical college.  The doctors and their students from the 18th century wanted to be able to dissect real bodies in order to learn anatomy.  The problem was that the surgeons were only allowed about 4 criminal bodies a year to dissect. The body demand created a new industry:  ‘Resurrection Men’  who sold the newly dead bodies and could get high prices for one. The rich started using mausoleums, vaults and table tombstones to deter these crafty tradesmen from lifting their beloved dead for an anatomy lesson.  Here is a table tombstone from the Greyfriars’s graveyard. Edinburgh greyfriars grave small Ironically, I believe this was the grave of a surgeon.  He knew how to keep those pesky body snatchers away.

In the 1820s in Edinburgh there were two men (Burke and Hare) who decided to cut out the undertakers and started to murder people by smothering them while compressing the victim’s chest.  In one year they sold 20 bodies to Edinburgh’s doctors before they were caught. But all good things eventually comes to an end.  The government in the United Kingdom passed the Anatomy Act of 1832.  Now bodies of unclaimed paupers were  confiscated by the government and disbursed to licensed  doctors only. The grave robbing trade was dead.

I liked this gravestone; short and to the point; Edinburgh greyfriars grave stone small I think this would be the perfect place for a Halloween party or a seance .

Now we see both sides of this historic graveyard; the sweetness of loyal Bobby the dog and the sadness of death and grave robbers.

Wee dog Bobby in Greyfriars graveyard

This ancient graveyard is supposed to be the most haunted place in Edinburgh.  If you come to visit it on a cold and rainy day, it gives off an atmosphere of  death and decay.  I got to visit it this summer on a sunny day and the very next day it was a cold and rainy day.  That is what weather is like in Edinburgh.    This graveyard is strange because of the dichotomy of its attractions.  The first side to this story is a sweet famous legend about a wee Skye terrier  named Bobby who is said to have sat on his master’s grave for 14 years until his own death.   (You must read the amusing debunk of this myth in Ian Smith’s blog.)  Here are the gravestones of all involved in this story; wee Bobby’s grave at the entrance of the church;  edinburgh greyfriars Bobby grave smallJohn Gray  the policeman who owned dear Bobby and the grave where he sat for 14 years until he died, edinburgh John Gray grave smalland James Brown, the graveyard sexton who kept the story alive and well to attract visitors and collect tips.greyfriars James brown sexton smallIf you look at the dates on these stones you will notice that perhaps the second wee Bobby outlived the sexton by 4 years. I image the next sexton picked up the gig.  Anyway, this  story has been so successful that Disney made a movie about it, and there is an entire pub dedicated to Bobby in front of the cemetery .edinburgh greyfriars Bobby smallWant to lift a pint to Bobby’s memory?  Amazing Bobby is still earning money for all involved.  I would say that is a loyal and excellent doggie.

The second part of the story of Greyfriars’ grave yard is definitely much more dark.  It is the story of imprisonment, beheadings, body snatching and ghosts.  That part I will take up in my next blog entry.  Come back for more if you dare….to be continued.

 

Stirling Castle & Mary, Queen of Scots

We took the train to Stirling to see Stirling Castle.  The train station was small and nicely designed. The train was very economical; it was only $16 for both of to go and return. The trip took about 50 minutes.Stirling Castel train small We walked up the hill (which we regretted as it was straight up) to the church of the Holy Rude  (means  Holy Cross).  We decided to look inside and catch our breath. church of the holy rood small  As with most old ( it dates from the  15th century) churches in Scotland, this one was a Roman Catholic church until the reformation.  Now it is part of the church of Scotland.  It is a place where  in 1567 the infant King James VI was crowned.   After exploring this church and graveyard, we walked up to the castle.  Here is a map of the castle; map of stirling castle smallThe castle sits on the top of Castle Hill with 3 steep sides for protection. Most of the principal buildings of the castle date from the fifteenth and sixteenth centuries. In 1542 Mary, Queen of Scots was crowned in the castle.

What you see now when you visit the castle is  buildings that were constructed between 1490 and 1600, when Stirling was developed as a principal royal center by the Stewart Kings James IV, James V and James VI. The great hall was painted gold which was a surprise as we are used to the gray stone look of most old castles.  Stirling Castle great hall small We were told by the tour guide that all of the buildings would have been painted gold to show people the power of the Steward kings. Inside the castle (restored to the time of 1540s) you can see many examples of King James V’s desire to show visitors that he was the glorious king of Scotland.  Almost every room has a large and colorful coat of arms over the fireplaces.Stirling Castle james mary arms small  Here is a photo of the throne room of James’ queen, Mary of Guise ; Stirling Castle Mary guise throne 5x7They were the parents of Mary, Queen of Scots. Mary’s father James V died when she was only six days old, leaving an infant queen on the throne. Her coronation was held nine months later at Stirling, one of the most secure places in the kingdom.She would spend most of her childhood here and return frequently during her adult reign.

Here are two views from the castle. You can see why it was such a secure place to keep the infant queen.Stirling Castle view smallstirling castle view 1  small I have always been intrigued by the sad story of Mary, Queen of Scots and it was moving to be in the same castle and rooms that she lived in during part of her life.  This is one of the reasons that travel is so valuable.  Now when I read the history or see a film about Mary, I can put her life in the place where she lived.