GERM
00:00:08.960 – 00:00:11.200
Godenmorgen! My name is Germ.

WORM
00:00:11.200 – 00:00:12.080
I’m Worm.

GERM
00:00:12.320 – 00:00:28.320
Welcome to the Germ & Worm Travel Health Podcast Episode 75 “IV Hydration Spas innocuous Fad or Danger Will Robinson?” It’s a big planet. See it in good health. I’m Dr. Paul Pottinger, also called Germ. I’m a professor of Infectious Diseases at the University of Washington in Seattle.

WORM
00:00:28.660 – 00:00:36.660
I’m Dr. Chris Sanford, also known as Worm, Associate professor in the Departments of Family Medicine and Global Health, also at the University of Washington.

GERM
00:00:36.980 – 00:01:37.740
So Chris, this is our job and our pleasure to answer excellent questions that come to us from our listeners across the country and around the world regarding travel health and travel wellness. Here’s a few of them for today. WTF is up with Chikungunya on Long Island? Prickly heat versus Disney Vasculitis: What’s the difference? Rotten Airbnb with super nice hosts: What are the ethics of an honest review? And how to avoid and treat low back pain on long trips? These questions and many more.

Please contact us with your questions and your stories and tips for success. Or if you just want a clarification on something you’ve heard on a previous episode.

The best way to get us is through our website, germandworm.com and there you’ll find a question portal and all of our previous episodes. Or just send us an email germandworm@gmail.com Finally, our medical disclaimer. This podcast is designed to inform, inspire and entertain. However, you should not use this podcast as clinical care before you travel. Please see a qualified healthcare professional for recommendations specific to you and your itinerary.

WORM
00:01:38.380 – 00:01:41.180
Paul, do you have any upcoming travel?

GERM
00:01:41.660 – 00:02:16.840
Upcoming travel? Why yes. Yes I do. So lucky to go tomorrow to Antarctica on a Nat Geo cruise sponsored by Nat Geo run by Lindblad from Ushuaia across Drake’s Passage and then down to the Antarctic Peninsula, then South Georgia island, then to the Falklands. So it’s going to be almost three weeks down in Antarctica.

My second time there, but the first time been to the coast last time was just the dead dry, high cold as hell middle. So this time I’m looking forward to a more tropical experience. I don’t know how tropical it’ll be down in Antarctica, but I will let you know. So I’m excited about that.

WORM
00:02:16.920 – 00:02:25.480
Well, I have heard universally favorable reports from people who’ve been on National Geographic tours, so I’m very curious to hear what you make of yours.

GERM
00:02:25.720 – 00:02:52.580
Yeah, this will be our third Nat Geo cruise after Galapagos and Costa Rica. So yeah, we love them. We’re not sponsored by them. It’s just we chose them on purpose. But I’ll let y’ all know. Follow German worm.

I’ll try to get some content for everybody for our listeners while I’m down there. And it should be super fun. Okay, Chris, I have a question for you. This comes from Anonymous, which I think is fine.

I’m reading a lot about IV hydration spas. Are they safe?

WORM
00:02:53.060 – 00:04:03.500
You know, thanks for the question. And this actually is a very popular thing now. These exist in 50 states and around the world.

And these non medical people, you pay them some money and they will either come to your home or you can go to them, put an IV needle in your arm and they tank you up with water. But also maybe vitamins, maybe magnesium. They make a lot of claims. They say it’ll make your hangover go away quicker.

They say it’s good for headaches and for head colds quite often. My general take on these is that you don’t need them and they’re under regulated.

It’s a big deal to tank up on IV fluids, just starting with electrolytes. It’s dangerous to make your sodium, your potassium, your other electrolytes go high or low.

The benefit for any of these claimed conditions, from hangover to head cold, are totally unproven. You have a very effective way of getting fluids into your body and it starts with your mouth. It’s what you do on a regular basis.

There’s other complications of IVs, but basically I think we need more government regulation. I think there should be more medical supervision. And so with what I know about these, I give these a large thumbs down.

GERM
00:04:04.140 – 00:05:08.020
Yeah, I do too. And that’s in the context of this podcast, which is travel health. But also just wearing my medical doctor’s hat in general.

That’s not only an overseas thing, that’s true domestically here in the United States. If you think you need IV treatment for any reason, hey, talk to your doctor, talk to your healthcare provider, your primary care person.

Please do not choose your own adventure when it comes to IV treatment, because if you do, you’ll end up seeing me. And I’m happy to treat you. It’s no problem. We’ll get to know each other.

And I’ll treat you for your viral hepatitis and your HIV and whatever else you picked up from this unregulated tubing that was not sterilized properly, a bloodborne infection. I mean, that’s obviously what I’m worried about. Plus the fact that maybe they give you Something that’s that fake. Or maybe it’s NOT fake. Maybe it really DOES chelate away your calcium. Our bodies are so good at regulating their water and salt content. If you need to make a change, almost always doing it by mouth is the right way.

That way it’s safe, it’s sustainable. I’m very, very skeptical and hashtag scaredashell of these IV spas.

WORM
00:05:08.100 – 00:05:20.000
Yeah. They try to propagate the myth that high tech is better, that if you have the money, you should give them money. In this case, low tech is better. Your mouth is safer, it’s more effective. So I would shun these.

GERM
00:05:20.240 – 00:05:21.120
Amen, brother.

WORM
00:05:24.560 – 00:05:29.200
All right, Paul, coming to you. Ooh. Good question. Do I need to be immunized for diphtheria?

GERM
00:05:29.520 – 00:08:56.060
I mean, you do. Everybody needs to be immunized for diphtheria. Do you need to be immunized again? Were you ever immunized in the first place?

Everybody should have a solid immunization plan against diphtheria. Why? Because it’s a preventable and shitty disease. So Corynebacterium diphtheriae is the bacteria that causes the infection, which we call diphtheria.

What is diphtheria? It’s a toxin mediated family of disorders. Corynebacterium diphtheria is a bacteria that lives on our skin and in our throats.

By itself alone, it’s quite harmless. It’s a microscopic bacteria. But this one particular species can in some cases make a toxin, a poison called the diphtheria toxin.

And that toxin is bad news. It causes all kinds of issues. It can infect a wound, a chronic wound that’s not being cleaned.

Well, that can kill the surface of that wound to make it very difficult to clean. It can get into the bloodstream and cause issues that range from sepsis to a poisoning of the heart.

Yes, you can have a poisoned heart due to bacteria, which is due to the diphtheria toxin. And finally, of course, it can go to the throat.

And that’s where most people think of the clinical disease of diphtheria can be catastrophic and awful in young kids because as the lining of the throat dies due to diphtheria poisoning, it sloughs off, but not fully, and it kind of sticks to the back of the throat. And this can make it hard for kids to breathe. So it can be a life threatening disorder.

And the wonderful news is that we have a family of terrific ways to prevent it. These are vaccines that we can give. It’s not a vaccine to kill the bacteria. It’s a vaccine against the toxin itself. We call that a toxoid.

And this toxoid is all you need and it works great. And you can give it to kids who are under age 7 years. That’s the DTAP.

You can give it to kids age 11 to 64, includes you and me, you know, that’s the TDAP. And there’s also just a tetanus and diphtheria toxoid, which can be given to people as well. We rarely use that for most of our listeners hearing my voice today, you should have your TDAP on, because TDAP is tetanus, diphtheria and pertussis. That’s good for adults and adolescents. It’s very safe. It works well.

And this infection of diphtheria that most Americans haven’t seen, haven’t heard tell since they were knee high to a June bug, because it’s something that we got rid of. Hey, folks, guess what? It’s coming back. It’s coming back globally and also domestically as well.

We have reports just in the last couple of weeks here in October 2025 about emerging issues with diphtheria. Tenfold increase in Mauritania. We have hundreds of cases in Mali.There’s all kinds of places around the world where we are seeing more and more of this over time.

And the good news is that if you are immunized against diphtheria, you’re also getting partial protection against the pertussis, the whooping cough, and you don’t want to whoop it up with whooping cough. More and more whooping cough in Argentina, in Guam, reports from all over the world about an increase in this, too.

So if you don’t know if you are current with your TDAP vaccination, please talk to your doctor. It’s always one of those vaccines we can easily give again.

For example, every healthy adult woman in America gets one of these shots with every pregnancy. We really do need to boost this immunity. And so I’m glad that this questioner asked about it.

WORM
00:08:56.300 – 00:09:18.520
Yeah, basically get a Tdap every 10 years and you’re covered for the three illnesses. Tetanus, diphtheria, pertussis, pertussis. The other name for that is whooping cough. So, yes, it’s a thing.

Yes, it’s getting more common around the world. Declining vaccination rates probably are going to make it more common.

But if you get your TDAP every 10 years, if you’re an adult, you markedly reduce your risk of getting this. Love it.

GERM
00:09:19.720 – 00:09:26.040
Okay, Chris. Question to you. What is prickly heat? How can I avoid it? How can I treat it if it happens?

WORM
00:09:26.280 – 00:10:17.250
Yeah, good question. So prickly heat is a common thing. It’s innocuous, but it’s really bothersome. It’s not an infection.

Prickly heat is when you go to a hot, humid place or you live in a hot, humid place and your sweat glands get blocked. And what that leads to is this red, bumpy rash on your skin. It can hurt, it can itch.

You may think you’ve picked up a nasty infection, but there’s no infectious organism. It’s not a virus, it’s not a bacterium. It’s just your sweat glands get blocked.

In this humid hot environment, it can be exacerbated by exercise because you’re sweating more. Treatment is really low key. Treatment is cool compresses and time. If it’s itchy, you can put a little hydrocortisone cream on it.

It’s bothersome, it’s innocuous. And there’s a related thing that can be brought on by humidity which I’m going to ask Paul about.

GERM
00:10:17.650 – 00:12:29.690
Yeah, so there’s a related issue or sometimes confused issue which is exercise induced vasculitis. This is often called the “Disney rash.” Why? It has nothing to do with Disneyland.

But this is something that primary care doctors see all the time in their patients who go on a vacation.

It could be to Disneyland, could be to Disney World, could be any place where it’s hot and humid and sunny and where they do a lot of walking, especially people who are not, not always the most active folks who don’t normally walk a lot. What’s happening with the so called Disney rash? Exercise induced vasculitis. That’s not prickly heat. That’s a true inflammation of the blood vessels.

And what I think’s happening here is that, well, somebody is not yet accustomed to being in a hot, humid environment. They get a lot of vasodilation. The blood vessels open up in an attempt to purge heat from the core.

And sometimes that happens to a degree that’s not quite healthy. And when that happens, you know, this person will end up with actual leakage of blood cells into the surrounding tissue.

So this presents with a purplish or red series of splotches in the skin. And it’s not like a sunburn or heat rash where you can press on the skin and make it blanch or go away in someone with a pale complexion.

No, no, this is a non blanching rash. It’s often on the feet or the legs, although it could be on the arms. And it’s often again, after tons and tons of walking, it’s benign.

It gets better on its own. Similar to the prickly heat you talked about. Get out of the sun, cool off, get to a place that’s less humid.

And in the case of vasculitis, you know, really elevating your feet, elevating your legs can be helpful to reduce the amount of lymphatic congestion and swelling that’s down there. The rule of thumb I give my patients, hey, when you’re at rest, I want your feet higher than your heart.

So just watching TV with your foot up on a little footstool. No, no, I want them up. And that can really help them to feel better quickly. Compression socks can help to reduce this.

Unless they make you sweaty and give you a heat rash, there’s really no easy way to prevent this except to gradually acclimatize yourself to these hot, humid, sweaty environments. Thankfully, both prickly heat and Disney rash, they tend to get better on their own.

WORM
00:12:30.320 – 00:12:52.720
To emphasize one point, I think Walt Disney is largely innocent on this one. We tend not to name diseases anymore after particular cities, countries, or theme parks. This could be called Six Flags Over Texas. So it’s not really Disneyland. It’s just walking around a lot in a hot, humid place. Golfers can get it. So apologies to Walt Disney for this.

GERM
00:12:53.040 – 00:13:04.300
I think it’s mad respect to old Walt because so many Americans do spend their vacations at Disney World, Disneyland, Disney, whatever that medical doctors, if you say the Disney rash, most of them will know exactly what you’re talking about.

WORM
00:13:10.220 – 00:13:13.420
All right, Paul, this is for you. What is hepatitis E?

GERM
00:13:13.660 – 00:17:23.249
Hepatitis E? E does not stand for. “Eh, forget about it.”

No, hepatitis E is part of our Alphabet soup of viral hepatitis.

These are infections that are caused by viruses that get into our body through different means and then can cause inflammation of the liver. Hepatitis means liver inflammation. Anything that ends in itis is inflammation. Hep means liver.

So liver inflammation caused by this particular virus, called the hep E virus. Hep E in the United States is very uncommon, much less common than hepatitis A, for example.

However, it’s important to know about because there’s plenty of hep E around the world. And for some of our listeners, they may actually be at risk for hep E depending on their planned international travel experience.

Hepatitis E, I want you to think about it as being similar to hep A. Right, Chris? This is spread typically by fecal oral root.

In other words, someone has the virus in their system, it’s in their GI tract, they defecate. And that feces is not adequately dealt with.

Either it gets into the drinking water supply or that person then wipes their backside, does not wash their hands properly, and prepares food for the next person. It can be, in other words, a foodborne illness.

Technically speaking, it could also be an STI if there’s oral anal contact between someone who is uninfected and infected. I want you to think about it like hepatitis A, meaning that it causes an acute or sudden onset of fever and feeling very sick.

Someone can look in the mirror and the whites of their eyes no longer look white. That’s called jaundice. And that happens when the liver is inflamed and it’s not managing its normal metabolic processes correctly.

For most people, hepatitis E, like hepatitis A, will be self limited. The treatment is supportive. We do not offer antivirals because we don’t have antivirals. We really make sure that that person is supported correctly.

Typically, people get better.

There are unfortunately catastrophic examples with both hep A and hep E, where for reasons we don’t fully understand, it can cause something called fulminant hepatic failure. Really just an overwhelmingly inflammatory response in the liver. And this can be life threatening. People have died this way.

One difference between the two is that hep E, you know, it has a special complication and association with people who catch it when they’re pregnant. Pregnancy is an independent risk factor for bad outcomes with hepatitis E. Why?

Well, you know, when women are pregnant, they’re relatively immunosuppressed. And that means that for whatever reason, hep B seems to really like getting into pregnant people’s systems. So that can be a catastrophe.

There are examples of this happening in number of countries around the world. We do have reports recently, right, Chris, of an outbreak in Gazira State in Sudan, where there’s ongoing transmission in this region.

Basically the recommendation is that if you’re traveling to Sudan, as you would with anyplace else in the world, be thoughtful about food and drink safety, trying to get the safest access to food and drink and clean water, like we’ve talked about here many times on the podcast. And this is a rare infection and it’s one that we do not in the United States have a vaccine for. Other countries do.

It is possible to get immunized against hepatitis E in a different country beyond the U.S. and so I think if you were interested in doing humanitarian work, working in areas of poor sanitation, talk with your healthcare Provider about this.

We don’t normally recommend that people get immunized for this, frankly, or other vaccine preventable infections beyond our Borders, because we’re U.S. doctors in the U.S. but the reality is that there may very well be a role for getting immunized for hepatitis E in people in extreme circumstances with very high exposures to fecal products in their food and drink. There are examples of this happening on cruise ships. That has been something else that’s been described.

Now, I mentioned to you a moment ago, I’m about to get on a cruise ship down to Antarctica. Am I worried about hepatitis, etc. No, I’m not. Am I worried about norovirus? Hell, yes, I am. And there’s nothing else for me to do about that either.

What’s your Hep E philosophy, Chris?

WORM
00:17:23.489 – 00:18:11.260
Well, first, a little more background. It’s found worldwide. It’s not common in travelers. The most common two zones it’s in are Sub Saharan Africa and East and South Asia.

So routine traveler, you know, you can’t get the vaccine in the US should you get it abroad? Routine traveler. We don’t routinely recommend that.

Yeah, if you’re going to have an intense exposure though, like working in a refugee camp, it would be reasonable to consider being vaccinated for this abroad. Also, if you are pregnant, check the country you’re going to.

And if you’re going to sub Saharan Africa or East or South Asia and there’s an outbreak of hepatitis E, it might be reasonable to postpone your trip until you are no longer pregnant. Again. This is quite rare in travelers, but given that it can be catastrophic, some avoidance while pregnant is probably the best idea.

GERM
00:18:11.810 – 00:18:29.250
Great advice as always. Thanks for that.

Okay, Chris, here’s a question. I’m really keen to get your philosophy. I have a philosophy.

I want to hear what your philosophy is from this questioner. What do I do when an Airbnb rental is a dump, but the hosts are really nice people? What are the ethics of giving an honest Airbnb review?

WORM
00:18:29.410 – 00:20:13.350
Oh, I could talk for a very long time on this. So when I say airbnb, I mean any sort of short term rental. This is not to slight the VRBO folks. So it’s simple.

If both the host is a nice person and it’s a nice place, you say nice things, it’s simple. If the host is a jerk and it’s a dump, you say bad things. But what I’ve struggled with, my wife and I have talked about this ad nauseam.

What do you do if it’s kind of a dumpy lodging. But the host is really a sweet, nice, helpful person. What do you say? And the reason we agonize is actually your reviews carry a lot of power.

A lot of people make their livelihood from their Airbnb rentals, and I and others choose the places in no small part based on previous people reviews. So what you say carries a lot of actual financial impact. The first question is really, who do you owe your primary allegiance to?

Is it to other travelers who might book it? Is it to the Airbnb hosts who are trying to make a living? Or is it in some abstract way to absolute truth?

And of course I don’t have an answer to this. I can tell you sort of what I’ve done, but this is something that I’ve struggled with.

And actually, listeners, if you have thoughts on this, please drop us an email and share your approach to this.

The only time I give a horrible review is if they I can think of once I did this in a neighborhood in Istanbul when the host committed the cardinal sin of the photos in the listing were not of the place we rented. They were of a different apartment. And so we slammed that place.

But there have been more than one time where the host is like, met us at the bus station and given us fruit. And the place has been, and I won’t say a hellhole, let’s just say suboptimal.

GERM
00:20:13.510 – 00:20:14.310
What do you do?

WORM
00:20:14.310 – 00:20:37.350
Because they’re a nice person. But the place is not that great. And I guess personally what I’ve done is knocked it down a bit.

So instead of giving it five stars, maybe I give it three, but maybe I allude in my comments to exactly what I didn’t like about the place. I really haven’t found a smooth answer to this, and I’d be curious, Paul, if you have any ways you could give us guidance. Guidance.

GERM
00:20:37.350 – 00:21:43.060
I mean, I think it’s what you said. You want to be honest and clear.

What makes me nervous is if someone says, I had a terrible experience, I had a bad time, how’s that going to help this? The next person who’s reading that review, if the review says this person was super lovely, I like talking to them.

They have an opportunity to up their game because the toilet overflowed or because, you know, there was raw sewage in the sink or whatever. Just be clear. And that way, you know, the person who’s reading the review knows what they’re getting into.

And that also gives an opportunity, you know, to the owner of that home to try to up their game. I also like the idea, Chris, that that conversation can happen outside of the online review situation.

Now, some people may be uncomfortable with that, actually giving direct feedback. That’s not how we do things in modern society, is it? No one talks to each other. Everybody’s doing stuff online.

But that would be another way to feel good about this and say, I really enjoy talking to you. Here’s a few things to point out.

And by the way, if you’re there and you’re having issues during the stay, I would hope you’d be able to reach out and say, would you please help fix this issue? The response to a question like that can tell a lot.

WORM
00:21:43.060 – 00:22:50.360
Yeah. And luckily Airbnb has a function with every rental where they send you a form after you leave.

And first you can say something directly to the host, which is not public, and then there’s a second box where you can make your public review. So often we’ll say if we liked the place in general, but there was an issue. We’ll say to the.

In the private remarks, you know, the toilet overflowed or what have you. The bed was scratchy. I think if you’re clear about both, you’re going to do pretty well. So you can say, “Hey, Jorge was a great guy.”

However, the place was noisy or there were flies or what have you. So I think as long as you’re clear, that’s good. Also, don’t blame the host for things that are not under the host’s control.

So, for example, if there’s a countrywide power failure or Internet failure, you can mention that, but don’t slam the host for that. I think it’s important to only list factors which the host has control over.

All right, Paul, this next question is for you. And this comes from Diane in Sheepshead Bay. “I live in Brooklyn, New York City, and it looks like we now have chikungunya here. Wtf question mark, wtf?”

GERM
00:22:51.400 – 00:25:22.660
Exactly. Right. So, yeah, sorry about this, Diane.

Yep, there are indeed reports from public health authorities out on Long island that there’s a case of someone who has tested positive for an infection called chikungunya. Chikungunya is a common infection worldwide. We’ve talked about it many times here on the podcast. An arbovirus infection or arthropod borne infection.

It’s in the dengue yellow fever family and it causes a febrile illness.

People feel like they have a flu and they can also have this really bad side effect, which is pain in the joints, and that that joint pain can last and linger for Quite a long time and it’s very difficult to manage.

It’s common, but it’s not common in Long island, to my knowledge, is the first time it’s ever been described in someone who says they’ve never traveled internationally.

Apparently this is someone who lives on Long island who got this test because they clinically showed up to a healthcare provider and they thought, oh, could be chikungunya. But they did not have that travel exposure. So more details to follow. This is torn from the headlines, but what this may turn out to be is a one off.

I’m not convinced that this is now going to become endemic within Long Island.

One possibility is that the infected mosquito itself got into the community by coming out of an airplane, so bit somebody in a different country where there is more chikungunya.

They flew, as mosquitoes do, in the cargo hold or the wheel well or something of an international jet, got off the airport premises and bit this person. That’s possible. Another possibility is that there was a person in the community there on Long island who had some subclinical mild chikungunya.

They got bitten by one mosquito and that same mosquito then bit somebody else. That would be local transmission. That is unlikely to become something that’s propagated and sustained.

To really sustain an infection like this, you need a lot of people out there who serve as a reservoir. A pool of infected blood that can be sucked up, amplified, and then transmitted mosquito bite to mosquito bite.

So I think this is going to be a one off. Let’s see if I’m wrong to this. Nice question right down in Sheepshead Bay. Don’t panic.

I think this is not something you need to worry about unless you travel internationally. Now. Truth is, we do have a safe, effective vaccine against this. It’s called vimkunya.

I’m about to get my own vimkunya on because I’m headed to Sri Lanka in a few months, but where there is a ton of chikungunya. But to sheep, said bay residents, Diane, and beyond. No, I do not think you need to spend a lot of money on this particular vimkunya vaccine.

WORM
00:25:22.820 – 00:25:52.810
Yeah. And also, if it was me, I wouldn’t start diligently putting on bug repellent because of chikungunya.

I think the risk of someone else getting this is low. And just playing devil’s advocate, let me point out, if you see 20 cases of a disease, then there’s probably really an outbreak.

If you see one case, one possibility is lab error. You know, the labs that test for this are not perfect. There can be overlap with other related diseases.

So with one case that’s so close to static or noise that I don’t think it is actionable at this time.

GERM
00:25:52.890 – 00:26:25.810
Yeah, I agree. This needs to be confirmed and let’s see if that pans out. That’s a great point.

The only thing I’ll say also to Diane and I really appreciate the question, presumably this is someone who lived in Sheepshead Bay back when West Nile virus was roaring through New York City, which no one predicted would happen. So I get it, people are worried about this. That was a different issue.

West Nile virus loves to get into birds and there’s hella birds all over New York State. So that was a different story and I’m hopeful this one will flame out. Okay, Chris, here’s a question to you.

What’s the best way to avoid getting a sore back when you fly?

WORM
00:26:27.730 – 00:27:42.730
Oh, thank you. Unfortunately, sore backs and travel seem to go together and this is something that I’ve had from time to time. I’m minding my own business. I take a couple long flights and then I have lower back pain for a few days.

There are a few ways you can bring your risk down of this. Probably the best is long term exercise before you fly. If you are more fit in general, you are less likely to get this.

So this is not a quick fix or a quick prevention. But for example, if you swim regularly for many months or years, you are less likely to get this.

If you do back exercises, if you run, if you do the elliptical trainer on a regular basis, you’re going to be better toned from head to toe and less likely to get this. So your chronic prevention is probably your best bet while you’re traveling. A couple things one, don’t just sit there.

If you have a nine hour flight, don’t sit there for nine hours. As soon as the pilot will let you get up and walk, maybe walk every 60 to 90 minutes. And also don’t lug heavy stuff beyond your ability.

Suitcases now tend to have wheels, which is beautiful. But if you lug a lot of heavy stuff beyond your baseline, you’re going to be more likely to pull some muscles.

So you can’t bring your risk down to zero. But there are a few things that might help.

GERM
00:27:42.810 – 00:28:07.840
I really appreciate that advice for me personally, since I’m a few hours away from getting on a plane down to Antarctica, it’s going to be quite a number of hours on there.

I’m not necessarily the biggest fan of our Apple overlords. But I did recently start wearing an Apple watch, and every hour it dings and says, time to stand. It reminds me, in fact, it dinged just a few minutes ago sitting here with you. So we need to wrap up this episode soon, I guess. But that can be helpful. There’s no substitute for fitness and getting out of that seat.

WORM
00:28:12.650 – 00:28:26.570
And actually this next question, Paul, is related.

How can I tell if I’m fit enough for a particular trip? So suppose I sign up for a hiking trip or a climbing trip. How can I know in general if whatever this trip demands I am able to do?

GERM
00:28:26.730 – 00:29:54.780
It’s a great question and I think learning more about that trip is important from a trusted source.

Now, you think that talking to the guide who’s going to be bringing you along is that answer. And that can be true. I would definitely describe my fitness level to the person who’s going to be guiding me, having said so.

So if you don’t know that guide, they don’t know you, and you’ve never met in person, then it can be also really helpful to talk with someone who you know and trust, who’s done the trip before.

In other words, do your own research, see what that’s going to require in terms of the number of hours per day on your feet, the amount of elevation you’re going to gain or lose, and you know, what the ambient temperature and humidity is going to be like, and then try to simulate that. I mean, this is not the time to just go from living at sea level straight up to altitude.

And if you do, let’s say you are like me, you do live at sea level and you want to go to high places. My only thought is to say, number one, you need take good care of yourself, do all the things that are great for your exercise and fitness.

Generally low back pain prevention is one of those things. The other thing to say is time. Give yourself time. And do you have an itinerary that looks flexible enough to accommodate that?

What if you end up with painful arches, some plantar fasciitis on the soles of your feet? What if you’ve got issues keeping up with higher altitude? These can almost always be dealt with if you just slow the hell down.

If you’re trying to squeeze a lot of adventure into a short period of time, I gotta say, it’s ambitious. And that can certainly lead to grief in my own personal experience.

WORM
00:29:55.260 – 00:30:32.830
The other person I’d run it by, if you have any question, is your personal medical professional.

You know, go to Your doc describe the trip and this is particularly important if you have any chronic issues like heart disease, lung disease, and just say, hey, doc, here’s the blood. Here’s the brochure from the travel company. Do you think this is reasonable for me?

And the doc may give an opinion, but the doc may want some additional tests. The doc may want to check your oxygen level, even do a treadmill if you have any cardiac risk factors. So I think Paul is right.

Go for the guide if you can concerning the trip, but concerning your own ability and medical history, go to your doc and get an opinion there, too.

GERM
00:30:33.070 – 00:31:41.570
Traveler, know thyself and heal thyself. I gotta say, this is important to me too, since I’m hopping on this plane now to Antarctica.

My wife and I were required to have a physical before we got on this boat. Now, cruising on a boat isn’t that physically taxing.

It’s mostly because they didn’t want us to drop off a heart attack and then cancel the trip for everybody else. There’s no place to stop when you’re down there. But it was a good reminder to me that you know the ship’s doctor or the expedition leader.

They want to know that if they take you on that you’re going to be able to do the work. Everybody, thank you so much for joining us here on episode 75 of Germ and Worm. As always, we welcomed your questions on Travel Health.

Just send us tips for success. Questions suggested Corrections we’d love to hear from you.

You can visit us on our website germandworm.com there you’ll be able to submit questions to reach us, but also search prior episodes and binge our podcast to your heart’s content. Please also follow us on the socials. That’s a free way to support this podcast. I’m Germ.

WORM
00:31:41.570 – 00:31:44.690
I’m Worm. It’s a big planet. See it in good health and we’ll.

GERM
00:31:44.690 – 00:32:05.040
See you next time.

This podcast is designed to inform, inspire and entertain, but this podcast does not establish a doctor patient relationship, and so it should not replace your conversation with a qualified healthcare professional. Please see one before your next adventure. The opinions in this podcast are Dr. Sanford’s and Dr. Pottinger’s alone and do not necessarily represent the opinions of the University of Washington or UW Medicine.