Health and Wellness on SAS

On to health: the deal here is Be Prepared! No one wants their trip of a lifetime marred by illness but it happens, so the idea is to be ready so that any episodes are as short and mild as possible. There is a full clinic and fabulous staff of doctors, nurses and PAs on board who will help you through any sickness. Use them wisely of course, like during clinic hours whenever possible, as opposed to waking them up in the middle of the night because your stuffy nose is preventing you from sleeping. There are three main types of illnesses that typically strike voyagers and you should plan for each one.

Nearly everyone worries about seasickness before the voyage and it's my impression that most people deal with it, to one degree or another, sometime during the voyage. There are a lucky few who never feel the least bit queasy but also a very few who just never get it under control. Everyone else deals with it for one to several days but soon gets their sea legs and it's no longer an issue. First, if you've had experience with any kind of motion sickness before, bring whatever worked for you then. I'm a particular fan of Bonine, which is the name brand of meclizine, the generic that is offered for free, along with condoms, in bins outside the clinic. It doesn't make you sleepy and works best if you take it just before the ship sails. BTW, one of the little known symptoms of seasickness is drowsiness so don't always blame it on your medication and be prepared to feel kind of wiped out in the first days of the voyage. If you've had significant trouble with motion sickness before, you might consider getting prescription Scopolamine patches from your doctor. You wear them behind your ear and they are very effective for some people. A word of caution (have I mentioned I'm a retired nurse?): the full dose, a whole circle, is often too much for people, depending on your body weight and drug metabolism. The side effects can be pretty awful so if in doubt or if you're having problems, cut the patches in half or even thirds if you're small. The point is to find the most effective dose without bothersome side effects and it isn't necessarily the standard dose. I'd also discontinue using them sooner rather than later and see how you're doing. But that's just my two cents worth - as always, your doctor can best advise you, or even better, a travel clinic since they specialize in these issues. Wrist bands that use acupressure points are effective for some people so you might start there, if you're into that sort of thing, and move on to drugs if that doesn't do the trick. Ginger in the form of tea, candy or even gingerale is a trusted remedy for mild symptoms. So bring a couple of options to see what works for you and remember that the clinic is there to help. Please do not stay in your cabin for days, not able to keep anything at all down, without asking for help. The medical staff can give you an injection in severe cases so use them if you can't get the seasickness under control yourself.

Few people manage to avoid some sort of respiratory illness during the voyage - it's just one of the side effects of close living in a large community. You can go a LONG way towards avoiding colds by washing your hands often, way more often than you would at home, and using the hand sanitizer dispensers located all throughout the ship. Make it a habit to squirt some sanitizer on before meals in the dining rooms - the machine is right there, just use it! Although you will be amazed at the fabulous and constant job the crew does of keeping the ship clean, you can be smart about where your hands go in the public areas of the ship. For instance, unless the ship is really rocking, I try not to use the handrails on the stairways - that knocks out 10 to 15 opportunities a day to pick up a cold. Again, you will see the crew cleaning those rails every day but I'm just sayin', be aware of keeping your hands as clean as possible. In case you do get a cold, bring from home whatever you've found works best for you - I always bring Tylenol and plain sudaphed, but that's just me.

The dreaded travelers' diarrhea is the last common illness SASers experience. Prevention is key here. The medical staff will advise you over and over in preport meetings before every stop about the food and water safety in that country. Pay attention, folks, and do what they say. It's my opinion that following those precautions will prevent 80 to 85% of stomach problems. As a general rule, I never take ice in my drinks or eat anything that is raw or I haven't peeled myself, including anything that is billed as a salad. I know, after you've soldiered through the limited salad offerings on the ship, those raw veggies and cut-up fruit salads look pretty great. I make exceptions only in really nice hotels and restaurants that cater to international travelers, but it's safest not to. Think about the toilet and hygiene facilities available to the food handlers and bypass that mango the street vendor has just peeled for you with his machete. There are many glorious food options in every country where you can sample and enjoy local cuisine that is thoroughly cooked so be sure to do that, just be smart about it.

Some people take a Pepto tablet before every meal in port, just as a preventative. But be sure to bring some type of over-the-counter diarrhea medicine with you if sickness strikes. Take it at the first sign of a problem. I like Lomotil; it's available in several forms. You might also ask your doctor or travel clinic about bringing a few Cipro tablets with you. This is an antibiotic that you don't have to take for days. If I get the first episode of TD, I take one Lomotil and one Cipro and I've yet to have it go any further, but that's just what works for me. Cipro is a very broad spectrum antibiotic and not to be used lightly or frequently - you may need it later in your life when you have a difficult to treat infection and you don't want to be resistant to it then. But it is my doctor's opinion that you're on a trip of a lifetime and you don't want it spoiled by days of diarrhea so it's appropriate to take the Cipro if necessary. Opinions vary widely about this so you and/or your doctor may disagree with me. Please do whatever makes sense to you and follow the advice you are given by professionals who know you.

A reminder about prescription drugs: You will need a few days more than the maximum three months worth of drugs most insurance plans allow you to buy at once. Check with your pharmacy and make plans for dealing with that well in advance of leaving. Once onboard, you will be asked to put all but a relatively small amount of most prescriptions in its original container in the clinic pharmacy for safekeeping. Please pack those drugs in your backpack when you come to the ship, better yet, in your money belt. The last voyage I volunteered to help send off, a student packed a very unusual and essential medication, one that couldn't be quickly replaced in port, in a small bag that he accidentally left in the taxi when he arrived at the ship the day it was leaving - huge problem. So, the things to be super careful with when you're coming to the ship, and always really: your passport and your prescriptions. Pretty much everything else you can get along without, borrow or buy in port.

Some words about general wellness issues. Sleep will likely be a challenge and you need to be as smart about it as possible. "I can sleep when I get home!" is a frequently heard mantra and I totally support the spirit of that. You are on a very special and once in a lifetime experience and you'll want to be there for every moment you can. That said, the voyage is more of a marathon than a sprint and you're going to need to actively manage your time and energy in order to get the most out of it. It's hard to understand before you leave how jam-packed the days of this voyage will be. Classes, homework, planning for the next port, shipboard activities and responsibilities, journaling, editing your photographs, meals, just plain hanging out with your friends and so much more will more than fill every moment on the ship. And then there are the time changes. Every  Spring voyage planned for the immediate future will be sailing west. That means that you will gain 24 hours, usually one hour a night nearly every other day, during the approximately 55 days at sea and then lose them all at once by skipping one day as you cross the International Dateline in the Pacific - I hope it's not your birthday! For those of you on the Fall voyage, it's a little more erratic than that so you'll have to be on your toes and pay attention to the announcements. Trust me, it's embarrassing to drag your half-awake self into a class and realize that you're an hour late. For the ocean sections that go east, losing one hour every other night doesn't sound like much but they add up and, along with everything else going on, can cause you to be very, very tired. My advice is to monitor yourself and go to bed early when you can, rather than watch those full seasons of Game of Thrones DVDs you bought in Vietnam - that you can definitely do when you get home. Also grab naps when you can and pat yourself on the back for getting that economical inside cabin that is darker than dark, day or night.

Exercise can be a challenge but also lots of fun. Like for many other things on SAS, flexibility is key. You will want to stay in good shape to walk, hike, bike and just be up for all the amazing experiences in these countries. There is a workout room with ellipticals, treadmills and bikes but it's very popular and you have to sign up in advance. Please follow the rules for that process so everyone who wants to can get a shot at the machines. There is workout equipment like weights and benches on the seventh deck and that's always a popular option. There's also a netted multipurpose court on the starboard side of the Deck 7 where you can play volleyball, basketball, etc. Teachers of all kinds of exercise like yoga, kick boxing, dance, etc. always turn up on board and will be organizing classes, so you can keep up with your practice or try something new you've been curious about. Running is a challenge either on the treadmills or on the horseshoe shaped "course" on Deck 7, especially in rocky seas or wet weather, but it can be done. Sometimes runners organize runs in port but that comes with its own safety concerns so do that wisely and in groups. Like with many other aspects of SAS, you can keep up with what works for you and challenge yourself to try something different as well - that's what it's all about.

Finally, I want to talk a little about mental health. Whether you realize it or not, your normal views of yourself and of the world and your place in it are about to be majorly challenged. That's the whole point, right? That process is exciting but can also be quite confusing and possibly overwhelming. There are difficult challenges in this SAS experience for everybody, whether it's finding someplace to sleep or eat in a country where you don't know the language or being face-to-face with heartwrenching poverty for the first time. You will be out of your comfort zone and away from your usual support people like parents and boy/girlfriends. Semester at Sea is very aware of your need for support on this voyage and there are many ways to get it. First, you'll rely on your new BFFs, those amazing people you're traveling with and sharing this life altering experience. Then there are the professionals on board who can offer lots of wisdom and guidance: your RD, known on land as resident advisor, and the professional mental health counselors on the ship, two people who are licensed psychologists or social workers. These people are pros with many years experience with college students - please use them. They are there to listen and help you process all that you are seeing and learning about yourself and the world. If you have dealt before with depression or anxiety, be smart about monitoring yourself for these recurring feelings and get help if you need it. I have seen several cases of students who had to leave the voyage because of these mental health issues. If these have been issues for you, it doesn't mean you shouldn't go but it does mean that you need to inform the staff and get help earlier rather than later. I'm a huge fan of Semester at Sea precisely because it does shake people up and ask them to look at the world and themselves in different ways - a very good thing.

It's a journey, as they say, and it's enormously rewarding and exciting. Just be prepared, stay healthy and be sure you get help along the way if you need it.

Happy and Healthy Eating on SAS

The featured speaker at one of our daily get-togethers for Lifelong Learners on Spring 2009 was the Hotel Manager, one of the officers of the ship's crew. One of his areas of responsibility is food service and he was gamely fielding questions from our group, a few of them somewhat negative in tone. He said, "Imagine your very favorite restaurant at home. Now imagine eating breakfast, lunch and dinner there for over 100 days. Don't you think you would get tired of even that food?" Point taken. The food on the MV Explorer doesn't even start as your favorite food so, yes, you can expect to get tired of it.

That said, I think they do a pretty good job of catering to all the preferences and restrictions for 800 people of all ages and backgrounds, especially when you factor in the availability and cost of fresh food in the ports we visit. Many of those passengers are young men who I'm convinced have hollow legs and are virtually impossible to fill up, hence a lot of pasta and potatoes, and the perennial favorite, peanut butter and jelly. The vegetarian and gluten-free options have gotten better and better and are clearly designated with signs on the buffet. On the night before a port, a menu of dishes from the upcoming country is offered. Barbecues on the seventh deck are a special treat and loved by all, as is the famous Taco Day. It boggles my mind to think of provisioning for 800 people (make that around 1000 people with the crew) for 100 days, on a budget that is nowhere near that of a cruise ship. Don't get me started on the ISE budget and what an amazing job they do stretching the dollar to run this program - did you know that one third of your fee goes to fuel alone? It's a nonprofit organization and, trust me, there is nothing leftover to buy more expensive food, especially given the availability and quality issues for fresh food in port.

My recommendation about food is two-fold: 1)make sure you vary your diet using all the options available and 2)bring from home or buy in port (including the city you leave from) some things that will make your tummy happy half way around the world. Many people are on the ship for weeks before they discover, for instance, the soup on a different table from the main buffet - it's often quite tasty and sometimes wonderfully unusual, like a cold fruit soup. The two salad dressings offered that day may not be your favorite but there is always oil and vinegar at the end of the line. Students soon discover how good the smoothies, pizza and burgers are in the snack bar on the pool deck but faculty, staff and LLLs should check those out early in the voyage. The galley crew is really quite talented and can put on an amazing dining experience so consider the option of Special Dining, that often includes menu items like shrimp cocktail, steak and fancy desserts. Just as with the snack bar, it costs extra, about $35 charged to your shipboard account, but definitely worth it for special occasions like a birthday. There's also a late night snack, usually small sandwiches and desserts, put out around 10:00PM, or 2200 ship time, that takes a while for people to discover.

You will find that any food or snacks you bring on board will be very welcome treats, especially on long stretches of sea days like the two ocean crossings. You can shop in the port you're leaving from after you get there, hopefully a day early to prevent any issues of lost baggage. Depending on where you are in the alphabet, you might be able to get on the ship and then get off again to shop the day the ship leaves but I wouldn't count on it. You can, of course, pack snacks from home and figure that the space used will be replaced with treasures you've bought when you pack to go home. In addition to your favorite granola or meal replacement bar, you might consider nuts, dried fruit and packets of flavoring to add to a water bottle, whatever doesn't spoil and takes up as little space as possible.

If you're shopping in the embarkation port, think about a favorite bottled salad dressing or salsa. There's a small refrigerator in your cabin. The small boxes of granola cereal appear rarely and go fast so you might bring your favorite. If you care about coffee at all, I've got some not great news: although it has recently improved, the ship's coffee ranges from not so good to kinda bad, depending on how picky you are. I'm proud to say that thanks to my daughter-in-law and her team at the corporate office in Seattle, you can now bring Via, instant Starbucks, with you and I highly recommend it - try it, you'll like it and it's perfect for this situation. A number of people bring a small French press and some ground coffee (hot water is always available) to get them started then buy wonderful international coffees in our ports. The supply of sweeteners is variable and doesn't usually include Stevia so if you're devoted to one of those, bring it.

In my earlier post about travel, I recommended that you do your traveling into the country in the early days of our stay and save the last day for exploring the port city. In addition to hitting the Internet cafe for uploading pictures and Skyping and the post office for stamps for all those marvelous postcards you wrote, you'll want to save some time to restock your food supplies. Remember that you can only bring food back onto the ship if it is still sealed in its original packaging so no snacking! And I wouldn't wait until close to on ship time to come through the security line with lots of bags of groceries - try to do it earlier in the day. It's fun to browse the local stores for intriguing brands of cookies, crackers, chips or other snacks - you might find a particular brand of Japanese cracker to be your new favorite and will get so addicted that you really miss it when you get home!

So, make sure you use all the options available on the ship, especially if you find yourself getting kind of tired of the food. And bring from home or buy in port anything that will spark up your daily fare and keep your tummy happy as you sail around the world.