Photo by Pedro Klien

The travel doctor is in the house, and it’s time to treat some of those common traveling maladies.

TRAVEL TODAY MAY NOT BE fraught with such old-school perils as scurvy and the possibility of kidnap – unless you have paid too little attention to your diet and choice of traveling companions. Yet the further off the comfy track you put yourself, the greater your likelihood of encountering one of the following travel tortures. So let the consultation begin.

Would you like a sweetie?

Long Distance Bladder

Symptoms
LDB can manifest during long-distance bus rides, where the bus in question lacks the facilities for onboard ablutions and makes few or no stops. The patient has typically drunk too much beforehand (tea and coffee are particularly evil), and finds himself pining for a bathroom as every bounce and jiggle of the bus threatens his increasingly delicate bladder. In later stages, the affliction may pass beyond mere discomfort to take on an altogether metaphysical dimension as the patient negotiates with new and increasingly implausible gods for relief.

It calls to you. Image by Vitor Sá - Virgu

Treatment
By the time LDB manifests, it is largely too late to do anything about it except ask the bus driver to stop for a short break. While language and bus company deadlines may make this approach difficult, the general body language for “I need to pee or there is going to be a fucking disaster on your bus” is fairly well understood the world over. This strategy is almost always successful, depending on your willingness to make a clown of yourself in front of the rest of the non-toilet-needing bus.

This affliction is fairly easily avoided. Steer clear of coffee and tea before boarding, as they are diuretic and will move through you like water on oiled glass. Same goes for alcohol, if you were thinking of substituting. When traveling, bring an absorbent snack like bread or biscuits to eat as you go. While you can’t (safely) defeat your body’s natural processes, spongy food can absorb some of what is in your tummy before it goes south, buying you additional hours of carefree travel.

Use this time to torment travelmates who did not think to do the same.

Bus Knee

Symptoms
Typically affecting those prone to the joys of travel on chicken buses of varying quality, bus knee is characterized by intense joint pain an hour or more into a bus ride. The time to onset of symptoms may vary according to the quality of the bus, the quality of the road, the length of the patient’s legs, and the presence of bolts or other instruments of torture in the back of the seat in front of you.

The patient (that’s you) experiences an all-consuming and acute pain in the front of the knee, occasionally extending to the hands, if they are used to try and shield the knee from the random and incessant knocking that it receives as the bus travels.

Legroom? What's a legroom? Photo by WhereTheRoad

Treatment
If possible, extend the affected limb lengthways into a space which will not involve touching your knee against the seat in front of you. If you have more than one seat to yourself, consider stretching sideways along the row. If you are sitting in the aisle (or are able to get to an aisle seat), extend one or both legs into the aisle to relieve pressure on them.

If neither of these strategies is possible, then it’s time for more advanced treatment. if you have a scarf or a thick top, or any other source of material, scrunch it into the space between your limb and the offending seat. While this will not relieve the pressure of the seat, it should assist in cushioning what is by now a growing bruise against further hard whacking. Use the time that this padding provides you to search for alternative seating, or in praying for the end of the ride.

Decision Fatigue

Symptoms
Frequently occurring whilst shopping, haggling with touts, or deciding tomorrow’s itinerary with overly anal co-travelers, Decision Fatigue is a real danger.

As in, it exists – research says so.

The typical afflicted person shows an inability to make well-considered decisions, opting instead – and without thinking – for the safest or least confrontational option from the choices presented.

Make a decision. And another. And another. Want some poi? How about a wooden croaking frog thing? T-Shirt? Image by mattw1s0n

Decision Fatigue can be a disaster if it strikes in the middle of, say, an outing to a local market. Many patients to whom this has occurred report purchasing not-so-witty-afterwards shirts, and accessories for a range of hobbies they do not, in fact have.

You never did bother to get the hang of poi, did you?

Treatment
ScienceTM suggests that decision fatigue may be related in some way to glucose levels, and that taking a break from making decisions in order to replenish said levels may restore some of your ability to make proper choices and maintain perspective. Since nobody carries glucose around with them, and it’d be a bit naff to start a streatside glucose cafe, the closest appropriate treatment is to take a snack or drink break.

Prevention being better than cure, if you know you are going to have a day spent haggling, try to do it early in the morning (after breakfast) or midday (after lunch). You will be in a much stronger frame of mind for declining shiny things.

Local Food Acclimatization Syndrome

(a.k.a. The Squits, Travelers’ Diarrhea)

Symptoms
This common malady affects up to one in five travelers abroad. Particularly the ones who are experimental in their eating. It is typically characterised by diarrhea, cramps, and bloating; it usually lasts around three to five days, but can hang around for as long as a week.

If there is blood in your stools, or you have severe abdominal pains, you might have cholera. Which is an altogether more serious affliction, and you need to find a doctor sharpish. A real one.

Delicious if done right. A ring of raging fire if not. Photo by ND Strupler

The causes of LFAS are generally all related in some way to bad sanitation. Either the food you were eating had nasty germs, or they were added somehow during the washing and handling. You can work out how.

Treatment
To avoid cases of LFAS, stick to drinking water from sealed bottles, or make sure it has been properly treated by boiling or other processes. Don’t eat raw food unless you can peel it yourself, and be suspicious of seafood. Prawns don’t just look shifty (it’s all in the eyes) – they can actually follow you home later that night and mug you in your bathroom.

Street food is not necessarily always a bad idea. Just make sure it is properly cooked. Given a choice between buying your dinner at the busy stall, or the stall with the sad looking guy who has no customers, follow the crowd. Busy food stands tend to keep stuff hanging around for much shorter periods between eating and cooking, plus local custom can be a good pointer to where the deliciousness is.

If it’s too late, and your ratstick lunch is starting an un-occupy bowels protest, all is not lost. Traveler’s Diarrhea will generally pass if you treat the symptoms and wait it out. Frequently drink lots of water to rehydrate. If you need to travel, consider taking an anti-diarrhea med like Immodium to reduce time spent in the loo. Otherwise it may be worth putting a good book in the bathroom and just taking the time to sit on the throne until your reign ends naturally.

Unless you are really and truly stranded in the middle of nowhere – which is unlikely, since you clearly found your way to some manky street food – you will also have access to the basics for making Oral Rehydration Salts. Put six teaspoons of sugar and half a teaspoon of salt in a litre of good water and drink that. It will serve you better for fluid replacement than water alone will.

If LFAS persists, or you start to feel feverish, it is a good idea to find a doctor, as diarrhea can sometimes be caused by bacteria that you will need to nuke with antibiotics from the doc before you can properly recover.

Riotous Hangover

Symptoms
Do I really need to explain the symptoms of a hangover to you? Crushing waves of nausea. Belching that carries the flavour of tequila back up into your nostrils. A general feeling of being little more than death warmed up.

Alcohol. The #1 cause of Riotous Hangover. Photo by Darwin Bell

Patients diagnosed with hangover may occasionally present more severe symptoms due to having underestimated the strength of the home country’s finest single malt rice whisky. Or having tried to eat the snake/scorpion/other dead animal found at the bottom of the bottle.

Treatment
If you suspect that you are likely to come down with a case of Riotous Hangover, drink a great deal of water that same night before going to bed. If you are drinking in the morning, then make sure you drink water alongside your drinks.

Six ounces of water per drink is a good rule of thumb. That’s 200ml if you speak metric. Eating oily food beforehand will also help mitigate the next morning, as a full and greased stomach is less prone to absorbing alcohol than an empty one.

This is all obvious, but bears repeating. I once met a guy who managed to make it as far as 24 years old without ever being told this stuff.

But assuming you didn’t do any of these things, and are presenting symptoms, all is not lost.

Emergency next-morning treatment typically follows two broad strategies – mitigation and evacuation. Mitigation is always a good idea. Drink more water to rehydrate, since your headache is largely a byproduct of your dehydration.

If, like my 24-year-old friend, you didn’t drink enough water last night, you also probably hate lectures right now. So make a note of how you feel and use it as an encouraging memory when you next make sweet love to the glasses of a strange bar.

Evacuation is for the truly dire cases of Riotous Hangover. Where you either wake up still-drunk, or feeling intensely nauseous. Find a quiet spot and perform a tactical vomit. A bathroom is ideal. I once saw someone do it in the parking outside Angkor Wat. That was much less ideal.

Once evacuated, make sure to rehydrate, since you have now lost all of your water. Oral Rehydration Salts (see above) are an excellent idea.

Drunken Spend

Symptoms
Holy crap, where’d my money go? Drunken Spend often occurs as a precursor to Riotous Hangover (some scientists argue a causal link). The condition always involves alcohol, and is particularly acute when a traveler is poor at doing price conversions from the local currency, or has a credit card.

That tequila was how much?! Photo by epSos.ds

Physical symptoms are generally absent, with patients reporting shame, self loathing, and occasionally wonderment at the holes in their wallets from the night before. The affliction may produce long-term psychological distress as the traveler is forced to count all of the things they could have done, but which are no longer possible due to their bout of DS.

Treatment
There is no known fix for Drunken Spend once it has taken place, though strategies do exist to prevent it occurring. Group therapy in which the prospective sufferer surrenders his cards and all but a suitable amount of cash to a responsible friend is one possible approach. Depending on the quality and trustworthiness of your lodgings, you may also consider leaving money and cards in a safe place in your room before hitting the bars. A room safe or a bag of filthy underwear works well.

The Endless Sweat

Not to be confused with hooking up, that other favourite travelers’ pastime. Tireless, merciless sweating typically occurs when:

  • It is unusally hot. (For you, the foreigner, that is.)
  • It is unusually humid.
  • You are performing activities which will induce perspiration. This may include hiking, extensive exploring of local attractions, or – in some climates – merely being alive.

Like morning dew. Just salty. And much less romantic. Photo by kullez

Dehydration is the most common result of excessive sweating with insufficient replenishment of lost fluids. Losing as little as 2% of your normal water level may cause a loss of appetite, discomfort, and constipation. Where levels of personal hygiene are substandard (that is to say, gently, if you are a filthy pig), prickly skin and heat rashes may also occur.

Treatment
Get more water. It’s truly remarkable the number of things that can be treated by drinking more. Except for Long Distance Bladder (above) – which is why it is important not to confuse advice you read on the Internet.

In the case of prickly heat and skin rashes, make sure to wash and air your clothes properly and scrub yourself thoroughly in the next shower you find. Taking a break from doing whatever it was you were doing in the sun is also marvelous advice. There are plenty of things to do in the shade. It’s the reason that cocktails and hammocks were invented.

Pack Back

Symptoms
Having bought the largest backpack in the camping store, and finding himself actually having to carry it, the traveler exhibits physical and emotional distress. Characteristics of Pack Back may include back pain, an unwillingness to put the pack on one’s back and, in extreme cases, an insistence on carrying it everywhere as though it were a large suitcase.

Whilst complaining loudly, or dropping increasingly less subtle hints that the buffest member of the group should help carry it.

No matter where you are traveling, you will probably not require a stuffed dinosaur. Photo by heartcaves

Pack Back is typically a combination of having selected an inappropriately large backpack, incorrectly configuring it, and then filling it with excessively heavy items. If left untreated, it can present psychological symptoms too. These include a growing dependency on tuk-tuks (or the nearest local equivalent), an unwillingness to seek out accommodation more than a block from the bus stop, and a complete aversion to hiking.

Treatment
Prevention is better than…-ok, you got that by now.

Pack back is fairly easily treatable, even when you are on the road. First off, check and adjust the straps on your backpack. They are designed to carry large loads quite efficiently if you adjust them correctly. It’s a popular misconception that you should be carrying most of your backpack’s weight on your shoulders.

A well-adjusted pack should actually be distributing much of that weight to your hips, to give your back far more of a rest. Not knowing this, it’s easy to assume that because you are feeling the weight of your backpack primarily on your shoulder straps, it is correctly configured. Here is a great video to walk you through some of the basics on correctly adjusting your pack so as not to kill yourself.

If you are already traveling and the sight of your laden backpack depresses you, consider whether you can jettison some of your stuff. Do you really need all that denim you packed? Can you leave it at the hostel you are staying at, or in storage somewhere to retrieve later? Or post items home if you will be traveling for a while and don’t want to toss any of it away? As a last resort, if you have loyal and well-packed friends, you can test the bounds of that relationship a little by asking to shift some weight to someone else.

Have you suffered any of these maladies on your travels? How were you cured? You were cured, weren’t you?

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