Borneo or Mount Sinai Hospital? An unfortunate choice -- but an easy decision.

So instead of spending a recent Monday morning as I'd planned, stuffing my suitcase with zip-off hiking pants and leech socks, I snoozed restlessly on a sofa in Mount Sinai's Abess Waiting Room. Soon, a surgeon I'd never met -- The Husband had made the choice -- would deliver the news that would determine much about our future.

The Husband's heart murmur had been discovered a few weeks before in an annual physical by the family doctor he's seen for 25 years. He'd experienced no symptoms except chest congestion that we'd written off as asthma. His weight was trim, cholesterol down, fitness level up. We had no way of knowing that his mitral valve was trashed.

As a veteran traveler to places far and wide, I can easily imagine the outcome if his condition had gone undiagnosed. Instead of fidgeting in the relative comfort of a Miami hospital with top-notch medical care, I might have been dealing with a disaster in the jungle, days from any modern facilities -- and alone.

It happens. Cardiovascular issues are the No. 1 cause of death for Americans abroad, accounting for 50 percent of the 5,000 to 6,000 fatalities annually, says Dr. Brian Terry of the Healthy Traveler Clinic in Los Angeles, quoting the Journal of Travel Medicine. (Traffic accidents, drowning and homicide -- all often mixed with alcohol -- also rank high.)

Some of the lessons here are purely medical: Develop a relationship with a family doctor, and see him or her annually. If you do need serious care and you have the luxury of time, do your research. (The Husband interviewed three surgeons before choosing his.)

Other tips are especially important for travelers. They come from our own experience and that of experts.

GENERAL TRAVEL

• Consider medical evacuation insurance; paying for an evacuation on your own can cost as much as $100,000. Single-trip travel insurance policies typically include evacuation and some medical care, plus protection against delays and lost luggage. (See www.insuremytrip.com, www.quotewright.com and www.squaremouth.com.) Note that your regular health insurance may not cover you abroad; check it out in advance.

If you're a frequent traveler, consider an annual medical evacuation policy like the one from Medjet Assistance (www.medjetassistance.com). This will get you to a hospital at home in case of a serious illness. (With all policies, read the fine print carefully.)

• Bring all prescription medications -- plus a few days of extra supplies. Snowstorms happen.

• Use safe sex practices. Terry tells the story of a rocket scientist -- no kidding -- on an extended assignment in Africa who contracted an STD from unprotected sex.

• Use seat belts and appropriate child car seats, and buckle up even in taxis. Car accidents are the No. 1 fatal injury for Americans abroad.

• If you have an unstable medical condition or have recently had surgery or other serious treatments, consult your doctor before you travel. Carry copies of your medical records and doctors' contact information, and be sure your companions know where to find them.

ADVENTURE TRIPS

• Before you head out on an adventure that is physically demanding or takes you to remote places, get a physical exam.

• Get in shape before you attempt physical challenges -- and be sure you've got the right gear. On my first adventure trip, I trekked through the Thai jungle in cheap sneakers, ending up with aching feet and leeches (from slipping into a rice paddy).

Join the discussion

The Miami Herald is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere in the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. In order to post comments, you must be a registered user of MiamiHerald.com. Your username will show along with the comments you post. Thank you for taking the time to offer your thoughts.

     Showing: Oldest first Newest first Most-recommended first Least-recommended first

@Nyx.AuthorDisplayName@ wrote on @Nyx.PostedAtTime@:

@Nyx.repliedToText@

@Nyx.replyAnswerText@

Reply to this Comment @Nyx.Recommender@ @Nyx.AbuseReporter@