TAHITIAN PRINCESS' CHIEF MEDICAL OFFICER OFFERS ADVICE TO CRUISE PASSENGERS
During a recent cruise on the Tahitian Princess I had the opportunity to speak with the ship’s physician, Doctor Lana Strydom, and her staff and was invited to tour their medical facility.
Dr Strydom and I sat down and she gave me specific information that every cruiser should know about how modern day cruise lines are prepared to meet the medical needs of the passengers and what passengers should do to protect their health while traveling. This interview was full of information that I found fascinating and important so, I wanted to pass all of this on to you. My first impression of the medical facilities was that it is more like a modern day compact hospital emergency room. Complete with examining facilities, lab testing equipment, a rather impressively stocked pharmacy and medical supply center and treatment rooms. The ship’s medical officer is also armed with many books of protocols, infection and treatment tracking software and tons of rules and regulations to go by while at sea. Dr. Strydom told me that she really needs to be prepared to handle every sort of common medical situation, from coughs and colds and forgotten medicines, to minor crew or passenger injuries or heart attacks and even animal bites. She also needs to be prepared to track and handle cases of the dreaded Norovirus and to be ready for any onboard emergencies that may result in casualties.
1. Although they have a fully stocked Pharmacy onboard (with products that mostly come from England) they are not to be considered your personal Pharmacy. If you forget or run out of your medication you will be required to have a physical before the doctor will prescribe for you. Yes, even if you walk in with your empty prescription bottle Princess protocol requires that you be seen and checked by the doctor. They may not have every drug in every brand that a passenger may use at home but they have onboard a product that is a suitable equivalent for most all situations. As we all know that with all the legal issues today the ship’s Doctor must err on the side of caution. Since the ship’s Pharmacy can’t possibly carry all commercial drugs onboard an arrangement has been made to have a network of land based pharmacies at their disposal in most countries that they call on. This way the shipboard medical staff can email the port agent to legally obtain the needed medication for delivery at the next port of call. They even have a network of physicians at their disposal in the event a new prescription must be ordered in compliance with local laws or a complicated medication must be administered by a specialist.
2. If you have an existing medical condition, Doctor Strydom recommends that you bring with you as a precaution a letter from your personal physician listing your medical diagnosis, dosage of your prescriptions and any electrocardiogram readings (EKG/ECG) and or blood work that can be used to compare in the event that you get sick. If you have an electronic medical record, all the better, don’t forget to pack that along with your other travel necessities.
3. She strongly suggested that passengers taking multiple medications bring a list of the brand and generic name of these drugs and the dosage. When she or the medical staff ask patients what they are taking they all too often get the response, “Well, I take the pink ones twice a day and the blue ones once a day etc. and they are for my diabetes, heart condition and urinary tract infection”… that is just not all that helpful. If you are not sure of all these cryptic sounding names, just ask your pharmacist to get these for you from your pharmacy records. Dr Strydom told me she has had to spend countless hours looking up the various brand names of meds from different countries when a patient comes in with a vial filled with capsules and tablets. Having the generic (non-branded) name makes that so much of a quicker process.
4. Medical Travel Insurance. Many people try to save the cost of purchasing insurance and I have to admit I have been one of them. In fact, some travel agents suggest that you can cut costs by not getting this; this is not a good idea! After seeing a passenger being airlifted by helicopter from our cruise ship one windy and foggy morning I began to rethink my reasoning. Dr. Strydom said that a private helicopter company can charge as much as $30,000. Sometimes, as in the case of the incident on our Top of The World voyage when the British Royal Navy came to the rescue, a governmental agency can help transport and the passenger may not be charged but that is not frequently the case. Even if a medivac is not needed there are some potential significant costs for treatments and in some cases you may need to cut your trip short-without a refund! For example, a simple broken bone can cost as much as $8,000. If you need to get off to have it set, as may be the case, or to have another type of surgery the cost can be astronomical and not all insurances are taken in all countries. We all have to make the call about medical and trip insurance but if we decide not to take it we can’t really complain about the charges.
5. Norovirus and other GI Disorders. We all have had to fill out the health screening forms prior to boarding. Hopefully we fill them out honestly but many passengers fear that if they say they have been feeling poorly prior to embarkation they will be turned away at the pier. According to Dr. Strydom, that is not the case. If you report symptoms at embarkation Princess permits you to board unless you are actively vomiting in the embarkation area. If you had been sick that morning or the day before they may require you to visit the ship’s physician once you are onboard and you will be examined and possibly quarantined for a short time, but you will be able to sail. The first 48 hours after departure every Princess Cruise Ship is on yellow alert for the Norovirus, just to be sure. If no cases are found it is lowered to green. On our cruise we did have the “nasty” bug rear its ugly head, or whatever it has, and we were immediately raised to red alert. Some passengers complained that we remained on red alert too long and it annoyed them, but the most annoying thing that happened was that they couldn’t serve themselves at the buffet…so, what’s wrong with being served? The Captain and ship’s Medical Officer do not make decisions about when to and for how long to quarantine by themselves, it is Princess corporate policy which is guided by the US Centers for Disease Control (CDC) that sets the standards. They have no discretion in the matter and must follow the protocols based on the number and percent of infections over time. The CDC has determined that you may not lower the red alert status until you have gone 72 hours with no more than one or two cases. The total number of cases on our cruise was 38 which included 5 crew members.
6. If you have a chronic medical condition and you want to go on a cruise don’t let it stop you, consult your own physician before booking and use common sense. If you inform the cruise lines in advance of any special needs they can relay the information to the physician onboard and your needs will be met as reasonably as possible. Dr Strydom said she had a passenger on the World Cruise who required a blood transfusion once a month. It was arranged at a hospital at a given destination and the passenger was able to go to the land based clinic when they reached port, receive her treatment do a little sightseeing and shopping and get back on the ship in time to sail.
I was amazed to see the compact treatment area and the ability to do x-rays, blood work, liver and kidney functions and all of the screenings (especially since on the world cruise they visit so many different countries) for malaria, rabies, and strep throat etc.
Dr Strydom is assisted by two nurses and has the ability to contact other physicians for second opinions. When asked how she liked her work on board, she smiled and said it is not always an easy job, particularly when the Norovirus hitches a ride or she has to take x-rays when the ship is rocking and the patient is moving, but she very much enjoys the work.
My husband the “Crabby Old Guy” who has his doctorate in Pharmacy worked for Pfizer for many years and was part of the original marketing team for Viagra. He couldn’t resist asking if Viagra was stocked onboard. The Good Doctor said it was once but not any longer…so, bring your own supply guys!
Thank you to Dr Strydom and her clinic staff for taking the time to answer all my questions and get a great tour of their impressive medical facilities. Indeed, as Captain Ravera told the passengers during one of our receptions, Medical may be one of the smallest departments onboard but it is one with very important responsibilities.