I'm having her practice safe water and food at home this summer. There are oocystic organisms endemic there, so chlorine dioxide is the only practical chemical treatment unless filtered first. That means either Micropur MP1 tablets (expensive water) or Aqua Mira (PITA to use - and D.R. doesn't like it). We can debate other chemicals ad nauseum, but keeping it fairly simple for her is one of my goals - she's smart and attentive, but not a gearnut like most of us here.

More on this in my reply to Pete.

Thanks - affirms some of what I've already told her.

Super! Thanks for the link and I'll pass this on to my niece.

Pete - I really appreciate all the time you took to reply. Thank you!

RE: Altitude - I know, I know - I even used to take diamox as a prophy when we had to do a high altitude rescue (= body recovery). She SHOULD know this stuff - Grampa lives at 8,500 ft ASL and we pop up to 13k or 14k when we visit (her from essentially sea level and me only 600 ft ASL), but I WILL cover it pretty amply with her later. As I wrote previously, I am assuming too much about what she KNOWS vs what she has done. FWIW, I'm giving her a copy of Wilderness Medicine and she will read it all.

RE Travler's lament - I told her to assume that she will suffer a bad case of a norovirus type ailment for 4 days (for planning purposes). I told her to ask about a prescription A-D, bring OTC like Imodium A-D, bring Kao-Con, and pack 16 packets of Hydralite that are reserved for re-hydration in this sort of medical need. The lactobacillus tablets are a good idea - thanks.

PFAK - Already on it. Am dunning her about NOT using any of those supplies on others - told her to pack additional 1st aid stuff for that but cardinal rule is PFAK is ONLY for self treatment. As for the sharps, I would do that for myself but don't know about her. I might try her out on debriding, suturing, and sticking before making a final decision on those supplies.

Any other thoughts on antibiotics? I thought about cipro for a couple of specific reasons besides its generally wide spectrum, but as I rarely ever use antibiotics myself, was considering other wide spectrum antibiotics. You're probably right - cipro might make the most sense.

Roger on the Ex Stream XR - already told her that either that or the Sawyer must be in her daypack-that-is-always-with-her for subtle "right now" safe drinking water. I'm looking at the Sawyer, but the Ex Stream is my certain bet for that role.

RE: Steri Pen and MIOX - you have too many toys <grin>. I remember your reviews of both of those. I HAVE been toying with the idea of the MIOX for the chemical side of things. How has the thing held up for you? Any durability or performance concerns? NBD for me to send spare batteries with her.

RE Filters - I, too, am a little concerned about making a big fuss about water around her hosts, so I'd like not to be too overt if possible. Due to oocysts I've been thinking filtration from the start. I use a Guide personally, but I have NOT settled on anything wrt filtration device for her. Pocket Filter is a known; First Need is a known (even with quirks); Guide / Hiker Pro is a known; etc. I like the potential of ceramic depth filters and look at the MSRs. But with the Ex Stream XR along, I'm thinking pretty hard about a simple gravity based filter such as Katydn's. No moving parts and she can use the Ex Stream in the meanwhile. Thoughts? BTW, anyone know how the water privatization/de-privatization fiasco has turned out?

RE Inoculations: I already told her to get a different doc - he didn't even follow the State / CDC guidelines. Rabies (!!!) and yellow fever. Yaaargh! She won't be as shot up as I am (no commercial plague available now), but I'll see that she gets better coverage. Sheesh! I about blew my top that he didn't give her Hep inoculations.

RE: raw foods - yup. Been on her about that, but... it's been my experience that things like a salad take down giants. See my comments on preparedness for Traveler's Lament...

RE: TP - Something I take for granted because I always pack it, so I would have missed telling her. Thanks.

RE: Socio/Economic/Governmental advice - priceless; thanks so much.

I really appreciate the reply, Pete - thanks so much. I will have her contact you directly in a couple of months - I'll PM you her name and email (<yawn> - tomorrow)

Best regards,

Tom

Oh - forgot to mention that I have warned her about UV burns (she looks like an AmerInd Princess so she probably will ignore me on that) and I've told her in no uncertain terms to bring controlled release DEET (Ultrathon or Sawyer) and to treat her clothes and bedclothes with pemethrin before she packs up for the trip.

Also got her aimed at Sierra Dawn products for hand laundry and personal hygiene (Campsuds products) - told her no scented soap or shampoo.

Waiting to see what malarial prophy the (new) doc will recommend. since she will be spending time in the Amazon basin, she will need to be on a prophy the whole trip. I'd normally use mefloquinine, but Bolivia isn't a theater I'm familiar with and that stuff can have some side effects. I think chloroquine is officially useless there now - will ask your opinion after I hear what her doc suggests.

Tom

A sleeping bag liner treated with Permitherine is also a good idea for use as personal bedding even in nicer hotels. I don't know if a mosquito net would also be a useful item where she is going.

"...I get so darned busy..."

Ya gotta slow down! Life is too short to be busy at "our" ages...

Sleeping bag liner is a good idea. I have a specific brand/style in mind. Pemethrin treatment is not optional <grin>. Thanks.

Tom

heh - hey, I'm eligible for my second pension now, can you believe it? Having fun working; wish I remembered to goof off more. Working on it this year - baby steps. Feels like I'm getting fat, though.

Besides, I'm concerned that if I slow down, they'll throw dirt over me.

Save some fun and relaxation for me - I'll figure it out one of these days.

The sharps aren't for her to use, but so that if she goes to a medical facility they have sterile sharps with which to work on her. This is a serious concern in the 3rd world (heck, look at what happened recently in Las Vegas with recycled sharps, don't even have to go there for problems <~>).

One thing I didn't notice anyone mentioning is insurance. Most regular medical won't cover out of country. I also strongly suggest you consider medical evacuation insurance as well. This can break the bank if it's required.