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Old December 28th, 2005, 10:00 PM
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Default Medical Staff (was infants on cruise)

As that thread is starting to go off-topic I think a new thread to discuss the Medical treatment, or lack thereof, might be something that is worth discussing.
My take is that they charge too much for such limited ability and should hire better MD's. Be sure to take with you a complete medical history including enough meds to last the entire cruise or any emergency meds you might need. Do not rely on the ship to have the meds you might need.
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Old December 28th, 2005, 10:52 PM
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Jim,

I will agree and disagree.

I disagree with the following:

Quote:
My take is that they charge too much for such limited ability and should hire better MD's.
The latter part of that sentence implies (to me) that the doctors on the cruise ships are the dregs of the profession. I don't believe that to be the case at all. Granted they are not the top performers in their profession either. I have seen more than a couple of occasions of outstanding care provided by these ships physician and medical staff. They are well equipped for what they are, i.e. a floating medical clinic and in fact are probably better equipped than a lot of non-emergent medical facilities (and though they treat emergencies, they are not classified as emergency facilities). I have never seen of a bad case of medical care being provided. Oh, I have certainly heard about some . . . but only on cruise boards.

I do agree with you on this:

Quote:
Be sure to take with you a complete medical history including enough meds to last the entire cruise or any emergency meds you might need. Do not rely on the ship to have the meds you might need.
Really, though, as far as prescribed meds, that is just common sense. The same for a medical history, if you have medical problems. However, I am not sure where you are going with the emergency meds. I take routine OTC meds (analgesics, cold medications, anti-diarrheal, etc) along with my prescribed meds. However, I am not anal about it. If an emergency does crop up, I believe the ship will have the emergency meds available. But one had absolutely better believe that the ship is not going to have a supply of their prescribed meds available.

Now to the point about overcharging. As I stated in the other thread. I feel that they do . . . . but it comes down to supply and demand.
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Old December 28th, 2005, 11:35 PM
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My DH became ill while on a cruise in Norway.
The doctor aboard was quite well trained from South Africa and did and excellant job condsidering 200 other pax and crew were also ill and one lady had a heart attack and was in the infirmary till she could be put ashore in Bergen. Several other incidents occured ...he went above and beyond .

Our bill was $500. but condsidering hubby had 2 antibiotic shots, antibiotics and daily checks on his temperature it was not a bad price.

Insurance covered it all.
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Old December 29th, 2005, 08:09 AM
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I saw a show on Tuesday I think it was Investigative Reports. They did a full hour on cruise ships and a large portion of it focused on the medical care. The report focused on an investigation done by a New York Times reporter who found that many times people died because of insufficient care. There was a case where a man had a heart attack and died and the MD on board turned out to be an osteopath(?) but was a registered MD with creditials but no experience with heart attacks. This report cited other issues such as equipment being available but not used in time and things such as misdiagnosing appendicitis which almost killed a little girl. I have to say that I was completely floored by the information contained in this report and that I never once suspected that the stuff that appears to be happening is actually happening. The fact that the ships are registered under foreign flags exempts them from any standards that we can impose and that is where things go wrong. I have to say this show was an eye opener for cruisers and bad publicity for cruiselines. I used to think infants on a ship were not a big deal, now there is no way in heck that I would travel with a child under the age of five, I just love my kids too much to take the risk.
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Old December 29th, 2005, 10:46 AM
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Kitty I am glad your insurance covered it all, because I still think 500 dollars is ridiculus. Mind you I do understand that on a ship at sea what choice does one have.

If your husband and 200 hundred other people were sick then it most likely was a virus and no one needed antibiotics . but then it is easy to give antibiotics and charge people too much for them. And daily temp checks?

I personally still feel that the medical services on board are basic at best, but with premium prices. I always bring my own drugs etc. I would not like to be charged 100 bucks for indigestion!

As for the doctors , I am sure there is in an interesting mix, but I think that having an M.D. behind your name and a pleasant personality are probably the most important factors when applying for the position , not any special ability to work in basically a floating clinic.

I would be considerned if I had any special health requirements, and I would ( and do) make sure to bring my own meds, thermonter and first aid items. I really would not enjoy spending 500 bucks on something worth 100.( say a few stitiches or a check to see if I had a temp. )
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Old December 29th, 2005, 11:09 AM
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First off, I would never classify Investigative Reports (or other such programs) as the authority on anything.

I would have liked to have seen that program though. I have to wonder just what the reporters definition of "adequate care" is.

If I were to believe all the instances the reporter cited as "gospel", I still would not be overly concerned. Why? Well a couple of reasons.

1) There are about 200 cruiseships travelling throughout the world. At least 110 of these could be classified as major ships (1,000+ passengers). For the most part they change passengers on a weekly basis. Given the 1,000 passengers per ship that equates to 5.7 million passengers a year. Given an average of 2,000 passengers per ship you can double that figure to almost 11.5 million passengers per year travelling on these cruiseships. You could go to any major city in the USA and would find that the % of whatever the reporter cited would be much greater. The bottom line with medicine and its' practice is that the practitioners are human and subject to human failure and folly.

2) I have read that most cruiseships experience a death or so each cruise. I have no idea if this is true or not (don't quite buy into it). But given it were true - look at the demographics of any cruise and you will see there are many senior citizens and more than a handful of really senior citizens onboard. These people die. Just a quick perusal of my local paper today (population about 100,000) showed that 11 people over 60 passed away. I think most of us would agree there are truly people on cruises who for medical reasons should not be on the ship. Additionally, how many of us who do cruise do not have a chronic medical condition that requires medication. The bottom line here is that people are going to become ill on a cruise. Unfortunately, some of them are going to die.

I am not naive enough to believe that there are medical types practicing on those ships who do not belong there (or anyplace practicing medicine) and that is a bit scary. But, I totally believe that the vast majority of these doctors are extremely competent.

2Littletime you wrote:

Quote:
There was a case where a man had a heart attack and died and the MD on board turned out to be an osteopath(?) but was a registered MD with creditials but no experience with heart attacks
I am not certain what the reporter was trying to infer. A MD is not an Osteopath, yet both are physicians. I am not sure how an Osteopath could be a registered MD. Perhaps with your (?) you are not quite sure what he said and the doctor was an Orthopod (orthopedic surgeon). I don't know. Either way, I find it hard to comprehend that as a physician (no matter his specialty) he/she would have gotten through internship without having some experience with heart attacks.
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Old December 29th, 2005, 12:46 PM
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sorry, I posted one on the other thread by accident.

I think that in addition to demographics as Doc pointed out, you have to look at a group of 1000 people, eating 4 square meals every day (I dont know about you guys but we rarely do that every day at home) also, eating very rich foods with heavy sauces and lots of pastries and cakes and cheesecakes (OH SH>>>IT I'm drooooling) and sugary heavy foods with often less exercise than we get at home (my wife and I don't workout when away).

All of that also makes for a greater likelyhood of medical issues at sea.

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Old December 29th, 2005, 01:15 PM
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My take on cruise ship medical officers is that they are basically general practitioners who have to treat a very large variety of issues and are not trained in all specialties.

Just like in any profession, there are good ones and bad ones. The problem is that you don't know until you are in a dire state. Overall I would make sure that I had the proper medications with me to handle any medical problem I had. There is no guarantee that they will have them or the dosages required.

I believe that the main thing that they try to do is stabilize and transport. The faster they are off the ship the better it is for the patient, the cruise line and the doctor.

Treatment of a serious condition is something they wish to avoid and I personally would too.

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Old December 29th, 2005, 03:02 PM
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I think it's a mistake for people to think that the medical care onboard be anywhere near equivalent to a surgical or emergency ward.

How many walk-in type clinics in your home towns can handle serious situation? How many of your home town GPs can do nothing more than send you for bloodwork, or make an appointment with a specialist? Most of these, if the situation is serious, will arrange to transport you to a full service ER.

And if you look at what your local hospitals and doctors charge I think you'll find it's not much less than ship's doctors.

All of that said, I've witnessed some very good care from the medical staff onboard in some pretty serious situations. They do a surprisingly good job considering their limited facilities.
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Old December 29th, 2005, 04:01 PM
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As far as cost is concerned it is expensive yes but it is not that much more expensive than here in the US. most people have insurance that help cover the cost of service but for those people without insurance the cost of medical attention is going to be between $200-400 depending on whats wrong.
Is it more expensive at sea? yes.
Is it a rip off compared to a standard clinic here on land? No
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Old December 29th, 2005, 04:09 PM
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2littletime, I also saw that show and can tell you that it is mostly garbage and media hype. There were many exerrations on that show including the Dr's on the ships. They are certified MD's, of that I have no problem. I would like them to be ER trained MD's however. That was my main concern for them. I do know that the crew sometimes will go to MD's when in port instead of the ships MD's. I have meet one Doc that was exceptionally qualified as I learned his background while dining with him and we also had one of the ships nurses join us on a HAL ship that was a real ER nurse from the USA and just did this for 3 month on and 6 off so she could travel on a ship. Not all Doc's on ships are bad, just some are not trained enough to suit me and do not have the proper equipment in some cases.
Back to that show, it is also pretty old and was very sensationalized. The statement that 50 people were injuried on the Ecstasy fire was very misleading. I think the number was about 23 or something like that and every one of them were crew that were fighting the fire. No passengers we hurt in any of the fires on the two ships they showed and many never knew it on the Tropicale until told about it. All lines have properl;y trained personell to fight fires and they know what they are doing. I was a sailor and even in basic we were taught how to fight shipboard fires and it is very differant from fires on land.
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Old December 29th, 2005, 04:17 PM
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DocJohn, yes there are often deaths onboard ships but it is simply because it's that persons time. Many people are elderly etc and, well, that's the way life is. The guy they were talking about on the show had massive surgery on his heart already and was a walking timebomb. It was his time and I seriously doubt given the full information, (which you had to listen very hard for BTW), he would have died had he had this attack in front of a trama center in the USA. The Doc's onboard are good folks, I just wish that they were all trained as emergency room physicians.
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Old December 29th, 2005, 05:43 PM
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Quote:
Originally Posted by pg.
Kitty I am glad your insurance covered it all, because I still think 500 dollars is ridiculus. Mind you I do understand that on a ship at sea what choice does one have.

If your husband and 200 hundred other people were sick then it most likely was a virus and no one needed antibiotics . but then it is easy to give antibiotics and charge people too much for them. And daily temp checks?
It was a bad cold that went very quickly to an upper respitory infection ...other pax were coughing and barking all over the place but many did not seek medical attention.
I have a low immune system but never got sick...go figure!
I do take OTC meds for most ailments but this was severe and required real meds.
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Old December 29th, 2005, 06:09 PM
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Jim,

This is a great thread (of course with my board name - one has to assume that I would like it). Thanks for starting it.

It would be nice if the docs on the ship were emergency room physicians, but I do not think that is practical nor even necessary. I would love to know what the requirements for the docs are. I know most are not kids just out of residency. I did have the pleasure of talking with one a few years back and was impressed with his credentials. His reason for being on the ship was quite simply that he needed to get away from the stress of his cardiology practice (of over 25 years). He called it his sabbatical. He had every intention of returning to his practice after about a year.

Mike M, you wrote:

Quote:
Overall I would make sure that I had the proper medications with me to handle any medical problem I had.
Isn't that really a bit unrealistic? If one is as young and healthy as you appear to be (that is your picture, right?), it may not be a real problem, but get older and lose some of your health, it could become one. Hell, I would have to carry an extra suitcase just for the possibilities. Seriously though, I do carry some OTC meds for colds, diarrhea, etc., plus my prescriptions medications. But that is it. It is just impossible to think of every medical problem you might encounter.

What can't be predicted nor even planned for are accidents. You break an arm, you are gonna have to see the ships doctor. Slice you hand real bad on a broken glass, same thing.
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Old December 29th, 2005, 06:21 PM
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A couple of things regarding this discussion


p.g. has complained about the cost of medical care aboard ship and I do agree that it can be a bit steep, but . . . . . and this has been discussed at length in various forums on all cruise boards . . . . . that is what insurance is for. Over and over and over I hear people diss insurance as a scam or not worth it because they are young and healthy. But people get ill, have emergencies, get hurt on cruises. You do and you may have to see the ships doctors. It would appear that that will cost you 300-400 bucks at a minimum. The insurance costs a hundred bucks or so for a couple for a weeks cruise.

Then there is the bane of the cruise industry - nonovirus and similar problems. There are people who refuse to see the ships doctor when they exhibit symptoms. They do so for a couple of reasons.

1) No one is gonna screw with their vacations. They know if the go to the ships doctor and complain of nauseau, vomiting, diarrhea, he is going to treat them and restrict them to their cabins. And they didn't pay XXXX thousands of dollars to be cooped up in their cabin.

2) They are unwilling to part with their money . . . at least at the rate the ships doctor is charging them.

So they don't go to the doctors and spread that stuff all over the ship and sicken even more passengers.

Oh well, off my soap box for now.
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Old December 29th, 2005, 07:06 PM
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A few years ago, my husband had an accident while in Grand Cayman and spend a few hours in their hospital. Once we got back onboard he went right to the ship dr. and we felt got much better treatment there, at a lot less cost compared to the hospital in Grand Cayman...there were things they should of done for him on land that they didn't and the ship dr. took care of all that. Yes, we ALWAYS buy the travel insurance in the event of something like this happening, its a small price to pay. We did get re-embersed after our regular insurance paid, so by having the travel insurance, it saved us hundreds...

We were very impressed with the medical facilities they have onboard Voyager, its a mini hospital with good and caring dr's. They also called once or twice to check up on things at no charge, they were wonderful. Its possible that this ship hospital is better than most, I have no idea, we were just very happy with the care he got by comparision to the hospital in port. The hospital in Grand Cayman would not even look at him, until I gave them a credit card and I felt they way over charged for what care was received compared to the care he got on the ship.
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Old December 29th, 2005, 08:45 PM
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Well, you go to see your doctor in the states and you see it is 200 and how long does the doctor see you? About 10 minutes? Then if you are lucky your co-pay is 20. The best deal I got was seeing a dietary specialist while pregnant, bill 200 but at least she spent half an hour(wup dee doo) with me and I got lots of useful dietery information. So I see the prices for the ship board expenses to see the doctor and I am not surprised.
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Old December 29th, 2005, 09:44 PM
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I saw what the Doc's did for Donna's hubby and he was given very good treatment so bravo for the Doc on the Voyager of the Seas.
As for cost, lets compare. I went to the ER here at home for what I thought was food poisoning and man was I in pain in my stomach! Turns out that it was a kidney stone attack, (yes I have had them often and even had surgery to remove them but it never hurt like that). I was in the ER for about two hours and they gave me two shots of Demerol and an x-ray to confirm the stones and then I was released. Now the bnill for this was $3,750 for the ER alone! In addition the Doc charged me around $350 I think and the X-rays were another $200 and the Doc that read the x-rays three days later in a city 125 milkes away also wanted a $100. I ended up paying the radiology bill or my portion of it for Medicare, told the Doc 125 miles away to get stuffed, and wanted to pay the ER bill, or my portion of it for Medicare but they would not file it, (I guess because the bill would be about $500 or so and my portion another $50 or so instead of the almost $4K) so they sued me and the judge told them no way, they should have done the Medicare thing and then to punish them ruled the bill paid or something so they not only could not ask me for anything but they were not allowed to file it with Medicare now! Good Judge. <G>
It does not matter if you are healthy or not, insurance is a necessary evil. I hate insurance companies myself but know that you have to have them 'just in case'.
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Old December 29th, 2005, 10:05 PM
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Well of course people die on a cruise. They die on cruises all the time. Everytime I'm on a cruise I'm dying to get to the bar, dying to get to dinner, and dying for a blackjack.

I know one thing, if I ever expire on a cruise I'm gonna ask for a refund of the portion I didn't use.

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Old December 29th, 2005, 10:42 PM
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Thomas you silly dude, you won't get a refund for the cruise portion you didn't use.

You may get a refund for the unused portion of port charges


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Old December 29th, 2005, 11:11 PM
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Last year on navigator my little guy split his forehead open in the skating rink (he's been taking skating lessons since he was 2) - go figure, anyway they stitched him up for less than a hundred bucks. The cost didn't really matter, what mattered was how we would have felt if there was no facility available (my wife and I would have been a wreck).

Once in the med wifey and I had a pretty nasty altercation with another sccoter on a greek island and we were banged up worthy of a good story, anyway there was no ambulance but a good citizen loaded me into the back of a van and drove us to the local hospital. When we realized where he was taking us we started insisting on going to the ship. He did not speak a word of english and we literally had to point towards the bay where the ship was anchored. Boy did we appreciate being treated on the ship. (just imagine what the "hospital" on the island looked like)

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Old December 30th, 2005, 08:10 AM
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Banker,
Thanks a lot! I didn't eat my breakfast yet. Ouch! That just really put any scooter ideas down the toilet.

I can easily change your profession. Banker- Baker Just noticed that when I typed wrong.

K
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Old December 30th, 2005, 01:40 PM
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banker - baker

It's all about cookin, cookin food, cookin the books, it's all good!

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Old December 30th, 2005, 02:58 PM
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Quote:
Originally Posted by banker
banker
( and my wife's derriere was completely bandaged on one side, she was thrown off the back of the scooter, landed 10 feet away on pavement wearing a bikini)
OWWWWWWWWWWWWWWWWWWWWWWW!!!!!!!!!!!!
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Old December 30th, 2005, 04:15 PM
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Doc,

I should have made myself more clear:

If you have any conditions that require special medications you should make sure that you have them in the the quantities required.

I know that you can't bring an entire pharmacy on board. I doubt any doctor would write that many scripts.

I have an anti-seizure medication and the doctor onboard did not administer the correct dosage for my weight. Luckily I had the correct dosage in my cabin. They did not have the correct amount onboard.

It also applies to anyone who may not have their blood pressure medications, insulin, etc.

Take care,
Mike
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Old December 30th, 2005, 05:24 PM
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just a post post,

I couldn't drive home (car was at park n fly) so we had to call my sister (no answer) left a message, call wife's brother (no answer) left message, got a hold of my parents and asked them to both pick us up, (1 to drive each car back).

Well guess what, the arrival doors open, we limp out and they're ALL there to pick us up.........

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Old December 30th, 2005, 05:33 PM
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Quote:
Well guess what, the arrival doors open, we limp out and they're ALL there to pick us up.........
Ahhh...now thats love!
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Old December 30th, 2005, 05:41 PM
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Quote:
If you have any conditions that require special medications you should make sure that you have them in the the quantities required.
Then pack a double dose and put in separate carry-on. Just in case you do something like leave your purse in the airport shuttle.

Or you get back and find out your airline is on strike and you can't get back for a couple days and you didn't pack enough meds. Don't count on a first class seat opening up because you have a medical condition. hehe

Not that I ever did either of those.


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Old December 30th, 2005, 06:27 PM
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I never pack any meds other than over the counter stuff in checked luggage. The stuff I use is something that drug dealers/users would love to get their hands on, not to mention it would get the DEA types all excited. Many meds that are required by people are highly desired on the street and even those that aren't are likely to be stolen on the off-chance they are sellable on the street. Always carry on your meds and never let them out of your sight.
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Old December 30th, 2005, 07:02 PM
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Quote:
Originally Posted by Jim Bragg
I never pack any meds other than over the counter stuff in checked luggage.
Jim
You beat me to that one Jim. I always pack our medications (both prescription and OTC) in our carryon. As Sailing gal suggested, I also always carry more than I will need, just in case of the unforseen. I never want to have to rely on getting my prescription refilled in Cozumel or Kingston.
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