KATHRYN OLMSTEAD

Only travel medicine clinic north of Bangor saves Central American trip

Posted Nov. 24, 2011, at 9:25 p.m.

It was not until the week before my departure for a trip to Central America that I read the details about immunization.

I had focused on the sentence: “No immunizations are currently required for visiting Belize,” in the materials we received weeks ahead of the journey. When I read on, I learned that certain vaccinations are recommended and I should consult my physician.

That’s when things began to escalate, leading me to the only travel medicine clinic north of Bangor, located in what was once the chapel for Loring Air Force Base in Limestone.

My call to my physician in Orono was prompted by a five-page single-spaced directive of health information from the Centers for Disease Control and Prevention in Atlanta, Ga. I had received it weeks earlier, but had just saved it on my computer with other email attachments.

Ten days before the departure date I printed it out. Two items caught my eye: a paragraph about the presence of malaria in all areas of Belize, especially the one where I would be traveling, and the statement, “To have the most benefit, see a health care provider at least four to six weeks before your trip to allow time for vaccines to take effect and to start taking medicine to prevent malaria, if you need it.”

That was just the beginning. My physician’s nurse noted that my last shot for diphtheria, pertussis and tetanus (DPT) was in 1989. That inoculation would be a must. When I could not confirm I was immune to measles, mumps and rubella (MMR) she scheduled me for a blood draw at Cary Medical Center in Caribou for immunity tests.

I decided to call the trip’s organizers to see how strongly they recommended the many immunizations listed by the CDC. They had made several trips to the community conservation projects we would be visiting in Belize, so I would just follow their advice.

“Oh, yes. Be sure all your routine vaccinations (MMR and DPT) are up to date,” I was told. “And immunizations against Hepatitis A and B are imperative.”

Hence, I was introduced to travel medicine, beginning with a call to the Bangor Immunization Clinic on Texas Avenue in Bangor. I had a long conversation with Jennifer, who found the same information from CDC that I had before me.

“You should go directly to the travel doctor in your area,” she advised when I told her I was in Caribou. Well, I didn’t even know Aroostook County had a travel doctor until I inquired at Cary Medical Center and received the phone number for Dr. Abhijay Karandikar, who runs the Travel Medicine Clinic for Cary’s Pines Health Services, a component of its Occupational and Environmental Medicine program.

I reached the Limestone clinic about 9:30 a.m. and, even though they were booked for the week, the doctor’s nurse Lori found a way to work me in within the hour. It was as though I were the only patient to be seen.

Dr. Karandikar carefully explained how I might acquire a variety of diseases, how they would be experienced and what options I had for protection against them. “You are the first patient to bring me maps,” he said, when I explained where I would be traveling.

While Lori administered injections for DPT and the first shot of an accelerated series for Hepatitis B, Dr. Karandikar withdrew to put together a packet of information including medical advice specific to Belize, general protective measures, components of a travel kit and guidelines for insect repellent and sunscreen. These materials he presented to me during a concluding consult in a folder also containing details on the vaccines I had received and a cover letter thanking me for visiting the clinic, offering sources of additional information and inviting me to call with any questions.

He also provided prescriptions for pills to prevent malaria and typhoid and to treat diarrhea, should it occur during travel. Since the Loring center had no vaccine on hand for Hepatitis A, I was scheduled to receive the first of that pair of shots at the Pines Health Center in Caribou later in the day.

In just a few hours, I had gone from ignorance and vulnerability to being informed and on a path toward protection. And my chagrin over waiting so long was erased by the genuine friendliness and competence of the people I encountered at every point in the process.

“Do I know you?” Dr. Karandikar asked over an outstretched hand of welcome when he first entered the examining room and introduced himself. “Hmmm. Did you attend a press conference about medical records I covered recently at Cary Medical Center?” I responded as we searched for a connection. “No,” he said finally with certainty. “I know you from your column in the Bangor Daily News.”

Kathryn Olmstead is a former University of Maine associate dean and associate professor of journalism living in Aroostook County, where she publishes the quarterly magazine Echoes. Her column appears in this space every other Friday. She can be reached at kathryn.olmstead@umit.maine.edu or P.O. Box 626, Caribou 04736.

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