Cruise ships are the ultimate vacation indulgence. You don’t have to think about food; it’s provided for you in abundance. You don’t have to think about where you’re going; the cruise ship takes you there. You don’t have to figure out what you’re going to do; it’s all there onboard the ship.
That level of pampering induces many cruising vacationers to just turn their brains off — or at least, let them slip into vacation mode. Unfortunately, this relaxed state of mind has led many a cruiser to make bad, and downright dangerous, health decisions.
Related: Confessions of a Cruise Ship Doctor
Yahoo Travel asked Dr. John Bradberry, a former ship doctor and medical director for a major cruise line, to tell us the biggest health mistakes he’s seen cruise passengers make. Some are obvious (do we really need to tell you not to get blackout drunk on a cruise ship?). Some, not as much. But avoiding these mistakes may save your life — or, at least, your vacation.
Overdoing the cruise-ship partying
Cruises tend to have a 24/7 party atmosphere, but all that activity and excitement could exacerbate underlying conditions that passengers may not even realize they have. (Photo: Thinkstock)
“Many Americans with an undiagnosed underlying coronary artery disease will board a cruise ship,” Dr. Bradberry explains. Then they proceed to do everything to excess. “If they drink, they tend to drink more than normal. They’re more physically active that normal — dancing in the discos, going on the shoreside excursions. And there’s a lot more sexual activity; a lot of Viagra gets used. If they smoke, they’re probably smoking more. And there’s the overeating,” says Dr. Bradberry.
That level of sudden excess can have a deadly outcome at sea.
“All of this put together can precipitate the first heart attack in patients,” says Dr. Bradberry. “I’ve seen it many times.” His prescription is pretty simple: Take it easy, even though you’re on vacation. “Be careful about overdoing everything when you’re on a cruise,” he says. And that leads us to…
We all get a little clumsier after a few daiquiris, but add slippery decks and a constantly swaying boat and serious accidents are more likely to happen. (Photo: R./Flickr)
Yes, this gets its own category, because too much booze has led to more than a few visits to Bradberry’s medical center. “Alcohol is a contributing factor to injury,” he says. “When you have the motion of the ocean combined with alcoholic beverages, that’s going to predispose to slip and falls.” While most of the alcohol-related injuries Dr. Bradberry treated were minor — “sprained ankles, abrasions, things like that,” he says — alcohol has been found to contribute to more extreme onboard tragedies. CruisePage.com reviewed every known “person overboard” cruise ship incident since 2000, and found that most of the victims were “either drunk or doing silly things” — which, as we all know, is a common side effect of drunkenness.
Fortunately, cruise ships are aware of the dangers, and crew members work to save drunken passengers from themselves. “The bartenders and bar waitresses are trained to observe when a passenger has had too much to drink,” says Dr. Bradberry, who points out that ship’s security is also on the hunt for overly intoxicated passengers.
Boarding the ship after suffering an injury or illness on shore
While cruise ships have medical staff onboard, if you get in a serious injury like a car accident while on shore, you might need more intensive care that only a hospital can provide. (Photo: Cherish Bryck/Stocksy)
Here’s something you don’t expect a cruise ship doctor to treat too often: car accident victims. But Dr. Bradberry says he’s treated more than his fair share. What typically happens, he says, is that cruise ship passengers will go ashore and rent a car or motor scooter. Then they get into an accident that dings them up a little bit, but not to the point where they’re unconscious or incapacitated. “We refer to them as ‘the walking wounded,’” Dr. Bradberry says.
But instead of seeking immediate treatment, these “walking wounded” return to the ship. And then later, once the ship’s at sea with nary a hospital in sight, their injuries will flare up, badly, and become a major problem for the patient and the ship’s doctor. “I’ve personally diagnosed people with multiple rib fractures and a partially collapsed lung from hitting the steering wheel after their Jeep overturned,” Bradberry says. As well-equipped as cruise ship medical centers are, they still are limited; in the extreme cases, the patient would have been better off going to a local hospital.
“It’s generally best to avoid the impulse to attempt to make it back to the ship,” Bradberry advises those who suffer a major injury or illness during a shore excursion. “Most major ports of call feature one or more very capable full-service hospitals.” Bradberry also recommends getting the contact info for your cruise line’s local port agent every time you plan to go ashore; he or she is the person to contact should an unexpected shoreside hospital stay separate you from your ship.
Related: The Cruiser: What I Love/Hate About Taking Cruises
Not getting travel insurance
Before shipping off to sea, check and see if your current health insurance covers you abroad or if you need to add travel insurance. (Photo: Getty Images)
“I’ve seen so many people get into a real bind because they’re assuming that Medicare or their private health insurance will cover them anywhere in the world,” Bradberry says. “Some [insurance plans] do, but most do not. And when you’ve been involved in a motor vehicle accident in Cozumel, or if you’re out at sea with a heart attack, and the next port is in Aruba or something like that, that’s a real inopportune time to find out that your insurance is not going to cover you outside the country. So it’s well worth it and very ill-advised to not take out travel insurance.”
Ignoring doctors’ advice
If a doctor’s professional opinion is that you shouldn’t go on a cruise, then you should listen. (Photo: Sean Locke/Stocksy)
If your doctor tells you not to go on a cruise, you probably shouldn’t go on a cruise. “On multiple occasions when such patients subsequently experienced serious medical complications during the cruise, when I called their personal physician via satellite phone to discuss the case, their doctor was stunned to learn the patient had gone on the cruise,” Dr. Bradberry says. It’s another reason to get travel insurance; many policies cover you if you have to cancel an already purchased cruise because of illness.
Loading up on prescription meds in ports of call
It might be tempting to load up on cheap meds at pharmacies like this one in Playa del Carmen, Mexico, but you could be putting yourself at risk – medically and legally. (Photo: Cris Haigh / Alamy)
Many medications that require a prescription in the United States can often be found over the counter, and cheaply, at international ports of call. But Dr. Bradberry says stocking up on meds can end up being a very expensive bargain. “For starters, such medications are not subject to FDA quality-control scrutiny,” he says. “What’s listed on the label versus the true content can be very different.”
In addition to the health risks, there’s also the matter of getting your medical souvenirs back home. “It is illegal to transport non-FDA-approved medications into the U.S.,” Dr. Bradberry says. “Plus, if it’s classified as a prescription medication in the U.S., you must have a prescription to bring it into the U.S.” Despite such warnings, people try to sneak in these cheap meds anyway, but they do so at their own risk. “Want to have a very memorable end to your cruise vacation?” Bradberry asks. “Purchase a sizable quantity of non-FDA-approved controlled-substance medications, such as narcotic pain killers or tranquilizers, in a non-U.S. port of call and attempt to convince a highly unamused U.S. Customs and Border Protection officer that you are not drug trafficking.” Some vacations don’t need to be that interesting.
Bringing your legally prescribed medical marijuana
Just because your prescription for marijuana is valid where you live, doesn’t mean that you can legally carry it or smoke it everywhere. Best to leave it it at home. (Photo: Lauren Light/Stocksy)
Congratulations: You live in a state where medical marijuana is legal. Should you ever decide to leave that state to go on a cruise, it’s best to leave your stash at home. “Prescriptions for medical marijuana are valid only in the state in which the prescription is issued,” Dr. Bradberry says. “Neither the cruise lines, the U.S. Coast Guard nor U.S. Customs and Border Protection typically recognize such prescriptions onboard cruise ships.” And just as you don’t want to have to explain a bag full of prescription pills to a Customs agent, you definitely don’t want to have to answer for the several ounces of Strawberry Cough in your toiletries bag.
Not washing your hands
Lots of people on one boat means lots of germs going around. Minimize your risk by washing your hands regularly. (Photo: James Godman/LuckyPix/Corbis)
Cruise ships do a “fabulous” job of preventing norovirus, Dr. Bradberry says, noting that there are about 20 million cases of the gastrointestinal illness on land in the United States every year that do not get the same media coverage as the few dozen or so cases you’ll see on the occasional cruise ship outbreak. “It is not a cruise ship illness.”
Yet outbreaks at sea do happen — often, Bradberry says, because a passenger boards the ship having already contracted it. “You could have someone who’s a little bit ill, they’re not washing their hands, and it’s very difficult to control.” So washing your hands remains the best defense against any outbreak. “Hand sanitizers can help,” Dr. Bradberry says, but should be considered as a supplement rather than a replacement for proper hand washing.
WATCH: Cruise Ship Safety
Lying about pregnancy
Yes, women sometimes give birth at sea. But it’s something cruise ships generally try to avoid. Dr. Bradberry says cruise ships typically bar pregnant women from boarding if they’re 20 to 24 weeks along or more. During embarkation, cruise lines often ask passengers to fill out questionnaires stating they’re not pregnant; crew members even search the crowd for women carrying more than luggage.
Still, Bradberry says some pregnant passengers slip through. “I remember one case. A passenger in her third trimester of pregnancy ended up delivering on board,” he says. “She’d lied on the questionnaire. And she was heavyset, so she didn’t have any physical appearance of pregnancy.” Fortunately, all turned out well. “The mother ended up naming the baby after the ship,” he says.
Happy endings aside, giving birth at sea is a risky proposition; cruise ships are ill-equipped to handle premature or complicated deliveries. No vacation is worth risking that.
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