Saturday, September 25, 2010

1.3 Foreign Travel Tips

Physician's Notebooks 1 - - See Homepage
Foreign Travel Tips (Update 11 Jan. 2019)

Acronyms in this Chapter: PMx is "past medical history"

  The following  column has the headings in order as they appear. Scan, scroll or search & find as you please.

Reason for making a trip
Air flight ticket-buying
Timing of Making Your Reservations
Refundable Ticket
Travel with companions
EAJ; Travel Insurance
Travel light
Setting out for airport
X-ray and Body Imaging Security Scans at Airport
Keep in mind we are now in the surveillance age
Check for Flight Delay Constantly
Food or drink at the airport
They announce your flight is overbooked
Your flight gets cancelled
Wheelchair Service through the Airport
Sit in non premium economy class
Do many-minute stroll on aisle
Stowing your luggage in overhead
 Important health notes based on recent observations
Before you leave the aircraft
TSA Lock
Specific Airport Tips & Pearls 
Airlines to Avoid
Compare Delta with United Airlines on Tokyo-NY route 
Airports I have known
Final End-note
Shanghai Trip Report 

Reason for making a trip: Give it strong preparatory thought – be sure you really need and want it, and then consider what you wish to get done and be sure you have the means and help to do it. Before you leave, check the weather at your destination.

Air flight ticket-buying advice here is based on our experience with United Airlines (UAL) and Delta Airlines round trip between Tokyo and New York City areas. For UAL, you save $25 by doing it online; for Delta, $20. These are flights that I make frequently; the reader can investigate his own routes.

Timing of Making Your Reservations: From a price standpoint, United was a little more expensive for a very early-making compared to a later reservation. On Delta, there was no difference in price. This should emphasize that one should shop around by using the telephone between the various major airlines in the weeks before making the final reservation.
   Important point: You may specify your exact trip without buying the ticket and have the airline operator hold it for you. On United Airlines, they will hold it for 72 hours and on Delta they will hold it for 24 hours. All things being equal, it is not good to schedule too early, meaning several weeks before a flight, because changes may occur that may cause you to cancel the flight for which you will have to pay a penalty. On the other hand, if you schedule too close to your leaving date, the aircraft may be totally booked and scheduling within a day of the flight is more expensive than a week or two before the flight. Generally about 2 to 3 weeks before the flight time is a good time to make the reservation. Also, day of the week counts: midweek is usually least expensive. Also least expensive mid holiday or the week before the holiday when most persons do not fly because they are planning to fly on the holiday. In Japan, never fly on Golden Week (First week in May) and Obon (Summer holiday season in Japan usually mid-August)

2 Little-Known Ultra-Cheap Times to Fly

Refundable Ticket: Most tickets on major airlines for intercontinental trips are refundable with a penalty of c.$300. But occasionally the ticket may be non-refundable so one should check before exhibiting one's credit card. Non-refundable tickets are usually only on promotional flight offerings. Keep in mind that once you reserve your flight with your credit card you will have 24 hours to change your mind without penalty. However, even if you cancel in the first 24 hours, your credit card will still be debited and you will get a credit card refund that may take months. This could badly affect your current credit balance. Concerning credit card, it can be disconcerting to misplace it in the midst of a trip as happened to me recently because I stupidly took it out of my regular set of cards and put it in to an outer jacket I had recently bought; then, at a friend's house, I mistakenly switched jackets with him and thought I had lost my credit card and immediately cancelled it by telephone only to be told a few days later by my friend about the switched jacket. So the whole thing made quite a disturbance on my trip. Lesson: Keep your credit card always together with your other important cards in your most internal pocket.

Airlines: Stick to major (Not smaller affiliates like Germanwings of Lufthansa) western country (Includes Japan) airlines and avoid country with political unrest, or major terrorists threat. Avoid Malaysia, Egypt and Indonesia Airlines above all! Japanese airlines give best service for price but may cost a little more than US Airlines.

If you travel with companions be sure of agreement on purpose and conditions of travel before you make the reservation. In general do not bring children. Traveling especially with close companions like husband or wife or child should ideally be, each one, in separate aircraft and each companion should get air-crash life insurance. I know that this advice is very unpopular and usually is not followed but why would you want your whole family wiped out in one crash? Of course, with a large family it could be impractical, i.e., each of the 6 children on a separate flight, but you should get the idea and try to use it in a practical way when you can.

EAJ; Travel Insurance: For overseas trips get a travel insurance for each trip that will cover your medical rescue in case you get major illness on a foreign trip. Without such insurance, medical rescue may cost US$100,000 or more. For details contact EAJ, Emergency Assistance Japan, Mr Ii at  Note that travel insurance for persons over age 60 does not usually include a death payment. That, you must buy at the airport.

Travel light! Travel light! Travel light! Carry-on with wheels. Max size for UAL or Delta carry-on is centimeter, 55 height x 35 width x 23 thickness. (in inches, 21 x 13 x 9; and it can change so check before you trip). Mostly there is no carry-on luggage weight limit but a few airports limit to a max 7 to 10 kg (16 to 22 lbs) and readers should use 10 kg as upper limit. This size gives max capacity for traveling light and such a piece of rolling luggage fits into international airline overhead and, in the airport, can be used as a seat when no chair or bench available. It should have a telescoped handle that can disappear when you need to carry. (Important because some airport lounges exclude travelers with rolling luggage). If you will use a hand-carry case for immediately available needed stuff, the max measurements that will fit under your forward seat are 43x32x10 cm but best not to have a separate bag because a hand-carry extra case is easily lost. What you might lug as too much baggage, you may better buy at destination. For clothes, just what you wear and one change. Keep in mind your jet aircraft will be too cool for short sleeve and short pants.
   Cell phones or iPads have built-in photo, video and clock, so no need for unattached cameras or time pieces. A mobile local phone is very, very useful in foreign country; with international phone the roaming charge can be very high.

Setting out for airport, be sure you know the terminal, the time for check-in, and go over all documents. Especially passport should be in accessible pocket and secured from dropping-out loss. Check well before departure date, your passport expiration date and visa stamps. As tickets are electronic, all you need is passport for check-in. Be sure not to forget your important plastic cards.

X-ray and Body Imaging Security Scans at Airport: Just after ticketing (or if you have boarding pass already) you must get security body check that in U.S. airports may include x-ray (Each x-ray increases risk of leukemia 10 to 20 years later) or millimeter radio wave body scan. How do you know which is which? The harmless body scans are in semi-open (glass) booths and you are asked to do a right body turn and extend both arms above head. You may avoid the x-ray by telling the TSA who checks your passport and boarding pass, after he has checked them, "I want to opt out of the x-ray."  Say it in a low voice and a friendly manner. He should reply "No problem" and refer you for full body pat down, which is done right away in public or private (Your option) and takes about 1 to 2 minutes and is not bad. The radio wave scans are harmless and not worth the effort to avoid.

Always keep in mind we are now in the surveillance age. You could be stopped and questioned for hours at the airport and your electronics confiscated and data copied. In individual case it is unlikely but be prepared for the possibility and do not carry anything you do not wish copied or confiscated.

Train yourself not to buy food or drink at the airport. If hungry before leaving, have breakfast or lunch at home and eat light. If you have lounge-privilege, keep it light and stock up on lounge foods to eat later. On aircraft, consider not eating every snack as it is set before you. I save the rolls, candies, salads or even main course in the discard bag to enjoy later on the ground. And before eating any airline foods I inspect what is in them. I do not eat mid-flight snack. I refuse the ice cream cup and save the sandwich. And with the pre-arrival snack I save for eating later. On drinks, stick to water and tea instead of sodas and juices because these latter are loaded with salt and sugars or artificial sweetener. Do not waste money or expose credit card for in-flight alcohol drinks or other in-flight buys.

Check for Flight Delay Constantly: Upon entering the airport for your flight, make it a rule to check the overhead flight schedules and keep tab on your flight's status. Especially if you have a close-interval connecting flight, an announcement of your flight's delay that may cause you to be late for your connection should immediately trigger a call to your airline for emergency rescheduling. Good service airlines have backup contingency plans for just this event and the sooner you discover the delay the easier it will be to remedy it.

If before boarding, they announce your flight is overbooked and ask for volunteers to do later flight, grab the chance unless good reason not to. Overbooked flights are high risk. Do not rush to get anywhere. Airlines should put you up in a nice motel for the night or reward you monetarily (or both). Never become obnoxious over being kicked off a flight.

If you are at airport at boarding gate and your flight gets cancelled just before a storm, stay in the boarding gate area and try to get on a flight to another large hub airport out of the storm's way and from there get reservation to your final destination. In worst case, stay in boarding area even overnights because when flights start re-booking, you'll have first access after the storm. Conditions are best in boarding area. Do not motel overnight.

Wheelchair Service through the Airport can be arranged if over age 65 or with even fairly minor disabilities. Even if you do not need it physically, it can be a great advantage when you need to speedily get through an international arrival after debarking your plane. Also in wheelchair your body and document inspection is minimal and fast. Check with your airline ahead of arrival; often you may arrange it when you buy your ticket by phone.

Sit in non premium economy class unless you need extra space for medical reason. Not just too expensive but in the upper class seats the food and drink is less healthy than in the economy because they overfeed with gourmet snacks and free alcohol. Also on some airlines, the upper class seat entertainment is not convenient and the strolling space is too limiting compared to economy.
  Select an aisle seat if you wish ease for getting up to stroll or to WC.

Do many-minute stroll on aisle at convenient times, several times during intercontinental flight. Sitting for many hours increases risk of blood clot in leg that may travel to lung and kill and also ups rate of attacks of leg and foot joint acute arthritis such as gout of big toe. (A single aspirin taken before flight will prevent both if you are high risk for blood clot)

  On stowing your luggage in overhead compartment on aircraft, be sure it will not fall out and injure someone on opening the compartment or that it is not so heavy it will harm your back or cause an accident lifting into overhead bin. And on opening an overhead bin, do it very slowly. And check in the overhead that you do not lose anything from the luggage. 

 Important health notes based on recent observations: High altitude intercontinental flight increases edema (swellings). The ankles swelling at the end of a long flight is the most frequent sign and should warn a traveler of possible weakened heart. Also the high altitude pressurized cabin air reduces your blood oxygen saturation to 90% or lower from its normal above 97%, not noticeable for a healthy young person but possibly provoking coronary heart pain or even infarction or brain stroke in traveler with coronary heart or cerebral artery disease. Be sure of your heart before flying, especially if over age 50, and do not overeat or over drink. If you can get a finger oxygen pulsimeter,  measure your oxygen saturation of blood (SaO2) during the flight. If  it drops below 85%, notify air attendant at once; it could mean a leak in aircraft air seal and portend crash or it could mean your own problem with heart or lung that might require mask oxygen.
  We have seen an attack of multiple sclerosis provoked by an intercontinental flight that caused an MS lesion to swell up and affect speech, breathing and swallowing within hours after take off. If you have multiple sclerosis (or a question of it), take a single high-dose oral corticosteroid dose under medical advice just before setting out on the flight. Also if you recently (few weeks before) had minor surgery like hemorrhoids, in vagina, tonsils, do not fly because of risk of hemorrhage in flight. Especially take care of bleeding risk if you take aspirin or are on other anticoagulant (Coumadin, heparins) to prevent blood clot.

Before you leave aircraft, check seat area carefully for forgotten item and as you walk forward to debark scan other area for forgotten valuables.

TSA Lock: All luggage you check in on a flight in the U.S.A. will be opened and inspected after you have given it for the flight. Unless you have a TSA Lock, the lock you use will be broken beyond repair in order to inspect. The TSA locks can be purchased at any U.S. airport. I use no locks and carry nothing of real value in luggage.

Airlines to Avoid: This is dealt with in the accident in transportation chapter and includes most smaller country airlines.  Specifically highlighted to avoid are Korean Airlines (Rowdy passengers, untrained crew; but we hear that recently things have improved), Malaysian and small German Wings Airlines (Suicidal pilots), Yemeni Airlines (Terrorists). Airlines of Mainland China and Russia are high risk for sabotage and poor training and equipment.  Best limit oneself to major western airlines and Japanese airlines.

Compare Delta with United Airlines on Tokyo-NY route 
We frequently fly between Tokyo and NY area and now were able to compare its 2 main carriers, Delta and United Airlines: First, Delta does not have a direct flight between the 2 destinations while United does; second, Delta caused us multiple delays due to computer problems while United really was perfect. So the advice for this route is: choose United
   Airports I have Known
  San Francisco International (SFO) Free WiFi and direct connection to the BART (Bay Area Rapid Transit). Overnights at the airport without hotel is easy and pleasant. If you want a good motel, check out the Dylan  in nearby Millbrae. Also note that trippers non stop from East Coast USA to Far East have one free stopover at SFO if they so choose
  Vancouver International is a good airport to do overnights. It has free WiFi and the Canada Line transit into the Vancouver Area is just across the street and 22 minutes from the downtown convention center.
Final End Note: On all kinds of trips, during boring intervals (on train to airport, waiting for transport) make use of the time by reviewing what is in your pockets and bags and arranging and inventorying your possessions in convenient way.

Here is a report of a recent trip to Shanghai written by my assistant, which may be useful.

Shanghai Trip (Ed: Note this is a first trip to Shanghai for tourism)

On my trip to Shanghai, I used Delta/JAL/China Eastern code share flight. China Eastern has a strange policy of no-use of cellphones even on airplane modes. Since the flight was less than 3 hours, I wasn't frustrated as much but it can be a huge bother on far-distance flights especially for businessmen or people who need to text. 
In the planes, they do not have separate monitors, so to some (like me) the flight without entertainment can be a pure agony. Most of the people were sleeping, but some were trying to sneakingly use their phones. Of course, human life is most important, so I don't want to complain much, but this was inconvenient. (Ed: Note this was frequent flier freebie so she got a no frills flight)
Prices, I think are not expensive and you will get a nice meal as well. You can choose between chicken/noodles or rice and it comes with salads and deserts. Airport in Shanghai is fairly modernized but not too impressive. 
Boarding took much time both on my way to China and on my way back. We had to get on a bus to get closer to the airplane.

Trip from airport to hotel - From airport, you can either take a taxi, subway or Maglev. I took Maglev because that was very unique to me and you can take subways within the city anyway. Subway is cheaper but slower (c.60 minutes to central Shanghai cf. 8 minutes by Maglev).  Maglev is more expensive than Subway but way faster. 
From the last Maglev station, you can change to the major subways and get off at the closest station to the hotel. Transfer is very easy and no problem because everything is written in English.

People in Shanghai are generally nice. Some things I noticed were: they spit at every corner and they can be overly loud. 
Sightseeing is easy due to a developed subway system. All the major touristy spots could be googled. Be careful for pick-pocketing. Soliciting is not excessive so don't worry.

Language: I'd say it's 50:50. Hotels are good, but some personnel have difficulty with English and understanding them can come with difficulty. On streets, people will understand you if you talk very slowly using easy words. Some Chinese people do not understand English,and would still continue to talk in Chinese. 

Eating in Shanghai: There are a lot of local restaurants and also street food good too. My recommendations are Chinese cuisine at an authentic Chinese restaurant including egg tarts, dumplings, and other famous gourmet, probably best eaten within your hotel because of safety. Chinese traditional tea is a must gift and is good for souvenirs. 

Places to go from Shanghai: I would love to know the difference between Beijing/other cities and Shanghai, I can't say much about this because I've never been to other places…

Why Go?: To see the modernized, developed metropolis. It will exceed all the expectations you have. It is said to be very different from South East Asian cities and of course very different from European cities. If you live in Tokyo, you may not find it as different though. 3 days are more than enough to tour around Shanghai. If you want to go farther, then I suggest having a tour package. 


           To read next now, click 1.4 Japan - C'mon a My House

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