Have Treatment? We’ll Travel!

“Sickness is a journey,” as some philosopher must have said, sometime. And if it’s true, then there’s no reason why getting better can’t involve a little travel too. Especially now, late August, when Southern California is on a slow boil. Oh, the heart does long to escape, and what better excuse than some exotic, soothing therapy--or a chance to save a few bucks.

Not that health care in this country is inadequate; patients around the world are waiting to get a room at the Mayo Clinic, the Johns Hopkins Hospital, Stanford University Medical Center--any good U.S. hospital--knowing that this country’s technology and standards of care are second to none.

And alternative medicine here is superb. You can get a Swedish massage, Chinese herbs, a course in Qi Gong, all administered expertly, and all without leaving Santa Monica.

Still, Americans have been traveling long distances for health care ever since we got here. Benjamin Franklin went to Paris in the late 18th century not only to negotiate treaties with France, but also to seek treatment for gout. Through the 19th century, men and women of means regularly traveled to the spas of Germany for “rejuvenation.” In more recent decades, Americans have flown to Germany for lithotripsy, in which ultrasonic waves are used to break up kidney stones; and couples seeking treatment for male infertility flew to Belgium, where a pioneering doctor first began injecting sperm directly into egg cells.

Both techniques soon were widely available here, and the traffic to Berlin and Brussels dried up.

And yet the journeys continue, to a variety of places, and for a variety of reasons. Curiosity. Adventure. Lower costs. Here is an informal sampling of some destinations that Americans are traveling to in search of something different:

Canada

Canadian border crossing agents are used to seeing them now, the cars with U.S. plates, the drivers staring out through anxious, bespectacled eyes--eyes bound for one of Canada’s scores of laser eye surgery centers. The most popular procedure, Lasik, mainly for nearsightedness, was widely available in Canada in the early 1990s, several years before it took off in the U.S. So eye doctors up north should have that much more experience. And with the weak Canadian dollar, it’s cheaper, by $1,000 to $2,000--although prices, as in this country, can vary a lot. Indeed, at larger clinics near the border, most or nearly all the patients come from the United States. Some ride up in shuttle buses provided by the eye clinic.

U.S. doctors suspect all that traffic has spawned what they derisively call “Lasik mills,” clinics that treat a high volume of patients, sometimes at the expense of personal attention. If you’re tempted to go, ask your own local eye doctor to recommend a clinic--and provide follow-up care, if necessary. And plan to see Vancouver Island or Banff before going under the beam. The world often looks blurred and sparkly for a day or two after your visit to the clinic.

Mexico

“Crowns, root canals, caps--I get it all done in Tijuana,” says Ned Baughman, 50, a painter living in Los Angeles. “I’ve gone so often, the dentist has become a friend of mine.”

In border towns like Tijuana, Mexicali and especially Los Algodones, just south of Yuma, Ariz., Mexican dentists are openly courting U.S. residents. With a population of just 10,000, Los Algodones has dozens of dental offices, which serve many of the hundreds of thousands of Americans who cross the border each year for cheaper prescription drugs and medical care. Dental work in Mexico costs about a third of what U.S. dentists charge. “If you don’t have insurance,” says Baughman, “that’s a huge difference.”

The quality of the work varies with the dentist. Baughman has had no trouble with his fillings and crowns. At the same time, dentists in California and Arizona can tell stories about crowns and root canals gone terribly awry. You must choose carefully: Ask about the dentist’s experience, and ask to talk to former patients. “And get there early in the day,” says Baughman. “They do make appointments, but really they take whoever’s there first.”

Southwestern U.S.

Of course, you don’t have to leave the country to find wholly different healing practices: Some originate right here.

As a rule, Native American tribes are skeptical of outsiders seeking to learn their healing practices, and it’s easy to see why. The demand for Native American herbs, ointments and cultural artifacts has spawned New Age trinket shops from Berkeley to Boulder and supports scores of commercial sites on the Internet. Among the few things that cannot be entirely commodified is the sweat lodge ritual, a blend of earth, fire and prayer that depends on medicine men and lodge leaders for its creation.

In a few quiet places, on native land, outsiders are being allowed into the lodge, to know some version of the experience. “It is an extremely moving and, yes, healing experience,” says Sandra Cosentino, whose Crossing Worlds Journeys & Retreats leads half a dozen groups a year onto tribal territory, usually Navajo, on cultural retreats.

The lodge ritual varies from tribe to tribe, but follows the same broad outline: A dome-shaped tent is erected around a shallow hole; participants enter the space in shirts and shorts. Several times over two to three hours, scalding rocks are brought from a campfire outside and placed into the hole. Meanwhile, the lodge leader conducts prayers, blessings, chants, meditations, songs--whatever he feels is appropriate. When the ritual concludes, says Cosentino, “you return to normal life renewed.”

Mexico/South America

Despite warnings from U.S. doctors, Americans still travel to Mexico and further south for face lifts, tummy tucks, breast implants and other cosmetic surgery. The cities of Cuernavaca and Guadalajara in Mexico; San Jose, in Costa Rica; Rio de Janeiro and Sao Paulo in Brazil; and Buenos Aires, Argentina, all have surgeons who attract people from this country, in part because of the cost. A face lift that runs $12,000 here might cost just $6,000 in Mexico, for example.

The work can be very good too. Amado Ruiz-Razura, a cosmetic surgeon in Houston who travels extensively in Latin America, says some of the world’s finest cosmetic surgeons practice in these countries.

But any major operation is just that--major--and often there’s little recourse if something goes wrong and you are outside the country. Don’t choose a foreign surgeon blindly, U.S. doctors say; get recommendations from a board-certified plastic surgeon in the States, someone who knows the foreign doctor and who could help if any follow-up work is necessary.

England/Europe

Dermatologists in Europe are no more skilled than their colleagues in the United States.

But they have some things that U.S. doctors don’t: several injectable, collagen-like skin fillers for wrinkles and lip augmentation that are not yet approved in the United States. They also have a treatment for spider veins called ethoxysclerol, an injection to make them disappear.

U.S. doctors say that these compounds are safe, work better than other injections in some people, and don’t cause as many allergic reactions. “They are the best products out there,” says Dr. Nick Lowe, a cosmetic dermatologist who keeps offices in Santa Monica and London, “and we are seeing American patients now, coming over for treatment.”

This is not to say that all cosmetic products available in Europe are trustworthy: There are fillers and implants being used overseas that are faulty and not available in the U.S. for good reason, Lowe says. Anyone planning a trip to see the Cliffs of Dover or Buckingham Palace--and who wants to return home looking extra “refreshed”--should first consult with a cosmetic surgeon here.

Switzerland

For almost 70 years now, the health resort Clinique La Prairie, along the shores of Lake Geneva, Switzerland, has coddled the rich and famous--and injected them with animal extracts that promise youthful beauty. The modern-day clinic says research has shown the injections both rejuvenate aging tissue and boost immunity to disease.

La Prairie uses sheep fetal liver cells that it touts as purified, free of bacteria and viruses. The injections of sheep cells may not tempt Americans and Europeans who are wary of mad cow disease, a brain-wasting virus that has turned up in some livestock overseas, but La Prairie promises that its cellular extracts are safe and nontoxic. Youth doesn’t come cheap, however: A week at the center, including tests, various health and beauty treatments plus room and board, costs more than $9,000.

Israel

Pickling yourself in the briny waters of the Dead Sea may not be your idea of an ideal vacation. But for folks with psoriasis or arthritis, this part of the Holy Land is a godsend. Dead Sea water is extremely high in salt and mineral content, which doctors believe soothes sore joints. Those afflicted with the patchy, cracked skin of psoriasis don’t come for the water, but for the sun. The area’s elevation--1,000 feet below sea level--means sunlight there has more skin-clearing UVA rays and fewer of the burning UVB rays than almost any other spot on Earth. A few weeks of this photo-therapy can clear away the scaly patches of psoriasis for weeks to months at a time, and make bathing in the sea a breeze.

Diane Lewis, a 31-year-old Santa Barbara artist, says that four weeks in Israel, bonding with fellow sufferers, is less expensive and more long-lasting for her than standard psoriasis treatments. She certainly feels more confident and more attractive when the patches that typically cover 95% of her body fade away.

“For us, it’s a miracle,” says Ben Freeman, 39, of Wichita, Kan., founder of the Dead Sea Psoriasis & Arthritis Treatment Foundation, which organizes trips to the Dead Sea.

China

Why fly 12 hours to Beijing when you can get superb acupuncture and herbal treatments in Chinatown, or Santa Monica, or perhaps the strip mall down the block? For several reasons, says Glenn Grossman, a Michigan acupuncturist who trained in Guong Zhou and has returned to China frequently. “People go to study with a master of traditional Chinese medicine. Or they have a fatal diagnosis that Western medicine has failed to cure. Or they have decided they want a combination--they don’t think, say, chemotherapy by itself is the answer, and they want herbal treatments too.”

Raymond Edge, a St. Louis doctor whose TCM Tours takes groups of American health care professionals to China, says it’s this mix of Western and Eastern approaches that attracts visitors. “At the China-Japan Friendship Hospital in Beijing, where we go, it’s about 60-40, Western to traditional Chinese medicine,” says Edge. “You can get acupuncture and massage in a hospital environment.”

Experts do caution against acupuncture outside the hospital; there’s no way to know whether the needles are sterilized, and you risk contracting hepatitis, among other things. If you’re interested, consult any local school teaching Asian medical techniques. Many arrange trips for students who want to study in China and have contacts who can recommend the best places to visit. TCM schools can also tell you where to go for arts, culture and food. “In China, they have a saying: ‘You have not eaten, until you have eaten in Canton,’ ” says Grossman. “And I’m here to tell you, it’s absolutely true.”

India

Thanks to celebrity doctor Deepak Chopra, the ancient practice of ayurvedic medicine, with its special diets, massages and fragrant oils, has skyrocketed to popularity in America. And now patients and practitioners alike are making pilgrimages to the country where it all started in 600 BC: India. Several adventure-travel outfits, including Myths and Mountains of Incline Village, Nev., and Spiritual Journeys of Wayland, Mass., organize trips to Kerala, in the south of India, to study ayurvedic principles with some of the masters.

“We’ve never been to India before, and we knew that it was something we wanted to do,” said Debbie Mathis, a meditation teacher in Leesburg, Va., who’s leading a two-week group tour next February with husband David, a family doctor who teaches ayurveda and offers ayurvedic treatments to patients. The trip will include lectures on ayurvedic treatments and consultations with a vaidya, an ayurvedic doctor.

Thailand

Search the World Wide Web under “Thai massage,” and you’ll hit two kinds of sites: those involving the ancient therapeutic art, and seedier sites that offer “massage” as a prelude to sex. Dr. Antonia Neubauer, founder of Myths and Mountains, an adventure and education travel company in Nevada, organizes trips to Chiang Mai, in Thailand’s far north, for people who want to learn about the legitimate type of Thai massage.

The 2,500-year-old form of healing seeks to create balance in the body by removing the blockages that get in the way of free-flowing energy. Thai massage incorporates stretching, gentle rocking and acupressure applied by the hands, elbows and feet of the practitioner. Tourists can get massages at the country’s top massage institutes, including the Old Chiang Mai Medical Hospital.

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Again, you could sample many of these therapies without straying far from Ventura Boulevard: Given time, the American health care marketplace--like American culture itself--absorbs and incorporates everything. But those who have traveled to seek special treatments say environment and culture matter as well. There is something more memorable, perhaps more lasting, about receiving traditional herbal care in the shadow of the Himalayas or the Taj Mahal--than in the shadow of the Century City skyline.

“To know the value of these ancient traditions,” says Cosentino, who leads cultural excursions into Native American land, “you have to leave the realm of the familiar.”

You may not always find a cure for what troubles you, of course. But by the time you get back, the evenings will be cooler, the kids headed back to school, the fall routine replacing the slackness of late summer. And you should have something that can be just as valuable: a story to tell.