Do I need ok by my internist if going on a really long trip?

Depends... If you have multiple medical illnesses and you take many medications, i like to have my patients check in before they go so that they have a plan for refills, monitoring labs, etc. If you're going abroad, it's also good to check in to make sure you have the necessary immunizations. If you're young, healthy, not going abroad, and take no meds that need refills.... No need to see doc!