I've been on a couple of med cruises, one in Jan 2010, and another in Jan 2012. The biggest difference will be you cruise-mates. The number of Americans will be less than what you find in the carib. The announcements will be in several languages, and some of the entertainment may be also. Some of their customs may not be what you expect in as much a making lines and entering and exiting elevators for instance. The men's swimwear sometimes can be

Food seems to be pretty standard cruise fare on board, but quite a bit better in the ports. Have fun!