Holiday Healthcare

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Your pharmacist can help you:

  • Take care of your health when travelling
  • Carry your medicines safely when travelling
  • Know what precautions to take before travelling

What should I do before travelling abroad?

It is important to prepare your trip well in advance. Follow these general guidelines before getting ready to travel.

  • Visit your doctor, practice nurse or pharmacist at least 6-10 weeks before you travel abroad to check on immunisation requirements. If you are travelling for more than a month, see them earlier.
  • For malaria requirements again visit your GP, practice nurse or pharmacist who will help you sort out your required medication.
  • Obtain a first aid kit and any medication you might need - including enough prescription medication for the trip.
  • Read up about your chosen destination to learn about the culture, laws and customs.
  • Check that your passport is valid and does not expire before you return.
  • Check on visa requirements for your chosen destination.

What is a DVT?

A Deep Vein Thrombosis (DVT) is a clotting of the blood in any of the deep veins - usually in the calf. If a clot develops, you will feel an intense pain in the affected calf. You should seek medical attention immediately if this occurs, especially after a long journey.

What are the symptoms of a DVT?

A DVT can occur some days or even weeks after a trip. In most situations you may not have any symptoms.
If the clot is large it can cause an obstruction and prevent the blood flowing through the veins. When this happens you might experience pain, redness and swelling in the calf – this pain is made worse when walking or standing. If these symptoms are experienced you should seek medical help immediately.

Complications can occur if the clot breaks off and travels to the lungs, blocking the flow of blood. Breathlessness and chest pain can occur hours or days after the clot formation in the calf. This is a potentially fatal condition and urgent medical attention is required.

Who is at risk of a DVT?

Not moving for long periods of time can increase the risk of DVT. The following factors can also add to your risk of developing a DVT:

  • Travel for more than 3 hours in the four weeks before and after surgery
  • A personal or family history of DVT
  • Recent surgery or leg surgery
  • Existing clotting abnormality
  • Obesity (BMI of above 30)
  • Hormones or the oral contraceptive pill
  • Inflammatory bowel disease
  • Varicose veins
  • Pregnancy
  • Existing cardiac problems or a history of cardiac problems or stroke
  • Dehydration
  • Aged over 60

How can I reduce my risk?

Those in a high-risk category should see their doctor or pharmacist before they travel and discuss prevention.
Those at risk should try to exercise at least every hour on long journeys. Exercise the calf muscles by rotating your ankles. Correctly fitting anti-thrombosis stockings/socks increase blood flow, therefore lowering the risk of DVT. These special stocking/socks should be worn on all forms of travel when a passenger is sitting still for a long period of time. See your pharmacist for advice.

What do I do about any medication?

Due to restrictions on many flights across the globe those travelling with existing medical conditions need to be aware of these restrictions when travelling with medication.

  • Travellers should be discouraged from taking medication onto flights unless it is for the immediate journey and an allowance of time at the other end to pick up your baggage (allow at least 4 hours).
  • It also recommends that all extra supplies of medication for your arrival should be placed in the hold luggage.
  • Any powder/inhalers or tablets can be carried in the hand luggage - up to 50 grams
  • Any liquids, creams or gel medications which are essential for the flight may also be carried in the hand luggage as long as they are smaller than 50ml
  • If an adult is travelling with a young child and wants to carry non-prescription medication onto the flight they will need to taste the child’s medication

As well as trying to follow these guidelines it is a good idea to carry a copy of your prescription or a letter from your doctor stating the amounts and types of medication verified for your use, including any essential non-prescription medication.

Is there any special Advice for Travelling with Insulin?

If you are a diabetic you should first try to get an exemption certificate from the airline you are travelling with – for this you will need to get a letter from your doctor stating your need for insulin.

What is jet-lag?

The world is divided into 24 time zones. Jet lag happens when you cross over a number of time zones and disrupt the body's normal 'biological clock'. When you cross time zones, you arrive hours ahead or behind the time in the country you fly from. The body has to adjust to new times of light, darkness and meals and often to differences in temperature.

Your internal body clock controls when you are sleepy and when you are alert, as well as hunger, digestion, bowel habits, urine production and body temperature. This 'biological clock' is normally synchronised with your local time so that you feel hungry in the morning and sleepy in the evening. When you travel across time zones, the body needs time to adjust.

What are the symptoms of jet-lag?

Symptoms of jet lag vary from person to person and depend on the distance travelled and number of time zones crossed. Symptoms you may experience include:

  • Disturbed sleep patterns; feeling sleepy during the day, but not able to sleep at night
  • Disrupted digestion and bowel habits
  • Feeling disorientated and/or clumsy
  • Loss of appetite
  • Fatigue
  • Lack of concentration/feeling less alert
  • Memory problems
  • Cold or flu-like symptoms
  • Feeling weak and light-headed
  • Lack of energy

It takes about one day to recover for each time zone you cross and can take up to a week to fully adjust.

How can I prevent jet lag?

Before you fly try to get plenty of sleep in the days before you travel. During your flight try to:

  • Adapt to local time as soon as you get on the flight by changing your watch
  • Take things easy in the first few days
  • If possible, break up long journeys with a stopover
  • Avoid overeating and drinking alcohol on the flight
  • Eat at the same meal times as your destination
  • Drink plenty of water on the flight (and before and after)
  • Try and do some light exercise on your flight and during your trip
  • Try to sleep or nap on the plane. This is especially important if it is going to be daytime when you arrive at your destination

When you arrive:

  • Get into a routine immediately
  • Allow yourself time to adjust when you arrive
  • Get some exercise every day
  • Drink plenty of fluids
  • Take oral re-hydration sachets to ease dehydration

Sleeping:

Avoid sleeping until bedtime; do not nap during the day, as it will not help you adjust to the local time. Do not drink caffeine or alcohol. Do not eat a heavy meal before going to sleep (but do not go to bed hungry). A relaxing bath can help you feel sleepy before bed.

Meals:

Eat your meals at the correct times for the new time zone. Have meals containing protein for breakfast and lunch to keep you alert and have a meal containing carbohydrates for dinner to help you sleep.

What are the risks of the sun?

As well as giving you painful sunburn, too much sun can age your skin and increase your risk of getting skin cancer. Remember, the sun is extremely strong in many holiday destinations - don't underestimate its power.

  • Protect your eyes by wearing sunglasses with proper UV filters
  • Try to follow this SunSmart code:
  • Stay in the shade between 11am and 3pm
  • Make sure you never burn
  • Always cover up
  • Remember to take extra care with children
  • Then use factor 15+ sunscreen
  • Babies should never be exposed to direct sunlight
  • Another risk is heatstroke or sunstroke. Don't do anything too energetic during the hottest part of the day, usually between 11am and 3pm, and make sure you drink lots of non-alcoholic liquids.

What about insect bites?

Stings and bites from insects are common. They often result in pain, redness, itching and swelling in the affected area. The skin may be broken and become infected if the bite area is scratched. If the bite appears infected (redness with or without pus, warmth, fever, or a red streak that spreads toward the body), see a doctor.

How should I treat insect bites or stings?

Treatment depends on the type of reaction. If there is only redness and pain at the site of the bite, application of ice is adequate treatment. Clean the area with soap and water to remove contaminated particles left behind by some insects (such as mosquitoes). Try not to scratch the area because this may cause the skin to break and an infection may develop. You may treat itching at the site of the bite with an over-the-counter antihistamine. Speak to your pharmacist for more information.

How can I prevent insect bites and stings?

You can minimise your exposure to insect bites:

  • Avoid outdoor activity during dawn and dusk as insects are more active then
  • Wear long-sleeved shirts, long trousers, and hats to minimise the areas of exposed skin. Shirts should be tucked in
  • Use insect repellents. Repellents applied to clothing, shoes, tents, mosquito nets and other gear will enhance protection

What are common symptoms of travellers' diarrhoea?

Most cases of travellers’ diarrhoea begins abruptly. The illness usually results in increased frequency, volume and weight of stool. Other common symptoms you may get are nausea, vomiting, stomach cramps, bloating, fever. In most cases, travellers’ diarrhoea clears up in 1-2 days without treatment.

How can I prevent travellers' diarrhoea?

  • Avoid eating foods or drinking beverages purchased from street vendors or other establishments where unhygienic conditions are present
  • Avoid eating raw or undercooked meat and seafood
  • Avoid eating raw fruits (e.g., oranges, bananas, avocados) and vegetables unless the traveller peels them
  • Avoid tap water, ice, unpasteurised milk and dairy products
  • Safe beverages include bottled carbonated beverages, hot tea or coffee, beer, wine and boiled water

What complications could I get with travellers' diarrhoea?

Because you lose vital fluids, salts and minerals during a bout with traveller's diarrhoea, you may become dehydrated. Children are especially vulnerable to dehydration and it can be severe. An oral rehydration solution is the best way to replace lost fluids. These solutions contain water and salts in specific proportions to replenish both fluids and electrolytes. They also contain glucose or another carbohydrate such as rice powder to enhance absorption in the intestinal tract. Ask your pharmacist to recommend a suitable product.

   
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