Category: advice

Check your Weight

The number of overweight males in the United Kingdom has continued to rise over the last 20 years, and you are at risk of health problems if you are overweight. Discuss with your Doctor what would be a suitable weight and, if required, make an effort to reduce your weight slowly.

When travelling, try to eat at regular meal times in your destination country. Avoid grabbing snacks inbetween meals. Eating a good breakfast at local time will set you up for the day and help avoid the eleven o’clock hunger pangs.

If the food is self-service, just cut down on your portions. Eating a little less food over a period of time will eventually reap rewards.

Check your Alcohol Consumption

Recognise that in many ways, alcohol is a drug and should be treated with respect. A weekly limit of alcohol should not go above 28 units, although a healthy limit should remain below 21 units per week. This amounts to about 3 glasses of wine or 2 pints of beer each day. Too much alcohol can have an adverse effect on your health — as well as causing impotence and a lower sex drive, it can cause damage to the liver, brain and heart muscle.

Alcohol can have a positive effect and has been seen to help reduce cholesterol levels when used in moderation. Red wine has been shown to have benefits when drunk with a meal.

In a study looking at alcohol related accidents abroad, it was noted that more accidents are caused by drunken pedestrians than drivers — if you must drink while you are away, make sure you have booked a reputable taxi company to pick you up and return you to your hotel afterwards.

Check how much you are smoking

If you smoke, you will be well aware of your increased risk of heart disease, lung cancer, respiratory disorders and general health. “No smoking” on most flights now gives the smoker an excellent excuse to give up.

If you do want to give up smoking, discuss this with your doctor and make sure you get full support and medication as an option. If you continue to smoke and this is making you unbearable to travel with, get advice from your Doctor. Many incidences of air rage are a direct result of people being stressed, as they are unable to smoke on long flights.

  

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Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Safety and Security

While sexual equality has meant that women are gain to the same rights as the male in the West, sadly this is not the same in all the countries of the world. Personal research into the area you are going to is essential, especially when travelling to Eastern cultures. It is important that you observe the culture around you, observing how the other women dress and behave, especially if you are planning on staying for a longer period of time.

For the woman travelling alone, a pair of dark sunglasses in some countries will not go amiss. Avoid eye contact with strangers, especially when travelling alone on public transport. Never behave in a way that will attract unwanted members of the opposite sex and beware of the clothing customs in the country you are visiting.

When travelling alone, always leave a schedule with someone at home and check in at prearranged times. When planning what to take with you on a trip, it is advisable to leave behind any expensive jewellery or objects and clothing that will draw attention to yourself.

Personal Health Issues

Remember that travelling can disrupt a normal menstrual cycle. The stress of preparation and tiredness that comes with jet lag and other issues surrounding the trip, can mean that your periods could be late or, in some circumstances, stop altogether. If you are worried that you are late and there is a risk of pregnancy, it is best to do a test. However if there is no risk of this, it could be considered a side effect of travel.

Some women, especially when travelling to the far corners of the globe, prefer to suppress their periods for the time they are away. This is possible to do if you are on certain kinds of pill or wanting to use them for your trip. In each situation, you should discuss the issue with your Family Planning expert or TravelHealth Specialist. This would also be a good time to check that you are up to date with your smear test.

If you are planning on having a period while you are away and are travelling outside of the Western World, it would be wise to take supplies with you. If travelling to remote areas where disposal could be a problem, a supply of small disposable bags and a tub of baby wipes should get you through.

Some women suffer from bladder problems, especially after having children, and are thus tempted not to drink too much when travelling. It is important in a hot climate to drink plenty of non-alcoholic fluid to avoid dehydration.

Urine infections and thrush are common among women travelling, especially when taking certain kinds of malaria tablets. If you suffer on a regular basis at home, ask your doctor if you can take some medication with you, along with a tube of canesten or your regular thrush treatment pack

In the relaxed environment of a far off country, the issues of contraception might come up — pre-plan and think ahead. If you are likely to have casual sex, always carry kite mark condoms with you in your purse, even if you are on the pill. If you are taking the oral contraceptive pill along with Doxycycline for more than 2 weeks, discuss your contraception with your regular Family Planning Specialist. Remember that traveller’s diarrhoea can interrupt the absorption of the pill, thus leaving you with an inadequate level of protection. If this is the case, a barrier method should be used as well. Discuss this with your Travel Health Specialist or Family Planning clinic before you go.

When crossing time zones, plan ahead when to take your oral contraceptive pill, keeping in mind that a break of more than 24 hours between doses will lead to inadequate protection and the possibility of breakthrough bleeding.

In today’s society the female traveller has a whole host of opportunities before her and should not be deterred from scaling the highest peaks. With good pre-planning and careful thought it can be a rewarding experience, as well as a safe one.

 

Vaccinations

Consult your doctor or TravelHealth Advisor several weeks before you leave. It is important to discuss every aspect of your trip, such as where you are going, for how long and how you plan to travel. Vaccinations may be required to help prevent infections during your holiday. In addition to routine holiday vaccinations, you might need to have a flu vaccination, especially if you are going on a cruise. Your doctor will be able to order flu vaccine at any time of the year.

Medications

Make sure that your GP or TravelHealth Practitioner is aware of any medication you take before they prescribe vaccinations for your trip. Reactions may cause reduced effectiveness or even serious side effects. If you visit an independent Travel Clinic for malaria tablets, remember that they will not have a copy of your existing medical history, so take along with you a list of your medication.

If you regularly take medication, make sure you take enough to last you until after you return from your trip — and be prepared for any delays. Also write down all medication you take and keep this information on your person in case of emergency.

Malaria tablets may be required for some destinations. Consult your General Practitioner especially if you are already on regular medication.

Always carry your medication in your hand luggage, and ask your GP to write a letter explaining the nature of your medication. If you are travelling to Asia, check with the embassy of the country you are visiting for regulations on bringing medication into the country.

Special Arrangements

If you have a pre-existing illness or disability, you may need to make special arrangements for travel or accommodation. Contact your tour operator and hotel to discuss your requirements and make sure that they have the facilities you need to travel in comfort.

If you need to keep medications cool, ask your travel agent for a room with a fridge. Make provision to keep your medication cool during the journey. It is important that you follow the instructions you received with your medication, as temperature may affect how well the medicine works.

If your medication requires to be taken at regular intervals, it may be worth getting some specific advice. Unusual increase in regular activity can change the rate at which some medications are absorbed. It is also important to allow for delays and different time zones when calculating your schedule. Your practice nurse can assist you with this.

Insurance

Check that the insurance offered by your travel company covers your requirements — you may need to take out additional insurance if the cover is not sufficient. Be thorough when completing the forms, as failure to declare a health problem may invalidate your insurance.

If you are travelling in Europe, be sure to complete form EHIC, available from your post office. This will need to be validated by your post office before you leave.

Arriving at your Destination

Make yourself familiar with the medical facilities of your chosen destination. Make sure you know the emergency numbers for your locality and know where to get help if you get into trouble.

Safety rules for food and drink are very important — ensure that you are aware of the precautions you need to take to eat and drink safely.

Ensure that you drink adequate amounts of non-alcoholic fluid to prevent dehydration.

Insect bites and minor cuts and grazes may take longer to heal in a hot climate. Take a small first aid kit to ensure you can keep a wound clean and dry whilst away. Seek medical advice if you are concerned.

Diarrhoea is a problem for many travellers. This is of particular concern for the mature traveller, and you may need specialist advice. Discuss what action you should take in the event of the onset of diarrhoea with your Doctor or TravelHealth Advisor.

Returning Home

It may be appropriate to have a health check with your Doctor or Practice Nurse. This becomes important if you have been ill whilst on holiday — repeat or additional medications might be needed to treat illness acquired abroad.

It is also important to take it easy and rest after your trip. Travelling can be stressful and you may require time to readjust to being home.

Useful Contact Addresses

Royal Association for Disability and Rehabilitation

12 City Forum, 250 City Rd, London EC1V 8AF.

Tel: 020 7250 3222.

Provide leaflets and booklets specifically for those with a disability. They also produce travel guides for the UK and beyond. A telephone help line is also available to address individual travel questions.

Diabetes UK

110 Queen Ann St, London W1M 0BD.

Tel: 020 7323 1531.

Provide leaflets and booklets that may be of value to the diabetic traveller. A telephone help line gives individual advice to anyone with questions regarding travel and their diabetic care.

Age Concern

Freepost, Ashburton, Devon TQ13 7ZZ.

Tel: 0800 00 99 66.

Produce leaflets covering many areas of interest to travellers over 50, those more specific to travel are fact sheet 4 and fact sheet 26. The fact sheets are free and comprehensive. A telephone help line is also available.

Age Concern Travel Insurance

Telephone: 0845 601 2234

Age Concern provides travel insurance cover without any age limitations. They are also able to provide cover for travellers with pre-existing conditions

British Heart Foundation

14 Fitzharding St, London, W1H 4DH.

Tel: 020 7935 0185.

Produce a fact sheet that addresses air travel following heart attack or surgery. A telephone help line is also available.

 

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Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

• Think through your trip before you go to anticipate every eventuality and be prepared!
• Think ahead of your child to prevent accidents – many countries do not have the same health and safety regulations you have at home.
• Take medication with you if you are unfamiliar with local medicines – child paracetamol, rehydration fluid, travel sickness medicine etc.
• Also take a copy of your repeat prescription if your child is on any medication should you need more medication while away, play safe and get enough from you Doctor before you leave.
• When travelling across time zones try to get your child adjusted as quickly as possible to the time with plenty of fresh air and meals at local times on arrival.

  

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Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

While most parents will agree that is impossible to have a totally stress free holiday with young children – being organised can help alleviate some of the stress…

Planning Ahead

Plan all necessary travel vaccinations for the trip well in advance to avoid stress, making sure that all childhood vaccinations are up to date prior to leaving.

Try to avoid taking young children to malarious areas while they are very young as some malaria medication is unsuitable for young children. Discuss this with your doctor if your trip is unavoidable.

The Journey

Plan ahead — think through your child’s normal schedule and try to keep to it if possible while you are travelling. This means feeding at their normal time, naps and other activities. Get your child into a daily routine AFTER arriving at your chosen destination – not during the trip.

Plan for travel sickness — bags, medication from your pharmacist or Doctor and a change of clothing. Some medications for children contain sedative properties – a good idea for a very long journey.

Keep everything your child needs for the trip in your hand luggage — no special toys in the suitcase!

During the trip give children activities at sensible intervals — not all the toys at once. Spread the entertainment out so you don’t run out of ideas after the first hour! Carry plenty of food and drink for the journey – sensible light snack food is good – hungry children don’t travel well.

Arriving at your Destination

Think ahead of your child to prevent accidents – many countries do not have the same health and safety regulations you have at home.

Take medication with you if you are unfamiliar with local medicines – child paracetamol, rehydration fluid, travel sickness medicine etc.

Also take a copy of your repeat prescription if your child is on any medication, should you need more medication while away. Play safe and get enough from you Doctor before you leave.

When travelling across time zones, try to get your child adjusted as quickly as possible to the time with plenty of fresh air and meals at local times on arrival.

Lower your expectations – remember this is a holiday and you need to have fun too!

  

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Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Going on a Gap Year? Whether you are planning to travel the world for fun, or intending to work as a volunteer as part of an Aid Agency, you will need to take careful precautions to ensure your continuing health and safety.

Vaccinations

Check your vaccination requirements at least 6 months prior to your trip. Make sure routine vaccinations are up to date, and check with your doctor or TravelHealth advisor on specific vaccination recommendations for the places you are visiting. If your trip is last minute, you should still visit your doctor, pharmacist or TravelHealth advisor as soon as possible.

Medical Check-ups

Visit your health care professional for a medical check up before leaving for your Gap Year. Some organisations will require this for acceptance onto their programme. Ensure that you are in good health before you go, and also get a dental check-up. This will reduce the possibility of having to receive emergency treatment abroad.

Insurance

Organise adequate insurance that will cover medical expenses AND the cost of repatriation back to the UK if necessary. Know your blood group. The Blood Care Foundation can organise emergency blood if the situation should arise that you require a blood transfusion.

Plan your Itinerary

Plan ahead and always let someone know your intended travel plans. Familiarise yourself with the customs and religious practices of the countries you are intending to visit. This can help to avoid offending the local inhabitants, in addition to making your stay much more enjoyable. Always check the political situation in each of the areas you are intending to visit — before you go.

Staying Healthy

Take heed of local and reliable advice concerning which food is safe to eat and which places are safe to visit. Wash your hands frequently with soap and clean water. Drink only bottled or boiled water, or carbonated drinks in cans or bottles. Avoid tap water, fountain drinks and ice cubes. Eat only thoroughly cooked food or fruits and vegetables you have peeled yourself. Remember: boil it, cook it, peel it or leave it. Do not eat food purchased from street vendors. Do not eat dairy products, unless you know they have been pasteurised.

To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot. Also keep groin areas clean and dry, as this area is also prone to fungal infections in hot climates. Always use condoms to reduce the risk of HIV and other STD’s. Consider all sexual partners as a potential risk of the HIV virus.

Malaria

If you will be visiting an area where there is a risk for malaria, take your malaria prevention medication before, during and after travel, as directed. Protect yourself from insects by remaining in well-screened areas, using repellents (applied sparingly at 4 hourly minimum intervals) and insect repellent impregnated mosquito nets, and wearing long-sleeved shirts and long trousers from dusk to dawn.

On Return Home

If you have visited an area where there is the risk of malaria, you must continue taking your malaria medication for the time suggested by your doctor — this varies with different types of medication. If you become ill with a fever — anything up to 1 year after your return — you must tell your health care professional that you have travelled to a malarious country.

Vaccinations

Check your vaccination requirements at least 6 months prior to your trip. Make sure routine vaccinations are up to date, and check with your doctor or TravelHealth advisor on specific vaccination recommendations for the places you are visiting. If your trip is last minute, you should still visit your doctor or TravelHealth advisor as soon as possible.

General Health

Ensure that you are in good health before you leave. Get a dentist check up – this will lessen the risk of needing emergency treatment abroad. Keep a record of your blood group, and consider joining the Blood Care Foundation, should you require emergency blood while away.

Travel Supplies

Take a well-stocked first aid kit with you and, if required, enough prescription medication for the trip. Check out our pre-travel shopping list and note the essential items needed for your trip.

Prevention of Accidents

Accidents can happen anywhere and are the top reason for medical repatriation among travellers. Think ahead – always wear seat bets when travelling in cars, never drink and drive, take special care when swimming in unknown water and never swim alone.

Safety standards of balconies and electrical appliances might not be the same standards as at home. Accidents can increases the risk of HIV or Hepatitis B & C if you require a blood transfusion in a high-risk destination.

Malaria Risk

Check out your malaria risk prior to leaving for your trip. Get good advice from your doctor or travel health advisor. Make sure you understand about malaria, so you understand why you need to take precautions.

In the year 2000 – the United Kingdom saw 1,400 cases of malaria. No medication will offer 100% protection so it is vitally important that you also don’t get bitten in the first place – with good methods of bite prevention.

Sex Files

Sexually transmitted diseases such as gonorrhoea, chlamydia, Hepatitis B and HIV are easily contracted if precautions are not taken. Casual sexual behaviour abroad can increase the risk of contracting HIV by 300-fold.

If you do engage in sexual contact, always use a condom. Use the web to find local sexual health clinics at the first sign of any problems.

Travellers Diarrhoea

The more care you take with what you eat and drink, the lower your risk of getting travellers diarrhoea.

Take some anti-diarrhoeal medication with you. If you also develop a fever, have blood in your stool, or are unable to drink fluids, you should see a doctor as soon as possible.

Sun Care

As the Australians say – Slip, Slap, Slop – Slip on a shirt, Slap on a hat, and Slop on some sun cream.

The sun is strongest between 10.00 – 15.00hrs. During this time make the most of the shade. Reapply sun cream every 2 hours and always put insect repellents on top of sun cream.

Be Informed

Get yourself an e-mail box that can be picked up from a remote server such as hotmail account. Make use of the account to store essential health information, and keep in touch with those at home.

Take time to get acquainted with local customs, religious holidays and laws and the political situation before going – it might save you a lot of trouble in the long run! Always let others know of your itinerary and plan ahead. If you change course, write or e-mail home, so others are aware of your schedule.

 

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Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

The only sexually transmitted disease that is preventable by vaccination is Hepatitis B – see your Doctor or Nurse 3-6 months before you intend to travel for advice.

Abstinence or sex with a trustworthy, lifelong partner is a highly effective way of preventing sexually transmitted disease.

Extra strong condoms should always be used when having casual sex, they should be bought at home, before travelling, as in many countries local condoms can be destroyed by heat and are often of a poorer quality.

Couples who do not have any sexually transmitted diseases and no other sexual partners can not contract sexually transmitted diseases while on holiday.

If you have any unusual rash, discharge or soreness on return from your time abroad you should stop having sex and see your Doctor or local Genital Urinary Medicine (GUM) clinic Nurse immediately.

  

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Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

What is Traveller’s Diarrhoea?

Any food or water from an infected source can cause traveller’s diarrhoea. Symptoms of traveller’s diarrhoea usually begin about three to four days after arrival. It can continue for up to ten days after return. The risk of traveller’s diarrhoea is very much related to the destination, level of accommodation and travel habits of the traveller.

Those who only go to 5* hotels will be at a lower risk of traveller’s diarrhoea than those eating and living in local accommodation and restaurants. There is some evidence to suggest that those who travel frequently (at least every six months) to developing countries – do build up a limited defense against Traveller’s Diarrhoea. However, this is not a life long immunity.

How to Avoid Traveller’s Diarrhoea

While in some destinations traveller’s diarrhoea will be inevitable to the traveller, some steps can be taken towards prevention and it is important to understand how traveller’s diarrhoea is transmitted.

Make sure that meat eaten is well cooked. Avoid seafood and abide by the “cook it, boil it or peel it” rule when eating in local restaurants. Wash salads with a good source of clean water – in fact when eating out avoid salads at all costs in high-risk locations! Avoid any food that has been re-heated and left at room temperature.

Apply strict hygiene while away especially after using the bathroom and before you eat food – never use communal, damp towels in public conveniences! Use disposable paper towels, antibacterial wipes or hot air.

Care with water is essential and this includes ice in drinks at the bar. As well as drinking soft drinks from cans it is good practice in developing countries to use sealed, bottled water, not only for drinking, but also for cleaning teeth and washing fruit.

When swimming avoid swallowing water in swimming pools, lakes or the sea.

Self Treatment of Traveller’s Diarrhoea

The first rule when traveller’s diarrhoea attacks is to try to get some rest and drink plenty of clear fluids. It is important, especially in hot climates, that you do not become dehydrated.

If you feel like eating, good foods are bananas, salted crisps, rice or clear soups. Avoid alcohol at all costs. In most cases, traveller’s diarrhoea is self-limiting and with a little rest and rehydration you can be on your way again.

Taking an over-the-counter anti-diarrhoeal medication such as Loperamide will stop the diarrhoea, especially if you have an important meeting or flight to catch. While it is important not to take more than the recommended dose, some people can feel constipated after taking this medication.

The reason people may believe they are constipated is that Loperamide works by slowing down the movements of the gut and restoring natural balance. Therefore people may then not need to go to the toilet for a while afterwards until the gut movements have been restored to ‘normal’. It can take a while for food to reach the gut again (as most or all of the existing gut contents have been rapidly removed as diarrhoea).

This medication should not be taken if you are passing blood or have a history of bowel problems; in this instance you should discuss an alternative treatment with your doctor before you leave for your trip.

Antibiotics (such as Ciprofloxacin), as advised by your doctor, should be taken if the condition does not improve or worsens. Diarrhoea treatment packs can be purchased at most travel clinics and contain a single dose of antibiotic, which can be taken if a fever accompanies the problem.

For women taking the pill it is important to recognise that absorption of the pill can be affected by traveller’s diarrhoea. If this occurs always use alternative protection, such as condoms, as well as continuing with your normal oral contraceptive pill.

When to Get Medical Help

If after 24-48 hours the diarrhoea does not improve or worsens it is good to seek medical attention, as the diarrhoea could indicate other conditions. This should also be done if you suffer from a preexisting condition of the bowel or immune system, if you are passing blood or have a persistent temperature.

Traveller’s Diarrhoea in the Returning Traveller

The returning traveller can also suffer from diarrhoea and it is important that you seek medical attention if you suffer on return, as this could also indicate other diseases that would need to be investigated by your doctor.

  

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Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

• Boil any drinking water you are unsure about – or drink bottled water – but always ask to open the bottle yourself in restaurants, checking the seal is in place – if in doubt stick to carbonated water – and make sure it fizzes!
• Use bottled or boiled water for cleaning your teeth, don’t open your mouth and drink water in the shower.
• In developing countries order drinks without ice, avoid roadside food vendors selling ice cream and unwashed fruit.
• Eat early if you have a buffet that has been sitting out for long periods during the day — food kept warm under food lamps can be a source of infection.
• Avoid – unpasturized milk, shellfish, soft cheeses, lukewarm food and empty restaurants!
• Boil it, cook it, peel it or forget it….
• Apply strict hygiene while away especially after using the bathroom and before you eat food – never use communal, damp towels in public conveniences! Use disposable paper towels or hot air.
• If you get diarrhoea – drink plenty of clear, clean fluids. It might be helpful to take diarrhoea medication along with you with some rehydrating fluid.
• If it continues for more than 48 hours and you are unable to drink, or are passing blood – SEEK IMMEDIATE MEDICAL ATTENTION