If you are planning to go away;
It is important to prepare your trip well in advance. Here are some general guidelines for getting ready. Source your first aid kit. We stock ideal holiday first aid kits that contain all the essentials you may require. Organise your medication. Do you have enough Prescription Medication to travel? Please speak to any of our staff and we can organise your prescription to ensure you have enough medication whilst on your travels.
DVT - Deep Vein Thrombosis
Travel related DVT is an added potential problem for 'at risk' travellers who are immobile for extended periods of time. While the problem is often associated with air travel, the risk is equally reported among those travelling by car, coach and train.
What is Travel Related 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, it usually makes its presence known by an intense pain in the affected calf. Medical attention should be sought immediately if this occurs, especially after a long journey. In some cases this can be fatal, if the clot breaks off and makes its way to the lungs where it can then affect the lung's ability to take in oxygen.
What are the symptoms?
A DVT can occur some days or even weeks after a trip. In most situations the person will have no symptoms and through normal movement the clot will break up. If the clot is large it can cause an obstruction and prevent the blood flowing through the veins. When this happens a person 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.
Who is at risk?
• Most cases have at least 3 predisposing risk factors :
• Travel for more than 3 hours
• A personal or family history of DVT
• Active cancer or cancer treatment
• Recent surgery or leg surgery
• Existing clotting abnormality
• Obesity (BMI of above 30)
• Chronic or acute medical illnesses
• Hormones or the oral contraceptive pill
• Inflammatory bowel disease
• Varicose veins Pregnancy or 2 months post-partum
• Existing Cardiac problems or a history of cardiac problems or stroke
• Dehydration Severe infection
• Aged over 60
How can I reduce my risk?
Those at risk should try to exercise at least every hour on long journeys. Exercise the calf muscles by rotating your ankles, or making use of the commercially available exercise equipment. Good hosiery will encourage circulation. However it is important that you do not wear clothing that will cause a restriction of circulation. Any hosiery should be measured properly to ensure a suitable fit. For long flights wear loose clothing. In the dry environment of a plane, it is a well-documented fact that too much alcohol, tea and coffee on flights can add to the problem of dehydration. It is therefore very important to remain hydrated during a long flight by drinking plenty of water and fruit juices.
In-Flight Stockings and DVT Socks
Research has shown that correctly fitting anti-thrombosis stockings or DVT socks increase blood flow, thus lowering the risk of DVT in those at risk. Advice related to stocking/socks should apply to all forms of travel when a passenger is sitting still for a long period of time.
Before buying any products it is essential that you assess your personal risk factors and speak to any of our staff for clarification. It is important that any DVT stocking/sock purchased be fitted properly by a professional. A stocking that is too tight and worn by a traveller with existing circulation problems can do more harm than good.
Malaria And Immunisations
It is important to seek advice if you are travelling to a malarious destination. Contact us at least 6-10 weeks before you leave to check on Immunisation and Malaria requirements. You can either drop into one of our branches or complete an enquiry form below and we will provide you with all the information you require. This information is also available form your GP and Practice nurse. Most deaths occur in those who take antimalarials irregularly or not at all, and if taken correctly Malaria can be prevented. Not all antimalarials are the same when it comes to side effects, duration of course and cost, so it important to seek advice. Prevention is better than cure so all travellers to malarious areas should take personal protection measures to prevent or avoid mosquito bites:
Try and keep their skin covered up particularly between sunset and sunrise.
Use an insect repellent on clothes and any exposed skin. If sleeping in an unscreened room a mosquito net [which should be impregnated with insecticide] is a sensible precaution. Air conditioning does help keep the mosquitoes away due to the lower temperature.
Travelling with Medication
Due to restrictions on many flights across the globe those travelling with existing medical conditions need to be aware of restrictions when travelling with medication. Some airlines now restrict the amount of hand luggage allowed on flights, it is essential to check with your individual airline prior to flying. The Chief Medical Officer in the UK has issued a procedure for those taking medication on flights (DOH 2006).It states that 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 luggage you check in. 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 (such as a GTN spray) If the amount is larger than 50mls you must make sure it can be tested before getting on the flight – in order to test the medication you will be asked to taste it – the airports have been advised to have plastic cups available for this procedure! 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 long as they are not allergic to it!) 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.
It is important to think through your trip. Research your destination carefully and think through the practicalities of how long you plan to be away, and what kind of activities you plan to take part in - will you be more or less active than you normally are at home? What about food, do you easily adapt to other foods or will you have a hard time finding something you like to eat?
Visit your GP or diabetic advisor in good time to sort out your supplies and equipment - A letter from your GP confirming you are a diabetic, and why you have needles in your possession, would be a good idea! Make sure you get a prescription for your medication, enough for the trip and a bit more. Purchasing a diabetic identity bracelet gives some travellers the piece of mind they need when travelling, as does having medications listed for emergency situations. Immunisations and anti-malaria medication are usually safe for the diabetic, and should be discussed with your doctor. When you travel by air it is not always necessary to order "diabetic meals". Check your carbohydrate intake regularly and, if required, top-up with snacks on the journey.If you are travelling into unknown territories, take plenty of snacks, especially if you are backpacking and are unsure of your final destination details. The journey might take longer than you planned, and the McDonalds you thought would be on every corner, might not be there!
Special Advice for Travel with Insulin
If you are a insulin dependent diabetic you should first try to get an exemption certificate from the airline you are traveling with – for this you will need to get a letter from your doctor stating your need for insulin. If this is not possible there is advice that has been issued by Novo Nordisk an Australian company and leading manufacturer of Insulin. While it has been written for those traveling from the Australia to the UK and USA it is good advice explaining how to pack insulin when it needs to go into the hold luggage as well as what to look out for to prevent it freezing.
When travelling by air don't be afraid to ask a flight attendant for more food or a slice of bread if you need it. When you are about to eat on a flight, don't take your insulin until you see the food coming down the isle - all kinds of things can cause a hold up or delay in it getting to you!
Always keep your insulin with you at all times. Insulin should always be carried in your hand luggage, out of direct sunlight or freezing conditions - such as an aeroplane hold!
If your insulin comes in U-100 check the conversion rate in countries where it comes in U-40 or U-80. It will be essential in this situation to get new syringes to avoid dosage mistakes.
Travel to tropical regions of the world will require you keeping the insulin in a cold pack, or in a cool place, maybe next to a cold water bottle.
Heat will affect the rate at which insulin is absorbed. In the heat, insulin is absorbed quicker. It is therefore important to monitor your levels in hot weather and adjust your diet as required. In a cold climate insulin is absorbed slower. Also if you find yourself cold and shivering it is possible to use up energy and lower your blood sugar levels. Monitor your blood sugar levels in extreme conditions and never let your insulin freeze. Adjust your insulin times when you reach your destination - you will have already discussed this with your diabetic adviser but just to remind you: When travelling WEST lengthen the gap between insulin doses or add extra food with an extra dose until adjusted.
When travelling EAST shorten the gap and reduce dosages.
Always check your blood sugar at regular intervals when you cross time zones, as you might need to adjust your dosages. Remember perfect control might not be possible in the first few days, but keep working at it.
The link below gives advice that has been issued by Novo Nordisk an Australian company and leading manufacturer of Insulin. While it has been written for those traveling from the Australia to the UK and USA it is good advice explaining how to pack insulin when it needs to go into the hold luggage as well as what to look out for to prevent it freezing.
Further advice is available from Diabetes UK .
Travelling with Asthma
Ensure you have enough medication for your trip. Speak to any of our staff and they will be able to organise further supplies form your GP surgery if you require so. Have your GP to write a letter confirming that you are an asthmatic. A letter from your GP, listing your medication, will help in an emergency. Also discuss with your asthma specialist a plan of action for you to follow should your asthma become more severe while you are away. You will need a record of which medication you need to take and when it is advisable to seek medical advice. Your medication should be suitable for the worst attack you have ever had. Carry your inhalers with you at all times and keep a spare one in your hotel room or accommodation. If you feel unwell, take regular peak flow readings and compare this to your normal rate. It is important that you seek medical attention if your condition deteriorates while you are away. Do some research into the location you are travelling to regarding pollution in the area; pollution in some cities around the world can easily initiate an asthma attack. Look into the availability of English speaking doctors in the area, should you need to seek medical attention
The desire to dip into cool water after a busy day can be enticing to anyone. Along with abiding by normal diving rules, asthmatics should not dive for 48 hours after a wheezing attack, however mild that attack might be.
Asthma can be unpredictable when travelling to a high altitude - some people away from the allergens and dust find they have no problems, while others find their asthma is worse in the cold, dry air. Acute Mountain Sickness (AMS) can affect anyone travelling to a high altitude (above 3000 meters) and holds no extra risk to the controlled asthmatic. However, an asthma attack as well as AMS will greatly increase the risks involved. You should carry inhalers with you at all times, however 'mild' you may consider your condition.
If you are aware of certain allergies, such as feathers in pillows, inform your hotel ahead of time so that your accommodation can be prepared in advance. If you are known to also develop serious reactions to insect bites, stings or nuts, discuss with your doctor the possibility of taking an Epipen with you along with a letter explaining its use for medical emergencies.
Travelling with Specific Needs
If you have a physical disability, travel can often be pushed aside for fear of often not knowing where to turn if you need help. As soon as you are aware of a trip, make an appointment to visit your GP or Specialist Nurse for a check up and to discuss the details of your trip.
Visit your GP or specialist nurse as soon as you can to get repeat prescriptions – get enough for the trip and a bit extra. To make it easier when you go through customs, get your GP to write a letter if you need to carry equipment or needles with you.
Malaria and Vaccinations
Disabilities do not stop you taking malaria medication or having vaccinations if they are recommended for your destination, unless you have contra-indications to them. Sort these out with your Travel Health Specialist as soon as possible.
Plan ahead - inform the airline or travel operators of your needs. They are used to providing special chairs, seats or meals, so do not feel you are 'putting them out' - it is their job to help you and make your trip as safe and comfortable as possible. Choose your method of transport with care, and when flying, go with the most direct route so that you are not left trying to change flights at numerous locations around the world. Discuss with the airline if you will need any assistance. Look into international organisations that can help with your particular needs. A search of the Internet can bring up all kinds of organisations -- there is even an organisation dedicated to providing a dialysis network in certain countries. Choose good insurance with a company that is aware of your condition. If you are travelling with a companion, make sure they are aware of their role in helping you prior to leaving. If you have a hearing disability, inform the flight attendant so that alternative safety instructions can be given to you.
When you return home, see your GP for a medical check up, especially if you have been ill while away.