Co-operative Healthcare’s Dr. Sean Answers Your Holiday Health Questions

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Although your hard earned holidays are a time to relax and do what you enjoy, things don’t always go to plan. We asked Co-operative Healthcare’s Doctor Sean Cummings to answer some of your to holiday healthcare questions to make sure that being poorly doesn’t spoil your well-deserved break.

1. Skiing and Altitude Sickness

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I’m going skiing for the first time this winter and I’ve heard that I might get altitude sickness. What are the symptoms and is there anything I can do to prevent it?

Altitude sickness develops typically after a few hours after arriving at an altitude of over 3000m. It’s unlikely as a first time skier that you would be spending any time at a height greater than this. Val d’Isère, a famous ski resort, is 3599 metres at its highest, but people can be become unwell with a generally mild form of the illness at between 1500 and 3000 metres. The likelihood of this is greater when exercising.

Altitude sickness can take many forms but is mostly a mixture of one or more of bad and persistent headache, confusion, unsteadiness and vomiting. Breathing problems may develop too and heart rate may go up. It is difficult to predict who might develop altitude sickness but some evidence suggests that younger people with a heavy build and who exercise at altitude are more at risk.

It can be prevented in the first place by slow acclimatisation over the course of a few days. If you are at a high altitude and you are skiing then almost certainly you will begin to descend within a short period which will help to relieve any symptoms you may have. Descending is the most effective treatment. Some people do use medications to help them, but these are mostly for very or extreme altitude experiences. Acetazolamide is one of the medicines we use to help. Click here for a very useful expert guide.

2. Travel Vaccines and Malaria Tablets

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I’ve found a great last minute holiday and travel in 6 weeks. Is this enough time to get any vaccines that I might need and to start a course of anti-malaria tablets?

You definitely have enough time to at least start your vaccinations before you go and to plan for a safe holiday – although man0079 destinations do not need vaccines or anti-malaria tablets.

Broadly, there are two types of anti-malarial tablets we recommend. These are doxycycline and malarone. Both have the advantage of you being able to take them at relatively short notice before you travel – so in your case, you definitely have enough time.

Basic vaccinations for travel include being up to date with diphtheria, polio and tetanus – these are always given in childhood in the UK and last a long time, so check with your GP because you may well not need these ones. Measles is a common problem in developing countries and so it is worth checking that you had your MMR vaccine in childhood. Common extra vaccines include cholera which is commonly given as an oral version, Dukoral. This has the great advantage of preventing toxigenic E.Coli infections too. We do recommend you consider a hepatitis A vaccination along with typhoid where necessary. There is a great NHS website which gives straightforward and easy to understand information on health when travelling which you can click here to read.

3. Travellers Tummy

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I’m travelling abroad for the very first time and have heard that it’s really common to get ‘travellers tummy.’ I want to enjoy my first trip outside the UK, what can I do to make sure I don’t get ill?

Whilst there’s no guarantee that you won’t be ill on your holiday, there are a few steps you can take to protect yourself. Most diarrhoeal illnesses come from poor hygiene – either on the part of the traveller or the restaurant or bar preparing the food and drinks. Basic steps include good personal hygiene such as making sure you wash your hands with soap and running water after using the toilet, and always before eating. Try not to touch the toilet door handle but use a tissue and dispose of it. If hand washing might be difficult, then remember that anti-bacterial hand gels and wipes are good substitutes. There is an alcohol free hand sanitiser in convenient snap open sachets called Sanisnaps which will protect your hands for up to 8 hours. In developing countries, always drink bottled water from a bottle with an intact seal, never have ice in your drinks and always use bottled or boiled cooled water for brushing your teeth. Be cautious buying food from street stalls – especially things like smoothies. Carefully consider things like unpasteurised cheeses, seafood and salads as these may contain bacteria, viruses or parasites. Fish which is “off” can sometimes cause a reaction called scombroid, which often looks like an allergy. The cholera vaccine Dukoral, which is taken as a small drink, will protect against toxigenic E Coli as well as cholera, so is well worth considering before travel especially to exotic areas.

Finally, some travellers like the added protection of taking a reserve supply of antibiotics, so if they do develop a travel spoiling diarrhoeal illness, they can try and nip it in the bud.

4. Travel Sickness

onlinedoctor5We’re looking forward to every part of our UK summer holiday in Scotland, apart from the long drive up there as my daughter suffers with travel sickness. Are there any anti-sickness medicines that you can recommend for a 5 year old?

Travel sickness is a common problem which seems to occur because of a mismatch between what you can see and what your body tells you is happening via your balance mechanism in the inner ear. Treating children is more difficult than in adults because some medicines are just not suitable at young ages. There are some simple measures you can use though to ease things. Try and encourage her to look outside the car – having a fixed point to look at allows the balance mechanism to stabilise. Try and discourage reading, playing with the iPad etc because that will cause conflict between her motion sensors and her eyes. Take frequent breaks and make sure she is well hydrated. Finally, if things really don’t settle, then you could consider using Piriton for children – although you should go and see your GP to discuss this before treating her.

5. Pregnancy and Blood Clots

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I’m 20 weeks pregnant and flying to Gran Canaria in a couple of weeks’ time. One of my friends said I should wear flight socks – are they necessary and what do they do?

Blood clots in the legs after long flights are fairly common and pregnancy can sometimes increase that risk a little further. The later you are in your pregnancy, the chances increase further. The risk will increase depending on how long the flight is and also how cramped you are. Flights to Gran Canaria are typically around 4 hours or so. Some people have a genetic predisposition which can make the likelihood of clotting even greater, so if other people in your family have had blood clots, then it may be worth asking your GP to screen you with a simple blood test. Smoking will also increase the risk of clotting.

Flight socks may reduce the risk of clotting a little – they work by compressing the veins of the leg aiding return of blood and helping make sure the blood is not standing still for too long. More importantly, though, is to make sure that you get up and walk up and down the aisle a few times to make sure you stretch your legs. Make sure you have a lot of water on board to keep well hydrated – it will also remind you to get up and walk to the loo.

Finally, if you were to develop pain in the lower legs, swelling of the calf or ankle or unexplained breathlessness, then you should see a doctor as soon as possible.

Don’t forget that the Online Doctor and Co-operative Healthcare are available for all of your travel healthcare needs at https://www.co-operativeonlinedoctor.co.uk/ or in a local store.

Published 8th December 2016

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