Cape Town - School holidays creep up on you without warning. Before you know it you are packing to leave on a family holiday and feel out of your depth.
This time of possible pleasure and relaxation can turn into a nightmare when a lack of foresight and planning leads to tension on the trip.
When medical matters arise, soon everyone joins in, accusing, blaming and complaining about whose responsibility it actually was to sort out the medical kits and medications.
Keeping your family healthy while travelling is all in the planning, and here are some key things to consider and act on before leaving home.
The destination
Know the terrain with its risks and local health issues. In this way you can plan effective vaccination schedules, clothing and all interventions to minimise risks of injury or illness. Double check that you are up to date with routine ones. Don’t leave this to the last minute as certain drugs – for example, antimalarials – may need to be started at least two weeks prior to travelling. Also remember that for certain visas and overseas trips you will need a definitive vaccination schedule. Our local travel clinics are the best places to have this confirmed and reviewed. The climate of the area also has a direct bearing on the health risks and active diseases. I always advise calling the local tourism office or chatting to regional hospitals or clinics about any current health epidemics before going there.
Medical aid and health insurance
Does your medical aid cover international travel – most people don’t know the fine print or conditions of cover. Always confirm this before booking flights as it is sometimes worth buying decent travel insurance which includes health-care coverage at a much cheaper rate through airline partnerships.
The medical kit
Consider the ages of people travelling and the risks of the activities planned. Prepare for skin lesions like cuts or abrasions, soft tissue injuries or sprains – burns at the campside fire or gas heaters. Antihistamine tablets and creams for allergies and insect bites. Meds for diarrhoea and vomiting as well as oral rehydration formulas prove useful. Children can be fussy when it comes to the taste of medicine. Don’t forget to check the expiry dates on drugs and remember that extreme temperatures and sunlight can denature or minimise the efficacy of drugs. Your medical kit should also include basic first aid items like plasters, scissors and antiseptic wipes.
Information preparation
Chronic medication must never be forgotten and a copy of your most recent prescription should be taken along. Often information about your medical history and surgical procedures must be supplied by the GP. Things like pacemaker or heart valve replacement info are useful. Prepare a reference file with your family’s medical information from blood types and immunisation records to allergies and details of any medication they regularly use.Contacts lenses and eyewear can break – so take a spare.
Practical tips on the road
* Hand sanitiser, wipes and a good routine of cleaning surfaces and hands before meals is invaluable.
* Practise more fist pumps and less hand shakes when greeting.
* Find fresh air where possible and avoid prolonged periods in crowded, confined spaces.
* Don’t share utensils if you are sick.
* Don’t eat food that is not stored overnight at the right temperature – pastries and chicken are dangerous breeding grounds for toxins.
* Carry spare plastic bags and wet wipes in case of motion sickness.
* Regular toilet breaks, however unpleasant the conditions may be, save complications.
* “Padkos” is a must – it saves money and limits you buying junk food and sugary snacks.
* Complement your main meals with fresh fruit, nuts and enough water
* If activities involve inertia and rides on a train or boat – motion sickness can be prevented by taking an antihistamine or anti-emetic beforehand
Holiday health issues
* Travellers’ diarrhoea. This can give a whole new meaning to the morning run. Symptoms include stomach cramps, nausea and vomiting. I must caution against dehydration, especially in children – often we act too late and the consequences can be dire. We all need to drink plenty of water and oral rehydration salts. If food can be tolerated orally (without vomiting), consider complex carbohydrates such as rice, potatoes, pasta or bread. Learn the spot checks of dehydration (reduced tear and saliva production, sunken eyes and a loss of skin elasticity). In small children, monitor the amount of wet nappies and urine production. Therefore if your body has too little fluid it holds on to the water you have on board and you urinate less. If the body pH level changes due to dehydration, we recognise the compensatory mechanisms of hyperventilation during breathing. Prolonged dehydration leads to kidney failure and a host of metabolic consequences that could cause irreversible damage. Therefore, seek medical attention immediately if you identify these signs.
* Jetlag. This leads to various problems like severe fatigue and sleep disturbance. The spinoff is a disgruntled and often irritable disposition with eventual mood disturbance. Other common ailments associated with flying are indigestion, feeling bloated and sometimes slowed bowel movements. The rhythms of your body are quite interesting and a change in your sleep/wake cycle as well as timing of meals and visits to the toilet, all play an important role. There is a gland in the brain called the pineal gland which releases melatonin – the hormone that assists in regulating the sleep/wake cycle. This gland is very sensitive to light exposure. Melatonin is often taken to help people cope with jetlag. When you arrive at your destination, it helps to synchronise to local time as soon as possible and be exposed to the daylight. Hopefully we can reset the body clock much faster.
* ENT issues. Upper airways issues are plentiful when travelling. Watersports are big, so ear infections from hot springs and spas are rife. Colds and flu-like illnesses are plentiful, so overcrowding and increased physical contact adds to the spread of germs. Bad weather means children and adults spend more time indoors – maximising contact and exposure to infections. Germs love warm, moist, dark environments. Ear infections present with pain, swollen glands and even a discharge from the ears. Fever is sometimes prevalent and if not dealt with immediately, complications can include throat infection and sinusitis. Allergies are often triggered by environments and fauna and flora can present a few challenges. Remember that moisture and humidity content and pollen loads differ from region to region.
* Sunburn. Even in winter, UV A and B rays cause damage to the skin. Protect your lips with a balm that contains SPF (a sun protection factor). Treating sunburn involves rehydration and sometimes even anti-inflammatories for pain.
* Fever. This occurs as a result of many infections. In children, uncontrolled and persistent fevers can result in febrile seizures or convulsions. Always carry some basic anti-pyretic medication or suppositories.
* Insect bites and stings. Calamine lotion or hydrocortisone cream can reduce irritability from itchiness. If there are signs of infection (redness, pus, fever and vomiting), call the doctor.
I am always baffled that people with known chronic medical issues do not take their medication at home, let alone on holiday. Why put your health and loved ones at risk by being irresponsible and even careless. Remember to take your asthma pump, epilepsy medication and warfarin. Diabetics cannot afford to be without meds – show that you care for your family and prepare better.
Cape Argus
* Dr Darren Green, a trusted figure in the field of media medicine, is a University of Stellenbosch graduate who adds innovative spark to health and wellness issues.
He features on 567CapeTalk and is a regular guest on SABC3 and the Expresso show. He is also celebrity doctor for the National Health Channel and a panel expert on SABC3‘s Doctor’s Orders.
He works as an emergency medical practitioner at a leading hospital and completed four years of training as a registrar in neurology.
This column does not replace a consultation and clinical evaluation with a doctor.