Travel Health

We all love a good holiday and for some, the planning stage is all part of the fun. We check out weather forecasts, accommodation options, tourist must-dos and try and find the best places to eat. But it's also really important to think about our health and take appropriate precautions to make sure we come home as healthy as possible.

Travel insurance is essential for any trip. We are very fortunate that in Australia, we have an excellent public health system so in an emergency, everyone will be treated, but that is not always the case overseas. A few years ago, Darren and I went to Singapore for a wedding. It was only a five day trip, but thought we should get travel insurance just in case, especially since I was pregnant with The Munchkin. It turned out it was very lucky that we did because although I was fine, Darren ended up needing to see a GP then a specialist and have some expensive tests and we got the cost of everything back on our travel insurance. As they say, "If you can't afford travel insurance, you can't afford to travel."

You should definitely see your doctor at least eight weeks before you travel for a basic check-up and to see whether you need any vaccinations. General vaccines such as typhoid and hepatitis A and B are advisable even in Australia. Some countries such as those in parts of Africa and South America, will not allow you to enter unless you have proof of certain vaccines such as yellow fever. The vaccine lasts ten years and needs to be given at least ten days before entry into a high-risk country. You don't want to fly all the way across the world, only to be sent straight back home at the airport!

Speaking of flying, long flights can increase the risk of you getting a DVT (deep vein thrombosis, or a blood clot which starts in the leg but can move to other areas). Pop into Terry White Chemists Berwick to check out our large range of compression stockings and socks and try and stay hydrated during the flight (go easy on caffeine and alcohol!) and make sure you move your legs and feet around periodically and occasionally walk around.

For some countries such as those in Africa and South East Asia, it may be advisable to take malaria medication. There are different regimes depending on where you are travelling to, but they all need to be started before your trip, taken whilst you are away and generally also for a short time once you return. Make sure you read the directions carefully and finish the entire course to ensure you are protected. Some malaria medications can reduce the effectiveness of oral contraceptives so you may need to take extra precautions during this time. You can protect yourself further by using appropriate insect repellents, covering arms and legs with clothing when outdoors (especially at sunset) and using mosquito nets.

Traveller's diarrhoea is also a risk, especially in developing countries. It is usually caused by consuming contaminated food or water which local residents seem to have acquired an immunity to. Symptoms can include nausea, bloating, cramps, loose and frequent bowel motions and a general feeling of being unwell. You can reduce your risk by avoiding ice, drinking bottled or canned water and other drinks, avoiding salads which may have been washed in local water, only eating fruit which you peel, avoiding undercooked or improperly stored foods (especially seafood and meat) and washing and drying hands thoroughly before and after meals and going to the toilet. If you are unlucky enough to come down with traveller's diarrhoea, keep hydrated (buy some oral rehydration solution from Terry White Chemists Berwick before you leave home), rest and stick to bland foods.

If you need to travel with prescription medication, ask your doctor for a letter explaning the details of the medications, what they are for and that they are for personal use. Make sure you have enough medication for the duration of your trip. Ensure you have some medication in your hand luggage in case your suitcase goes missing and make sure that all your medications are in their original packets with the pharmacy labels on them. It's also worth checking that your medications are legal in the countries you are visiting. For example, codeine which is found in many over-the-counter painkillers such as Panadeine, is illegal in Greece and classed in the same category as heroin. Click here for contact details of the foreign embassies in Australia to check on your medications.

Our staff at Terry White Chemists Berwick are a great source of advice before you travel. They can assist you in putting together a basic first aid kit, help with alert bracelets and necklaces, dispense any vaccines and other medications and supply everything to protect and treat sunburn, insect bites, cuts and grazes and other common health conditions. We also have a Travel Health Self Care Card with lots more advice to help you on your way.

So get organised before your trip and happy travelling!

References and further reading

• Travel Health Self Care Card, Pharmaceutical Society of Australia, published February 2011
• Australian Government's Smart Traveller website
• Travel Clinics Australia website
• World Health Organization website
• Travel Health - Yellow Fever Vaccine Fact Sheet - Better Health Channel, published November 2010 (accessed 19 September 2011) 
• Travellers's Diarrhoea Fact Sheet - Better Health Channel, published August 2011 (accessed 22 September 2011)

Springtime & Hay Fever...aa-aa-choo!

It's so lovely to see the blue sky and flowers blooming after Winter. Ah, who doesn't love Spring?

Hay fever sufferers, that's who. And when I say sufferers, I really mean sufferers.

For those who don't get hay fever, it's difficult to understand exactly how terrible it can be. I mean, it's just a bit of sneezing, right? Wrong.

Hay fever is also known as allergic rhinitis - rhino- from the Latin word for nose and -itis meaning inflammation. Around 1 in 5 Australians are expected to have an allergic condition at some point in their lives and it can occur anytime of the year, not just in Spring. Symptoms may include sneezing (mild to uncontrollable), a runny or blocked nose, an itchy or tickling sensation in the nose, throat, ears and roof of the mouth, red, puffy and itchy eyes and a loss of smell or taste. These symptoms may affect concentration and even sleep, making severe sufferers tired and irritable. The symptoms are often at their worst in the morning and on windy days when there is more pollen in the air.

Hay fever is caused by an overactive immune system reacting to certain triggers or allergens. Pollen is the most common allergen, but dust mites, mould spores and animal cells or hair (commonly cats or dogs) can also cause problems. Often people with hay fever are also unlucky enough to get eczema, asthma or hives and it generally runs in families. In fact, if either mum or dad has hay fever, the child has about 30% chance of also having it. If both parents have hay fever, it's about 70% likely the child will have it.

There are lots of non-prescription treatments for hayfever available at Terry White Chemists Berwick. Some of these include:

• Antihistamine tablets, capsules or liquids - the most popular ones are non-drowsy and can be taken once a day. For whatever reason, different ones work best for different people so it may be worth trying a few to work out your favourite.
• Antihistamine eyedrops - these help itchy, swollen and runny eyes.
• Decongestant nasal sprays or drops - particularly useful for a runny or blocked nose, but shouldn't be used for more than five days in a row as long-term use can damage nasal tissue.
• Corticosteroid nasal sprays - these help prevent and reduce the inflammation in the nose and help with symptoms of sneezing, runny or blocked nose and puffy or watery eyes. They start to work within a few hours, but will achieve their maximum effect within a few days. They need to be taken continuously during the hay fever season to work best and are safe to use long-term.

Some people may benefit from immunotherapy which aims to build up your body's tolerance to allergens by gradually increasing exposure to them, usually by repeated injections or sometimes drops placed under the tongue. Immunotherapy should only be done under medical supervision as it can be dangerous and even life-threatening. Speak to your doctor for more information or check out this link.

So what else can you do to help manage your hay fever? Some suggestions include:

• Avoiding triggers. For example, keep an eye on the pollen count during weather reports and stay inside on days with high pollen forecasts, windy days or after thunderstorms.
• Keep car and house doors and windows closed during pollen season.
• Shower and wash your hair after being outdoors to remove pollen.
• Splash eyes often with cold water to help flush out any pollen.
• Smear petroleum jelly inside your nose to reduce the amount of pollen that you inhale.
• Avoid cigarette smoke as it can make you more sensitive to other allergens.
• Keep animals outdoors.
• Clean your house regularly to reduce dust and mould.
• Hard surfaces such as floorboards and tiles are likely to be better than carpets and rugs.
• Remove sheepskins and woollen and feather bedding from bedrooms.
• Wash soft toys regularly in hot water (60°C).

Our staff at Terry White Chemists Berwick would love to help you manage your hay fever, regardless of how mild or severe it is. Pop in for a chat and don't forget to ask for your Hay Fever Self Care Card.

To finish, I thought I'd attach this very cute clip. I can't be certain that this bear has hay fever, but I'm sure hay fever sufferers can relate!

References and further reading

• Hay Fever Self Care Card, Pharmaceutical Society of Australia, published February 2011
• Australasian Society of Clinical Immunology and Allergy website
• Hay Fever Fact Sheet, Better Health Channel, published June 2011 (accessed online 8 September 2011)

Safety of Medicines in Pregnancy and Breastfeeding

When I was pregnant with The Munchkin, I was lucky enough to have a pretty uneventful pregnancy. I never got morning sickness, I didn't have too much by way of sleep disturbances, I felt pretty energetic throughout. As I said, very lucky. Pretty much the only weird thing I had was the occasional urge to dry retch when I brushed my teeth. Weird, right?

There were times when I almost forgot I was pregnant, and was only reminded when I looked down at my ever-growing belly. But when you are pregnant, there's suddenly a whole bucketload of new things you need to think about, and not just in relation to decorating the nursery.

It would be lovely to think that pregnant and breastfeeding women never get sick and never need any medications, but unfortunately, this is just not the case. Long-standing conditions such as asthma and epilepsy still require treatment during pregnancy and breastfeeding. Then there's the usual bugs and viruses that we are all still susceptible to. And don't forget that we are not just talking about prescription medications. There's also medications that you buy over-the-counter at your pharmacy and herbal and complementary products. Even medications that are in creams or ointments, in nasal sprays or eyedrops or patches can be passed across to your baby.

Medications taken by pregnant women can pass across to the baby via the placenta, just as the baby receives nutrients. Some medications can actually affect baby's development or cause miscarriage.

In addition, medications taken by breastfeeding women can pass across to the baby via the breastmilk. This may cause baby to have symptoms of drowsiness, difficulty settling, cause vomiting or diarrhoea or may affect baby's suckling reflex, making feeding difficult.

So how do we know what is safe and what isn't? This question is slightly more complicated than you would expect.

As a general rule, pharmaceutical companies don't test their medications in pregnant or breastfeeding women. For that reason, pharmaceutical companies are usually reluctant to emphatically state their medications are safe. Information about the potential safety of medications in pregnancy and breastfeeding is usually extrapolated from studies in animals such as mice. There are, however, groups worldwide which collate information and look for trends and your pharmacist and doctor will be able to access this information for you.

Some general rules which can help if you do need to take medications whilst pregnant or breastfeeding are:

• Always remind your doctor and pharmacist you are pregnant or breastfeeding so they can check the safety of any medications. Don't forget to mention over-the-counter and herbal products.
• Consult your doctor or pharmacist before suddenly stopping any medications.
• If you are on long-term medication and planning to start a family, discuss this with your doctor and pharmacist before getting pregnant. It may be wise to switch to another medication which is safer in pregnancy.
• If you do need to take a medication whilst breastfeeding, chat to your pharmacist about the best time of day to take it and keep a close eye on baby for any adverse effects (e.g. drowsiness, irritability, change in bowels).
• Limit or avoid alcohol if pregnant or breastfeeding. Click here for a leaftlet produced by the Australian Breastfeeding Assocation titled "Alcohol and Breastfeeding: a guide for mothers".
• Limit or avoid caffeine (coffee, tea, cola, energy drinks).
• Avoid recreational drugs.
• If you are a smoker, there's never been a better time to quit! For more advice on quitting, pop into Terry White Chemists Berwick for a chat with our pharmacists and ask for our Self Care card on Smoking. Quit Victoria also has a great website with heaps of information and advice.

The best advice to always discuss any concerns about your medications with your doctor (and obstetrician if you have one) and pharmacist. Our pharmacists at Terry White Chemists Berwick would be pleased to have a chat about any health-related issues, including those related to pregnancy and breastfeeding. They will be able to look at the appropriate references and help guide you towards what is safest for you and your baby.


References and further reading

• Medicines and Breastfeeding Self Care Card, Pharmaceutical Society of Australia, published July 2008
• Smoking Self Care Card, Pharmaceutical Society of Australia, published February 2010
• The Royal Women's Hospital Victoria website
• Quit Victoria website
• Australian Breastfeeding Assocation website
• Pregnancy and Drugs Fact Sheet - Better Health Channel, published October 2009 (accessed online 3 September 2011)
• Pregnancy and Smoking Fact Sheet - Better Health Channel, published February 2010 (accessed online 3 September 2011)