Nobody expects to get ill on holiday, but it does happen. Sadly, as a GP, I've lost count of the medical miseries I've heard about that could have been easily avoided. Fortunately, with a few sensible precautions both before and during your holiday, you should be able to ensure that the only mementos you bring back from holiday are happy ones!
Jet lag and flight worries
You'll be fine if you're holidaying in Europe, but anywhere further abroad can bring jet lag as a consequence.
Your body clock finds it harder to adjust to shorter days than long ones, so you'll suffer more when you travel from West to East (when the clocks go forward).
Top tips to reduce the effect include getting plenty of sleep before you go; going to bed earlier on the nights before you travel East and having a stopover en route if possible. It's also worth avoiding alcohol and caffeine, but drinking plenty of other fluids on the journey and staying outside in daylight as much as possible when you arrive. If you're staying for more than a few days, try to move your schedule on to the new time zone as soon as possible. But if you're only there for a couple of days, you may find it less disruptive to stay on home time if it's feasible.
Although not common, clots on the leg - deep vein thrombosis, or DVT - are a risk if you're flying for more than four hours. To cut your risk, drink plenty of non-alcoholic fluids, avoid alcohol - which can dehydrate you - and get up regularly and walk up and down the cabin. Every half hour, turn circles ten times with each ankle to keep circulation flowing in your calves.
Stay sun safe
Sun is hottest between 11 am and 3 pm - and don't forget that reflected sun can burn you even in the shade.
So avoid the sun when it's strong, cover up as much of the body as possible and make sure you apply high-factor sun cream liberally. And don't be tempted to save money by using last year's sunscreen - the ingredients go off over time, especially once the bottle is open, so may not be as effective.
Hangover holiday hell
Beware spirits (it's easy to underestimate your intake); alternate alcoholic drinks with soft ones; and don't drink until the evening. Best of all, find out if your hotel serves non-alcoholic cocktails - just as much fun without the side effects!
Tummy bugs are even more common if you're outside Western Europe, the USA or Australasia. The mantra for food:
- Avoid buffet food where possible in hot countries - germs multiply with terrifying speed in warm temperatures.
- You may think you're avoiding drinking the local water, but the local water is exactly what you'll be having if you put ice in your bottled drink!
- If you're not absolutely sure of the food, boil it, peel it, cook it or forget it.
- Don't let your guard down where food precautions are concerned because you're in a smart hotel. The kitchen may be clean and hygienic but the flies that settle on the food don't care where they are.
Mosquitoes and other nasties
These days many of us jet off on long-distance holidays, forgetting that there are some nasty infectious diseases outside the Western world.
If you're going anywhere outside of Western Europe, Australia or the USA, make an appointment with your practice nurse at least eight weeks before you travel. They can advise you on any travel immunisations you need. You may also need anti-malarial tablets which you start taking before you leave and continue for one to four weeks after you return - your nurse can advise on the best type and length of course.
Insect bites and stings are always miserable but if you're in an area affected by malaria, avoiding them is even more important (even if you're taking tablets). Wear long-sleeved shirts and long trousers in the evenings, when mosquitoes are most active; use insect repellent even in areas covered by thin clothing, and spray insect repellents (ask your pharmacist) in your bedroom.
Check your prescription
As far as medicines are concerned, it pays to check well in advance if you have enough to last for your whole holiday and a week or two after you return. If not, contact your pharmacist or practice for a repeat prescription.
Take all your tablets with you in your hand luggage in case your case gets lost by the airline - you can buy new clothes while you're away, but getting a supply of medicine in a foreign country can be a real challenge!
Some medicines, like insulin, must be kept in hand luggage as the low temperatures in the hold can damage them. You'll need a letter from your doctor to say you can take insulin and your syringes on to the plane - you should present this at security.
It's always worth checking on the website of the embassy of the country you're going to for details of any medication restrictions they have. Some are surprising - who'd have thought bringing too much Vick's nasal spray into Japan could be illegal?!. This is particularly important if you're travelling with controlled drugs, where (even if the drug isn't illegal, as with codeine in some countries) you'll need a specific letter from your prescriber or, in some cases, a licence.
Likewise, you may need a letter saying you're fit to fly if you're pregnant - airlines differ, but most won't let you fly if you're over 36 weeks pregnant, or long haul over 32 weeks. Check with your airline and be prepared to pay for doctors' letters.
Your travel first aid kit
Most countries will have pharmacies where you can buy remedies for travel maladies, but explaining your symptoms in a foreign language can lead to embarrassing misunderstandings! So if you can, take your own holiday first aid kit.
Along with simple plasters (including blister plasters), consider these options, all available from your pharmacist without prescription:
- Hyoscine tablets for travel sickness.
- Antihistamine tablets for insect bites and stings.
- Diarrhoea tablets containing loperamide (two capsules straightaway, then one every time you have an episode, up to six capsules a day).
- Tablets for nausea and vomiting caused by tummy bugs (I recommend one called Buccastem, which you dissolve by putting it high up in your gums so you don't have to swallow it).
- Indigestion relief tablets.
- Insect repellent spray, especially if you're going to an area affected by malaria.
Don't forget insurance
If the worst does happen, it's crucial to have travel insurance to cover the cost of treatment abroad. An EHIC card entitles you to the same treatment as a native in any country within the European Economic Area, but that doesn't mean it will be free. It also doesn't cover everything, so take out travel insurance as well.
If you do get ill abroad, your holiday company or hotel should be able to direct you to emergency care. Make sure you have your EHIC card and insurance details with you!
With thanks to 'My Weekly' magazine where this article was originally published.