Archive for the ‘Medical Conditions’ Category

DVT: What You Need to Know

Friday, December 11th, 2009 by Frank Gillingham, MD

Immobilization can lead to DVT.One thing that‘s most likely NOT on your holiday wish list this year is Deep Venous Thrombosis (DVT), but if you are going to be traveling for any significant periods of time, you are at risk for developing one.  Regardless of your age or physical health, you are susceptible to these blood clots that form in the large veins well below the skin’s surface.  The Quasi’s Bell Tower blog recounts the experiences of one young, healthy American student who suffered through DVT last year in Romania. 

Generally, DVT occurs in the leg and if it stays there, you should be ok. However, a DVT can break off, completely or in pieces, and travel through your body up to your lungs. Once in your lungs, this condition is identified as a pulmonary embolus (PE) and could result in death.

Immobilization of any kind raises your risk of developing DVT — this includes immobilization on an airplane, in a car, etc. Other factors that can raise the risk of DVT include regular smoking, obesity, pregnancy, use of birth control pills, dehydration, recent surgery or other medical problems requiring hospitalization, certain types of cancer or heart disease, and structural abnormalities of the veins. Some people are genetically predisposed to blood clots — so your family history is important–and senior travelers may also be at higher risk.

Symptoms of a DVT often include leg pain or tenderness, redness, or swelling.  Symptoms of a PE often include chest pain, shortness of breath, and cough (sometimes with blood tinged sputum).

If you are planning a long trip, follow these tips:

  • Get up, stretch and/or walk around every 60 minutes or so. Request an aisle seat so it’s easier to do so. Bulkheads and exit rows also provide more leg space and easier entry/exit. If you can, elevate your legs intermittently during the flight.
  • Drink plenty of fluids to avoid dehydration (coffee and alcoholic beverages don’t count!).
  • Move around and exercise in your seat, making sure the seat presses up against a different part of your legs every once in a while. Don’t cross your legs for prolonged periods of time.
  • Medical Grade support stockings can be helpful and don’t require a lot of effort to either obtain or to use — ask your doctor or pharmacist.

If you develop any symptoms of a DVT, persistent leg pain, redness or swelling, or symptoms of a PE, shortness of breath, cough or chest discomfort, seek immediate medical attention.  If you’ve had a DVT or a PE in the past you’re more likely to get one again in the future.  And, keep in mind — the longer the flight or the car trip, the higher the risk.

Image by: exonumia  http://www.flickr.com/photos/exonumia/ / CC BY-NC-SA 2.0

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The Safe and Healthy Traveler’s Guide to Packing: Part Six – Managing Migraines

Wednesday, September 16th, 2009 by Maya Northen

migraineIf you are one of the 30 million plus Americans that suffer from migraines, you know how debilitating the sensitivity to light, sound, air pressure and movement can be.  Traveling with a migraine can be especially tricky, particularly when in a foreign country where the treatment options may not be the same as in the U.S. So while you are packing, consider the likelihood of needing to manage a migraine on your trip. 

Some migraines can be hormonal (mainly in women) and therefore the timing can be rather predictable. In these cases, try to avoid travel during times you are more likely to suffer a migraine. Though this isn’t fail-safe, it could help to decrease the chances.

For many, migraines can be quite unpredictable and impossible to prevent. However, there are a few things you can do to prepare yourself in case you do get a migraine while traveling.

If you have a history of migraines, bring any medication (over the counter or prescription) that has worked for you in the past. Keep it in its original bottle — to avoid trouble at customs — and make sure you know the generic name in addition to the brand name. Medications often go by different brand names overseas, but if you know the generic name, the pharmacist or doctor can provide a similar drug if you need it. 

A search for triptans (the most effective class of drugs for the majority of migraine sufferers) on HTH Worldwide’s mPassport mobile application returned this information:

Imitrex is available in the US as tablets (25, 50, 100 mg), or as a nasal spray (5, 10, 20 mg/spray).  It is most commonly called Imigran in other countries, although other names include Suvalan (Australia), Sumitriptan (Canada), Sumaptan (Egypt), Imiject (France), Migratan or Suminat (India), Imitag (Ireland), Sumatridex (Israel), Sumitran (Malaysia, Singapore), Sumamigren (Poland), Migralevel Ultra (UK) and even Dan Tong Jing (guess which country sell it as this).

But medications are only part of the plan. Migraines can be triggered by lack of sleep and physical stress. Try to adjust to your host country’s sleep/wake cycle as quickly as possible.  If you are taking an overnight flight and have trouble sleeping, an over-the-counter sleep aid can help you get some rest and adjust more quickly.  Melatonin, a natural hormone produced by the pineal gland, can be taken in supplement form to help you adjust your internal clock more quickly.  Both melatonin and exposure to the natural light cycle of your destination are widely recommended for reducing jet lag which may often bring on a migraine.

If you have problems with noise and light during a migraine, bring ear plugs and an eye mask with you on your travels in an effort to lessen your exposure to these potential triggers. 

Certain foods may enhance a migraine in some people. If this is you, bring along plenty of snacks that don’t amplify your pain to ensure that you have some food options that won’t bother you.

Then there’s caffeine — this is tricky as some migraine remedies contain small amounts of caffeine to open your blood vessels. However, some studies show that caffeine can actually make a migraine worse. Based on your personal experience, you will either want to embrace or avoid caffeine. 

If you tend to get nauseous from migraines, ginger pills (or candies) can be helpful to relieve nausea and can be found in most health food stores.

Stay hydrated. It may be tempting to try that French wine or German lager, but it probably won’t be worth it! Water is the best thing to drink during a migraine, especially on a plane where people are already prone to dehydration.

Stay active. This can be tricky when battling a migraine, but research has shown that exercise can bring relief. You don’t have to go for a 10 mile jog, but exploring your destination on foot for a few hours may allow you to use sightseeing as therapy.

Finally, choose your destinations and seasons carefully, if possible. Some people feel their migraines worsen in humid, high pressure climates, as well as at high altitudes.

By the way, the 14th International Headache Congress that met in Philadelphia over the weekend heard Cindy McCain give the keynote address chronicling her battle with migraines and the global prevalence of this affliction.  She is campaigning for a cure of what is considered by the World Health Organization as “one of the most disabling medical disorders in existence.”

Fellow migraine sufferers, share your remedies!

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You’re Grounded! (But you don’t have to be)

Friday, July 10th, 2009 by Moira Bishop

fearofflyingAn estimated 20% of adults have a fear of flying (aka aviophobia, aviatophobia and aerophobia), and the recent news regarding devastating airline crashes is causing more people to question the safety of air travel.  Is it safe to fly?  Is there a safer way to travel?  Should I just stay home and avoid the risk altogether?

As we have pointed out in recent posts, it is safe to fly.  Very safe, actually.   Air travel is the second-safest mode of mass transportation (elevators and escalators are the most safe but unless you’re Willy Wonka, an elevator isn’t an available mode of international travel).    

Should you stay home and avoid the risk of traveling?  That’s probably not a good option.  Even if you choose to avoid air travel for vacations, you probably can’t avoid it forever.  Your job may require you to travel or you may need to go visit a sick family member.

Fear of flying is a very real fear and is almost as common as the fear of public speaking.  Aviophobia can stem from other fears such as fear of tight spaces, crowds and heights.  There are real anxieties and conditions that cause the fear and there are also real treatments.  R. Reid Wilson, lead psychologist for American Airlines’ fear of flying program, surmises, “People frighten themselves by thinking of the possibility of a problem during a flight.  Instead, they must learn to think of the probability of a problem, which is extremely low.”

A recent CNN article suggests that overcoming the fear of flying starts with trusting your plane, your pilot and the aviation industry as a whole.

Dr. Martin Seif, a psychologist and creator of the Freedom to Fly program, urges those in his program to “Stay in the situation and out-bluff anxiety.”  The idea is that if you face your fear in small doses (i.e. spending time in an airport, watching planes take off and land, boarding a stationary plane) you will eventually be able to overcome them.

MSNBC offers Ten Tips for the Fearful Flier which are practical and reasonable. But if these tips don’t help, check out Fear of Flying or one of the many other safe flying programs available so that you’re transportation options are not limiting your vacation destinations.

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Help For Travelers With Food Allergies

Thursday, May 14th, 2009 by Moira Bishop

foodallergyThere’s been a lot of attention paid to food allergies in the last couple years. But what happens to folks with food allergies when they travel overseas?

At least 12 million Americans suffer from food allergies And 90% of all food allergy reactions are caused by 8 foods:  milk, soy, eggs, wheat, peanuts, tree nuts, fish and shellfish.  Country music star Trace Adkins  championed this cause when he appeared on the Celebrity Apprentice last year and raised awareness for the Food Allergy & Anaphylaxis Network (FAAN), an organization dedicated to  educating and advocating for Americans living (and of course traveling) with food allergies.  

So what happens to this education once a person with a food allergy leaves the country?  Americans are spoiled by the mandated labeling that appears on packaged foods and even restaurant menus. But in a foreign country, this helpful information might not appear or you may not be able to translate it. The downside could be significant.

The good news is that there are tools available to help you manage this risk. Select Wisely offers translation cards that you can keep in your wallet and refer to when you are ordering foods in unfamiliar territory. mPassport® offers you the ability to translate phrases to allow you to communicate your allergies in many different languages.  Words certainly take on value when you realize that knowing five simple ones such as “I am allergic to peanuts,” can save your life.   

What it means is that you can have food allergies and still be free to travel the world. Just do your homework before you board the plane. Sure, you can go on vacation and just eat bread (as long as you don’t have a gluten allergy), but if you want to get the full experience of a foreign culture, you’ll want to get a taste for the local cuisine.

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ADHD (and other mental health conditions) around the Globe

Thursday, April 2nd, 2009 by Carol Foley

rxpad6College years bring opportunities to explore the world. Young adults are adept at traveling light, but today many carry the weight of living with a mental health condition. They may be traveling with Attention Deficit Hyperactivity Disorder (ADHD) or a more serious condition, or, as often happens, a new condition might emerge when an adolescent leaves home for the first time (for reasons Vikram Tarugu cites  in The Real World: Recognizing Illness in Young Adults).

Early diagnosis and treatment of mental health conditions is crucial, so it’s important for students abroad or hoping to go abroad to discuss any suspected symptoms with a mental health professional.  Fortunately, the latest medications and therapies enable diagnosed young people to go pretty much wherever they want without fear and with the blessing of school officials. Coming forward to seek treatment won’t disqualify students from a study abroad program, but it will help ensure that steps are taken to arrange proper treatment and support in the host country.

Finding the right practitioner can be a challenge; in many cultures, physicians are not accustomed to prescribing medications for mental health conditions. Even in a western European country such as Germany, a search may need to be undertaken to find a doctor that will provide care consistent with a treatment plan prescribed in the U.S.

And there are other hurdles as well. Psychiatric medications are typically controlled substances and bringing them across an international border may be illegal. For example, the common ADHD drug Adderall is banned in China, Argentina, the United Arab Emirates and the countries of Western Europe.

Even when legal, medications often vary by brand name and dosage, so getting a prescription filled or refilled can be problematic.  There are tools to help travelers figure these things out, but it’s obviously better to know about them before setting off on your journey. For example, at HTH Worldwide, we have an online and mobile translation tool that finds generic and brand equivalents for over 350 commonly prescribed medications.

Careful preparation may not always be enough because symptoms may first arise upon reaching the destination and may be misinterpreted as culture shock, stress or anxiety. We’ll talk more about that in future postings but in the meantime, remember the importance of self-awareness.   If these conditions persist, they may be symptoms of a larger problem that could be diagnosed and treated by qualified professionals nearby before the situation gets severe.

Certainly, increased understanding and advanced treatment methods have made world travel easier for students. But barriers remain. We have still miles to go to raise awareness of what it takes to keep students healthy while traveling.

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