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**Latest**: Yellow fever vaccination
Pencoed Medical Centre is now an officially registered "Yellow fever centre". This means that anyone requiring yellow fever vaccination (required when travelling to certain parts of the world) - whether they are a patient of ours or not - can receive all of their necessary vaccinations at Pencoed Medical Centre.

One of the benefits of the Internet is that it can be accessed from all over the world. At the Medical Centres, we are often asked questions about travel and disease whilst abroad on holiday. This page includes some of the more common queries. We are aware that patients may find themselves ill whilst on holiday and this page is designed to give our patients general advice that they may access whilst away from home. It is NOT intended to replace a proper consultation with a Doctor. If you are worried, please seek proper medical advice as you would if you were at home. If you have visited this page, please let us know - we would be delighted to hear any suggestions on improving this section and to know if you found it useful. We will add to this page depending on feedback from our patients. Unfortunately, we are unable to respond to e-mail enquiries of a personal nature for medico legal and security reasons (as outlined on our homepage).

Sunburn    Diarrhoea    Deep Vein Thrombosis    Cuts & Grazes     Insect bites    Hay fever    Sprains     Women's Health

Holidays in the UK    Medicines     Travel Sickness    Travel & Pregnancy    Pre-existing illness     The Diabetic Traveller

Sunburn
First of all, try not to get sunburn at all! Prevention is all important in the case of sunburn. There is clear evidence that sun exposure can increase the chance of developing cancerous lesions, including "Malignant Melanoma". This may be even more important when children become sunburnt.

If you already have sunburn, then there are a few thing you can do to make yourself comfortable.

Diarrhoea
Diarrhoea means passing frequent loose, watery stools. Most cases of diarrhoea are due to infectious causes. In other words, you may have taken bacteria or viruses by mouth (from dirty hands, food or drink). Prevention is better - bottled "safe" water for drinking, washing food and brushing teeth, hand washing and clean all vegetables & fruit (bearing in mind the safety of the water used to clean the food!). Our bodies may try to get rid of these bugs by trying to eradicate them from the bowel as quickly as possible. This may lead to vomiting and diarrhoea. The most important thing here is to replace fluids. Drink as much as you can - "little & often" if you cannot tolerate large volumes. In addition to fluids, you may lose essential salts from the body. It is possible to replace fluids and salts by drinking special rehydration drinks - "Dioralyte" and "Electrolade" are two examples. These may be purchased from the chemist before you go (or they may be available abroad. If not, the local pharmacist may be able to offer a similar product). Don't worry if you cannot tolerate food. In the short term, fluids are much more important. It may be best to avoid dairy products, because some diarrhoeal illnesses can temporarily affect our ability to digest "lactose", which is a sugar found in dairy products. If you are lucky, you may be able to flush out the bugs by taking lots of fluids by mouth. Sometimes, this is not possible and some infections may need specific treatment - again, if you are concerned, the diarrhoea is prolonged (72hrs in a fit adult, but as little as 24hrs in the elderly or child), or the patient is listless and drowsy, feverish, blood in the diarrhoea, then do not hesitate to see a Doctor (as you would if you were at home). Finally, a word on constipating agent such as "kaolin & morphine" etc. Some products sold over the counter have the effect of "stopping" or slowing down the diarrhoea. Although controversial, this may impair your body's attempts to "flush out" the bugs. If the cause is an infectious diarrhoea, you may be better avoiding these products and drinking as much as you can. Again, children (& babies) and the elderly can be particularly susceptible to diarrhoea - have a low threshold for seeing a Doctor if you are at all concerned.

Deep Vein Thrombosis (or "DVT", "Economy class syndrome")
A deep vein thrombosis is due to a blood clot in a vein. "Economy class syndrome" is a misnomer - the problem is not restricted to economy class, nor flying in general. Thrombosis can occur anywhere in the body, but clots in the deep veins of the calf muscle (below the knee at the back of the leg) are what are termed "DVT". The classical symptoms are those of swelling in one leg (if you press hard with a finger, it will leave a dimple when the finger is removed), pain, redness and heat in the muscle. A DVT in one leg will not produce symptoms in the other leg - so, DVT usually leads to symptoms in one leg rather than both (unless, by chance you have contracted DVTs in both legs at the same time). In other words, one leg appears more swollen that the other. Often, the calf muscle may also feel hard. Sometimes dorsiflexing the foot (the same movement that you make with your ankle if you were lifting your foot off the accelerator of your car) may produce pain in the calf. A DVT may present with some, all or none of these symptoms. Other conditions may produce similar symptoms (muscle strains, skin infections and rupture of cysts behind the knee). A DVT can be fatal. If you are concerned that you may have a DVT you should see a Doctor immediately. The following can be risk factors for developing a DVT:-

There are a number of things that you can do to reduce your chances of getting a DVT

NHS Direct have produced a section on DVT Click here to learn more (remember that we are not responsible for the content at external sites)

A House of Lords Select Committee carried out a comprehensive review of the subject in November 2000. They concluded that the risk of developing DVT following a long distance flight is estimated to be between 0.1 and 0.4 per thousand of the general population.

Travel and Pregnancy
You should not travel abroad whilst pregnant if you have a history of miscarriage, premature labour, vaginal bleeding in pregnancy or "pre-eclampsia" (a condition where blood pressure goes up to dangerous levels). Airlines are generally reluctant to accept a woman who is more than 32 weeks pregnant - check with your individual airline (and check that you have a seat with enough room!). You will be at an increased risk of DVT (see above). You should carry comprehensive documentation including estimated date of delivery and blood type. Check that you have valid travel health insurance covering duration of the pregnancy, complications, delivery and the postpartum (i.e. after delivery) period. Also check that this policy covers the newborn and that repatriation is available and covered, if necessary. If travelling to an endemic area, the risk of malaria is significant and potentially very serious for both mother and baby during pregnancy. You must weigh up the risk/benefit of antimalarial medication, but Chloroquine and Proguanil have been prescribed safely in pregnancy for many years (your Doctor may recommend taking Folic acid 5mg on alternate days if you are taking Proguanil). Generally speaking, "live" vaccines should be avoided in pregnancy but "inactivated" vaccines (such as Hepatitis A, Typhoid and Tetanus) may be given safely, preferably during the second and third trimester of pregnancy if there is a significant risk of contracting these illnesses. Remember that the illnesses themselves may be more dangerous to you and your baby than the risks of any medication.

The Diabetic Traveller
Any illness contracted will pose a greater threat to diabetics, whether diarrhoea, infections, malaria or seemingly minor illness. You should be especially careful to prevent any illnesses. In particular, you should be up to date with all of your immunisations and you should have a very low threshold for seeing a Doctor if you become unwell. Make sure that you have adequate supplies of needles, syringes and insulin in your hand luggage. Blood sugar testing machines (and spare batteries!) are a good idea. Insulin may remain stable at room temperature for one month, but it may be destroyed by freezing (as can happen in the cargo hold of an aeroplane). Unaccustomed exercise in a different climate (or unexpected delays) may make your blood sugar drop quicker than it does at home, so you should always carry a supply of carbohydrate to stave off hypoglycaemic attacks. If your journey lasts less than 8 hours, you may wish to stick to your home time management of your diabetes. For long journeys, work out changes to your insulin regime well in advance by consulting diabetic clinic. Make sure that you have comprehensive travel health insurance that covers diabetic patients.

Pre-existing illness
If you have had a heart attack (myocardial infarction) you should not fly within two to four weeks, depending on severity. A patient who has had ear surgery should not fly within two months. If you have a perforated eardrum, you should wait until it has healed completely before flying. Surgery involving a body cavity (such as chest or abdomen) or pneumothorax ("collapsed lung") should not travel for at least three weeks. If you have chronic obstructive airways disease or emphysemia, you may need supplementary oxygen during the flight and you should discuss the matter in detail with the airline and your Doctor beforehand. Patients treated for cancer with chemotherapy or radiotherapy should not have "live" vaccines until 6 months after the end of treatment. Of course, all of this advice is very general and you should discuss your exact individual requirements with your own Doctor well in advance of making plans to travel. Make sure that you have comprehensive travel health insurance and that it covers all pre-existing conditions.

Minor cuts and grazes
Our skin provides defence against the bugs that lead to infection. A cut or graze may allow bugs in. If the wound is bleeding, apply pressure for as long as it takes to stop. This may be as long as 15 minutes. If the bleeding continues, continue to apply pressure. Bleeding from points below the heart can be greater, so you can help to reduce the bleeding by lifting the affected limb above the level of the heart at the same time. Next, clean the wound using an antiseptic solution (salt water if none available) and apply a clean dressing to prevent contamination with bugs. You may need to consider other risks, such as HIV and Hepatitis B, if applicable. Tetanus is a risk, if you have not been immunised or not had a booster within 10yrs. If the wound gets more painful, or surrounded with an increasing area of "redness" and swelling, or if it discharges coloured pustular fluid as the days go by, this could be a sign of infection. If infection develops, you should see a Doctor because you might need antibiotics. Again, see a Doctor if you are at all concerned.

Insect bites
Insect bites usually produce multiple itchy bumps a few millimetres in diameter. You may ease the symptoms by using an antihistamine cream or tablets. Common antihistamines are "Piriton" (chlorpheniramine), "Clarityn" (Loratadine) and "Zirtek" (Cetrizine). Be careful if you are driving - some medicines may make you feel drowsy.

Hayfever
An allergy to pollens - can include tree pollens as well as grasses and flowers. Tree pollen allergy can occur early (March) in the year. Symptoms include itchy, watering eyes, nose and a cough. Mainstay of treatment is with antihistamines (see above) in the form of eyedrops, nasal spray and/or tablets. Generally speaking, tablets tend to be more potent and have a widespread action. It is also possible to use a steroid spray e.g "Beconase" (Beclomethasone), but this may take several days to achieve full effect (up to 14 days or longer). These treatments are available over the counter at the Chemist. Be careful if you are driving - some medicines may make you feel drowsy.

Travel sickness
Treatment is usually with an anti-emetic pill (e.g. "Stemetil"). Some may have a sedative effect. Be aware, if you are driving, that this treatment might make you feel drowsy. Eating "little and often" may be better than large, fatty meals.

Sprains and "Twisted ankles"

See notes under our other health information pages. Remember R.I.C.E. - Rest, Ice, Compression with a bandage or "tubigrip" and Elevation of the limb. If the patient is unable to move the limb, weight bear or if there is obvious deformity, then there could be a broken bone.

Women's health
You may find our pages on "The Pill" useful. It is possible to postpone your menstrual period by taking tablets ("Norethisterone" 5mg three times a day starting 3 days before anticipated onset of menstruation. Menstruation occurs 2-3 days after stopping the tablets), but you would need to discuss this in detail with your Doctor beforehand and you would need a prescription, provided that this medicine is suitable for you.

Holidays in the UK
Remember that you have access to an NHS GP wherever you are in the UK. Simply contact the nearest GP (even if you need a Doctor out of hours) and he may look after you as a "Temporary Resident". If you have unexpectedly run out of tablets, you may be able to get an emergency supply from the chemist if you take the empty packets and identification along with you.

Medicines
Obviously, remember to take plenty of medicine with you, taking into account possible delays. Remember that the cargo hold of the plane may be cold enough to have a detrimental effect on your medicine - including insulin for diabetics. It may be better to keep your medicine in your hand luggage and keep it with you at all times. Paracetamol is very, very useful if you need it - particularly if you have children! You may wish to take a supply of "Calpol" (paracetamol) with you "just in case".

See also Self treatments of common ailments and the Combined Contraceptive Pill