Sunday 21 January 2018

Ask the GP: How can I deal with my medical conditions while abroad?

Health insurance is vital when a person with medical conditions is travelling abroad. Stock Image
Health insurance is vital when a person with medical conditions is travelling abroad. Stock Image

Nina Byrnes

Advice from our GP on looking after your medical conditions while abroad and on what may be causing recurrent eye infections in a child.

Q. My husband has booked a trip away for my 70th birthday. I have a number of medical conditions requiring prescription medication. Have you any tips to make travel easier?

Dr Nina replies: Travelling away from familiar access to medicine and healthcare can be daunting for those with a chronic disease. When preparing for any foreign holiday, considering your health is as important as considering your wardrobe or travel choices.

Health insurance is vital, especially if travelling outside of the EU. If you have private health insurance, this may provide some cover for travel abroad, but always check your policy before you travel. You may need to top up your policy, or if you have pre-existing medical conditions, some insurance companies will require a medical report from your doctor documenting your fitness to travel. Within the EU ensure that you have a European health card, which will provide access to local public health care.

Planning your trip through the airport is important. Those with arthritis or limited ability to walk far can arrange for transport or mobility assistance through security and to your gate. This must be arranged at least 48 hours in advance of your flight.

Travelling with medication is stressful, especially with all the restrictions that are now in place for carry-on baggage. Ensure that you have enough medication with you for your entire trip and bring some extra to cover any unplanned delays. Bring a copy of your prescription with you with details of the generic names and doses clearly detailed. You may need to provide this at airport security to confirm the need to carry these drugs and it will help if you need to seek an emergency prescription abroad. You should also bring your doctor and pharmacist's name, address and phone numbers with you. Carry a letter from your doctor that clarifies your medical history along with a list of medication, and any allergies. This can also verify if you need to carry items such as syringes or needles.

Transport all your medication in your carry-on bag. Securing emergency prescriptions abroad can be very difficult to do. Some medication is temperature sensitive and the temperature of the cargo hold of an airplane can vary from very cold in the air to very hot on the ground. Carry your medication in its original packaging and not in dosing boxes. This will make it easier for airport personnel to verify its authenticity. Also talk to your doctor before you travel to arrange a dosing schedule when travelling across time zones. Some medication is best taken at the local hour, but the interval between doses remains the most important for certain medication, and you may need to adjust the times at which you take it.

If you find yourself abroad and needing medical assistance or prescription medicine, talk to your tour provider or hotel staff. They can usually direct you to medical services that are used to dealing with tourists or who speak English. Your travel insurance should also have an emergency contact line and this can be a helpful source of advice on local care. Some medication that is only available on prescription in Ireland can be purchased over the counter abroad. Talk to a local pharmacist for advice.

Q. My son seems to have recurring eye infections. His lids are sticky every other week. He seems to be able to see OK and the eye itself looks alright. We clean his eyes regularly and he isn’t in a crèche. What’s causing this?

Dr Nina replies: Tears produced in a tear gland in the upper eye drain from the eye through the tear duct which runs from the inner corner of the eye to the back of the nose.  5% of newborn babies will have an immature tear duct. This causes an effective blockage in the drainage system. Watering or tearing of the eye may starts days or weeks after birth. Sticky discharge occurs at times, as the normal process for clearing bacteria from the surface of the eye is impaired.

Thankfully the tear duct issue resolves itself in ninety per cent of cases by the time the child is twelve months and so specialist review or any kind of procedure is not necessary unless infections are severe or symptoms persist beyond the first year of life.

If discharge is thick of the conjunctivae is becoming red or inflamed, infection may be present and antibiotic ointment or drops may be required.  Antibiotics don’t clear the duct and discharge can reoccur.  Taking a medical swab of the eye will help to identify the cause of infection. Massaging from the inner corner of the eye to the outer corner of the nose and from the side of the nose to the inner corner of the eye will help clear any debris from the blocked duct. This may need to be done many times a day. If symptoms persist more than a year you may be referred to see an eye specialist who can perform a procedure to clear or open the duct.

Recurrent sticky eye in new-borns is rarely due to other bacterial infections such as chlamydia, gonorrhoea or viral infections. In these cases the conjunctivae is usually red and infected and the baby may be unwell in itself. These causes are rare.

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