Traveling with Children

Perhaps the ones who suffer the most when there are delays are those traveling with young children. Carry essential supplies for changing and entertaining and make use of the play areas situated in many European airports. Being on holiday with children can be exciting and carry wonderful memories for years to come - or it can end up with parents needing a break as soon as they return home!

• Think ahead of your child to prevent accidents - many countries do not have the same health and safety regulations you have at home.

• Take some remedies or medication with you if you are unfamiliar with local medicines - child paracetamol, rehydration fluid, travel sickness medicine etc. Also take a copy of your repeat prescription if your child is on any medication should you need more medication while away, play safe and get enough from your Doctor before you leave.

• When travelling across time zones try to get your child adjusted as quickly as possible to the time with plenty of fresh air and healthy meals at local times on arrival.
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Fear of Flying

This is a common psychological health problem among travelers; recent estimates suggest that between 10-40% of all travelers experience some kind of phobia. Many factors can be associated with this condition, all of which need careful consideration and help. While factors associated with a fear of flying can be psychological in nature, travelers can also experience further pre-travel stress due to poor pre-travel preparation.

Good planning is essential to overcoming travel fears. Many in-flight medical emergencies can be attributed to the stress that builds up at the airport, before you get on the plane. If you are at risk of DVT, discuss prevention with your doctor or nurse.

If you can, pre-book seats and order any special meals you might need, including any children's meals. If you have any health disabilities, contact the airline in advance of your trip to discuss special requirements, such as wheelchairs or assistance on and off the plane. If you have never traveled to your airport before, allow plenty of time to get there. If you are unfamiliar with the airport layout, or are a first time traveler, try a practice run prior to your day of travel.

Understand that travel fears are common. Try to avoid excessive alcohol or drugs as a way of helping you to cope. Alcohol will not get rid of fears and often makes them worse; it will also leave you dehydrated. If you have to travel a long distance by air, try to avoid connecting flights. A little extra money spent on a direct flight is worth the expense, if it means no added anxiety about possible delays or missed connections.
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Travel-Related DVT

A Deep Vein Thrombosis (DVT) is a clotting of the blood in any of the deep veins - usually in the calf. If a clot develops, it usually makes its presence known by an intense pain in the affected calf. Medical health attention should be sought immediately if this occurs, especially after a long journey. In some cases this can be fatal, if the clot breaks off and makes its way to the lungs where it can then affect the lung's ability to take in oxygen.

A DVT can occur some days or even weeks after a trip. Most cases have at least 3 risk factors - the risk increases as risk factors increase. Very little established health research exists in relation to travel. However there is a wealth of information from hospital research specific to DVT. The following factors increase the risk of travel related DVT:

• Immobility for an extended period of time
• An existing history of DVT
• Malignancy
• Recent surgery or leg surgery
• Existing clotting abnormality
• Obesity
• Chronic illnesses
• Hormones or the oral contraceptive pill
• Varicose veins
• Pregnancy or 2 months past pregnancy
• History of Cardiac problems
• Dehydration
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How to reduce the risks of a DVT

Those at risk should try to exercise at least every hour on long journeys. Exercise the calf muscles by rotating your ankles, or making use of the commercially available exercise equipment. The health risk applies to any form of travel where you are routed to one place for hours at the time.

For long flights wear loose clothing. Due to the change in atmospheric pressure in a plane, parts of your body can expand due to increased gas! In the dry environment of a plane, it is a well-documented fact that too much alcohol, tea and coffee on flights can add to the problem of dehydration. It is therefore very important to remain hydrated during a long flight by drinking plenty of water and fruit juices.

With much attention given over the potential risks associated with Travel Related Deep Vein Thrombosis, it is not surprising that many people are looking for health products, which will offer protection. Health Research has shown that correctly fitting anti-thrombosis stockings increase blood flow, thus lowering the risk of DVT in those at risk. Advice related to stocking/socks should apply to all forms of travel when a passenger is sitting still for a long period of time.
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Coping with Jet-lag

Our bodies adjust to a natural rhythm that promotes sleeping at night and being active and alert during daylight hours. When we travel across differing 'time zones' our normal rhythm is altered. The sleep disturbance and loss of ability to concentrate, as well as the irritability felt during that time is called jet lag.

The earth is divided into 24 time zones, with time changing by one hour for every 150 of travel east or west of the Greenwich meridian. Traveling from London to New York means turning your watch back by five hours. And traveling to Japan entails turning your watch forward by nine hours (nine time zones). Hence arriving in Tokyo by plane from London at bedtime your body will feel as though it is lunchtime. It takes time (about one day per time zone crossed) to adjust to local time.

In order to cope with Jet lag you should get a good deal of sleep before your journey. It is also important to rest as much as possible during your flight. Planning to arrive at your destination as near to the time when you normally go to sleep will also help with the adjustment. If you are able to plan your itinerary allow time on arrival for adjustment.

Some people advise changing their watches to destination time when they get onto the plane. While this helps many people, for those who are on regular medication, such as diabetics, watches should remain on home time until you are able to adjust your medication to local times on arrival at your destination.

On arrival at your destination get active as soon as possible and adjust your meals and activities to local time as soon as you can. Exposure to light is also a good way of naturally allowing your body to adjust. If you need to take a short nap - use an alarm clock or a helpful friend to wake you up!

Airplane earache

Have you ever taken a relatively long trip on a jet and discover as the plane begins to descend, that your ears really hurt? For several hours after the flight you can have a very difficult time of it understanding what people are saying too! If you phone up any medical health personnel at airports you usually get health advice about chewing gum, sipping drinks, swallowing and so on, but it has never helped me.

Why do we get earache? When the plane is gaining altitude, the surrounding air pressure decreases quickly, causing pressure to build up in the middle ear cavity, pushing the eardrum outwards as the plane climbs. Sometimes yawning or swallowing can help to relieve the pressure a bit but the pressure changes too quickly for some people to adjust to.

Really bad air earache usually hits (well it does with me) when the plane descends and the heavier pressure outside pushes the eardrum inwards. This can create a sense of blockage or outright pain. This is because low pressure in the middle ear cavity creates a vacuum effect, which tend to stick the Eustachian tubes of the ears together, rather like a flattened drinking straw.

If sipping and swallowing does nothing for you, try this: Close your mouth and pinch your nose tight shut. Then blow out your cheeks and that will force air into your middle ear. You will need to make your cheeks bulge a lot, and don’t be worried if you hear a click – that’s the sound that tells you it has been successful.
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Preventing accidents when you are away

There are more tourist deaths related to road traffic accidents and drowning than from diseases! When you are away on holiday or away from home you tend to be more relaxed. And in an uninhibited environment away from social restrictions that you may normally live by at home - being off guard means a higher risk of having an accident! Here are a few tips to avoid accidents:

Preventing Insect Bites

Malaria is not the only disease that is transmitted by mosquitoes - Dengue Fever is becoming increasingly more common in tropical climates. Your first line health protection against any insect borne disease is not getting bitten in the first place. Risk of contracting certain diseases varies with location of your accommodation and for those traveling to rural areas certain risks increase.

While malaria mosquitoes feed between dusk and dawn, other types of mosquitoes carrying different diseases bite at other times of day. It is important to discuss with your Health advisor when you are at risk of mosquito borne disease and what time of day carries the greatest risk. Mosquitoes tend to respond to light in their feeding habits, some preferring daylight, others darkness.

Malaria mosquitoes usually prefer low light hours after dusk until dawn. Dengue mosquitoes' peak biting times are the few hours before dusk and the few hours after dawn and are present during the day light hours.

Avoid being bitten by mosquitoes by applying a good mosquito repellent to exposed areas every 6 hours. Clothes can also be impregnated with repellent for further protection. If wearing sunscreen, apply your repellent on top. Keep your legs and arms covered with clothing to lower risk of bites on the skin.

Avoid wearing dark colours, as they can attract mosquitoes. While mosquitoes are able to bite through many materials, canvas mosquito boots and thick denim jeans will make it more difficult in rural areas, where the risks are always the greatest.

Use a 'knock-down' spray in the evening or a plug-in insecticide to get rid of mosquitoes before going to sleep, or to leave plugged in overnight. Avoid strong perfumes, hair sprays or after-shaves as they can attract mosquitoes! Use air-conditioning if it is available. Because air conditioning helps keep the mosquitoes away due to the lower temperature, it is important that it is left on all day and that the windows or shutters are not left open at night!

Try to avoid evening walks beside rivers and ponds as this is where mosquitoes breed. Other biting insects include the small sand fly, which is capable of spreading Leishmaniasis in certain locations; ticks, which are responsible for diseases such as Lymes disease; and mites which can cause scabies; as well as many other different species.
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Avoiding Stomach upsets and Travelers Diarrhoea

Traveller's diarrhoea is the most common health problem among those who travel to tropical locations and in many parts of the world it is merely a case of when, rather than if. Any food or water from an infected source can cause diarrhoea. Symptoms usually begin about three to four days after arrival. It can continue for up to ten days after return. The risk of diarrhoea when traveling is very much related to the destination, level of accommodation and travel habits.

Those who only go to 5 star hotels will be at a lower risk of suffering digestive upsets than those eating and living in local accommodation and restaurants. There is some evidence to suggest that those who travel frequently (at least every six months) to developing countries - do build up a limited defense against Traveller's Diarrhoea. However, this is not a life long health immunity.

While in some destinations, digestive upsets will be inevitable, some steps can be taken towards prevention and it is important to understand how traveller's diarrhoea is transmitted.

• Use bottled or boiled water for cleaning your teeth, don't open your mouth and drink water in the shower.

• Make sure that meat eaten is well cooked. Avoid seafood and abide by the "cook it, boil it or peel it" rule when eating in local restaurants. Wash salads with a good source of clean water - in fact when eating out avoid salads at all costs in high-risk locations! Avoid any food that has been re-heated and left at room temperature. • In developing countries order drinks without ice, avoid roadside food vendors selling ice cream and unwashed fruit.

• Eat early if you have a buffet that has been sitting out for long periods during the day - food kept warm under food lamps can be a source of infection.

• Avoid - unpasturised milk, shellfish, soft cheeses, lukewarm food and empty restaurants!

• Apply strict health hygiene while away especially after using the bathroom and before you eat food - never use communal, damp towels in public conveniences! Use disposable paper towels or hot air. • If you get diarrhoea - drink plenty of clear, clean fluids. It might be helpful to take diarrhoea medication along with you with some rehydrating fluid. If it continues for more than 48 hours and you are unable to drink, or are passing blood - SEEK IMMEDIATE MEDICAL ATTENTION.
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Self Treatment for Digestive upsets

Despite all these health precautions, if you should suffer an attack of a stomach or bowel upset just follow these guidelines:

The first rule is to try to get some rest and drink plenty of clear fluids. It is important, especially in hot climates, that you do not become dehydrated. If you feel like eating, good foods are bananas, salted crisps, rice or clear soups. Avoid alcohol at all costs. In most cases, this condition is self-limiting and with a little rest and rehydration you can regain your normal health and be on your way again.

Taking an over-the-counter anti-diarrhoea medication such as Loperamide or Immodium will stop the diarrhoea, especially if you have a flight to catch. While it is important not to take more than the recommended dose, some people can feel constipated after taking this medication. The reason people may believe they are constipated is that Loperamide works by slowing down the movements of the gut and restoring natural balance. Therefore people may then not need to go to the toilet for a while afterwards until the gut movements have been restored to 'normal'.

It can take a while for food to reach the gut again as most or all of the existing gut contents have been rapidly removed as diarrhoea. This medication should not be taken if you are passing blood or have a history of bowel problems; in this instance you should consider an alternative health treatment before you leave for your trip.

Antibiotics as advised by your doctor, should be taken if the condition does not improve or worsens. Diarrhoea treatment packs can be purchased at most travel clinics and contain a single dose of antibiotic, which can be taken if a fever accompanies the problem. For women taking the pill it is important to recognise that absorption of the pill can be affected by traveler's diarrhoea. If this occurs always use alternative protection, as well as continuing with your normal oral contraceptive pill.
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Protection in the Sun

Recent media reports have questioned our faithful trust in our high factor sun creams. The results of studies have suggested that sun cream alone will not prevent skin cancer and reports suggest that increased rates of skin cancer could possibly be, directly or indirectly, related to our use of sun cream.

Sun cream is often applied too thinly - to cover the whole body about an eggcup amount is needed every 2-3hrs. It should also be applied at least 30 minutes before going out into the sun. Insect repellents should be applied on top of sun cream where needed. You should never stay in the sun for excessive periods of time in the belief that your sun cream will offer unlimited protection.

The higher the SPF factor on your cream, the greater the protection against UVB rays which cause burning. When used regularly and in proper proportions - you should not need more than a factor 15 - even in a tropical climate. A high SPF factor will only help prevent burning - it will not always protect against UVA rays, which are not taken into account when calculating the SPF. UVA protection is usually rated separately between 2 and 4.

It is important when traveling to recognise both the long and short-term risks associated with too much sun exposure. This is true not only on the beach, snow, sand and water will also reflect the sun's rays and our choice of clothing can play a part in protecting our bodies.

Wear clothes that will protect you in the sun - sunglasses, clothing of tightly woven fabric and a sun hat covering the neck, ears and back of the neck. By avoiding the sun between 11am and 3pm you can prevent sun burning and overexposure. Too much sun even in the UK can eventually lead to skin cancer, ageing or sunburn.

When you arrive at your destination don't sit out all day on the first day - gradual exposure to the sun is far healthier and safer, increasing your time as you get used to the sun. Drink plenty of non-alcoholic drinks while in the sun to prevent dehydration. If you are on any medication check with your doctor before you go away as some medications can make you more sensitive to the sun.

By taking at least some of this advice you will probably have an easier and more pleasurable trip and holiday. Have fun and Bon Voyage!
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Further Reading

Find out about health and nutrition around the world

Some more advice about the benefits and dangers of too much sun

Some more traveling advice here A page of questions relating to areas of health including travel.

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