Client Travel Tips

Dominique Tessier, MD, CCFP, FCFP

In a busy travel clinic, it is difficult to cover all the important aspects of travel medicine. After the recommendations regarding vaccine preventable diseases, vector-borne disease prevention, the prescription of medication for malaria prevention and self treatment of travellers' diarrhea, the traveller may not be listening to you anymore. A simple document addressing "comfort" issues to be given to the patient at the end on the consultation may be helpful.

We made such a document into a colourful poster, with nice icons, and placed it on the waiting room wall. Very popular! It is with pleasure that I share it with you, hoping you will leave the source on the document.

Tips That Travel Clinics Can Pass on to Their Clients

Check the specific entry request for each country to be visited. Consult the Consular information for travellers. You can call to the consulate or visit this web site: www.dfait-maeci.gc.ca Note: this reference is in French. An English version is available by clicking "English."

Travel light. Bring the very minimum you will need. Call the place where you will stay to see what they have available. Forget about irons and blow dryer. In most cases, these only mean more weight. If you are good at minimizing, you may be able to manage with carry-on luggage only. This could save you 30-45 minutes both at departure and arrival (with your ticket, you can go directly to the departure gate and get your boarding pass there). Of course, this also avoids luggage not taking the same route as you. Luggage on wheels is a bit more expensive, but is usually worth it. Kids love to pull them. In general, a plastic-coated photo or a colour string can help identify your checked luggage and avoid common mistakes.

Get yourself comfortable. Especially for long flights, bring a few extras: inflatable pillow, ear plugs, eye mask, slippers or warm socks and some reading and writing items. If you are tall or have joint pains, ask for an isle seat to stretch your legs. Otherwise, window seat are more comfortable as the wall allows you to lean against it to sleep. If your back gives you trouble on flights, also ask for an aisle seat, enabling you to get up and walk about more frequently without disturbing the other passengers. If you will be in a hurry on arrival, ask for seats in the front of the plane.

Bring a book, cartoons, magazines, CD player, writing material and, why not, your travel diary to work on en-route.

Hydration is a must. Humidity level on commercial flights is extremely low, less than 15%. The longer your trip, the more it will affect you, causing headaches and dryness of your skin and mouth. Bring your own small bottle of water that can be refilled during the flight. And use a nasal lubricant like Salinex® or Rhinaris®. Avoid caffeine and alcohol; these are diuretics. Gaseous drinks may increase flatulence.

Eat what is good for you. Special meals can be ordered, if you notify the airline at least 72 hours in advance. You can also have your request put in your profile with your frequent flyer accounts or travel agents. Bring personal items like citrus fruits, nuts and dried fruits, crackers, granola bars and chocolate. Snacks are most appreciated by kids. Gum will help during landing. Most food items cannot be brought into a new country. You may have to discard what's left, if any, on arrival.

Most airlines offer the following special diets: Hindu, kosher, Muslim, Japanese, Childen's, fruit plates, fish and sea food, diabetic, without gluten/sulfite/lactose, low fat, low calories, low sugar, soft diets.

For infant formula preparation, take the powder form instead of liquid. Most airlines can warm infant bottles on board. But it is much easier to put the pre-measured amount of powder in a plastic bag (like Playtex®) and to use a calibrated bottle to add the amount of warm water required. Then you need only one bottle bag holder. This saves a lot of room, and decreases the risk of spoiled milk.

Food allergies. Carry your own Epipen® if you or your children suffer from food allergies. Peanuts are a major problem. Most North American and European airlines have banned peanuts on their flights. But they cannot control what other passengers bring aboard. For a child who is seriously allergic, inform the passengers in the nearby seats, explain the risk to the child ("candies" found on the floor), and be prepared with an Epipen® on hand.

Prevent motion sickness. Many medications are now available to decrease this uncomfortable feeling. Trans-dermal patches (Transderm V®) can be used but they must be applied at least 12 hours before departure. Closing your eyes may help. Never leave with an empty stomach; this increases the risk.

Bring all your medications in your hand luggage. The luggage compartment of the aircraft may not be heated, bringing the temperature down to minus 55°C. Injectables like insulin and Epipen® may freeze and break. Inhalers are also very sensitive to freezing. Other medication may be "transformed" without showing any sign of it. Never mix different medications in the same bottle to save room. Custom agents do not appreciate it. If needed, ask your pharmacist for smaller containers with proper labels on each of them.

Get the special attention your condition requires. On flights and cruises, you can usually request the following special services: oxygen (for severe anaemia and cardio-respiratory problem); an escort at airports (for the visual and hearing impaired and for children travelling alone); wheelchairs designed for aircraft aisles (most wheelchairs in use are too large for these ailes); guiding dog; special fares for accompanying persons; hearing adapters for the audio system; and baby hammocks, for example.

Extra clothes in your carry-on luggage. This may be a good idea just in case your luggage does not reach the same destination as you.

Carry travel insurance. You never know when you might become ill or have an accident. Insurance is important, even if you have an ongoing medical problem that may not be covered. Be honest. Accidents and other illnesses will be covered.

Be patient. On most trips, delays of one kind or another are almost inevitable. Try to avoid tight connection. And take life, and travel, with a smile.

The Canadian Health Network, in collaboration with the Canadian Public Health Association, have recently made available on its web site, in English and in French a document on Frequently asked Questions (FAQ) regarding immunisations. I was one of the consultant and I believe this document can be helpful for your clients. You will find answers to the following questions :

• What is a vaccination and how does it work?
• Why do we need to get vaccines against diseases that have been wiped out?
• Are vaccines safe?
• How well do vaccines work?
• What are the common myths about vaccination?
• When should children be vaccinated?
• When should adults be vaccinated?
• What vaccinations should I get if I am going to travel outside Canada?
• Are there any reasons why someone should NOT be vaccinated?
• Where can I get vaccinated, and do I have to pay?