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16 January 2012 / leggypeggy

On medications—use restraint

I was impressed to see that Europe uses braille on packaging for medications. What an amazing idea.

I have mixed feelings about the Travel Doctor. They do a useful service, but sometimes they overdo it.

Before we headed to Africa in 2009, Canberra’s Travel Doctor gave us a lot of excellent advice about malaria prophylactics and the medications to go with it (more about that soon*). They also gave us a whole raft injections (a couple of thousand dollars worth), and then some.

According to our yellow International Certificates of Vaccinations or Prophylaxis, Poor John and I are protected against yellow fever, hepatitis A and B, influenza, meningitis, typhoid (almost out-of-date), cholera, DTP (diphtheria, tetanus and pertussis, also called whooping cough), and rabies. I thought encephalitis was there too, but I can’t find it.

Regardless, I’m still annoyed about the rabies.

In 1986 in Burma, I was bitten by a dog that became rabid (long story). I had all the post-exposure injections, plus the serum. These were the new and improved French concoctions that came out about that time. These jabs are in the bum, not the stomach. Much better system.

Nowadays, the Travel Doctor gives a preventive jab, then tests your level of protection. If your level is still low, they give you a top-up poke. But preventive jabs only buy you time. If you are bitten by a rabid animal, you still need to go through the whole course of rabies injections, but you have a little extra time to get to help. This is especially useful when you are travelling in remote locations.

I told the Travel Doctor not to give me the first shot, but to jump straight to the test. Good grief, I’d had 15 rabies stabs in the bum and figured I was already well protected. But no, no! They argued that the French jabs were new in 1986 and not really tested when I had them, and I might not be protected.

I should have stood my ground. I paid $130 for the jab and then some additional outrageous sum for the test, only to be told that my immunity level was eight (8) times over the recommended level. Poor John’s was still low and he needed the second jab. My first jab would have paid for his second.

But their overdoing it doesn’t stop at rabies. The Travel Doctor recommends taking a slew of medications with you—a few general antibiotics, plus two or three for specific types of infections. Trying to be obedient travellers and in an effort to protect against the worst, we loaded up on double lots of everything, as well as malaria prophylactics. We’re talking $300-plus in meds (not including the stuff for malaria).

In the end, I never used any of them except the malaria prophylactics (which were essential). I gave most of the rest away, but ended up disposing of everything that was out-of-date when we got home. What a waste. Especially because almost everywhere you go, you can buy whatever meds you need at a fraction of the price you’d pay at home. Just be sure to check the expiry dates.

For that matter, check the expiry dates of any meds you take from home. The first malaria prophylactics we got from the Travel Doctor were going to expire halfway through our trip.* I’m so glad Poor John noticed that before we left. They replaced them all but, in my opinion, they weren’t nearly apologetic enough. It was their mistake because our paperwork specified our away-dates. Instead, they were annoyed that we’d discarded the packaging (which is how Poor John happened to notice).

And now for the meds we did use on the African trip.

We were lucky enough to have a doctor/nurse couple travelling with us for the first third of that trip. They freely shared advice, medical help and the meds they carried with them. They were so generous that when the wife/nurse got sick in Namibia, I was glad to be able to contribute some of my never-used supplies.

I got an ear infection in Mali, which didn’t really become a problem until a few countries later. Nothing in anyone’s medical kit would have helped. I needed ear-drops that I bought for next to nothing in a local chemist’s shop. And although there are genuine fears that meds in Africa might be fake, the ones I bought did the job.

I had one other problem—sort of secret women’s business. You don’t need to know the details because it wasn’t serious, but you should try to imagine me acting out where and what the problem was. Sometimes I have enough French to be dangerous, but not enough French to be understood.

We didn’t take many meds on the London to Sydney jaunt, but we still took too much. I took two courses of antibiotics (not the six or eight that went to Africa) and we didn’t use any. That said, these were for my teeth/gums and I’d have been damn glad to have them if I’d needed them. So no regrets there.

We also took ace bandages (someone else used one), water purifying tablets, Strepsils (used a few), paracetamol, plasters (band-aids), gauze and bandages.

Oh, and I took my blood pressure meds on both trips. If blood pressure is an issue for you, remember that you can get your blood pressure checked in most pharmacies/chemist shops around the world (not China). My blood pressure is great when I travel. So much so that my own local doctor says he now recommends overland travel to all his patients who suffer from high blood pressure.

Note: Comments on this post have some good tips about meds, so be sure to check them out.

Also don’t forget to pick a number before 29 February 2012.

8 Comments

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  1. Louise M Oliver / Jan 17 2012 12:16 am

    Goodness Peggy! I know you were travelling in places that are sometimes remote and that have their own peculiar difficulties. But if I had to take all of the stuff you and Poor John took, plus my regular stash of medicines, I’d need a suitcase for my medicines. Oh well, that’s it then. No six-month overland trips for me! Not that I was going on one anyway but now I just won’t be able to because they’ll have to choose between me and my medicines and, knowing my luck, they’d probably choose the medicines! Thank you for yet another really interesting post.

    Cheers
    Louise

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    • leggypeggy / Jan 17 2012 11:22 am

      The main thing about meds is that you can buy almost everything enroute. I ran out of blood pressure tablets halfway through the African trip (Australia only allows you to get a six-month supply at any one time). I was able to buy plenty of my exact tablet in Namibia and South Africa. They were most likely available in other countries, but I didn’t need to look.

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  2. Sy S. / Jan 17 2012 11:29 am

    Hello Peggy,

    Better to be safe then sorry…… by taking all the precautions and items (within reason), you just never now what you might need in an emergency. How about aspirins, Ibuprofen, cold medications… an Instant Cold Pack Disposable Squeeze Bag ? (Kimberly-Clark); squeeze the bag and it turns very cold, to use on bruises, bumps, swelling, toothaches.

    Your listing is interesting and I will copy and paste for my archives…

    Tx,

    Sy S.

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    • leggypeggy / Jan 17 2012 11:51 am

      Hi Sy
      We did take paracetamol and a pack of cold and flu tablets (which we gave to someone else and then needed in the last week in Australia). The truck was equipped with a better-than-basic first aid kit, so many things were available. Plus, with 25 people on a truck, someone is bound to have something you might need in an emergency.
      Sometimes you are surprised by how little you need in an emergency.
      Poor John was the truck’s first medical emergency in Africa. The second time we cooked, he dropped the campfire grill on his toe and ended up with a nasty hematoma under the nail. The doc who was travelling with us (he was there as a passenger, not as a doctor) sterilised a needle from someone’s sewing kit and punctured the nail to release the pressure. And that was that.
      When I got hit by the motorscooter in Hanoi, there was nothing anyone could do. I didn’t even need a band-aid, even though I was quite knocked around.
      And, of course, there can be horrible emergencies for which no one can prepare.

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  3. Donna Sch / Jan 19 2012 1:35 am

    The most remote place I have ever been was Suriname and the info pamphlets from MASTA were extremely useful. Incredibly detailed if you are going somewhere way off the beaten track. But I did end up taking much more than needed. Antibiotic-wise I would probably stick to Augmentin (amoxycillin with clavulinic acid) as that covers everything from a UTI to toothache to lots of skin things and maybe have a course of a quinolone for food poisoning plus anything really serious. Pain stuff can be tricky as you have to check different countries policies. Eg codeine in Greece can get you arrested. In NZ and the UK acupan/nefopam which is a non-opiate takes the role that Panadeine Forte has in Australia. Aspirin for dental pain but you should be able to get that anywhere. Ibuprofen if you are prone to traumatising yourself. My ex came off his motorbike in East Timor and we had a very interesting phone call as he went through the meds at the local shop. No NSAIDS but lots of aspro and steroids.
    Sports tape is always handy to have and can be used for non-medical things at a pinch. I probably would bring some Elocon ointment for funny rashes becauses that stuff is once a day and jolly effective in a very small tube.
    I never take cold and flu stuff because they mostly work on placebo effect. I would take a salbutamol inhaler for coughs because that often is much more effective at stopping a pesky cough even if you don’t have asthma. An antihistamine can be handy if you are prone to itchy rashes. The sedating kind if you have sleep issues and the non-sedating for everyone else. Doubles up as a treatment for mild allergies.
    Rabies jabs are no fun. The ex got bitten by a monkey in ET which is rabies-free officially but nearby Flores is not. So he got jabbed all over his arm. And he is a fainter at the best of times.

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    • leggypeggy / Jan 19 2012 7:40 am

      Thanks Donna. You’ve added some great advice.
      I forgot about the sports tape and antihistamines. I took and used both, and shared them around as well. Antihistamines also help to lessen the effect of bug bites. I’ll pack an inhaler on the next trip.
      Have never encountered a problem regarding pain killers, but I’ve never had my bag searched like that at a border.
      I’m going to add a paragraph in the main post, recommending that people have a look at your comments here. 🙂

      Like

  4. Waldo Konkle / Feb 5 2012 6:42 am

    I don’t even know how I ended up here, but I thought this post was good. I don’t know who you are but certainly you are going to a famous blogger if you aren’t already 😉 Cheers!

    Like

    • leggypeggy / Feb 10 2012 6:30 pm

      Maybe not famous, but I am having a good time sharing details about our travels.

      Like

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