Author Archive

Fear of Flying

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20-25% of persons suffer from this,  and it can have a serious impact on  the  life choices of a sufferer, and even their family. It is a learned response to aircraft and it can be  ‘unlearned’ with the right help. The Wikipedia entry on fear of flying calls it  Pteromerhanophobia, …  a fear of being on an airplane (aeroplane), or other flying vehicle..  It is also sometimes referred to as aerophobiaaviatophobia, or aviophobia. Fear of air travel is a recognised “phobia” but it is rarely just a fear of travelling on a plane. The flying phobia is usually based in a more basic fear such as fear of enclosed spaces (claustrophobia) or fear of not being able to escape from a situation (agoraphobia) or even a fear of heights.

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Marshall Islands

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In December 2013, 19 Doctors attended the inaugural Pacific Critical Care Conference in the Marshall Islands. Director of Capstone Health Dr Matthew Atkins and employee Dr Stephen Massey from were fortunate enough to be among the participants.

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Travel to India

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Towards the end of my second semester of university at the University of Queensland, I expressed to a friend the desire to “one day” do voluntary work somewhere/anywhere overseas.  To which her reply was “Well, I’ve actually just started helping Lattitude do interviews for a volunteer placement starting next February. I can send you a link on Facebook, if you want.”

Fast forward three months, and I was deferred from University and on a plane to New Delhi, nervous and excited for the upcoming months.  As part of Young People without Borders, a new initiative for the Foundation of Young Australians, I was off to teach at a school for underprivileged in Dehradun, a city at the base of the Himalayas.

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Israel Holiday

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‘Boker Tov’, good morning!

Our tour of Israel lasted for twelve days, and every day was packed with visits to historical sites; many recorded in the Bible. It was thrilling to stand in historical places which are so well documented, and to see many towns and cities thriving due to the influx of immigrants seeking a better life style.  As an example, over one million Russian Jews have settled in Israel since the Union of Soviet Socialist Republics (USSR) was disbanded in 1991 under President Michael Gorbachev’s time in office. The present day population of Israel is close to 8,002,300 people.

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Meningococcal B vaccine

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Dr Julie Burke – Yeppoon

BEXSERO , the first broadly effective Meningococcal B vaccine is indicated for immunisation of infants (from 2 months of age), toddlers, children, adolescents and adults against Meningococcal serogroup B (MenB) disease.  It’s  availability to travellers will be particularly useful for infants and exchange students, students studying overseas especially in  residential colleges, people without a functioning spleen, or those with other conditions that impair their immunity.

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Q Fever “Gangnam Style” Toowoomba

Our Toowoomba members’ clinic has been very busy all year with Korean backpackers seeking Q Fever Vaccine prior to working at the local meat works.

This initially presented a few problems with language barriers but we have  had the Q  Fever pre vaccination questionnaire translated into a Korean format (many thanks to Jon Barrell TMA member in Daylesford Vic) .

Other News from the Toowoomba Clinic

Our Wilsonton practice has just completed a much needed makeover with new carpets and a complete repaint, which has drawn wonderful compliments from both staff and patients alike.

We have two new doctors Dr Richie Jaggi and Dr Emma Gradner-Smith also doing weekly sessions which has improved our ability to provide extra appointments.

Our nursing staff pool has also expanded and we have now have four dedicated travel medicine nurses, Natalie Webb, Rebecca Eaton , Belinda Rowney  at  the Wilsonton Medical Centre  and Emma Kropp.

New TMA  Member  at  Brookwater/Springfield

My Life Medical Group opened a new state of the art General Practice within the Mater Health Centre  at the entrance to Brookwater Golf Club earlier this year.This a rapid growth area of South East Queensland and a new direct rail line opens there very shortly.  Dr Cormac Carey is providing travel medicine  consultations  at the clinic and appointments can be made on 3199 3299.

 

Happy Q Fever Patient

Happy Q Fever Patient

Brookwater Clinic

Brookwater Clinic

 

 

 

 

 

St Andrews Hospital Practice

St Andrews Hospital Practice

 

 

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dengue fever outbreak in USA

Prepared by TMA member Toowoomba/Brookwater

For  most travellers to the USA the risk of dengue fever would low on the list of health issues,  however the following report of a dengue fever outbreak adds a sobering reminder to practice  mosquito avoidance measures even in first world countries.

According to the Texas Department of Health, 6 laboratory-confirmed, locally acquired cases of dengue fever, the first locally acquired cases since 2005, have been reported in Cameron County in southern Texas State since early November 2013. Additionally, 23 laboratory-confirmed, locally acquired cases have been reported in Martin, St. Lucie, and Miami-Dade counties in Florida State since August 2013. Sporadic cases without sustained transmission are reported in central and southern Florida State each year. Travellers are advised to practice daytime insect precautions.

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Rabies in Congo

Prepared by TMA member Toowoomba/Brookwater

In August 2013, Médecins Sans Frontières (MSF/Doctors Without Borders) started a rabies intervention in the east of the Democratic Republic of Congo after an alarming number of people were bitten by rabid dogs, and at least 10 people died. Doctors will provide PEP to people bitten or scratched by a suspected rabid dog in the Lemera region in the province of South Kivu this hyperlink.

Rabies in Congo pic

MSF teams struggle to help in an isolated area of South Kivu

After decades of conflict and instability in the Democratic Republic of Congo, measures to control canine rabies have not been implemented, and data on the size of the problem is simply not available.

“The current rabies situation now affecting humans in Lemera is exceptional and must be urgently addressed,” said Dr Jantina Mandelkow, who is leading the MSF team. “We’re doing all we can but we urge others to recognise the severity of the situation and commit resources to its containment and resolution.”

– See more at: https://rabiesalliance.org/media/news/rabies-control-measures-implemented-in-dr-congo#sthash.8vJCL33A.dpuf

MSF teams struggle to help in an isolated area of South Kivu

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Typhoon Haiyan travel advice

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Prepared by TMA member Narre Warren

It is now over a month since Typhoon Haiyan (called Yolanda in the Phillipines) struck the Philippines on 8/11/13. The worst hit provinces were Leyte and Eastern Samar, which experienced sustained winds of 270 kph, gusts of up to 312 kph, and a storm surge in coastal areas as high as 7 metres. Not all travel is for pleasure. Typhoon Haiyan travel advice is be prepared and be informed.

The official death toll from the Phillipines Government is approaching 6000, the injury toll 27000, and 1800 people as of mid December 2013 are still listed as missing. These figures are considered by most to be conservative.

Enormous international aid efforts are underway. Significant infrastructure damage has caused problems with sanitation, food supply, electricity, transportation, shelter, communications, security, and medical care.

Typhoon Haiyan Pic 1.docx

What a mess

This all has implications for people who are considering travelling with aid organisations, or in those visiting relatives and friends to help them. 

The following advice applies to both groups of travellers:

1                Take a kit with you from your travel medicine clinic to treat diarrhoea; diarrhoeal illnesses are likely to be more common after a disaster where serious flooding has occurred. Follow the usual safe food and water precautions advised by your travel clinic

2                Use mosquito repellents with more than 30% DEET to prevent mosquito borne illnesses such as Dengue Fever and Chikungunya. Mosquitos will breed in greater numbers around flooded areas. The areas worst affected by Typhoon Haiyan are the islands of Leyte, Samar and Cebu; they are not affected by malaria so malaria tablets are not required for these islands.

3                Be vaccinated for Hepatitis A and Typhoid; update your tetanus injections as debris clearing will often result in injury. Have a flu injection, and speak to your travel Doctor about other vaccines you may need.

4                Avoid injury—most deaths after a natural disaster are due to blunt trauma, crush-related injuries, and drowning. Use caution around damaged or down power lines, 

water-affected electrical outlets, and interrupted gas lines.

5                 Avoid stray or frightened animals. Seek medical help immediately if you are bitten or scratched by an animal and wash out the wound. Consider rabies vaccination before you go, or seek rabies vaccination within 48 hours of any animal bites.

Typhoon Haiyan Pic 2.docx

 

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Decompression Sickness ( The ‘ Bends ‘ )

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Prepared by TMA Member Boronia 

Decompression Sickness (DCS)  is also known as Acute Decompression Illness (ADI) or, more colloquially, as the ‘bends’ (because the pain involved can bend a person).

DCS in the setting of scuba diving or deep-sea diving, refers to an illness caused by an overly rapid ascent to the water’s surface.

During a scuba dive, the diver absorbs additional quantities of oxygen and nitrogen into the blood and tissues.  The nitrogen is dissolved into the bloodstream, where it remains during the dive.  Once a diver begins their ascent,  the surrounding water pressure decreases. If this transition occurs too quickly, the nitrogen does not have sufficient time to leave the bloodstream and be exhaled via the lungs.  Instead, nitrogen bubbles form in the bloodstream which can enter tissues throughout the body.  

Factors increasing risk of DCS

 

  • Increasing Age
  • Being female
  • Poor fitness
  • Obesity
  • Dehydration
  • Alcohol / hangover state
  • Fatigue / sleep deprivation
  • Sickness
  • Heart muscle defects
  • Ventricular wall defects
  • Airways disease (eg. asthma)
  • The rate of ascent
  • Flying after diving
  •  Repetitive dives
  • Exercise after diving

 

Symptoms of DCS

 Approximately fifty percent of divers with DCS develop symptoms within 1 hour after surfacing, 90 % within 6 hours and 98 per cent within the first 24 hours.

Generally, the sooner the symptoms develop, the more serious the DCS is likely to be.

DCS symptoms vary significantly because nitrogen bubbles can lodge in different parts of the body.  The symptoms experienced are largely determined by the where the bubbles ultimately lodge. eg.  bubbles that lodge in the joints will cause joint pain; bubbles under the skin can cause a blotchy rash/itching; bubble formation in the spine may lead to limb weakness/ paralysis, etc.

 

  • Joint pain (most common).
  • Dizziness.
  • Headache.
  •  Nausea.
  •  Vision disturbance.
  •  Skin changes (blotchy rash, itching).
  •  Disorientation.
  •  Extreme fatigue.
  •  Loss of consciousness.
  •  Hearing problems.
  •  Difficulty breathing, coughing.
  • Tingling/numbness.
  •  Muscle weakness.
  • Paralysis.

 

Early Management of DCS

Seek medical treatment as soon as any symptom of DCS  is noticed.  If available, apply 100% oxygen by mask ASAP to help relieve some symptoms and reduce oxygen-deprived tissue injury. Treat dehydration, maintain blood pressure and prevent shock.

Hyperbaric oxygen therapy in a high pressure chamber reverses the pressure changes that cause the nitrogen bubbles to form. The bubbles redissolve and can then be exhaled by the lungs.

Decompression Picture

 

Prevention of Decompression sickness 

Avoid flying within 24 hours after diving (increasing altitude during a flight will further decrease pressure in the bloodstream, hence potentially increasing bubble formation and exacerbating injuries).

  • Avoid alcohol before diving.
  • Maintain good hydration.
  • Be well rested prior to dive.
  • Avoid diving when sick/weak 
  • Dive within the limits set out in the diving tables. (Be wary of fudged diving tables.)
  • Avoid hot baths, spas and saunas soon after diving.
  • Choose dive destinations where hyperbaric chambers can be reached rapidly.
  • Know the location of the nearest hyperbaric chamber.

 

Divers’ Emergency Service (DES)

This is a free phone consultation service for diving-related medical emergencies. They can also provide the location of the nearest hyperbaric chamber.

24 Hour Hotline:

ph: 1800 088 200 (toll free from within Australia)

618 8212 9242 (if calling from  outside Australia

 

 

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Travel Health Information

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