Archive for the ‘Maitland’ Category

The Kokoda Track

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The Kokoda Track

Ann-Maree Smith ( traveller/ patient of the Maitland Clinic )

When an email crossed my desktop early in 2014 and my 37-year-old nephew came on board, it was on. With four months left to departure, we made good use of training in local forests and national parks. Steep hills became loved, like never before. Our favourite climb was 153m, up and down five times, with 12kg in our backpacks. We also went to the gym, using weights to improve strength.

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Kayaking in Remote Solomons 
- Morovo Lagoon

Prepared by TMA Member Maitland

Public Health Physicians also need travel health advice. Another satisfied (and healthy) Chromis customer. And the beautiful fish is our symbol. Check our website www.chromis.com.au for more information on us and our services.

As we set out that first day, my daughter was convinced we were in a travel commercial. Under blue skies we paddled through clear warm tropical waters with spectacular views of the coral and sea life below. There were mangroves and palms to the waters edge, an occasional idyllic sandy beach and hardly a soul around. And even when the heavens opened that afternoon, we were delighted. Paddling in warm rain!

We camped in tents on a tiny uninhabited island that first night then visited local lodges for the next two. We explored islands and villages, clambered to a waterfall, shared an impromptu evening of music and had a brief insight into local culture and history. This is a beautiful and undeveloped region and kayaks are such a gentle, peaceful way to explore it.

Back at Uepi we sadly returned our boats and settled in for days of exploring the local reefs. The dive from the resort jetty was amazing; school fish, giant clams, reef sharks and a scorpion fish. And then there were scores of other snorkelling sites a short boat ride away; big drop offs, coral gardens, sea snakes and crayfish and an extraordinary diverse range of fish. On one special pre-breakfast snorkel our family had exclusive water time with a school of Manta Rays.

By good fortune our visit coincided with the Festival of Pacific Arts and Honiara was host to a superb mix of neighbouring peoples. For a few fascinating nights we soaked up the singing and dancing, traditional arts, short film festival, photo exhibition, and fireworks. Good fun.

We loved the Solomons and would happily return. We took the usual enteric precautions, took antimalarials and stayed well.”

… Prepared by patient of Chromis Travel Medicine Service 


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Acute Mountain Sickness (AMS)

… Prepared by TMA Member Maitland: Dr Puru Sagar Chromis

A survey among travelers departing from Cuzco International airport in Peru showed that almost half of all travelers (48.5%) interviewed reported symptoms of altitude sickness, and 17% had severe AMS. One in five travelers with AMS was forced to alter their travel plans. Three people were admitted to hospital and one was urgently evacuated.

Only one-sixth (16.6%) of the group used Acetazolamide (Diamox) for prevention of AMS, but more than 60% used coca leaf products.

Unfortunately, the use of coca-leaf products (usually tea) was found to be associated with a greater risk of developing AMS in this study. Use of coca-leaf can have other negative side-effects (changes in circulation and cardiac arrhythmias) as well as a positive urine drug screen to cocaine.

Other recent reviews have found that Diamox 250 mg half tab twice daily reduced the risk of developing AMS by about 48%. There was no benefit in taking higher doses. Diamox is strongly recommended for travelers flying into Cuzco (elevation 3,225 m) and is often required at lower altitudes (around 2,000 m).

These scientific studies underline the need to obtain accurate and up-to-date advice from an experienced travel medicine practitioner before undertaking trips to altitude. Prevention is really worthwhile.

The Travelling Well iPad app or iBook from Dr Deb the Travel Doctor has very useful information on preventing and recognizing altitude illness.

 

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Japan and Your Medications

… Prepared by TMA Member Maitland NSW:Dr Puru Sagar Chromis Sept 2012

It is generally well known that you can’t take certain medications into Middle Eastern countries but did you know that there are restrictions on medications imported into Japan, even for personal use? It is illegal to bring into Japan some over-the-counter medications including cough and cold, sinus, and allergy medications containing stimulants or codeine. Did you know that your body (specifically, your liver) can convert a 30mG tablet of codeine into as much as about 5mG of actual morphine? In Japan, codeine is thus considered a narcotic and its importation is prohibited. An illegal or backyard chemist can distil as much as 23mG of morphine out of a 30mG tablet.

Japan will generally allow up to a month’s supply of your personal medication as long as it is not a prohibited substance (such as narcotics and stimulants). However, you will still need to declare your medication at customs. Quantities larger than a month’s supply, including syringes, pumps, and CPAP machines, may still be allowable provided you have pre-arranged an import certificate called the “Yakkan Shoumei”. You will need two copies of an Import Report of Medications, a signed Declaration, an Explanation of the Products, a copy of a doctor’s Prescription or Direction, your travel documents listing arrival date and port, and a return envelope with Japanese postal stamps. Only when the Pharmaceutical Inspector “can confirm that your application documents are complete and he admits that you speak the truth, he will send you a ‘Yakkan Shoumei’ by post”. The Japan Ministry of Health lists an example form filled out by one Sherlock Holmes trying to import morphine for personal use during a conference in Japan!

The US Government warns its citizens that “some US prescription medications cannot be imported into Japan, even when accompanied by a customs declaration and a copy of the prescription” and that Japanese officials have detained travellers carrying prohibited items “sometimes for several weeks”. Apparently, Japanese officials do not make on-the-spot humanitarian exceptions.

If you are going longer than a month, please note that Japanese doctors can prescribe similar, but not identical, medications to yours (the generic will be the same but the brand name will be different). You can generally find a list of English-speaking doctors and medical facilities on the web, noting that medical treatment in Japan is world class but expensive. Buying drugs such as Viagra or Prozac on the black market in Japan can lead to arrest and imprisonment.

Prior to travelling overseas, it is wise to undertake some preliminary research well in advance of your travel date about medication importation, even if that medication is for personal use. A good place to start is atwww.smartraveller.gov.au but more comprehensive information is generally available from the embassy/high commission websites or that country’s Ministry of Health website. If in doubt,  ask your TMA doctor.

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