4 Types of Travel Notices that Can Save Your Life!

The CDC provides travel health notices for travelers regarding possible health issues at their destination site. Health issues at any destination can be created by severe weather (floods, hurricanes, etc.), no power resources available, no potable (drinkable) water, insect or animals, outbreaks of diseases or wars.  The CDC provides a travelers health page, as well as the US Department of State on their Travel Alerts and Warnings page.  For weather conditions, visit the NOAA International Weather Selector page.

4 Types of Notices

Watch A (Level 1) notice encourages travelers to practice usual precautions, such as, vaccinations, hand washing, and avoiding mosquitoes.

Alert (Level 2) notices encourage travelers to practice enhanced precautions, such as, additional vaccinations, and monitoring for local disease outbreaks.

Warning (Level 3) notices encourage travelers to avoid non-essential travel because they are at risk for exposure, such as, a large scale outbreak, war.

Avoid (Level 4) notices instruct travelers to avoid all travel due to dangerous situations that can put their life at risk.

Safety Considerations

Animal safety, such as, exposure to bites, scratches, saliva, and fecal/urine from cats, dogs, bats, rats, and insects, can result in long term or permanent illness or death. Rabies is still a very common infection around the world.  Insect bites from fleas, flies, mosquitoes, ticks, and bed bugs can cause a host of infections from mild to serious.

Hypothermia and frostbite can be acquired from destinations with cold weather.

Sun or heat exposure from hot weather destinations and UV rays can cause sunburns, and heat stroke.

High altitudes can cause altitude sickness which can then result in flu like symptoms, carbon monoxide poisoning, pulmonary and cerebral edema. High altitudes have a low pressure of oxygen that affects humans more than animals.

Natural disasters can cause injury by blunt trauma, drowning, and crush related deaths.

Food and water safety is crucial to the traveler. Fresh cold pasteurized milk, alcohol, and steaming hot drinks and food should be safe.  Heat kills germs.  Bottled and canned water and drinks are safe if the traveler opens them.  Buffets can lose heat and get contaminated.  Dry or packaged foods are usually safe as long as it is not handled by others.  Avoid raw food, street food, and bush meat as Ebola and SARS can be spread to the traveler. Tap water is risky for drinking, showering, and brushing teeth. Fountain drinks and ice are also risky.  Fresh juice is safe if washed in safe water and squeezed by you.

Acute vs Chronic Bronchitis

Acute bronchitis is more common during cold and flu season. Acute inflammation is caused by a virus or bacterial infection and usually resolves on its own except for people with:
1. Respiratory irritants such as cigarette smoke, pollutants, chemicals
2. Lowered immune system- such as children, elderly, pregnancy, cancer,
diabetes, HIV
3. Heartburn- GERD
4. Respiratory conditions- Asthma, Chronic Obstructive Pulmonary Disease
(COPD)
Symptoms usually began with upper respiratory set the symptoms such as sore throat stuffy nose and cough. The cough starts as a dry hacking nonproductive and usually interrupts sleep. After a few days mucus production begins. Chest X rays may be normal or show inflammation. Scattered wheezing may be noted, and fever may be present. Respiratory infections can last up to 3 weeks. Symptoms include cough with little to no sputum, low grade fever or chills, sore throat, body aches, tightness or pressure of the chest. Sputum tests look for type of respiratory infection such as pertussis.

Chronic bronchitis involves excessive mucus production. There is a relationship between the amount and duration of cigarette smoking and severity of bronchitis. But in advanced stages of chronic bronchitis, emphysema can develop as well as heart failure, increased airway obstruction, and Polycythemia which can result in pulmonary embolism. Diagnosis occurs when the cough and increased mucus production occurs three months each year for two years. Advanced stages of chronic bronchitis can resemble emphysema. Over time chest xray results would show hyperinflation of the lungs. Pulmonary function tests show airway obstruction.

Seek medical care if:
1. Cough lasts more than 3 weeks
2. Prevents you from sleeping
3. Fever of more than 100.4
4. Yellow/green/dark colored mucus or having streaks of blood
5. Having wheezing or SOB

Treatment includes bed rest, and increase of fluid intake as well as:
1. An antibiotic if infection is bacterial
2. Cough medicine- to help expectorate mucus. Cough suppressant only at
bedtime allows for better sleep
3. Inhalers to reduce inflammation and open narrowed passages in your lungs
4. Wear mask if your exposed to respiratory irritants at work
5. Use humidifier
6. Vaccines- flu, and pneumonia
7. Hand washing to prevent spread of viral infections.
8. Use hand sanitizers

Heartburn!

Heartburn, or acid indigestion, is a burning sensation mid chest that worsens when you bend over or lay day. It usually occurs after eating and at night.  It is caused by reflux. Reflux occurs when the acid in your stomach backs up into your food pipe (esophagus), resulting in inflammation.  It is considered a disease when you have symptoms more than 2 times a week.

Gastroesophageal Reflux Disease (GERD) is a condition of digestion that allows stomach acid to go up the esophagus due to a weakening of the muscle at the point where the esophagus ends and your stomach begins. GERD often interferes with routine daily activities, and result in damage to your esophagus.

Symptoms- heartburn, vomiting or spitting up blood, bitter taste in mouth, burning chest pain, dry cough, painful throat, painful swallowing, and hoarse voice.

Complications- scarring of esophagus, bleeding in stomach or esophagus, ulcer formation in esophagus or stomach

Risk Factors

Spicy or hot foods

Alcohol, soda, caffeine

Fatty foods

Gassy foods (certain vegetables)

Pregnant

Obese

Smokers

Abdominal hernias

Treatment for GERD

Antacids– help to neutralize the acids in your stomach, but will not treat the inflammation of the esophagus. Over use can cause constipation and diarrhea.

Gaviscon

Tums

Maalox

Mylanta

Rolaids

Histamine-2 (H2) Blockers -Reduce production of acid in stomach. May not be as good for treating esophagitis (inflammation that occurs in the esophagus). Histamine stimulates acid production, especially after meals, so H2 blockers are best taken 30 minutes before meals. They can also be taken at bedtime to suppress nighttime production of acid. Examples of prescription H2 blockers:

Nizatidine (Axid)

Famotidine (Pepcid)

Cimetidine (Tagamet)

Ranitidine (Zantac)

 

These drugs are useful at relieving heartburn, but may not be as good for treating esophagitis (inflammation that occurs in the esophagus).

Side effects can include headache, abdominal pain, diarrhea, nausea, gas, sore throat, runny nose, and dizziness.

Proton Pump Inhibitors (PPIs)

Drugs that block acid production more effectively and for a longer period of time than the H2 blockers, PPIs are best taken an hour before meals. They include:

  • Rabeprazole (Aciphex)
  • Esomeprazole (Nexium)
  • Lansoprazole (Prevacid)
  • Omeprazole (Prilosec, Zegerid)
  • Pantoprazole (Protonix)
  • Dexlansoprazole (Dexilant)

Many doctors do not believe that one drug is more effective than the others in treating GERD. These medications are also good for protecting the esophagus from acid so that esophageal inflammation can heal.

Side effects can include headache, diarrhea, abdominal pain, bloating, constipation, nausea, and gas.

Home Care

Avoid eating foods and drinks that trigger heartburn. fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, citrus fruits (Pineapple, strawberries), vinegar, foods that can cause gas (peppers, cabbage,) and caffeine may make heartburn worse.

Do not over eat.  Try eating smaller frequent meals.

Do not lie down after a meal, and wait 2- three hours after eating before lying  down or bending over

Elevate the head of your bed

Do not smoke.

Avoid medications that can irritate your stomach, like NSAID’s (Aspirin, Aleve, Ibuprofen)

Weight loss may help to reduce abdominal pressure pushing acid into the esophagus

Avoid wearing tight clothes

Seek medical attention if symptoms occur for more than 2 times a week, and over the counter medications do not help, if you have difficulty swallowing, nausea, vomiting, or weight loss.

6 Key Symptoms of Asthma

The Mayo Clinic defines Asthma as “…a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult…” The Environmental Protection Agency (EPA) reports there are 24 million people with Asthma, 6 million of which are children. Over 14 million doctor office visits were related to asthma, and 1.8 million emergency department visits.

6 Symptoms Key to Asthma

1. Wheezing
2. Cough
3. Frequent episodes with difficulty breathing or shortness of
breath, with or without wheezing.
4. Frequent episodes of chest tightness.
5. Symptoms worsen when exposed to respiratory irritants, such as
cigarette smoke, pollen, animal fur, exercise, etc.
6. Symptoms worsen at night.

Asthma is a controllable condition through an action plan. According to the National Heart, Lung, and Blood Institute, and the National Asthma Control Initiative the goal of therapy is control by prevention of asthmatic episodes. An action plan allows asthmatics to be healthy, and active, and involves:

a. Following your treatment plan prepared by your medical doctor.
b. Managing environmental triggers.

Knowledge is power!
It is important to be aware anxiety does not cause asthma. Asthma is caused by an inflammation. Asthmatic medications do not cause addiction. Asthmatic medications do not lose their effectiveness over time. Never delay starting treatment to see if the asthma will improve by itself. Always check you have enough medication left in the inhalers, as well as for expired dates. Corticosteroids are safe, and are not the same as anabolic steroids. Watch for asthma triggers such as respiratory irritants (pollutants, second hand smoke, flu, etc.) that can worsen symptoms. Rinse mouth after using inhaled medication. No eating peanut butter.
Daily control is demonstrated by good breathing, no cough or wheeze, being able to have a good night sleep, and the ability to play and exercise. If you have cough, mild wheezing, chest tightness, especially at night use your quick relief medication. If your symptoms are not controlled within 20 minutes or after 2 efforts of quick relief, call your doctor or go to urgent or emergency care. If quick relief medication is required more than 2 times a week, then call your doctor. Do not wait to get emergency help if you are breathing hard and fast, your nose is flaring, your ribs are moving deeply in and out, you have difficulty walking and talking, you have blue lips, fingernails or earlobes. Get the flu vaccine every year.