Medication and First-Aid
last update: 14 March 2020
Vital medication should always be in the carry-on, and the first-aid kit in the check-in baggage.
Keep all medication and first aid items in their original packaging just in case customs officials need to check them, and keep the instructions as well.
Always have a copy of the official prescriptions as well.
Take with you a letter from your doctor describe your medical condition and the need for prescription drugs.
Have copies of these documents on paper, but also on your computer, iPad or iPhone.
It's even better if you have the labels from the chemists, with your name on them.
Flying and deep vein thrombosis
Aeroplanes are usually pressurised to the same atmospheric conditions as found at above 3,000 metres, i.e. oxygen levels will be only about 14.3%, rather than about 20.9% at sea level. In addition there is a general increased risk of reduced blood flow from lack of movement and cramped sitting conditions. Also dehydration is a common side effect of flying due to low humidity in the aeroplane.
So flying increases the risk of deep vein thrombosis, a type of blood clot that occurs in the veins deep in the body, and most often in the legs. A blood clot can cause a blocked blood flow to the lungs, heart or brain. This in turn can cause a heart attack or stroke.
Some types of medication can increase the risk of a blood clot. Sedating antihistamines (H1-antihistamines) can be used to induce sleep, but this is a bad idea for air travel since they are known to depress breathing, and thus reduce even more oxygen intake. As a sleeping aid it is best to use melatonin or valerian.
To reduce the risk of a blood clot when flying you should drink plenty of water, stretch your legs, and move around in the cabin. Low-dose aspirin can stop blood cells from sticking together.
The effect of alcohol is increased when flying, and tea, coffee and other caffeinated drinks can have a dehydrating effect and make it harder to sleep.
Deep vein thrombosis can develop in the lower or upper leg, and more rarely in other veins such as in the arm. A blood clot can go directly to the lung circulation (pulmonary embolism), blocking the blood supply of the lungs and causing shortness of breath. The first sign is swelling of one side of the calf or the entire leg, which can be accompanied by a painful tenderness and reddening. A lung embolism will produce shortness of breath and rapid pulse rate, sweating, dizziness, fainting and coughing up blood.
Compression stockings of the lower leg prevent blood from pooling and then clotting. They should be worn on long-haul flights.
When flying, and particularly when descending for landing, your ears can feel blocked or painful. This is due to the pressure change, which can cause an unequal pressure between the air in the middle ear and the air outside the ear. As the air pressure increases during landing it can push the eardrum inwards and this can be painful. The air space in the ear is linked to the back of the nose through a tiny channel called the Eustachian tube. So the idea is that the air pressure can be equalled by opening this tube, and this happens when you swallow, yawn, or chew. For most people simply swallowing will work, others just suck a sweet. The so-called Valsalva manoeuvre can help, where you try to breathe out gently with your mouth closed, whilst pinching your nose. This can help your ears 'pop'.
Many countries impose strict controls on 'importing' certain medications, and in particular on narcotics and psychotropics (Wikipedia has an extensive list). Analgesic opioids and their derivatives (e.g. morphine and codeine) can be highly regulated in some countries. Some countries have banned sedating antihistamines. For example, the United Arab Emirates also bans the importation of a number of other types of medication, so always check what the rules are on the official websites.
As a general rule, don't carry any narcotics or psychotropics.
Take only what you need for the trip, and always carry your prescription with you. Ensure that the prescription has your full name, doctors name, the brand names and the exact dosage. It is even better to also have a letter from the doctor describing your condition and the treatment plan (which may also be useful if you need to consult a doctor during the trip). Keep tablets together with the original packaging and with the information leaflet. It is best to take enough medication with your to last the whole trip. Take the medication in your carry-on baggage.
So remember to always take copies of all prescriptions
Keep a letter for the doctor stating the reason for the treatment, the names of all medicines, the doses and that they are for personal use
Note emergency numbers and health insurance information
Proof of vaccination
List of contact addresses
Only take medicines that you routinely need at home, and take enough for the entire trip, plus a bit extra.
Carry all medicines in their original packaging with clear labels that identify the persons name and the recommended dose.
And don't forget a second pair of prescription glasses.
You can of course always carry a first-aid kit that would do justice to an emergency operating theatre. Or you can just take the absolutions essentials, namely:-
Antibacterial spray (e.g. Lanacane also cools/soothes for cuts, burns, bites, irruption, pain and infection)
Digestive problems (e.g. Oxyboldine)
And insect repellent (active ingredient DEET or picaridin), and treatment for itchy bites (e.g. 'After Bite')
Download one or more first-aid apps on your smartphone
And finally sunscreen and sunglasses