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By
Dr David Delvin
Your
Health While You're Holidaying - or Living - Abroad
You've
got to look after your health while you're abroad. That
applies to people who are just HOLIDAYING - and to the increasing
number of British folk who are LIVING abroad.
And
if you live in another country, I'm afraid I have some bad news for
you. Unfortunately, the Government is considering a plan to
WITHDRAW NHS access for Brits abroad! This has very
serious implications.
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More
of that in a moment. Bur first of all, I'd like to look at the
health of holiday-makers.
A
very high proportion of people of retirement age go abroad for the holidays,
sometimes two or three times a year - and especially to escape the
British winter!
It
is important to realise that there's quite a fair chance that you
will get ill while you're abroad. After all, illnesses are much
commoner in the 55-plus age group. Furthermore, there's no
question that a lot of overseas countries - particularly the hot ones
round the Med - have a lot more nasty 'bugs' than we in the UK do.
So
you need to protect yourself in three ways:
*
Have adequate insurance
*
Take precautions (such as jabs) before you go
*
Take your medication with you
Let's
look at these three points in turn:
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TAKING
OUT ADEQUATE INSURANCE
These
days, to go abroad without adequate health insurance is
madness. Though the E111 form - obtainable at any British Post
Office - provides quite a bit of cover while you're in an EU
country, I feel that anyone who travels outside the UK should take
out private cover.
Fortunately,
health cover is reasonably cheap - though you may have to pay a lot
more if you're quite advanced in years, or if you suffer from some
serious illness. If you go abroad every few months, there's a
lot to be said for getting a policy that covers you for the whole year
- rather than buying a new one for each trip.
One
word of warning: please do make sure that you tell the
insurance company the ABSOLUTE truth about health and medications.
Only recently, I saw a very nice woman patient who had to cancel her
holiday at the last moment, because of sudden sickness. The insurance
outfit refused to pay out - on the grounds that she'd forgotten to declare
the fact that she'd had a surgical operation 20 years before.
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TAKING
PRECAUTIONS BEFORE YOU GO
In
many overseas countries - particularly the warm ones - there are considerable
health risks. So please don't neglect those boring old immunisations
- and those even more boring malaria pills! They might save
your life.
How
do you know what jabs or pills you need? Well, nearly all general
practices have a list of what immunisations or tablets are advisable
for going to foreign countries. These days, there is usually a
Practice Nurse who specialises in these matters, and who can tell
you almost immediately what jabs you should have before going to anywhere
from Jordan to Java!
Further
very good - and very up-to-date - information is available from British
Airways Travel Centres.
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TAKING
YOUR MEDICATION WITH YOU
A
high proportion of people aged over 55 are on medications of some sort.
You do need to take adequate supplies of your pills, inhalers or
whatever. Get them well beforehand, so that you're not rushing
to the chemist's on the day you're due to leave.
A
good rule is to take a week's EXTRA supplies - just in case you get
delayed. To be stuck at a foreign airport without your heart pills
or asthma inhaler is no joke!
A
good tip - especially as you get older - is to pack a LIST of all
your medications. This could save your life if you were suddenly
taken ill. I remember one man who was struck down by a serious
medical condition while in Florida. He couldn't speak - but happily
the American doctors found a complete list of his medication in his
wallet, and were able to give him the right treatment.
A
surprising number of people think that if they run out of pills
while abroad, their own doctor in the UK could somehow send them
some more. Alas, this is NOT the case. So ..... be prepared.
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LIVING
ABROAD
Huge
numbers of British people - particularly 'retirees' - now live abroad,
at least for much of the year. Their favourite abodes seem to
be:
¨
Spain
¨
France
¨
Italy
¨
America
¨
Australia
¨
Portugal
Well,
jolly good luck to them, I say!
BUT
... there's a nasty big cloud on the horizon. In August,
it emerged that the Department of Health is seriously thinking of
withdrawing free NHS care for pensioners who live overseas for more
than six months of the year.
You
see, most older folk who have taken up residence on the 'Costa Lota'
(or wherever) have the reassuring feeling that if things went badly
wrong health-wise, they could always nip back to Britain for medical
care.
THAT
IS WHAT THE GOVERNMENT IS THINKING OF PUTTING A STOP TO. SO BE
WARNED!
It
will be some time before these changes are brought in, because the whole
scheme is being 'put out to consultation' at the moment.
But
Age Concern have issued a statement saying that the new plans will
worry a lot of pensioners, who may be 'forced to pay' if they return
to the UK for medical care.
Rather
surprisingly, it turns out that some years ago John Major's
Government brought in legislation which said that if you live
outside Britain for just THREE months a year, you would not be entitled
to sue the NHS for free. But so far, this rule has never been
applied.
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TAKING
CARE OF YOUR HEALTH IF YOU LIVE ABROAD
Nowadays,
I frequently see patients who live in Spain or Portugal or some
other pleasant country - but who have popped back to the UK to visit
their families or to deal with business matters.
From
seeing the sort of problems which they have encountered, may I offer
these few pieces of advice:
¨
As soon as you get to
the country where you're going to live, find yourself a good doctor
- preferably an English speaking one
¨
Learn the language - particularly
phrases like 'I have a lot of pain' ('Tengo mucho dolor ...')
¨
Register with the local
health service - in the EU, you're entitled to free or reduced-cost
treatment;
¨
If you're treated in
a hospital, get them to give you written Documentation about your
illness, and about the therapy they gave you - most places are pretty
good about this;
¨
If possible, get
yourself an English TRANSLATION of the document - these days, it's
very common for people to come home to Britain, and then hand
their GP a 10 page report, written in Spanish, which he does not
understand;
¨
Bear in mind that
medications abroad may be very different from UK ones - you may not
be able to get your British pills in 'foreign parts,' and vice
versa.
That
last point causes considerable problems! This summer, I've
seen quite a lot of people who 'hopped home' from Spain or Portugal,
and who asked me to write a prescription for the tablets or suppositories
which they'd been given while abroad. In many cases, this was
quite impossible - as the brands simply do not exist in Britain.
In
short, living abroad can be a tricky business. So take
care!
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Q I
was given some wonderful injections by a Greek doctor this
summer. I brought six of the little ampoules home with
me. But when I went to my London GP, gave him one of the ampoules
and asked him to inject it into me, he refused! He said he had
no idea what the stuff was, and he didn't want anything to do with
it. Is he entitled to take this attitude?
A I'm afraid so, ma'am. No British doctor is going
to inject an unknown medication into you - because if something went
wrong, the legal consequences would be disastrous for him.
Your best bet would be to find a Greek doctor in London, and ask her
/ him what the ampoules contain. If there's a leaflet with
them, it should be easy to get it translated.
Q
My wife and I have been out in the Far East. Since we came
home last month, I have had recurrent bouts of fever and feeling
rotten. My doctor has not been able to find a cause for
this. Do you have any ideas?
A
The most important thing is to rule out MALARIA - which is often brought
home by holidaymakers. Ask your doctor's Practice Nurse to
send special blood samples to the lab for malaria testing. If
the feverish attacks continue, you should consider contacting the Hospital
for Tropical Diseases in London.
Q My daughter has been living in Australia for some time,
and has been trying for a baby there - with no success. She
now wants to be investigated for infertility. Could she come
back to Scotland and have the necessary tests on the NHS?
A I'm very doubtful if the Health Service would pay for
this. A particular problem is that her male partner will need simultaneous
investigation. If he is Australian, I can't see that Britain
is going to pay for him to have sperm counts, etc.
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Q
Is epilepsy hereditary? I had it when I was young, and I am so afraid
that my little grandson may inherit it.
A There
is a bit of a 'family tendency', ma'am. But it's not a very
strong one, so the odds are heavily against your grandson developing
the condition.
Q I
had a hysterectomy when I was 40. Now I have met a new and
delightful man. Is there any reason why we shouldn't have intercourse?
A None
at all, ma'am. You may need to use a spot of helpful
lubrication, such as K-Y Jelly or Eros Woman.
Q I
am 58 years old, and have suffered from 'Allergic rhinitis' since
childhood. As a young man, I had a displaced nasal septum and
a nasal polyp. This year, I have so far had six courses of
antibiotics and one course of steroids. I have just been
referred to an ENT consultant. Do you think he will be able to
help me?
A
There's a very good chance of it - especially in view of your past
history of structural nasal problems. I'm not absolutely clear
why you've been taking antibiotics for an allergy - but maybe
there's some infection present as well? Good luck with the Consultant.
Q I'm
57, female, and need to see a gynaecologist about bleeding which has
occurred several years after I 'said goodbye' to the
menopause. Am I entitled to insist on a FEMALE gynaecologist?
A First
of all, can I say something that is of the GREATEST possible importance
to all Retirement Matters readers? Vaginal bleeding which
occurs AFTER THE MENOPAUSE is a potentially serious symptom, and must
always be investigated promptly.
So you DO need to see a gynaecologist a.s.a.p. If there are NO
female gynae specialists, then your only alternative would be to go
to some other locality - such as London.
Q My
doctor seems to be completely unable to cure my bad
back. Should I consult an osteopath?
A Absolutely,
sir. Osteopaths and chiropractors are very definitely the best.
people to see regarding back pain. I'll be writing about both these
disciplines on the Retirement Matters site next month - in an
'Alternative Medicine' feature.
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