Travel tip for Kilimanjaro: visit the travel clinic

Wednesday, January 24, 2018

I am really starting to get excited about my upcoming holidays.  The ski slopes of Verbier are getting dumped with powder, more women are signing up for our Kilimanjaro climb, and I am pretty sure I want to scuba dive in Thailand.  There are so many adventures to be had and not enough time to plan them all.

Turns out when you travel to tropical places (which is something my husband and I rarely do), you need to do a bit of research and planning to make sure you are prepared with adequate vaccinations and medications.  With my trips to Tanzania, Thailand, and Cambodia coming up, I contacted the Walk-In Clinic to see what jabs I would need to be safe.

You may remember that I had a wellwoman physical with the Walk-In clinic over the summer.  I found utilizing a private practice gave me the luxury of time.  I could talk to the doctor in depth without feeling pressured to fit all my questions in within the 15 minute time slot.  Luckily for me, the clinic was able to book me in for to their travel clinic service with in a week.  The clinic offers a consultation appointment, where you speak to someone to review what you will need, or simply request a vaccine that is unavailable at your local GP.  They also have regional packages destinations such as Africa, India and South & Central America.

When I booked in, I was warned that I would need a consultation first and then a follow up appointment for my jabs.  I took the this to mean a 15 minute conversation during which we would order my jabs and then a needle sticking session on another day.  I couldn't have been more wrong.  I had an entire hour to go through the travel advice website, NaTHNaC, line by line for my different destinations.  My doctor and I discussed the benefits and possible side effects, plus what I have had in the past.  We looked at all three countries, made a list and then reviewed the vaccine schedule for each as some require several doses at different time points to be effective.

My big tip, no matter where you are headed, is to book a travel clinic appointment six to eight weeks ahead of time in case your vaccine needs to be ordered, requires several doses, or it takes a while build immunity.  In addition, you should know what vaccines you have had previously and when.  Some vaccines will last your entire life while others need periodic updating.

For my Kilimanjaro trip, there is also a malaria risk below 1800 meters.  My doctor was able to discuss the different medications available and what would suit me.  The side effects of some can be scary, including depression and hallucinations.  As I am already on a SSRI, this ruled out Lariam, which you only have to take once a week.  We agree upon the antibiotic doxycycline, which is in the tetracycline family.  In high school, I had horrible acne and was on tetracycline for a while.  I don't remember any unbearable physical side effects (aside from being prone to sunburn) so I am very comfortable with the choice.  The downside is remembering to take it every day and I have to keep taking it up for four weeks after my return.  Our destinations in Thailand (Bangkok and Phuket) are 'low to no risk' which do not require malaria prophylaxis.

The last thing I wanted to discuss was altitude sickness.  Out of everything that could possibly impact my trip, I am most worried about this.  It seems to be very unpredictable as to who is affected.  Fit, fat, skinny, strong, young, old- there is no way to know.  Anecdotally, I have heard low blood pressure makes you more susceptible as well as not acclimatizing properly.  People report feeling severely hungover with a bad headache, nausea, vomiting, and being really tired.  For all the energy and planning I have put into this trip, it would be a shame not to see the sunrise at 5895 meters (19,341 feet).  Unfortunately, the doctor didn't know much about the condition and could not recommend whether I should carry the medicine, let alone take it prophylactically.  Crowd sourced side effects from my Adventure Queens Facebook group include pins and needles feeling and having to pee a lot.  Since I am not good at peeing outside, this is a worry for me.  My doctor was going to do a bit more research before my next appointment in two weeks time so we can talk about it again.

On this visit, I got Hepatitis A, a rabies booster, and cholera vaccinations.  I would have got Hepatitis B too, but there is a global shortage of the vaccine.  The cholera will require another dose at my next visit (which is just an effervescent drink) and meningitis.  At the same time, I will pick up my prescriptions for my anti-malaria pills and altitude sickness tablets.  Because most of my Kilimanjaro trip will be on the side of a mountain, we took greater precautions with more vaccines which will also cover my trip to Thailand and Cambodia.  Remember though, it is up to you and your doctor to discuss and agree what is right for you.

If you have any experience with climbing and/or altitude sickness, please leave me a comment below with your experience.  I am eager to learn as much as I can before the trip.

Many thanks to the Walk-In Clinic for their support of my trek to Kilimanjaro.  Services provided were complimentary, but all opinions and views are my own.  Please speak to your GP about your travel plans rather than follow my advice and experiences.  I am not a medical professional, just a biology nerd.

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