Tuesday, January 8, 2019

Travel Clinic - Vancouver Coastal Health

What a great experience at the Travel Clinic Vancouver Coastal Health. The staff were positively delightful. Everything was really easy.  Lovely offices at 601 Broadway.  It’s on the ground floor at the back so a tad tricky to find.  

The receptionist was welcoming.  The intake form easy to understand.  Dr. Angela Ernst was truly praiseworthy.  As a clinician myself whose done a bit of travelling I had some significant concerns about travelling to Ethiopia. Mostly mosquitoes and falciparum malaria.  Black water Fever.

It’s interesting that in my residency in community medicine and public health I’d learned about Falciparum Malaria and Sickle Cell Anemia. The British medical doctor, Dr. Burkett of Burkett Lymphoma fame  had noted a correlation between the two areas of distribution of these disease.  Dr, Burkett hypothesized the overlapping distribution of the two diseases was more than just coincidence. It was postulated that the carrier state of Sickle Cell anemia was selected for in the overlapping regions. 

Now here I am decades later heading out to where these textbook mosquitoes breed. I’ve already bought Ben’s 20% Deet. 

Dr. Angela Ernst was on top of everything.  All the latest vaccines. I’m not a Luddite anti vaxxers. Thanks to Dr. Ernst I’ve got my Hep B and A vaccine, my tetanus renewed, meningitis vaccine. I even had my yellow fever certificate renewed.  I had the shingles vaccines a couple of years back so that was good. I had TB treatment in the US after acquiring the infection as a flyin doctor in Northern Canada. Dr. Angela even offered me the flu vaccine which I was glad to have now that I’m aged enough to be in a population which warrants it.

The staff actually poked me with no loss of limb. They were so competent and caring that the vaccines were less painful than a mosquito bite.

What Dr. Angela Ernst gave me was a ‘holy’ prescription for MALARONE ,the malaria prophylaxis. This is why one needs a travel specialist.  There are a dozen anti malarials and malarial prophylaxis. Historic quinine was in the tonic water mixed with gin to protect the colonia era British travellers.  Different malaria’s require different anti malarials today.  Thank God Dr Ernst conscientiously keeps abreast of the advances and changes in international infectious diseases.

She also gave me Zithromax  for traveller’s diarrhea. I told her I’d written a paper comparing Septra and Doxycycline for traveller’s diarrhea some 30 years ago to. Today the recommendation was this newer medicine I only ever recommended for STD’s and URI’s.  

It felt so safe here.  How can one ever travel without visiting a travel clinic?  I came here when I took off to study medical Spanish in Costa Rica and again before sailing solo across the Pacific en route to the Mariana Islands.  My friend Laura told me she’d been to this clinic and loved it before she flew out to th Marianas. My friend Mary Lou is heading out to the Phillipines for vacation. She came to this clinic too and loved it,

I confess I was exuberant. The prospect of being a ‘free man in Paris’ again after a few years is intoxicating. I last felt this way about adventure and exploration going to Cappadoecia.  The Christians built under ground churches there to survive the invasions and persecution. Now I’m so looking forward to seeing the rock churches of Lallibela.

The cost was minuscule too, cheap for private medicine, the cost of a room for a night.  The benefits the same as insurance.  I loved Dr. Ernst’s comments on footwear and clothing, ways to protect myself to maximize the benefits of travel while minimizing the risks. 

 
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