Dr who understands diving and Malaria

Questions relating to medical issues and treatment. Where possible and appropriate, we will request comment from qualified and reputable NZ-based diving doctors. If your query relates to a personal medical issue, we recommend you contact your GP or relevant medical specialist.

Dr who understands diving and Malaria

Postby Cameron_R » Wed Jul 16, 2008 12:16 pm

Hi,

We're heading to Vanuatu soon, and need to find a Dr in the Auckland area who can help us with a prescription for anti-malarial's. Can anyone recommend a dr that has an understanding of both 1) travel + Malaria, and 2) diving?

Thanks
Cameron
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Re: Dr who understands diving and Malaria

Postby Andy » Wed Jul 16, 2008 1:06 pm

With a bit of luck, Greg V will see this and give you an informed medical opinion.

It might also be worth giving Oxygen Therapies a call? Or the Navy hospital?


My completely non-medical understanding is that there are a number of anti-malarial drugs often prescribed; some are safe to dive and some not. The only ones I've ever used are chloroquine and mefloquine. Chloroquine is becoming less effective, but generally should be ok to dive with.... Greg, can you confirm? Mefloquine is nastier with some unpleasant side effects - these include palpitations, tremors, dizziness, rashes and joint pain.... so easily confused with DCS.

My last experience with mefloquine was enough for me to not ever take it again - it was worse than actually having malaria! A big thing with malaria control is avoidance. Do everything you can to not get bitten, take your own mosquito net for the evenings, plenty of insect repellent.
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Re: Dr who understands diving and Malaria

Postby taylerr » Wed Jul 16, 2008 2:04 pm

I'd be interested in the response too as I'm off to the Solomons at the end of September.
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Re: Dr who understands diving and Malaria

Postby Gregv » Wed Jul 16, 2008 10:26 pm

Cameron_R wrote:Hi,

We're heading to Vanuatu soon, and need to find a Dr in the Auckland area who can help us with a prescription for anti-malarial's. Can anyone recommend a dr that has an understanding of both 1) travel + Malaria, and 2) diving?

Thanks
Cameron


I guess I can offer some general advice, but I'll leave specific advice and the prescription to your regular GP.

My initial response to your questions has to be 'ít depends'.

To make any useful response, I'd need to know where in Vanuatu you will be spending your time (eg Vila vs rural Santo), what sort of accomodation you will be staying at (hotels vs more basic accommodation), and for how long (pharmaceutical prophylaxis is not always indicated for shorter or very long stays, depending on other risk factors).

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Re: Dr who understands diving and Malaria

Postby Cameron_R » Thu Jul 17, 2008 9:24 am

Thanks guys. We're staying in Santo, and Port Villa.

But to be honest, I'm really looking for names and locations of Dr's in the Auckland region who I can actually go and see to get specific information. Don’t take this the wrong way, because I do appreciate the information, but I'm not going to take medical advice from a forum on the internet :) As far as I know, I need to go see a Dr. to get a prescription anyway.

Greg - are you saying that my regular GP would have enough knowledge to understand any possible interactions of the medications and diving?

Thanks
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Re: Dr who understands diving and Malaria

Postby Andy » Thu Jul 17, 2008 1:31 pm

Cameron_R wrote:Greg - are you saying that my regular GP would have enough knowledge to understand any possible interactions of the medications and diving?


Showing my prejudices a bit here, but it's probably worth asking your pharmacist as well as a GP about the effects of the drugs. They quite often are a bit more up to date on drug interactions etc (no offence, Greg).

If you're really concerned, you probably do want a proper diving doctor - I would suggest looking at the OSH list, rather than the list that NZUA supply.

The OSH list is on the web;

http://www.osh.dol.govt.nz/services/div ... tors.shtml

These are the doctors approved to conduct the commercial dive medicals, so typically I would expect them to know a bit more about diving medicine than those who do recreational diving medicals. This could be a bit of an assumption, mind you!

I've used Heather MacDonald at Hyberbaric Health/HBOT in the past for dive medicals and a couple of other dive related issues. Certainly no complaints.
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Re: Dr who understands diving and Malaria

Postby Cameron_R » Thu Jul 17, 2008 3:05 pm

Awesome!
Thanks Andy!
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Re: Dr who understands diving and Malaria

Postby Gregv » Fri Jul 18, 2008 12:14 am

Cameron_R wrote:Greg - are you saying that my regular GP would have enough knowledge to understand any possible interactions of the medications and diving?
Cameron


What I was saying was that without some knowledge of your background medical history, I could make no specific recommendations regarding possible side effects. Someone familiar with your medical history could. Of course, they may not have much knowledge about diving medicine. Neither will your average pharmacist.

Short answer, as a diver visiting Santo, doxycycline 100mg once daily for 7 days before leaving through to 4 weeks after return from the malaria risk area is likely to be your best bet (provided you're not pregnant, on the pill, or sensitive to tetracyclines).

See what I mean? It depends.

As Andy suggests, any of the Designated Diving Doctors listed on the DoL list should provide good advice on this.

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Re: Dr who understands diving and Malaria

Postby Cameron_R » Fri Jul 18, 2008 9:05 am

Thanks Greg. I'll go see someone, but it's always good to know what I'm getting myself in for, so the info is much appreciated :)
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