Category Archives: Health and Safety

Dealing with Winter Blues

Contributed by Kelly Bembry Midura. This article was originally published in the November, 2012 issue of AAFSW’s Global Link newsletter. Read more about the Associates of the American Foreign Service Worldwide here.

Winter is coming...

Winter is coming…

It’s that time of year again. In northern latitudes, the days are now getting shorter and colder. Some people love the onset of winter, but others dread the coming months. For those of us with Seasonal Affective Disorder, AKA “winter blues,” the changing seasons mean months of fighting off lethargy, aches and pains, and crankiness. In short: all the symptoms of mild depression. No fun!

Women are especially susceptible, for some reason, being much more likely to experience SAD than men, according to the Mayo Clinic. However, men who have SAD tend to be more seriously affected by the disorder.

I’m a southern gal who didn’t miss winter one little bit while posted to Central America. However, our first European tour, in Prague, was much more difficult than it had to be because I did not fully recognize and deal with the symptoms of SAD. Now posted to Vienna, I’ve done a bit of research and found solutions that are highly effective in fighting off my winter blues.

You have to have the gear. Never mind the cost. Never mind what other people are wearing. Never mind looking like an overdressed dork if you have to. Once that cold gets in your bones, joint stiffness and aches will soon follow. Be prepared! Think layers, especially around your core areas, hands, feet, and head. I love the silk underwear sold by LL Bean, REI, and other “outdoorsy” retailers. In winter, I wear a silk tank almost every single day, under a turtleneck and cardigan or overshirt. (And that’s just for indoors!) Lightweight cotton tanks and tees can also be helpful layers for retaining warmth. Invest in good, warm socks and shoes. And for heaven’s sake, don’t go out without a hat. You’ll catch your death.

Get moving. Every single day. One major issue I had in Prague was that my only regular exercise was walking. This was either miserable or impossible on many winter days due to nasty weather and ice on the streets. Though this wasn’t such a problem at our next post, Washington, I did learn how valuable a nice warm gym can be on a frigid day. Here in Vienna, I am religious about working out during the long, cold, gray winter, usually three times per week. On other days, I bundle up and go for an hour’s brisk walk, or hike in the hills around Vienna with my husband on the weekends.

Exercise will not only increase your metabolism and warm you up, but will have a positive effect on your mood for the rest of the day. But, again, you need the gear for both outside and inside. Water-resistant hiking boots and a rainproof coat are a must, especially in Europe. Don’t go to the gym in a ratty old t-shirt and shorts. It will just make you feel worse. Invest in a real workout outfit in a breathable fabric. Don’t forget good-quality athletic shoes to prevent damage to your feet and knees. Put your favorite high-energy music or an interesting podcast on your mp3 player and go for it!

Try a light therapy lamp. These can be helpful, though I don’t personally think they resolve the problem altogether. I have a small portable model that was issued by our medical unit at post. During the winter, I use it on the kitchen table while I have my coffee and check emails in the morning. Interestingly, I have noticed that if I don’t set a timer and leave the lamp on for too long, I actually feel “hyper.” Friends have reported the same effect. Start with just ten or fifteen minutes, then experiment with the lamp to see what length of exposure works best for you.

Consider a low dose of medication if other methods do not resolve the problem. In my case, I am so affected by winter blues that I need a small dose of anti-depressant to ‘top off” the other measures. You may or may not need this, but particularly if you are posted to one of the dark, cold countries for the first time, I would encourage you to be open to the possibility. SAD is a real medical issue and quite common in some countries even among people who otherwise have no issues with depression. It may require a medical solution.

Finally, get the heck out of Dodge! There’s a reason so many Europeans fly south in the winter. You may not even have to go far to find relief. Last January, we traveled just a few hours south of Vienna, to northern Italy for a week. My husband actually likes winter for some inexplicable reason, but even he was amazed at how good it felt to lose a layer of clothing and get away from the persistent gray skies on the other side of the Alps. I’m pushing for Rome this winter. It turns out that I don’t need the tropics to feel better; I just need to not be actually freezing and see some sun for a little while.

Seasonal Affective Disorder can be difficult to identify, but it’s not that difficult to cope with once you understand the nature of the problem. Get the right gear, take action, and enjoy that cold-weather post!

 

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Tick Borne Encephalitis in Austria

If you hike or spend  time exploring the Vienna woods and parks, you might have seen signs warning against ticks (Zecken in German). Around Central Europe, there are increasing amounts of ticks that can cause tick-born encephalitis (TBE), a viral disease transmitted by the bite of an infected tick (i.e. not every tick transmits the disease).

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TBE is a serious infection that attacks the central nervous system and can cause long-term neurological symptoms. There are more than 10,000 TBE cases reported in Europe each year.

Ticks are most active from March through November, with greatest activity in spring and summer. They live in soil and climb as high as 70cm (28″) on grass and bushes to look for their hosts (animal and human). They usually attach themselves to hair-covered portions of the head, behind ears, elbow, backs of knees, and to hands and feet.

Prevention

There is no known treatment for TBE and the only way TBE infection can be successfully prevented is through vaccination. One effective vaccination recommended for Austria is manufactured by the Canadian corporation Baxter (the vaccination is called FSME-IMMUN).

Other measures for general tick bite prevention:

  • avoid tick-infested areas when possible (read the warning signs!)
  • wear light-colored long-sleeved clothing, tight at wrists and ankles, and shoes that cover the entire foot
  • apply DEET to skin and permethrin to clothing
  • check skin and clothes regularly for ticks

For more information

Thanks to the Medical unit at the U.S. Embassy for help with this post.

Over the Counter medications

Getting sick abroad in a different culture is always a bit scary so we at TriVienna greatly appreciate the U.S. Embassy’s medical unit’s help in putting together this great  list outlining how and where to find common over the counter (OTC) medications in Vienna.

If you spent some time browsing the drug stores here (e.g., Bipa, DM), you have probably noticed that they don’t stock that many pharmaceuticals (on the other hand, if you are looking for toiletries, cleaning supplies, perfume, make-up etc, this is the place to shop!). In Austria, you have to shop for your medications at the Apotheke – check out our previous post on where to find them.

Inside an Apotheke, you will notice that medications are typically not openly displayed for you to browse. Instead, you  need to consult with a pharmacist (Apotheker) who is trained in advising customers and can provide prescription-free medications to common ailments [s/he can also fill your prescriptions]. In my experience, many Apothekers speak English very well too (and if not, I am sure sign language can go a long way!).

Please note that a number of common U.S. OTC medications are not available without a prescription here in Austria; these include:

  • the decongestant Sudafed (pseudo-ephedrine)
  • 1% hydrocortisone cream
  • motion sickness medication Dramamine (dimenhydrinate known as Vertirosan in Austria); and
  • some anti-histamines require a prescription (Clarityn/loatidine does not)

What follows is a list of typical U.S. brand OTC medications and their Austrian equivalents or Austrian brand suggestions on medications to take for common health problems. Obviously, if you have a serious medical issue or symptoms are dragging on, please consult a physician right away. If you are looking for English-speaking specialists, check our page with some suggestions and feel free to email us if you have others to recommend.

Cold & Cough

  • Robitussin; Mucinex – helps loosen cough –> Wick (Vicks) Formel 44 Hustenlöser
  • Robitussin DM (dextro-methorphan) cough suppressant –> Wick Formel 44 Hustenstiller
  • Nyquil –> Wick Erkältungssirup für die Nacht
  • Neo-synephrine topical decongestant spray (limit to 3 days max.) –> Vibrocil Nasen Spray/Gel
  • Afrin topical decongestant spray, varying strengths –> Nasivin Spray

Pain & Fever

  • Tylenol (infant/child/adult; check dosage carefully) –> Mexalen or Ben-u-ron
  • Motrin –> Ibumetin (adult only)

Seasonal allergies & hives

  • Claritin –> Clarityn or Loratadin
  • Benedryl –> Calmaben Dragees 50 mg (twice as much medication as U.S. 25mg OTC Benedryl!)

Athlete’s foot & skin fungus (ringworm)

  • Mycelex –> Canesten Clotrimazol
  • Desenex; Mictin; Lotrimin –> Daktarin 2% creme

Monilial Vaginitis (Vaginal Yeast Infection)

  • Gyne-Lotrimin –> Canesten Vaginaltabletten or creme

Head Lice

  • Austrian suggestion: A-par Shampoo

Scabies

  • Austrian suggestion: Infectoscab Creme (similar to Kwell in the U.S.)

Diarrhea

  • Imodium pills –> Immodium Tabletten 

Constipation

  • Austrian suggestion: Dulcolax Tabletten (stimulant laxative – use cautiously)
  • Metamucil –> Pascomucil Pulver

Antacids

  • Maalox –> Alucol Tabletten
  • Gaviscon –> Rennie (floats on stomach contents; best for reflux-like symptoms/heartburn)
  • Austrian suggestions: Riopan

Insect Repellant

  • Austrian suggestions: Autan; No Bite

Emergency care in Vienna

This past weekend, I paid my first visit to the ER in Vienna after my daughter got bitten by a mosquito on her eye lid (you read that correctly, beware of the mosquitos this season!). We’re all good now but the process of finding emergency care was a bit confusing so here’s a quick guide as to where to go and what to expect.

In our case, I took my daughter to AKH’s emergency room as it was the easiest hospital for me to get to (U6 stop: AKH) and has a broad range of specialties (I wasn’t sure if she needed an eye specialist and/or a pediatrician – her eye was swollen shut).

One thing to keep in mind is that AKH is a huge complex so finding the right signs to follow can be a bit overwhelming. If you are looking for emergency care,   follow signs specifying “Notfall” (emergency) and/or “Unfall” (accident/trauma). There are a number of information booths and staff  speak English.

Once you arrive in the ER, your case will be assessed (triage) by a physician who will hand you paperwork to complete (asking for your contact information) that you then bring to the “Leitstelle” (think administrative nurses’ station). You will need photo ID (passport or red legit card) and be charged 150 Euros (yes, before you see anyone). You can pay in cash or with Austrian bankomat/debit and international and Austrian credit card. A few weeks later, you will receive a bill from AKH with the remaining balance (or in case you overpaid,  you will receive instructions how to collect your money).

You will then be directed in which waiting area to sit before you are called. Please note that privacy is very limited here.

Emergency phone numbers (medical):

  • Ambulance (die Rettung): 144
  • Call the ambulance in case of true emergency and when you need help transporting a patient. Note that the ambulance will determine upon assessment where to take the patient for the appropriate care (they will be in  radio contact with the appropriate hospital).
  • Pharmacy service: 1455 ( In each district pharmacies take turns staying open during lunch, overnight and at weekends. See also our pharmacy post)
  • 24-hour emergency psychiatric support: 31330 (see also the brochure)

Additional emergency phone numbers:

  • Fire department (die Feuerwehr): 122
  • Police (die Polizei): 133
  • Vienna poison control: 406-4343

Hospitals with a trauma center:

  • Allgemeine Krankenhaus/pediatric clinic                                       Währinger Gürtel 18720, 1090 Vienna, Tel: 404-0019-64
  • Krankenanstalt Rudolfstiftung                                                            Juchgasse 25, 1030 Vienna, Tel: 711-65-0
  • Wilhelminenspital                                                                      Montleartstrasse 37, 1160 Vienna, Tel: 491-50-0
  • St. Anna Kinderspital / pediatric hospital                                                             Kinderspitalgasse 6, 1090 Vienna, Tel: 40170

FOR MORE INFORMATION ON VIENNA EMERGENCY CARE:

Thanks to all the TriMission people who provided their valuable input – particularly Sina!