I feel lethargic and nauseous after long car journeys. Any suggestions?

Q: After long car journeys, when I tend to be the passenger, I feel lethargic and slightly nauseous for 24 hours. I don't get travel sick during the journey but find this after-effect very debilitating. Do you have any suggestions?
Penny Munday

Dr Jules Eden replies: Travel sickness is most often due to the difference in stimuli between what the eyes are looking at and what the balance centres of the inner ear are telling us. When you try to read in a car, for example, your eyes are fixed on a point on the page. As the car turns corners, the endolymphatic fluid in the semicircular canals, which is responsible for telling the brain which position the head is in, sloshes around these canals. The end result is a feeling of nausea as the eyes say you are in a fixed position, but the body is obviously moving. To counteract this, always look in the direction you are travelling. In your case, it may be better to drive, and certainly never sit in the back of the car. Finally, exhaust fume poisoning can make you feel tired and nauseous, so check the exhaust is not leaking the carbon monoxide-rich gas into the car as well.

Q: My son has spent seven years guiding in Africa where he contracted malaria. On a recent trip home he hoped to have blood tests for that, and to confirm he hadn't picked up anything else. Unless he was showing symptoms when he could present himself at a local A&E, the Tropical Diseases Hospital recommended referral from a GP, which took too long. Is there a walk-in, one-stop-shop for comprehensive testing for diseases or one that would arrange an appointment by email prior to his next trip to the UK?
Steve Fuger

A: I suggest he tries a private clinic in London where any travel health-related test can be done - from stool samples for giardia to blood tests for bilharzia. It is possible to have the results back in a few days. Try Travelscreening, based in Harley Street. He can pre-book an appointment by email for when he next returns here.

Q: I have suffered from psoriasis for seven years and, since returning from a three-week holiday in Thailand, I am pleased to see it is distinctly less noticeable. However, during the holiday and since my return, I have been experiencing excrutiatingly itchy hands and feet (palms and soles). Do you think it's related to my psoriasis?
Miranda Hudson

A: No, this does not sound like a psoriatic symptom. If your skin is looking better, it would be odd for the body to be feeling like this. It is more likely to be a new infection or more probably an infestation. A likely candidate could be scabies. So, see your GP quickly: if it is scabies you need to treat yourself to a complete covering with a lotion such as Ascabiol. It quickly treats the problem, which never returns as long as you hot-wash clothes and sheets.

Ask the flying doctor If you have any questions you want to ask Dr Jules Eden, email travel.doctor@theguardian.com, or write to The Flying Doctor, The Guardian, 119 Farringdon Road, London EC1R 3ER.

Dr Jules Eden created E-med as an online support service for anyone who finds themselves a long way from a doctor's surgery. You can get free pre-travel information on any destination in the world. Log on and click on the Travel Clinic icon.

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