Having trouble sleeping? Melatonin sleep aid supplement.

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Melatonin supplements promise sound, natural sleep. Here’s what you need to know about your body’s natural melatonin production and melatonin sleep aids.

Sleeps experts initially give general recommendations, such as keeping the lights low in the evening to help his mind and body prepare for sleep. If you have to work in the evening or answer emails, use filters to screen out the blue and green wavelengths of light emitted by his smartphone and computer. “Your brain associates this light with daytime, and it can interfere with melatonin’s sleep-promoting effects. A filter can help.” Many types of blue-light filters are available online and in stores.

Melatonin sleep aids are growing in popularity, according to a nationwide survey from the Centers for Disease Control and Prevention. If you’re among them or are considering melatonin for sleep, it’s smart to understand exactly how melatonin works.

“Your body produces melatonin naturally. It doesn’t make you sleep, but as melatonin levels rise in the evening it puts you into a state of quiet wakefulness that helps promote sleep,” explains Johns Hopkins sleep expert.

“Most people’s bodies produce enough melatonin for sleep on their own. However, there are steps you can take to make the most of your natural melatonin production, or you can try a supplement on a short-term basis if you’re experiencing insomnia, want to overcome jet lag, or are a night owl who needs to get to bed earlier and wake up earlier, such as for work or school.”

Work with, not against, melatonin’s sleep-inducing signals.

Melatonin levels rise about two hours before bedtime. Create optimputer, smartphonor tablet—the blue and green light from these devices can neutralize melatonin’s effects. If you watch television, be sure you’re at least six feet away from the screen. Turn off bright overhead lights too. Meanwhile you can help program your body to produce melatonin for sleep at the right time of day by getting exposure to daylight during the morning and afternoon. Take a walk outside or sit beside a sunny window.

Consider melatonin sleep help for occasional insomnia.

Even sound sleepers have trouble falling asleep or staying asleep once in a while, You may want to try melatonin or eep if you have difficulty for more than a night or two. Research shows that a supplement may help people with insomnia fall asleep slightly faster and may have bigger benefits for those with delayed sleep phase syndrome—falling asleep very late and waking up late the next day.

Know when to stop.

If melatonin for sleep isn’t helping after a week or two, stop using it. And if your sleep problems continue, talk with your health care provider. If melatonin does seem to help, it’s safe for most people to take nightly for one to two months. After that, stop and see how your sleep is. Be sure you’re also relaxing before bed, keeping the lights low and sleeping in a cool, dark, comfortable bedroom for optimal results.

Do not use melatonin if…

Do not use melatonin if you are pregnant or breastfeeding or have an autoimmune disorder, a seizure disorder or depression. Talk to your doctor  if you have diabetes or high blood pressure. Melatonin supplements may also raise blood-sugar levels and increase blood pressure levels in people taking some hypertension medications.


Use melatonin sleep supplements wisely and safely. Contact our doctor for more information and before taking any medication.



It’s the start of fall which means ….. flu season is here.


Last year, flu hospitalizations were the highest they’ve ever been; 106 out of every 100,000 people were hospitalized for the flu in the 2017-18 season, with people over age 65 accounting for 58 percent of those hospitalizations and 180 pediatric deaths.

Flu and the common cold can both make you feel crummy, but they are caused by different viruses. Colds are usually milder and do not result in serious health problems associated with the flu, like pneumonia or hospitalizations.

Right now, being prepared is the best thing you can do before the season hits. Here’s what you need to know.

When does flu season start?

Flu season may start as early as October in North America, but generally, it begins sometime in the fall and ends in March. The flu virus, however, can be detected at any point throughout the year, which is important to know if you ever have symptoms, even in the summer. Experts can’t really predict the severity of each flu season, as different strains of the virus can have different impacts on timing and length of the season.

Should I get the flu shot? When?

Yes. With few exceptions, the Centers for Disease Control and Prevention recommends everyone 6 months of age and older to get vaccinated every year. It is the first line of defense in treating the flu. Although people who are moderately or severely ill should wait to recover before getting the shot. Only people with severe, life-threatening allergies to the vaccine or any of its ingredients should avoid the shot. According to the CDC, anyone who is between 2 and 50 years old should get either the shot or the nasal spray. The American Academy of Pediatrics, however, says the flu shot is the preferred choice over the nasal spray for children

You can get vaccinated at any time as fall approaches, but October is probably the best time to get it done. The CDC recommends that everyone get vaccinated by the end of October, which gives your body the roughly two-week period it needs to develop an immune response to the vaccine prior to the start of peak flu season. If you miss this deadline, however, the vaccine can still offer some benefit. So it's important to get it as long as people are still getting sick.

What if I’m pregnant?

It is highly recommended that all pregnant women get the flu shot. The body changes during pregnancy — heart rate and oxygen consumption increase while lung capacity decreases. That means if a mother-to-be gets the flu, they are more susceptible to life-threatening complications than the general population. So all women who are or expect to be pregnant should get the flu vaccine.

I heard the flu shot makes you sick. Is that true?

No. The flu vaccine contains an inactivated virus, which means that the virus contained in the vaccine can’t actually infect you. It does take one to two weeks for your immune system to protect you from the flu. So, if someone becomes sick after their shot, it is most likely because their body wasn’t protected from the flu yet, not from the vaccine itself.

Similarly, there are sometimes mismatches between the virus strain someone gets sick with and the strains used to make the vaccine. In these cases, the vaccine might be imperfect at fighting all strains of the flu that might exist, but it's still the best defense we have.

How do I know if I have the flu?

Flu symptoms often come suddenly, and can vary significantly depending on the person. These include fever, cough, sore throat, nasal congestion, body aches, headaches, and fatigue. While the flu may seem similar to a common cold, colds are usually slower to develop, and less likely to result in fevers.

Some patients with severe infections may have symptoms — like difficulty breathing and confusion — that are cause for concern and might require immediate medical attention to treat them. Medical attention should also be sought for children with the flu who develop bluish skin, aren't waking up or aren't eating. In all cases, if the person's symptoms suddenly worsen after appearing to initially improve, a visit to a clinician is warranted.

I think I have the flu. What do I do next?

In most cases, if symptoms are mild, staying home and leaving only to get medical care is the best course of action. If you must leave the house, wear a face mask, wash your hands, and cover coughs and sneezes with your elbow.

People with severe symptoms, as well as people at high risk from the flu (young children, people 65 and older and pregnant women), should contact their doctors if they develop symptoms. In some cases, people may get antiviral medications, which can lessen symptoms, shorten the time of illness and reduce complications.

How is the shot made?

Manufacturers have many methods of producing flu vaccines. The most common method is the egg-based vaccine, where strains of the virus are injected into eggs and incubated for several days. They are then weakened or killed and afterward purified to be used in a shot or nasal spray.

The next method is through cell-based technology. In these vaccines, the eggs used to incubate the virus are replaced with animal cells. This method is faster in producing vaccines than the older egg-based method.

Another method uses recombinant technology. In these cases, a certain gene is taken from the flu virus, to be inserted into a different non-flu virus which grows in insect cells. This genetically altered non-flu virus then replicates in insect cells. After the virus has been replicated, manufacturers purify the protein produced from the flu gene, which is used in the vaccine. The advantage of this method is that it doesn't use eggs, so people with severe egg allergies can be vaccinated.

What are the side effects of the flu shot?

Most side effects are mild and resolve quickly on their own. Soreness in the area of the shot is pretty common. In addition, people may have headaches, fevers and nausea. Seek immediate symptoms if someone is showing signs of a severe allergic reaction, such as difficulty breathing, hoarseness or eye and lip swelling.

Where should I get the flu shot?

Get your 2018/2019 flu shot / vaccination here.



Preventing its spread requires good hygiene and high vaccination rates. If you are experiencing any symptoms, avoid contact with other people. If symptoms are starting to get severe, contact our doctor. Working together will be critical in halting flu season.

Tips for staying healthy while studying abroad

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The study abroad experience is very exciting, filled with never before faced adventures and challenges. However, you will also be faced with some challenges to your physical body. In order to make the most of your experience abroad, you need to remain healthy. Even if you have not suffered from a major illness in the past, we recommend that you take the appropriate precautions before embarking on the exciting adventure that awaits you abroad. 

It would be in your best interest to get a physical checkup prior to going abroad checking for any ailments you might be unaware of and seeing your doctor to make sure you get any treatment needed that might not be as easy to find while abroad. Be sure to bring copies of your health records with you, just in case of emergency. Although your school may request a set of these documents, you should prepare an extra set and keep them with you. The following documents written in English (Ask your Physician) should be brought abroad: 

- Personal Medical History
- Immunization/Vaccination Records
- Drug Prescriptions: summary of any regularly used medications. You will need to be issued a prescription in the country you are staying in.  

You will be adjusting to life in a completely new environment inside of a new culture while studying abroad. In making the adjustment away from the familiar lifestyle of your home country, may come some changes which affect your health. Lifestyle changes in your eating habits, sleeping patterns, local climate, and stress level, can also affect your physical health as well as your emotional well being. 

Remember that it takes time to adjust to a new environment and that all of your fellow students are in the same situation. There are many people available to help you in making your adjustment as smooth as possible. Your school''s international student advisor, student health service personnel, and guidance counselors are willing to provide assistance whenever necessary.

Stress Management

Your health has a direct effect on your academic success. If you are healthy, well-rested, and alert, you can achieve peak academic performance. Planning for a successful adjustment into the foreign culture will help you overcome some of the initial challenges of changing your environment. "Culture shock" is the name given to the feeling of disorientation and discomfort associated with initial arrival into a new culture. "Cultural adjustment" is the process of learning about and growing comfortable in the host culture.

During the process of adjusting to a new culture you may experience mixed emotions as well as periods of stress. For example, you may temporarily experience changes in moods or attitudes. Some students report anxiety and loneliness, as well as changes in sleeping and eating patterns. 

Fortunately, this is only a temporary condition and there are many effective ways of reducing this stress! The first and best way to cope with unavoidable stress is to keep your body in good physical condition by eating well, exercising, and getting enough rest. Be sure to make time for activities which you really enjoy, whether alone or with the new friends you have made while abroad.

Another way to reduce "culture shock" is to talk out your worries. If you have made some friends, talk with them about what you are thinking and feeling. If you feel more comfortable talking with a professional, seek assistance from your international student services office or the student counseling center at your school. The important thing is to express what you are feeling. If it gets to much for you, you can contact our doctor for some support and understanding. 

If You Get Sick

Know in advance what to do if you become ill or injured. You can book an urgent or routine appointment with our doctor while studying in Barcelona. If you are not located in Barcelona, our doctor offers online/phone services including digital prescriptions for anyone in need during their stay in Europe. 

Click here to contact us or book an appointment.



Tips for Healthy Travels

Travel Tips

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Keep hydrated — It is especially important during the summer holidays to keep hydrated (2 L of water a day) and to maintain a healthy diet, including vegetables, fruits, proteins and carbohydrates. 

Rest - Trips can be quite hectic, especially for those visiting more than one country. It is important to try and rest (7-8 hours night sleep) and to try and nap (30 min) throughout the day. 

Common Cold/Cough — With a/c and changes in temperature, it is common to suffer from a cold, nasal congestion and coughing. It is advised to keep hydrated, rest and take paracetamol/ibuprofen to help with the pain. If any of the following should appear, it is advisable to visit your doctor: 

Fever. Chesty Cough. Night cough. Green Phlegm. White spots on your tonsils. Conjunctivitis. Earache. Persistent headache, especially on your sinuses. Rash.

Traveler's diarrhea — Contaminated food or water, viruses, anxiety and jet lag can contribute to traveler's diarrhea. It often strikes abruptly and causes four to five loose or watery bowel movements each day. In most cases, traveler's diarrhea will go away in a day or two without medical treatment. Most doctors don't recommend preventive medications such as antibiotics or anti-diarrheals (Pepto-Bismol/Fortasec), except in special circumstances. The best prevention is good hand hygiene and food and water safety. International travelers should drink only bottled beverages . For food, the general rule is: "Boil it, peel it, cook it or forget it.", especially in high risk countries. If diarrhea persists more than 48 hours, you experience fever, blood in your stools or have abdominal pain, we recommend you to contact our doctor.

Motion sickness — Travelers susceptible to motion sickness should consult a doctor about over-the-counter or prescription medications. Some natural remedies have been shown to reduce symptoms, too. Options include acupressure wristbands, ginger tea or dietary supplements.

Care before travel — Travelers of all ages leaving the country can benefit from a pretravel medical appointment, ideally four to six weeks before departure. The doctor will perform a physical exam and assess the health risks associated with travel plans.In most cases, the patient's regular doctor can provide this care. Travelers with specific medical conditions who are heading to Asia, Africa or Latin America may benefit from an appointment at a travel medicine clinic. There, care providers often have advanced training or board certification in travel medicine or tropical medicine. While services at these clinics vary, many providers offer a comprehensive overview of health hazards associated with specific travel plans and detailed advice on how to stay well. Contact our doctor if you have any travel consultations.

Jet lag — Older adults may have more severe jet lag and take longer to recover. Travelers can minimize jet lag by shifting to the local schedule as soon as possible. Travelers may be able to avoid jet lag by adjusting sleep schedules a few days before traveling.



Each year thousands of travellers decide to visit countries that require certain types of vaccinations. Our private travel clinic will give you travel health advice, vaccinations and malaria tablets.

For all your vaccination and malaria prevention needs, simply book an appointment for a consultation with our travel health doctor. 

Below is a link to check the vaccines that, during consultation with the doctor, will either be recommended  or must be carefully considered  for travel to your destination:





It's that time of year again, when along with an improvement in the weather, millions of people are welcoming the sniffling, sneezing and itchiness of seasonal allergies.

The number of people who suffer from these airborne allergies, a condition known as allergic rhinitis, has been on the rise in recent decades, especially in European cities, where pollen is sticking around for longer than usual.

Fortunately, for allergy sufferers across the globe, there is hope.

How allergies work

The body creates an allergic response by what's called an allergen — for people with seasonal allergies, that would be pollen from trees, grasses and weeds.

When that pollen makes it into the nose of an allergic person, their immune system mistakes it for a harmful foreign invader and goes into overdrive.

It releases antibodies to attack the allergen, which prompts cells in the person's nose, throat and lungs to release chemicals such as histamine, which is what leads to that sniffling and sneezing, or in more severe cases, asthma attacks.

Traditional therapies

There is no cure for seasonal allergies, so treatments have typically focused on managing the symptoms or avoiding allergens in the first place.

For medicinal treatments, the two usual standbys are antihistamines, such as Benadryl or Allegra, along with steroid nasal sprays like Flonase or Nasacort. There is also a new nasal spray that contains both.

Sublingual Immunotherapy

For those who suffer from allergies, tablets containing small doses of the allergen are dissolved under the tongue either daily or a few times a week for a period before and during allergy season. It's based on the idea that by exposing the immune system to small doses of the allergen, you can make your cells more tolerant to it.

This is a whole new type of desensitization which works in principle the same as allergy shots. But they are easier to take, probably safer, and it's done at home instead of the doctor's office It makes it quite easy for children and people who don't like needles to desensitize themselves.

Some studies also suggest that after about three years of daily treatment, sublingual immunotherapy provides a long-lasting effect for many people, basically reprogramming the body to be more tolerant of the allergen.


Injecting antibodies

Another type of treatment, specifically for people with severe asthma, blocks the communication pathways in an allergic response. A patient would receive a shot of antibodies that target the "communication molecules" that lead to inflammation.

That cost is high and it may be reasonable for people with severe allergies or asthma, but probably doesn't make sense for the casual allergy sufferer.

Potential vaccine

New research is showing some early promise for a potential allergy vaccine. The treatment works by essentially teaching the immune system how to respond to allergens in a normal way.

Unlike other immunotherapies that only work on specific allergens, the molecule would be effective for all of them — so it wouldn't matter if you're allergic to pollen, dust, cats or dogs.

Previous studies also showed that researchers could use the molecule to reprogram the immune systems of mice who were already allergic to pollen, a finding that could eventually pave the way towards finding a cure.

The treatment is still in animal testing phase and has a long way to go before it even reaches human clinical trials.



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You have decided to move to Barcelona to study from abroad. It is your fist time but some of your friends have been there before and they have given you recommedations. Deciding where to live is key to make the most out of your semester or year abroad and it´s important to inform yourself about the different areas (do you prefer to be near the beach? do you prefer to live with other students? Would you prefer to be in building with all students?

Barcelona is divided into 10 "districts". The most popular areas for student accomodations are: 

  1. The City Centre: we find the actual old quarter called Ciutat Vella. Surrounding this quarter are two very popular residential areas called Eixample Dreta (Right Eixample) and Eixample Esquerre (Left eixample). The majority of students stay in this areas. 
  2. University Area:  Eixample esquerre is were many universities (UAB, UB, ESADE, etc) are located. There are also two districts which are popular for students: Corts and Gracia.


Ciutat Vella

Well, let’s start from the beginning… Ciutat Vella (Old City) is comprised of four different neighborhoods (Barri GoticEl Raval, Barceloneta, El Born). It is one of the most beautiful and charming areas of the city. If you have ever visited the city before, you probably felt in love with this area and you decided that this was where you wanted to live one day!

This area is jammed with bars, music venues, restaurants, etc. so it might be noisy in some parts, especially in Barri Gotic, where pedestrian streets are quite narrow. If you like to be in the middle of the action you just found your area!
However, when you choose your apartment just make sure that there is not a bar or restaurant terrace below.

This is a very touristy area and, as a consequence, the cost of living might be more expensive, especially for grocery stores and restaurants. In terms of rent, it is an affordable area. The average rent for a two bedroom apartment goes from 500 to 700 € per month.

In general the Old City has great transport connections with the rest of the city. The Gothic Quarter, Raval and El Born are connected with the University Area by the tube Lines 1 and 3. Barceloneta’s connections are not as good, only the tube Line 4 reaches there.


This large area named Eixample is located beyond Plaça Catalunya and is divided in two parts, ‘Eixample Dreta’ and ‘Eixample Esquerra’ by Passeig de Gràcia. In this area the buildings are built in an easily recognizable grid shape designed by the architect Ildefons Cerdà.

Eixample Dreta

Eixample Dreta is one of Barcelona’s most exclusive neighborhoods. It has a great location as you can walk to Plaça Catalunya and Sagrada Familia. You are also close to Passeig the Gracia which is an exclusive shopping area and to the Gothic Quarter where you can enjoy Barcelona’s nightlife. It also has great tube connections as L1, L2, L3, L4 and L5 stop in this neighborhood.

Rent in this neighborhood is generally quite high, still you can find some nice apartments with an affordable rent. Conversely, Eixample Esquerrais a student area.

Eixample Esquerra & Corts

Eixample Esquerra and Corts neighborhood form the University Area (Zona Universitaria), where the majority of students live, since many universities are based there, for instance ‘Universidad de Barcelona’, ‘Universidad Politécnica de Cataluña’ or ESADE.

Corts is also the financial neighborhood of the city, where many international companies, businesses and hotels are located. Nightlife in this area is quiet since the majority of professionals don’t live here and students tend to head towards Eixample, especially around Plaça de la Universitat. In this area there is also the Barcelona FC’s stadium Camp Nou, so if you are a Barça fan you just found your neighborhood!

Transport connections are also great. The tube lines L1 and L3 can take you to ‘Ciutat Vella’ in less than 20 minutes.


Gracia is the new hip upcoming neighborhood which used to be a town until 1897, when it got incorporated to the city. It still maintains its bohemian style, with large squares where bars set up their terraces, local markets and independent stores. It has the famous Parc Guell from Gaudi.

Many students are moving to this neighborhood because of its trendy scene. Moreover, it has great connections to the University area by the tube line 3 and to ‘Ciutat Vella’ and Barceloneta beach by line 4. It is also possible to cycle but there is quite a stip hill.

Check these websites for accommodation in BCN




Airplane ear. Flying with a cold or an ear infection.

The stress exerted on your eardrum and other middle ear tissues when there is a difference of pressure between your ear and the environment (e.g. when flying) may damage your ears. You may experience airplane ear at the beginning of a flight when the airplane is climbing or at the end of a flight when the airplane is descending. These fast changes in altitude cause air pressure changes and can trigger airplane ear.

Usually self-care steps — such as yawning, swallowing or chewing gum — can prevent or correct the differences in air pressure and improve airplane ear symptoms. However, a severe case of airplane ear may need to be treated by a doctor.


Airplane ear can occur in one or both ears. Airplane ear signs and symptoms may include:

  • Moderate discomfort or pain in your ear
  • Feeling of fullness or stuffiness in your ear
  • Muffled hearing or slight to moderate hearing loss

If airplane ear is severe or lasts more than a few hours, you may experience:

  • Severe pain
  • Pressure in your ear similar to being underwater
  • Moderate to severe hearing loss
  • Ringing in your ear (tinnitus)
  • Spinning sensation (vertigo)
  • Vomiting resulting from vertigo
  • Bleeding from your ear

When to see a doctor

Usually you can do things on your own to treat airplane ear. If discomfort, fullness or muffled hearing lasts more than a few hours or if you experience any severe signs or symptoms, call your doctor.

Request an appointment with Dr. Victoria Howe


Airplane ear occurs when an imbalance in the air pressure in the middle ear and air pressure in the environment prevents your eardrum (tympanic membrane) from vibrating as it should. Air pressure regulation is the work of a narrow passage called the eustachian tube. One end is connected to the middle ear. The other end has a tiny opening where the back of the nasal cavity and the top of the throat meet (nasopharynx).

When an airplane climbs or descends, the air pressure in the environment changes rapidly, and your eustachian tube often doesn't react quickly enough. Swallowing or yawning activates muscles that open the eustachian tube and allow the middle ear to replenish its air supply, often eliminating the symptoms of airplane ear.

Ear barotrauma also may be caused by:

  • Scuba diving
  • Hyperbaric oxygen chambers
  • Explosions nearby

You may also experience a minor case of barotrauma while riding an elevator in a tall building or driving in the mountains.

Risk factors

Any condition that blocks the eustachian tube or limits its function can increase the risk of airplane ear. Common risk factors include:

  • A small eustachian tube, especially in infants and toddlers
  • The common cold
  • Sinus infection
  • Hay fever (allergic rhinitis)
  • Middle ear infection (otitis media)
  • Sleeping on an airplane during ascent and descent

Frequent or severe airplane ear may damage the tissues of the inner ear or eustachian tube, which increases your chances of experiencing the problem again.


Airplane ear usually isn't serious and responds to self-care. Long-term complications may occur when the condition is serious or prolonged or if there's damage to middle or inner ear structures.

Rare complications may include:

  • Permanent hearing loss
  • Ongoing (chronic) tinnitus


Follow these tips to avoid airplane ear:

  • Yawn and swallow during ascent and descent. Yawning and swallowing activate the muscles that open your eustachian tubes. You can suck on candy or chew gum to help you swallow.
  • Use the Valsalva maneuver during ascent and descent. Gently blow, as if blowing your nose, while pinching your nostrils and keeping your mouth closed. Repeat several times, especially during descent, to equalize the pressure between your ears and the airplane cabin.
  • Don't sleep during takeoffs and landings. If you're awake during ascents and descents, you can do the necessary self-care techniques when you feel pressure on your ears.
  • Reconsider travel plans. If possible, don't fly when you have a cold, sinus infection, nasal congestion or ear infection. If you've recently had ear surgery, talk to your doctor about when it's safe to travel.
  • Use filtered earplugs. These earplugs slowly equalize the pressure against your eardrum during ascents and descents. You can purchase these at drugstores, airport gift shops or your local hearing clinic.
  • Use an over-the-counter decongestant nasal spray. If you have nasal congestion, use a nasal decongestant about 30 minutes to an hour before takeoff and landing. Avoid overuse, however, because nasal decongestants taken over several days can increase congestion.
  • Use oral decongestant pills cautiously. Oral decongestants may be helpful if taken 30 minutes to an hour before an airplane flight. However, if you have heart disease, a heart rhythm disorder or high blood pressure, or if you've experienced possible medication interactions, avoid taking an oral decongestant unless your doctor approves. If you're a man older than age 50, you may experience serious side effects after taking decongestants containing pseudoephedrine (Actifed, Sudafed) such as urinary retention, especially if you have an enlarged prostate. If you're pregnant, talk to your doctor before taking oral decongestants.
  • Take allergy medication. If you have allergies, take your medication about an hour before your flight.

If you're prone to severe airplane ear and must fly often, your doctor may surgically place tubes in your eardrums to aid fluid drainage, ventilate your middle ear, and equalize the pressure between your outer ear and middle ear.

Helping children prevent airplane ear

These additional tips can help young children avoid airplane ear:

  • Encourage swallowing. Give a baby or toddler a beverage during ascents and descents to encourage frequent swallowing. A pacifier also may help. Have the child sit up while drinking. Children older than age 4 can try chewing gum, drinking through a straw or blowing bubbles through a straw.
  • Consider eardrops. Talk to your child's doctor about prescribing your child eardrops that contain a pain reliever and numbing agent for the flight.
  • Avoid decongestants. Decongestants aren't recommended for young children.




"When researchers studied several groups of young adults and looked at the extent to which high cholesterol in early adulthood is linked to later development of heart disease, they found that high levels of LDL ("bad") cholesterol were 5.5 times as likely to have a buildup of calcium in their coronary arteries (an early indicator of heart disease) than those who had optimal levels.

Most of the time, high cholesterol in young adults occurs for the same reasons it does in older people: obesity, lack of physical exercise and a diet that includes too much sugar and too many junk foods and fast foods.

On the positive side, lifestyle and dietary changes can often help bring cholesterol levels under control. I suggest starting by eliminating processed foods, sugary drinks and quick digesting carbohydrates. That means avoiding manufactured food that contains trans fatty acids (TFAs), which increase total cholesterol, raise LDL and lower HDL ("good") cholesterol. 

The real cause of our high rates of cardiovascular disease could be sugar, rather than saturated fat. We whoudl not only be eating less foods that can increase cholesterol levels, we just also be increasing vegetables and olive oil to our daily diet. 

Losing weight may also help you lower your cholesterol – even modest weight loss can do the trick. Regular exercise is important; it can increase HDL ("good") cholesterol levels. If you smoke, quit. And since emotional stress may prompt the body to release fat into the bloodstream (raising cholesterol), we should also be addressin stress issues.

Victoria Howe, MD. Andrew Weil, MD.

Mark Pletcher et al, "Associations of retrospective and concurrent lipid levels with subclinical atherosclerosis prediction after 20 years of follow-up: the Coronary Artery Risk Development in Young Adults (CARDIA) study," Annals of Epidemiology, doi: 10.1016/j.annepidem.2013.06.003.

English speaking doctors in Barcelona


Docteur anglais à Barcelone

Both private and public healthcare in Barcelona is of a high quality and has a good reputation worldwide. International patients have noticed the country’s fantastic treatment, and a high amount of foreigners travel to the city as medical tourists.

During your stay in the city (whether it is short or long term), you might have the need for medical assistance and you may probably feel more comfortable in an english speaking environment. If you need to see a doctor, you can contact Dr. Victoria Howe, who provides general medicine and surgery consultations. She works with an extensive network of english-speaking specialists for her referrals together with an english speaking lab. 

Our English speaking doctors are all internationally trained and are registered both in the Spanish General Council (COMB) and their home country council. For instance, our Cardiologist is american board-certified, our Women´s  health specialist is a member of the GMC (UK) and our Psychologist is a member of the London Therapy Society. 

If you need to be admitted to hospital, we will cater for all your needs and help you throughout the process. We collaborate with Quirón group hospitals (https://www.quironsalud.es/international/en/hospitals) for admissions and surgeries.

If you need to contact our doctor, please call us on 0034 672299222. 

Other emergency numbers are:

Ambulance: 061
Police: 088
EU Emergencies: 112
Fire: 080, 085
National Police 091


Influenza activity continued to increase in the temperate zone of the northern hemisphere while in the temperate zone of the southern hemisphere activity was at inter-seasonal levels. Worldwide, influenza A(H3N2) and B viruses accounted for the majority of influenza detections although influenza A(H1N1)pdm09 viruses were predominant in some countries.

  • In Europe, influenza activity increased above baseline levels in most countries in Northern and Southwestern Europe with sharp increases in respiratory illness indicators in some countries. Activity remained low in countries in Eastern Europe. Influenza B virus detections remained frequent and the subtype of the influenza A viruses detected varied depending on the country and the surveillance system (outpatient or inpatient systems). Please contact our doctor if symptoms persist more than 2-3 days and you experience a high fever, wheezing, acute tiredness, intense headaches or difficulty breathing.
  • In North America, overall influenza activity continued to increase in the region, with detections of predominantly influenza A(H3N2) viruses.
  • In Western Asia, increasing influenza activity was reported in Israel and Jordan with predominantly influenza B and A(H1N1)pdm09 virus detections, respectively.
  • In Central Asia, low to no influenza activity was reported.
  • In East Asia, influenza activity continued to increase in recent weeks. In both Northern and Southern China, ILI and influenza activity continued to increase, with influenza B Yamagata-lineage viruses predominantly detected followed by influenza A(H3N2) viruses. Increasing detections of influenza B and A(H3N2) viruses were reported in the Republic of Korea.
  • In South East Asia, low levels of influenza activity were reported.
  • In Southern Asia, increased influenza activity was reported in Iran with detection of all seasonal subtypes.
  • In Northern Africa, influenza activity was predominantly due to influenza A(H1N1)pdm09 virus detections. Activity increased in Egypt and Morocco; and Tunisia reported sharp increases in activity.
  • In Western Africa, influenza activity continued at lower levels compared to previous weeks. Detections of predominantly influenza A(H1N1)pdm09 viruses were reported from Burkina Faso, Côte d’Ivoire, Ghana and Togo. In Middle Africa, Cameroon reported activity with influenza A and B viruses and the Democratic Republic of Congo reported detections of influenza A(H1N1)pdm09 viruses. In Eastern Africa, sporadic influenza detections were reported in Madagascar, Mozambique, and the United Republic of Tanzania.
  • In the Caribbean and Central American countries, low to no influenza activity was reported.
  • In the tropical countries of South America, low to no influenza activity was reported.
  • In the temperate zone of the Southern Hemisphere, influenza activity decreased overall to inter-seasonal levels.

Interview with Barcelona-based English-speaking women’s health specialist Dr Victoria Howe

You have a specific health programme for women’s health consisting of different diagnostics and prevention packs. Can you explain a bit about what it comprises?

In our Women’s Health Division, we are now offering very specific programmes that are targeting the most relevant women’s health medical issues, such as the menopause, stress management, digestive health, pregnancy support, cardiovascular risk etc. We have created a variety of ‘packs’, adapted to each patient’s needs, following a concierge medical pattern. This means we have an initial medical consultation with the patient and then we assess their needs and create a personalised program for them. The majority of programmes include a medical assessment, a physical examination, an ECG and blood tests.

What is the price for the assessment and are clients able to claim the cost back from insurance companies?

The price can vary depending on the consultation. I am the General Practitioner for women and their families. If the patient is looking for a women’s health consultation or would like to enroll in one of my programmes then this is also available. This will be included in the pack if the patient decides to go ahead with it. Insurance companies (there is a list on our website) reimburse the majority of our fees.

What services does a Women’s Health Specialist offer and what is your philosophy?

My philosophy is that the patient has to be approached as a whole, through education and counselling. The patient should be well-informed and able to participate in their own care. In the past number of decades, doctors have sub-specialised so much that we have forgotten to see the body as a whole and the patient as an individual. Instead, modern medicine has mistakenly treated patients as numbers and statistics that need to be cured. I believe that we need to take care of each person with time, communication, excellent care and a more nurturing approach. A Women’s Health Specialist does exactly this. Medicine is based not only on treating patients but also in preventing health conditions through lifestyle medicine.

What kind of impact does stress have on a women’s health?

Society is starting to be become more conscious of the importance of well-being and our mental state. Until now, stress has been overlooked and has not become an issue until we started to study the evidence and the impact it has on our health. Stress has been related to a number of medical pathologies including cardiovascular disease, mental disease, hormonal imbalance etc. I also believe that managing stress physically, emotionally and psychologically can also lead to a more productive life, improving our social skills, our personal relationships with family and friends and our levels of satisfaction with ourselves.

What advice would you give to someone who is suffering from stress and finding difficulty controlling it?

Stress is constantly in our lives. It can show itself as frustration while waiting in a traffic jam or a confrontation with someone, but it is your decision how you manage it and how you want it to affect your life. We have to learn to cope with the stressful elements that we encounter daily at work and at home and this is where we can help. We provide strategies, techniques and procedures to help you manage these stressful situations. It basically helps you change the way you look at things and identify the warning signs of stress. We restructure the processing of decisions and help the patient change any factors that are harmful in their lives.

Many women may suffer from hormonal imbalance and not be aware of it. What are the signs?

There are many signs that your body is not adjusting to changes in your hormone levels but we have to assess them carefully as they could be signs of some other pathology.

The main signs are:

  • Unexplained increase in weight and hunger
  • Loss of libido / vaginal dryness
  • Mood swings
  • Sleep disorder
  • Fatigue
  • Cycle related spots
  • Breast changes
  • Blood pressure changes
  • Night sweats

How do hormones change in a women’s body once you approach perimenopause?

Basically, when approaching the menopausal transition, estrogen and testosterone start to decrease. This could happen either progressively, abruptly or even continuously, which would explain the different degrees and severity of symptoms in women. It is important to pay attention to these hormones as well as other relevant hormones in your body to rule out other conditions.

Do you think that there is enough information available for women approaching the menopause or do you think there is still a stigma surrounding it?

Nowadays information for menopause / perimenopause is available for everyone and our scientific evidence for the reactions and physiology of this period of our lives is well documented. But it is certainly true that many women, especially those under 50, which is the average age for menopause, feel embarrassed, worry or are even scared at the prospect of starting menopause. We still feel young and fertile so the idea of the menopause sounds incredibly daunting. It is important to remember that every woman will encounter this process and it is essential to feel at ease with our bodies no matter what moment in life you are in.

Do you advise a combination of both conventional and alternative medicine for women who are suffering negative effects from the menopause?

Standard medical management is very useful for women with relatively serious symptoms that affect their daily lives. Many women, though, reject the risks associated with hormone replacement therapy which treat their menopause symptoms and instead seek relief from alternative sources. Although researchers are still studying and looking into many of these therapies so as to determine their safety and effectiveness, there is a series of well-known evidence-based alternatives that are recommended for patients suffering from the menopause / perimenopause. I am completely in favour of using either conventional or alternative therapies as long as my patients are aware that even natural substances have real physiologic effects, including potential adverse effects and drug interaction, which need to be supervised by a doctor.

What specialist care do you offer pregnant women that they may not find in the public system?

Our maternal / pregnancy programmes are focused on offering women who are trying to conceive, who are pregnant or new mothers, a ‘concierge’ doctor who will provide them with the medical advice they need. It is an innovative programme that provides support (together with their obstetrician / gynaecologist) based on personalised care and service. It combines a holistic maternity care with a ‘concierge-level service to ensure healthy and happy women throughout their journey. This type of medical care, quite popular in the USA, caught my interest after being pregnant and finding that many other mothers-to-be were finding themselves isolated or desperate for medical advice and guidance, especially those who were living abroad. Pregnant women find themselves asking the question “is this normal?” many times and resorting to the internet for answers. This is the reason I created this maternal programme for any woman who needs my help.

Do you think there are enough birth choices available to women in Catalonia?

I believe Catalonia has one of the best health systems, both private and public. I agree that sometimes women’s choices are not listened to and that some birth options are not that common here. The most important and key element in being pregnant is feeling confident with your birth plan and with the doctor / gynaecologist in charge of your birth. We need to create an environment with our health professionals in which there is respect and trust both ways.

How daunting can it be for a pregnant women whose doctor does not speak their language?

It can certainly be very daunting for any woman to experience birth in a foreign country. We are trying to create a secure and friendly clinic for all patients so they can feel at ease with us. We are becoming a reference clinic for expats, tourists and, more importantly, for any patient who wishes to receive a more personalised medical care.

You have also trained as a Digestive Surgeon and you have created a division of digestive health. To whom is it directed and what can you offer them?

The Digestive Health programmes that we offer target women who are suffering from very common and often overlooked issues, such as abdominal bloating, gas, constipation, heartburn and other gut imbalances. These symptoms are caused by conditions such as esophageal reflux, IBS, colitis etc but could also be related to the health of our digestive system and the chronic inflammation of its components. This could end up affecting other areas of your body, such as your skin, your immune system, your liver, your heart etc and we should try to find the ‘closest to perfect’ balance in our bodies so we can prevent and manage these cases. I offer patients a number of programmes that take care of the needs of each individual, while also studying their nutrition and digestive health profiling.