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Here's How to Stay Healthy Aloft

While the thought of flying gives some people white knuckles, commercial airliners are actually much safer than cars, bicycles or even your own home.

But being airborne involves more potential health considerations than you might think. Veteran fliers and medical experts know some tips to prevent these conditions.

An open ear

Depending on how high you're flying, a typical airline cabin is pressurized to the equivalent altitude of 5,000 to 8,000 feet above sea level. Ascending usually causes no problems, but some people can experience pain during descent if their middle ear doesn't readjust to the increasing pressure.

Yawning or swallowing can help ease the pain; so can chewing gum. Or try this: inhale, close your mouth and pinch your nostrils shut, then gently push the breath from your lungs up toward the back of your throat and nose. This will force air up into the eustachian tube and equalize the pressure in your ears.

But what if you're seriously congested beforehand? Stuart R. Rose, M.D., the Northampton, Mass., author of the recent International Travel HealthGuide, suggests asking your doctor about postponing your trip if you are suffering from an acute ear infection, heavy cold, sinusitis, hay fever or an upper respiratory infection.

He recommends the following strategies:

  • If you have nasal congestion due to allergies, ask your doctor to prescribe a cortisone-type nasal spray and/or a non-sedating antihistamine.

  • If you're congested from a cold, take a decongestant two hours before departure.

  • Use a nasal decongestant two hours before landing, and blow your nose frequently to remove mucus.

Economy Class syndrome

It's hard to enjoy sitting in a cramped position in economy class for several hours. For most passengers, all this means is slight discomfort, or maybe a few pins and needles. But for a few, sitting like this can cause venous stasis or deep vein thrombosis (DVT), the settling of blood or actual clot formation in the veins of your legs.    Although often associated with economy class, DVT may occur in people in first class or in any transportation where the person sits for a protracted period. 

A more serious complication of DVT is a pulmonary embolus (PE). This is a clot that moves from the legs to the lungs and may cause mild to serious or fatal consequences. The longer a person sits without moving the higher the risk of developing DVT and subsequently "throwing" a PE. Flights over 12 hours have the greatest risk while DVT is uncommon in flights under four hours. Other risk factors include increasing age (age over 50), overweight or obesity, a previous history of PE, cardiovascular disease, cancer, oral contraceptive use or pregnancy, recent surgery and dehydration. Moving the legs frequently, jiggling the feet, stretching the calves by flexing the foot up toward the shin and getting up frequently and walking up and down the isle improve blood flow in the legs. Preventing dehydration is important. Always maintain adequate hydration while traveling.

Don't lag behind because of jet lag

While jet lag has a widespread reputation, it occurs only on certain types of flights and in certain sets of circumstances. Among the symptoms: daytime fatigue and the inability to sleep at night, gastrointestinal distress, tired muscles, headaches, moodiness, and general malaise. Other factors contributing to jet lag include travel stress, sleep deprivation and fatigue.

But the primary cause of jet lag is the disruption of our circadian rhythms--the internal clocks on which our bodies run--caused by travel either east or west across multiple time zones. Body temperature, hormone releases, eating and sleep-wake cycles all operate on circadian (circle the day) rhythms. They are controlled by both internal clocks and external clocks, such as sunlight and social cues.

Traveling across time zones throws these internal and external clocks out of sync and jet lag results. Your internal rhythms adjust easier when you travel west across time zones, which tends to lengthen your day. That's because without exterior cues (clocks, daylight), our bodies would run on a 25-hour clock, studies have shown. Eastward travel shortens the day well below that 25-hour cycle.

While researchers investigate ways of combating jet lag, including bright light treatments and pills containing hormones to adjust internal clocks, medical experts advocate a common sense approach. The most basic advice: When in Rome, do as the Romans do.

Tips to avoid jet lag

Before you leave:

  • If possible, try to get your body on your destination time schedule.

  • Get plenty of sleep; don't stay up late packing the night before.

  • Light: If you travel westward across several time zones, try to get three hours of outdoor light the afternoon you arrive in order to extend your biological clock. If you travel eastward several time zones, get early morning light as soon as possible in order to tell your body it should be waking up earlier. If you travel more than six time zones, however, take mid-day light instead.

  • If you have trouble sleeping, experts recommend taking a short-acting sleeping pill--but only for the first few days. Ask your physician's advice on this.

  • By the day after your arrival, begin eating and sleeping on local time.

Do drink the water

Dehydration certainly plays a role in jet lag. Blame the air you breathe inside the airplane. The high-altitude air pulled in through jet engines is extremely dry; relative humidity aloft is as low as 10 to 20 percent.

So, to prevent dehydration, experts advise:

  • Drink extra liquids shortly before you depart.

  • While in-flight, avoid alcoholic beverages. Alcohol is a diuretic that promotes dehydration.

  • Don't drink too much coffee; it also promotes dehydration. Also, excess caffeine can cause over stimulation, nervousness, tremors and anxiety.

  • Limit fruit juices or soft drinks. They contain too much sugar and/or caffeine, experts say. Grapefruit juice and excess sugar are also diuretics.

  • Do drink plenty of water. Try for a liter or more for a six or seven-hour flight, in addition to what you drink with your meals.

  • After you arrive at your destination, continue to drink extra liquids.

Online Medical Reviewer: Daphne Pierce-Smith, RN, MSN, FNP, CCRC
Online Medical Reviewer: Fiveash, Laura DrPH, MPH, RD
Online Medical Reviewer: Godsey, Cynthia M.S., M.S.N., APRN
Online Medical Reviewer: Lambert, J.G. M.D.
Online Medical Reviewer: Lee Jenkins
Date Last Reviewed: 10/11/2009
© 2000-2014 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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