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 Travel & Leisure

March 2012
Confidence On Board
Dr Sairam Pasupuleti
 
Air travel is comfortable and fast and it has become affordable to a significant section of the populace in recent times. Therefore, having adequate knowledge of disease prevention is helpful.

It is usual to experience minor ailments when flying irrespective of whether it is a short haul flight or a long haul flight.

Common in-flight ailments and some issues behind in-flight ailments may be classified as psychological and physical. Psychological ailments associated with air travel are stress and anxiety. Among the physical ailments and issues are deep vein thrombosis, cabin pressure sickness, motion sickness, jet lag, worsening of pre-existing illnesses, sore hips and aching back, travelling during pregnancy, and travelling with infants.

Common in-flight ailments
  • Deep vein thrombosis - is a condition where the blood clots in one of the deep laid veins of the calf or thigh or pelvis as blood flow becomes sluggish. It is usually the result of the traveller being dehydrated or having recently suffered trauma, example - abdominal surgery, heart disease and even childbirth. DVT is more common in passengers travelling long distances.
  • Jet lag is very common. Jet lag is a case when the body’s internal clock is out of sync with the actual time, often made worse when travelling east, or through many different time zones.
  • Worsening of pre-existing illnesses: Changes in altitude during a take-off and landing, issues like ascent, descent, change of direction, turbulence and rapid changes in brightness when the plane passes through the clouds may cause the onset of some conditions. It is why patients with brain conditions caused by thrombus or haemorrhaging are barred from air travel.
  • Sore hips and an aching back: Long duration air travel causes inevitable soreness in the hips and the feet become numb when remaining seated with the legs bent for more than ten hours.
  • Pregnant women: Women less than 36 weeks pregnant may travel by plane after getting a check up done by their doctor. During the flight, pregnant women should do regular leg exercises in order to promote blood circulation. Keeping the safety belt fastened (around the lower abdomen) is recommended in order to avoid placental abruption caused by turbulence. Women who are more than 36 weeks pregnant are more likely to suffer premature labour due to pressure changes and turbulence when travelling by air.
  • Infants: Many airlines prohibit an infant less than 14 days old from boarding a plane. This practice helps avoid the danger from damage to tissues and organs that are unable to adapt to pressure changes.
  • Cabin pressure sickness is caused as the plane’s cabin is pressurized when flying at high altitude. This air pressure is much lower than what we are used to and causes breathing problems and earaches.
  • Motion sickness is the most common in-flight health risk experienced by air travellers and it is more so, if there is a lot of turbulence.
  • Mental stress and anxiety: Some passengers may get stressed on their first flight.
Periodic medical check up for air crew and frequent flyers
  • Specially look for history of epilepsy, diabetes mellitus and heart disease
  • Resting ECG with tracing
  • X Ray Chest PA View with film and report
  • Blood Hb, TLC, DLC reports
  • Urine routine examination
  • Pure tone audiogram

How to prevent such stress?
Psychologists suggest: First, relax in a comfortable position by leaning the chair back, putting your hands on the armrests, relaxing your eyes, clearing your mind, breathing slowly and relaxing your muscles. Second, reduce the degree of anxiety by diverting your attention by talking with other passengers, reading, listening to music, watching videos and observing people and things around you. Mental stress will be alleviated as the amount of anxiety is reduced.

Preventive Measures
  • Drinking lots of water throughout the flight, avoiding alcohol, wearing loose-fitting clothes and walking around the cabin every hour or so will prevent DVT.
  • Passengers suffering from heart or breathing problems should always carry their medication in their hand luggage.
  • Keeping seat belt fastened during flight and taking Vitamin B6 will reduce motion sickness.
  • Adjusting meal times and sleep times more in tune with the time of the country being travelled to and resetting the watch to the new time zone after take-off prevents jet lag.
  • The following foods are advisable before boarding the plane: bread, noodles, yoghurt, green vegetables, lean meat, sweets, chocolate, fruit, honey, fruit powder. They are for preventing indigestion and traveller’s diarrhoea.
  • Chewing gum and candy will keep auditory tubes open and prevent otitis media (inflammation of the middle ear).
  • Holding the nose with thumb and index finger, closing mouth, and forcibly blowing out will relieve symptoms like stuffy ears and earache.
  • Standing up regularly to stretch the muscles and joints and walking around relieves sore hips and aching back.
  • Avoiding eating foods that contain too much animal protein as they may cause flatulence at high altitudes.
Fear of Flying
Commercial air travel continues to be an anxiety causing factor to a significant section of the general public and some members of the aircrew. When this anxiety reaches a level that interferes extensively with a person’s ability to travel by air, it becomes a case of fear of flying. Fear of flying may be a distinct phobia in itself, or it may be an indirect combination of one or more other phobias related to flying.

The fear of flying receives more attention than most other phobias because air travel is often difficult for people to avoid. The fear of flying may prevent a person from going on vacations or visiting family and friends, and it can cripple the career of a businessperson by preventing them from travelling on work-related business.

The fear of flying may be rooted in various other phobias too
  • Fear of crashing resulting in death
  • Fear of closed-in spaces such as that of an aircraft cabin
  • Fear of heights
  • The feeling of not being in control
  • Fear of vomiting can make the person vomit, thus making flying hard
  • Fear of flying over water or night flying
  • Fear of turbulence
  • Fear of terrorism.
Dr Sairam Pasupuleti is Emergency Medical Officer Department of Accident and Emergency, Apollo Hospitals, Chennai


    
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