Air Travel

One of the first subjects to come up when we discus air travel is jet lag. The symptoms we call "jet lag" are really due to more than just changing time zones. The stress of a long trip, too little sleep along the way, dehydration from the dry air in the plane and a host of other factors all play their part. Try to drink so much fluids that you have to make frequent bathroom trips. Also avoid alcohol, caffeine and most of the food, choosing rather to sleep as much as possible on the long leg of the trip. If possible, choose a flight that arrives at night so you can go straight to bed and then get up on local time. If you have to arrive in the daytime, immediately start living by the new schedule. A one-time dose of a sleeping pill your first night there may also help.

There is a jet-lag diet that is recommended but it is too time-consuming and complicated for most people to remember. Ditto with scheduled exposure to daylight or other bright lights. Simply being outdoors as much as possible during my first couple of days helps as much as anything.

Melatonin is getting a lot of attention. Scientifically, it makes sense. The placebo-controlled studies show that it is better than sugar pills if taken according to a strict multi-dose regimen. But just popping a few melatonin capsules is statistically no better than sugar pills regardless of the dose. Considering what we DON'T know about melatonin, many physicians are still avoiding it.

The main danger on long plane flights is dehydration. The dry air in the plane, eating on the run and irregular schedules all add up to too little fluid in and too much out. This along with prolonged sitting, especially in a cramped position, may cause blood clots in the legs and pelvis. To prevent these dangerous clots we recommend drinking plenty of fluids but not caffeine or alcohol as these aggravate dehydration.

The extra fluid intake may also help to prevent constipation--another aggravating difficulty in travel. The stomach and intestines are apt to not empty well, allowing gas to build up in the intestinal tract. This gas can cause uncomfortable swelling as altitude increases so it is best to wear loose-fitting clothes.

One of the discomforts you may experience is earache. This is caused by the change in air pressure and its effect on the ear canal. A number of remedies have been recommended for this--most of them successful some of the time. None of them successful all of the time. Chewing gum or sucking on hard candy is probably the most common remedy. Swallowing helps to equalize the pressure inside and outside the ear. Forcefully increasing inner ear pressure by pinching your nostrils and blowing your nose is often suggested and equally often condemned. Theoretically it is possible to rupture your eardrum or do other serious ear damage by doing this. A group of ear specialists who were recently surveyed on this matter, though, admitted that none of them had personally seen a case of ear damage from this. Physicians commonly recommend the use of a decongestant (e.g. Sudafedâ, Afrinâ) or antihistamine (e.g. Claritinâ, Hismanalâ, Allegraâ, Benadrylâ) before flying. Recent studies have shown that this, too, may not be as helpful as postulated. New on the market are pressure-equalizing ear plugs (see our catalog.) These have not been around long enough to undergo independent medical evaluation but they have been garnering good reports among the traveling public. One thing that will definitely aggravate an earache is an ear infection. If you already have an ear infection it is definitely best to get it treated before your travel by air. It may even be wise to postpone your trip.

Another problem worsened by air travel is toothache. Again, changes in air pressure contribute to this, as may the decreased availability of regular oral hygiene. These factors may flare-up a dental abscess or other dental problem. It is a good idea to have a complete dental check-up before you go on an overseas trip. If you are caught with a toothache, however, a good short term remedy, found in many first aid kits, is Oil of Cloves which can be applied to the offending area.

Flying may also aggravate respiratory problems. People like to blame air pollution but the air in commercial airliners is probably the cleanest air you will ever breathe. It is also the driest (this is necessary to prevent water condensation on essential electrical components.) It is the dry air that can result in coughing, sneezing, bloody nose and other respiratory symptoms. Once again, drinking a lot of fluids may help. It is also a good idea to carry along a decongestant or cough medicine in case the symptoms become intolerable.

In spite of pressurization, the air pressure and the oxygen level in an airplane is less than at ground level. If you have recently had surgery, therefore, this could cause uncomfortable swelling. Also, the lack of oxygen could aggravate cardiac or respiratory conditions. In these instances you should check with your physician or a travel medicine specialist before travel. Supplemental oxygen may be available on the flight but only by special arrangement.