Travel: air travel

Travel
Flying has revolutionised travel. Air travel is safe and
comfortable; however, ‘air sickness’ and jet lag are problems
that face many travellers. Deep venous thrombosis (DVT)
is a special risk for long journeys (more than 4 hours).

What is jet lag?
Th is is the uncomfortable aft ermath of a long fl ight in
which the person feels exhausted and disoriented, has
poor concentration, insomnia and anxiety. Th e problem
on arrival is poor concentration and judgment during
daytime.
Other symptoms that may occur include anorexia,
weakness, headache, blurred vision and dizziness.
Jet lag is a feature of fl ying long distances east-west
or west-east through several time zones, causing the
person’s routine daily rhythm of activity and sleep to
get out of phase.

What factors infl uence jet lag?
General factors
Noise, vibration, air humidity and sitting still for long
periods can infl uence jet lag.
Specifi c factors
Duration of the fl ight, time of departure, changes in
climate and culture at the destination aff ect the severity
of jet lag. Th e problem is aggravated by:
• stress of the pretrip planning
• last-minute rushing and anxiety
• lack of sleep during the trip
• overeating and excessive alcohol during the fl ight
• smoking.

How can you minimise the problem?
Careful planning and a few simple hints observed during
and aft er the fl ight can ease jet lag.
Before the fl ight
• Allow plenty of time for planning.
• Plan a ‘stopover’ if possible.
• If possible, arrange the itinerary so that you are fl ying
into the night.
• Ensure a good sleep the night before fl ying.
• Ensure a relaxed trip to the airport.
• Take along earplugs if noise (75 to 100 decibels)
bothers you.
• Discuss prevention of DVT with your doctor. Compression
stockings and aspirin will be helpful.
During the fl ight
• Fluids: Avoid alcohol and coff ee. Drink plenty of nonalcoholic
drinks such as orange juice and mineral
water.
• Food: Eat only when hungry and even skip a meal
or two. Eat the lighter, more digestible parts of your
meal.
• Dress: Women should wear loose clothes (e.g. long
skirts, comfortable jeans, light jumpers) and avoid
restrictive clothing. Wear comfortable (not tight)
shoes and take them off during fl ight.
• Sleep: Try to sleep on longer sections of the fl ight (give
the movies a miss). Close the blinds, wear special eye
‘masks’ and ask for a pillow. Consider using sedatives.
• Activity: Try to take regular walks around the aircraft
and exercise at airport stops. Keep your feet up when
resting, and perform in-fl ight exercises by fl exing the
major muscles of the legs. Avoid resting the calves of
your legs against the seat for long periods.
• Melatonin: Th is hormone is closely linked with our
sleeping patterns and is claimed to prevent jet lag. Its
use is controversial, so check with your doctor.

At your destination
Take a nap for 1 to 2 hours if possible.
Wander around until you are tired and go to bed at the
usual time. It is good to have a full day’s convalescence and
avoid big decision-making soon aft er arrival. Allow about
3 days for adjustment aft er the London to Australia
fl ight.

Who is fi t to fl y?
Patients with these problems should avoid fl ying:
• upper airways congested by infection, including
infl uenza
• severe respiratory disease (emphysema, chronic
bronchitis, pneumothorax)
• unstable heart failure
• severe anaemia (below 70 g/L)
• pregnancy beyond 200 days (28 weeks)
• previous violent or unpredictable behaviour
• within 4 weeks of a myocardial infarction (coronary
or heart attack)
• within 14 days of a cerebrovascular accident
(stroke)
• within 14 days of major surgery
• brain tumour or recent skull fracture
• recent eye surgery.
Special precautions are required by travellers with:
• Colostomy: Patients should wear a large colostomy
bag and take extra bags.
• Varicose veins: Wear supportive stockings and exercise
frequently.
• Plaster casts: Th ose with broken limbs in plaster should
be careful of swelling.
• Pacemakers: Th ose with pacemakers may have a
problem with X-rays at some overseas airports.
Mention it to offi cials before passing through security
equipment.
• Epilepsy: Medication should be increased on the day
of travel.
• Diabetes: Diabetics should discuss their therapy and
control with their doctor.
• Previous DVTs: Check with your doctor.

Thanks to: John murtagh's patient education