Health checked and cleared for take-off

Air travel can bring serious risks for those travellers with pre-existing conditions


Summer has arrived, and with it the prospect of fun in the sun. And, for many people, that means booking a flight to warmer climes.

With bags packed, passports and tickets checked, you might feel ready for take-off, but before you rush off to the airport, take a minute to consider your health.

Dr Mark Murphy, spokesman for the Irish College of General Practitioners, outlines a few simple steps to ensure we arrive as fresh and healthy as possible at our holiday destination:

Hydration

“The air within aircraft cabins is dry, and for those who are fit and healthy, this will not result in any significant dehydration,” says Murphy. However, he says, if you drink alcohol, or drinks containing caffeine, dehydration could develop, “so passengers should drink sufficient water to keep urine its normal pale colour”. The dry air can also dehydrate skin and lips, so it’s good to keep moisturiser handy.

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Altitude

The GP explains that high altitude is generally considered to be from 2,400 metres (8,000 feet) so aircraft cabins are maintained at a pressure equivalent to between 1,800 and 2,400 metres. This means that altitude sickness symptoms are not usual during flights, but people with certain health conditions should still take precautions.

“Those with pre-existing lung or heart problems may be more likely to experience symptoms during or after flights, and being aware that they may be due to altitude can be helpful. Dehydration may make symptoms worse, as may strenuous exertion, so people with serious pre-existing lung disease may need to seek specialist advice before planning flights and sometimes request, in advance, supplementary oxygen supplies [for during] the flight or after arrival.”

Medication

As air travel can have an adverse effect on young children, elderly people or people with certain medical conditions, Murphy says ensuring your medical supplies are up to date is crucial.

“Passengers should remember to carry medication in their hand luggage to ensure they are not lost in transit and can be taken at the appropriate times. Patients with diabetes should be prepared for any eventuality (delays, cancellations, rerouting or stopovers). They should carry extra food and snacks to ensure adequate intake or, perhaps, to supplement airline food. And if you are prone to travel sickness, consider taking an anti-sickness tablet, as persistent vomiting can lead to hypoglycaemia [low blood-sugar levels].”

Pregnancy

“Air travel is generally considered safe in uncomplicated pregnancies up to 36 weeks,” says Murphy. However, women with high-risk pregnancies should seek medical clearance before travel.

Some experts believe women are at a greater risk of deep vein thrombosis (DVT) during pregnancy and the postpartum period; these travellers should be advised of DVT- prevention measures.”

DVT

Although not common, deep vein thrombosis (DVT) is the most frequently cited condition associated with air travel, and occurs when a blood clot develops in the deep veins that carry blood from the legs to the heart. When this occurs, the leg can swell and the calf muscles can become painful. A DVT in the lower leg needs to be treated with blood-thinning medication but can be complicated and dangerous if the clot breaks off and travels to the lung.

People with a higher risk of a thrombosis include those:

- with a history of DVT

-who have advanced cancer

- with a chronic debilitating illness causing serious immobility

- who have had recent surgery or deep injuries; for example, a fractured hip

- who are over 60 years of age

- who are pregnant or have had a baby less than two months before the flight

- with a family history of a clotting disorder (called thrombophilias, for example the factor V Leiden mutation)

- who are obese

“By sitting still for long periods in cramped positions, air travel can increase the risk of a DVT developing,” warns Murphy. “Preventive measures for the general population to reduce this risk should include good hydration, restricting alcohol and coffee intake, regular stretching of the leg muscles and exercises.

“Elastic compression stockings can reduce ankle swelling, though the evidence that they prevent thrombosis is uncertain. For those at serious risk, a single injection of a blood-thinning agent, called a low molecular weight heparin, given shortly before departure should be considered [in consultation with the person’s GP]. Aspirin is no longer recommended as a useful drug to prevent DVT formation.”

Jet lag

Anyone who has ever been on a long-haul flight will know how debilitating jet lag can be and, apart from feeling extremely tired, symptoms can also include loss of appetite, disturbed sleep for days after a flight, nausea, bowel changes and poor concentration. Although nothing can be done about the length of your flight, you can take some simple measures to minimise the effects of jet lag:

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Ensure you are well rested before taking off.

- Break up long journeys with a stopover if possible.

- Try to sleep on the flight.

- Ask your GP for help with medication and discuss what is best for your body, as everyone has different requirements.

Overall

- Keep well hydrated.

- Avoid alcohol and caffeine.

- Remember to bring necessary medicine on board and take at correct times.

- Move around the aircraft whenever possible, particularly on long flights.

- Wear compression stockings if at risk of DVT.

- Get sufficient rest and try to relax.