In Flight Problems
The vast majority of people flying abroad do so in commercial aircraft and without any trouble, unfortunately the characteristics of flying does present a problem for some. If you think flying may be a hazard for you, please seek advice from your general practitioner or physician.
Most airlines will not allow passengers to travel with certain conditions and regulations will vary from one airline to another, so if you are in doubt you should obtain advice from the medical department of the airline concerned. Conditions which you may need to discuss with your own doctor before travelling and / or need clearance from an airline include:
- Pregnancy, some airlines will not carry beyond 32 weeks others will carry up to 38 weeks.
- New born babies for the first few days after birth
- Recent heart attacks and other unstable cardiac conditions
- Recent, intra cranial, chest or abdominal surgery
- Recent pnuemothorax and some hypoxic pulmonary disease
- Some recent / current sinus or ear infections.
- Unstable psychiatric illness
Deep vein thrombosis (DVT) and pulmonary embolus (PE)
There is still much debate surrounding the relationship between deep vein thrombosis and long distance air travel. The development of DVT's and PE's, which is where clots break away from their holding veins, deep in the legs or pelvis and clog up the heart and lungs - has been linked with prolonged mobility for many years. This can be long distance air, car or bus travel, prolonged surgery and even from sitting in front of the television for long periods of time. Long distance air travel does however have added risks.
Some travellers are more at risk of developing DVT's than others. Those at high risk of forming a DVT are those with recent major surgery, strokes or people with paralysed limbs as well as passengers with a personal or family history of clotting. There is an increased risk for travellers over 40 years of age, the obese, those with varicose veins, limb injury or recent surgery. The risk is also increased for pregnancy, women on the pill or taking other hormonal drugs and those with recent heart disease.
Symptoms may include swelling, pain, tenderness and redness especially involving the calf and the pain may be worse when bending the foot upwards. Symptoms may develop during the journey but more often it occurs hours or even days later.
Measures to prevent DVT's include:
- Exercise calf muscles whilst seated every half hour or walk around the cabin if possible.
- Keep the legs uncrossed
- Avoid the consumption of alcohol and caffeine, before and during the flight.
- Drinking sufficient water or juice.
- Take short naps rather than long ones thus avoiding prolonged inactivity.
- Loose fitting clothes may also be beneficial, to avoid constriction of veins.
Other measures which may help those at high risk, however travellers should consult their own medical practitioner first are:
- Compression stockings.
- The use of oral aspirin.
- The non-use of sleeping tablets.
Problems arising from the environment within the aircraft
Reduced pressure
When cruising at 12500 metres, most modern airlines maintain cabin air pressure similar to those at 2200 metres on the ground. As an aircraft climbs pressures in the closed cavities of the middle ear, chest and abdominal cavity will become higher than in the cabin and cause distension, with problems for some passengers. The reverse occurs when the aircraft descends.
Passengers with colds, middle ear infections, and allergic problems such as hay fever should seek medical advice before travelling. As should travellers who have had recent head, chest or abdominal surgery.
Reduced oxygen
At cruising altitude levels of oxygen in the blood are reduced, which can affect passengers with lung disease or anaemia. People with poor lung function, uncontrolled heart failure, and cardiac irregularities should consult their general practitioner before travelling.
Jet Lag
Jet lag normally affects passengers who travel more than 4 hours or more and westward travel is usually tolerated better than when travelling eastwards. It normally takes one day per time zone (hour) for the body to adjust to its new surroundings. The effects of jet lag are normally, tiredness and insomnia and can also include nausea, vomiting, general malaise, constipation and poor concentration. These effects can be made worse by alcohol and hangover. Ways of countering jet lag can include:
- Change your watch as soon as you get on the flight: the quicker you adapt to the time zone the lower the level of jet lag is likely to be.
- When you arrive in the new time zone, spend time outside during daylight hours as natural light can help align your body clock.
- Adjust your meal and bed time to the local timetable as soon as possible.
- Avoid heavy commitments on the first day
- The impact of alcohol on the body can be two or three times more potent when you're flying so one glass of wine on the flight has the effect of two or three glasses on the ground. Therefore avoid alcohol before and during the flight.
- Get as much exercise as you can, walking up and down the aisle, doing stretching exercises in your seat which can help reduce discomfort and allow you to have a more relaxed flight.
During extended stopovers on a long-haul flight try to take a shower: it can help wake up your circulation and get things moving.
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