Sunday, October 28, 2012

Aviation Medicine for Airline Passengers

Aviation medicine is normally thought of as meant for pilots and cabin crew, but it is also important for passengers. Traveling as an airline passenger can be rather exhausting.

The stress usually starts even before the journey has begun.

Carrying heavy bags might add to the physical stress of traveling. Disruption of the daily routine may also cause problems like fatigue, insomnia, constipation and stress.

Many questions may arise.

Can I eat the food that is being served on board the plane?
Where can I take my medication?
Shall I take my diuretic pills as usual?
Does flying affect my illness?
Am I fit to fly?

Did I get everything packed?
Can I carry my medication though the security check?
Do I have all certificates for my medications, syringes etc.?
Do I have all the necessary vaccinations and the vaccination certificates?

Planning the trip carefully can alleviate a lot of this stress.
Ask your doctor or pharmacist if you are in doubt.

It is also wise to bring a few common medications along that you might need during the trip should you get ill.

Many major airports have medical professionals working in clinics at the airport ready to attend to passengers in need of medical attention.

Topics that we are covering on this page are:

The falling air pressure
COPD or Chronic Obstructive Pulmonary Disease and Asthma
Dehydration
Stress
Being confined to a chair and to sit for a long time
Crossing time zones
The risk of infections
Pregnancy
Allergies
Nausea
Surgery

The falling air pressure

The most defining factor for aviation medicine is the falling atmospheric pressure.
Our bodies are developed for life at sea level.

When we fly at higher altitudes we are exposed to a lower air pressure.
With the falling air pressure the amount of oxygen that we can breathe is decreased, even though the fraction of oxygen in the air remains unchanged. To compensate for this, all modern airliners are equipped with pressurized cabins.
The air pressure inside the cabin is normally kept to a level corresponding the atmospheric pressure of the altitude of 1200 meters or about 4000 ft. In an aircraft without a pressurized cabin the altitude is not allowed to be higher than flight level 100 or 10 000 ft or about 3000 m.

For the healthy passenger this is only noticeable by the pressure building up inside the ears that is easily relived by swallowing or yawning a couple of times as the plane ascends and descends. This will normally open up the muscular tube that connects the middle ear to the upper respiratory tracts behind the nose. If this is not enough you might try to squeeze your nose and in the same time blow some air into your ears.

Small children also feel this pressure in their ears. It is not uncommon that infants cry during take off and before landing. This is often caused by the effect of the air pressure. The crying itself is actually thought to help the child clear the ears.

At this altitude most healthy people will be able to breathe and work normally for a prolonged period of time.

Some conditions and health problems might make it unwise or even dangerous to be exposed to this environment.

COPD
If you are suffering from COPD or Chronically Obstructive Pulmonary Disease, severe Asthma or Respiratory Insufficiency, you should consult your doctor before booking an airline ticket. If you have problems breathing on the ground, traveling at 4000 ft will not improve your breathing.

If you are suffering from a common cold, sinusitis or earache, it is wise to take decongestant medication before getting on a plane. Otherwise you might suffer from acute pain in your sinuses or ears when the plane is climbing or descending through the air.

Another condition that can cause severe pain when the air pressure is falling is a faulty tooth.
The condition is caused by the swelling of the nervous- and soft- tissue on the inside of the tooth. When the outside air pressure is falling the gasses dissolved in the tissues inside the tooth is expanding. Because of the hard envelop, the tooth itself, the tissue cannot expand. Instead the pressure is building up inside the tooth, causing an explosive pain. A pain so strong that people are known to have passed out because of it.

Heart patients suffering from conditions like unstable angina, leaking heart valves or severe anemia should consult their physician before getting on a flight.

Patients with pacemakers can normally fly without any problems. Just remember to bring your card along.

Dehydration
The air-conditioned air inside an aircraft is normally very dry. If you are flying on a long flight you should try to drink water enough to prevent you from becoming dehydrated. As a rule of thumb one might expect having to drink about 1-2 dl of water extra for every 2-hour of the flight. Dehydration can lead to a headache, nausea and a slight elevation of the body temperature but it also increases the risk of developing a blood clot in your veins.

Stress
As mentioned earlier flying as an airline passenger might be quite stressful. By preparing and planning your trip in advance you can alleviate a lot of this stress.

Do not drink alcohol to calm yourself down. This might actually have the opposite effect.
As a matter of fact, the effect of alcohol is stronger at a higher altitude.
Alcohol also worsens the dehydration and can lead to nausea and headache.

Try to start your trip being well rested and relaxed.


Deep Vein Thrombosis
Being confined to a chair and to sit for a long time has certain risks.
One of the major issues connected to air travel has been the risk of developing a blood clot the veins of your legs. This is called a deep vein thrombosis, and can be potentially deadly if the clot is detaching itself from the vein in the leg and follow the bloodstream to the lungs. To avoid this some doctors advocate the use of Acetylic Salicylic Acid. Please ask your doctor about this before taking the drug. Everyone does not need or can take this drug.

Avoid swollen legs by moving your legs like if you are working the pedals of an old fashioned sewing machine.

Crossing time zones
The classic Jet Lag is still a reality. Personally I find it easier to fly from east to west than wise versa. That is, it is easier to make the day longer than to make it shorter, and thereby loosing a night’s sleep. I usually find it easier to "sleep in to" a new time zone and "sleep out of" a new time zone, than trying to stay awake.

The risk of infections

The air inside the aircraft is circulating, but is also filtrated in the process. It is not recommended to travel if you are feeling ill, especially if you got a cough.

Pregnancy
Ask your doctor or midwife for advise before traveling on a trip. Read the general conditions section from the airline and ask for approval if in doubt.

Allergies and Special food on board

Allergies - Allergy special food can be ordered from many airlines around the world. If you are suffering from a severe allergy, remember to tell the cabin crew about it before you get in the air.

Diabetics - Diabetic diet can be ordered in advance from many airlines around the world. Otherwise, live as normal as you can.

Vegetarians - Vegetarian food can be ordered from many airlines around the world.

Nausea
Airsickness is a common problem.
Turbulence, psychological factors, anticipation etc. can be the cause of feeling sick when flying.

Here are some tips on how to avoid or cure the airsickness
Loosen your clothes, especially around your neck.
Open the air intake, let cold air blow in your face.
Breath slowly.
Lean backwards, close your eyes and try to sleep.
If you are sitting by the window, you might try to look at the horizon.
Take a glass of cold water.
Relax and remember that the aircraft is built to withstand even the toughest turbulence.
Put a small roll of cotton in one of your ears.

If this is not enough:
Take a small dose of a motion sickness medication.

Some general advice
Wear clothes that are loose and comfortable. This will minimize the risk of forming a blood clot. Do not eat too much before you start your trip, do not drink alcohol, and do not drink carbonized soft drinks. A mild laxative might come in handy to avoid constipation.

Avoid swollen legs by moving your legs like if you are working the pedals of an old fashioned sewing machine.

A flight during the day can be less stressful than during the night.

Rest 24 hours after a long flight and do not make any crucial decisions right after a long flight.

Surgery
If you have recently undergone surgery, please consult your doctor before flying. This is most important if you recently have had eye, chest, or dental surgery.

Finally
Do not be afraid to ask the cabin crew for help!
Always ask your Doctor for advice if you are in doubt!

SOURCE: Air21World.com

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