Images of passengers huddling on the wings of an Airbus A320 after it was ditched in the Hudson River in January might have set you wondering about the risks of travelling by air. Thankfully, air safety records are good – aircraft are generally sound and pilots well trained.
But what about other dangers? Fortunately most common in-flight problems are troublesome rather than truly life threatening, but they can ruin the start of a holiday. Here’s how to avoid them.
Perhaps one-third of people have a true fear of flying, but many more have concerns about arriving at the airport in time, securing the right seat or falling ill. Some feel claustrophobic and out of control.
Symptoms ‘Butterflies’; feeling nervous or restless and jumpy; tension; a sense that something awful is going to happen; clammy palms; queasiness; poor appetite.
What you can do Set out well prepared and allow plenty of time. Try to have low expectations – then you won’t be critical and disappointed. A few doses of Valium (on prescription) help; yoga relaxation techniques are also excellent.
Motion sickness is caused by conflicting sensory signals – your eyes and the balance organs in your ear are telling you different things. Air sickness, though, is more complex than simple motion sickness. You can become psychologically conditioned to feeling ill – as soon as you smell aircraft food, for example – especially if you have previously experienced air sickness.
Symptoms Nausea, followed by a watery sensation in the mouth; yawning; going pale; vomiting.
What you can do Trials found the drug metoclopramide and ginger equally effective in treating nausea: ginger biscuits can be helpful. The antihistamines cinnarizine (Stugeron) and meclozine (Sea-Legs) work well, especially if you take the first dose three hours before take-off and then take further doses every eight hours. Tablets containing hyoscine (Joy-rides, Kwells) can be taken to treat rapid-onset motion sickness.
Travel bands (wristbands with an acupressure button) help some, although evidence for efficacy isn’t strong. Try closing your eyes, listening to music and eating sensibly – take small, frequent, light snacks; avoid greasy food and quantities of fluid that slop around in your stomach.
Blood in the legs is pumped by muscle activity; if you are inactive for more that five hours the blood may stagnate and form a clot in the calf veins. DVT is more likely if you have close blood relatives who’ve had clots, if you’ve had a major operation, leg surgery or a leg fracture in the past three months, if you have cancer, if you’re pregnant, if you’re overweight or if you smoke.
Symptoms Leg-swelling, specifically when one leg is more swollen than the other, and if one is hot, red or throbbing. DVTs most commonly happen ten days after a long-haul flight.
What you can do Eat oily fish in the 24 hours before departure. Avoid taking sleeping pills or getting very drunk on the flight. Move about the plane and perform exercises that tense the calf and thigh muscles. Also, exercise before and after the flight helps reduce the chance of DVT. Buy properly fitted flight socks and put them on while lying down. Recent research suggests that having a flu jab reduces your risk of DVT by 23%.
Common bacteria and viruses float around inside aircraft. On modern planes these are filtered out effectively; unfortunately, air movement within the plane does pull potentially infective draughts past you on the way to the filter – microbes will be shared between people sitting close. The only consequence of this is likely to be a post-flight cold, but other infections (including chickenpox) are not uncommon.
Symptoms None while actually on the plane.
What you can do Sadly, nothing. Echinacea is said to stimulate the immune system. I know of no other medicaments that have any proven effect against on-plane germs; some people wear face masks – however, these not only look ridiculous but there is no evidence that they help.
It takes about a day for every hour of time difference for your body clock to adjust to new time zones.
Symptoms Fatigue; inability to sleep in new time zone; irritability.
What you can do Melatonin seems to be very effective, but you still can’t buy it in the UK. It is now available on prescription for people over 50 with insomnia. It is probably unwise to take sleeping tablets on the plane because of the DVT risk, but a few doses on arrival can help you readjust. The homeopathic No-Jet-Lag combination has many fans.
Wind down before your trip rather than madly rushing around – start stressed, arrive stressed. Many people like to set their watches to the time at their destination as soon as possible; others stick to the at-home time. Experiment to see which helps you.
Sunshine promotes your body’s own melatonin production. Protein-rich breakfasts and lunches and high-carbohydrate evening meals also help readjustment.
The aircraft environment is at a lower pressure, so you lose more moisture from your lungs; the air is also drier. Cabin crews tend to offer drinks in insufficient quantities.
Symptoms Thirst; dry mouth and nose; feeling prune-like; itchy skin.
What you can do Avoid excessive alcohol and strong caffeinated drinks. Irritate the cabin crew by asking for drinks frequently. Buy water (or refill your water bottle) once you’re airside at the airport. You could also anoint the inside of your nose with heavy-duty grease such as Vaseline.
Spaces within the skull should be air filled but can become thick with mucus. When mucus blocks the pressure-release points you feel pain, especially as air pressure changes – most likely if you fly with a heavy cold, recent ear infection or sinusitis. Antibiotic treatment isn’t an instant cure.
Symptoms Ear ache, sinus pain and pain at the front of the face – especially on descent. Sinusitis can feel like your eyeball is exploding or like having a screwdriver rammed into your cheekbone.
What you can do Preferably, reschedule your flight if you have an infection. Otherwise try leaning over a bowl of hot water so that you inhale steam. Take no more than one or two doses of a decongestant (such as Sudafed) an hour or two before take-off.
Chewing gum helps equalise the pressure on either side of the ear drum. Avoid fizzy drinks before and during a flight – pressure changes to the gas within your stomach can cause abdominal pain.
Garlic (a clove a day) & ginger Both are traditionally used to thin the blood
Tropical fruit Papain (in papayas) and bromelain (in pineapples) may help prevent thrombosis
Ginkgo biloba & cat’s claw Extracts from both of these plants probably reduce the stickiness of red blood cells
Grape seed extract & skins, tea, red wine & berries Flavinoids in these may help to reduce the risk of clots
Tea made from holy basil (aka tulsi – Ocimum sanctum) Said to have mild anti-thrombotic properties
Oily fish Essential fatty acids in oily fish, cod liver oil and cold-pressed vegetable oils reduce blood cell stickiness
Zinopin capsules (French maritime pine bark extract, or Pycnogenol, with ginger) May reduce the risk of DVT and help control ankle swelling on long flights
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