Dr. Anil Minocha
Holiday season also means the season of travel. Americans are travelling far and wide, to new and exotic destinations. Whether it is driving long distance, sea journey or flying, one must be aware of health risks associated with such travel. Many of risks to health can be reduced by being proactive.
Coach Class syndrome occurs as a result of prolonged sitting in a cramped economy class seat in the plane for prolonged periods. This can cause clots in legs that can result in life threatening complications. Deaths have been reported. While subjects at risks for clots are at higher risk, no one is immune. Take an aspirin before embarking on the journey unless disallowed by your provider.
Do not sit still for more than 2 hours in the plane. An hourly visit to the rest room is a good excuse. While sitting in your seat, exercise your feet and legs with movements at your knee and ankle joints. Many airlines now routinely show videos of exercises that you can do while sitting.
Avoid alcohol and caffeinated products so as to minimize the loss of fluids through urination. If you must drink alcohol, do drink a glass of water for each drink consumed.
Upper respiratory infections are common during the winter. Air in the plane is filtered so as to minimize the risk of spread of infections. However, respiratory infection may be spread by coughing and sneezing by a fellow traveler sitting close by. Patients with respiratory infections are more likely to get ear blockage and pain during take-off and landing process. Pseudoephedrine (Sudafed®), diphenhydramine (Benadryl®) may be used to avert such an experience.
Blood oxygenation is not normal during the flight since the plane is not fully pressurized as it is on the ground. Patients with heart failure, chronic lung disease or severe anemia like sickle cell disease may need additional oxygen while in flight.
Motion sickness may occur. Try to get a seat over the wings in the planes. Take a nap instead of reading. Consume small amounts of simple foods and beverages. Avoid any oral intake for short flights. Medications like diphenhydramine (Benadryl®) and scopolamine patch (Scopace®) before the departure are of benefit. Always consult your doctor prior to use because many of these medications may cause significant side effects especially among senior citizens.
Practice safe driving
Have plenty of rest/sleep prior to long trip. Eat before your trip. Pack on healthy snacks and water bottles. Do not drink alcohol.
Take a break every 100-150 miles even if you don’t feel up to it. Fill up gas tank, get some fresh air, stretch your legs, and use the restroom.
Warning signs for sleepiness include:
- Frequent eyes closing or inability to focus.
- Frequent yawning
- Wandering off to adjacent lanes or curbside and make abrupt corrections
- Driving too slow compared to the overall traffic.
- Failure to follow traffic signs
Infections are common. Risk of infections can be minimized by taking certain precautions. A consultation with the local travel health clinic is a wise investment if traveling to a developing country. Such a clinic can help set you up for appropriate vaccinations. Contact your state health department or nearby medical school for information about such clinics.
Avoid fruit salads, lettuce, and chicken salads. Fruits peeled just before eating are safe. Do not use unboiled water even for brushing teeth. Bottled drinks should be consumed from the bottle with a straw rather than from a glass. Locally bottled water may however not always be safe. If bottled water is not available, boil water for 5 to 15 minutes or 5 drops of tincture of iodine to a quart of water. Carbonated beverages are safer than noncarbonated ones. Beer and wine are okay. Ice in drinks is not safe unless made from boiled or filtered water. Alcohol cannot sterilize water.
Traveler's diarrhea is a concern when traveling to any area with new and different kinds of foods. The more adventuresome your culinary tastes, the greater the risk. Contaminated foods are bigger source of traveler's diarrhea than the contaminated water. Antibiotics are effective in reducing the risk of travelers’ diarrhea but are not recommended for routine prophylactic use. Probiotics are also effective in reducing the risk but without the risks associated with the use of broad spectrum antibiotics. However, not all probiotics species are equal.
Air travel up to 36 weeks of uncomplicated pregnancy is not a problem. Wear the seat belt below the abdomen. Avoid air travel if you have high blood pressure during pregnancy. Air travel does not pose risk to the baby. Be sure to check with the doctor first.
Metallic component of certain implanted medical devices may activate security systems. Be sure to take a letter from your physician. Patients with chronic illnesses should wear medical identification bracelet or necklace.
Don’t forget to take your personal medicines with you especially syringes and needles in case of those requiring insulin. Take the medicines on the plane with you in your purse or carry-on baggage.
Above all, relax and stay safe. Plan your time well so you don't have to rush. Happy holidays!
Dr. Anil Minocha is Professor of Medicine at LSU medical school in Shreveport, La. Connect with him on Facebook at www.facebook.com/anilminocha and follow him on Twitter @dranilminocha