Health Considerations — The Healthy, Happy Traveler

Flying is a Routine Activity for millions of Americans, and raises no health considerations for the great majority of them. However, there are certain things you can do to ensure that your flight is as comfortable as possible.

Changes in pressure can temporarily block the Eustachian tube, causing your ears to 'pop' or to experience a sensation of fullness. It is much more difficult for your ears to adjust to the change in pressure when the plane is going down than when it is going up. To equalize the pressure, swallow frequently; chewing gum sometimes helps. Yawning is also effective. Avoid sleeping during descent; you may not swallow often enough to keep ahead of the pressure change. If yawning or swallowing doesn't help, use the 'Valsalva Maneuver'.

The Valsalva Maneuver

If you want to have a 100-percent success rate at popping your ears, you should employ the Valsalva Maneuver. In this technique, you pinch your nose, close your mouth and blow against your cheeks with gradually increasing pressure until your ears pop. If you pop one ear but not the other, you blow again, releasing your grip slightly on the nostril on the side of the popped ear; this will keep the pressure from getting too high on that side but still allow you to pop the ear which needs it.

Babies are especially troubled by these pressure changes during descent. Having them feed from a bottle or suck on a pacifier will often provide relief.

Avoid flying if you have recently had abdominal, eye or oral surgery, including a root canal. The pressure changes that occur during climb and descent can result in discomfort. If you have an upper respiratory or sinus infection, you may also experience discomfort resulting from pressure changes. Postpone your trip if possible. (Check to see if your fare has cancellation or change penalties.)

A final tip on pressure changes: they cause your feet to swell. Try not to wear new or tight shoes while flying.

Airliner air is dry; if you wear contact lenses, blink often and limit reading. Alcohol and coffee both have a drying effect on the body. Airliner cabin air is relatively dry to begin with, and the combination can increase your chances of contracting a respiratory infection. If you wear contact lenses, the low cabin humidity and/or consumption of alcohol or coffee can reduce your tear volume, leading to discomfort if you don't blink often enough. Lens wearers should clean their lenses thoroughly before the flight, use lubricating eye drops during the flight, read in intervals, and take the lenses out if they nap. (This may not apply to extended wear lenses; consult your practitioner.)

If you take prescription medications, bring enough to last through your trip. Take along a copy of the prescription, or your doctor's name and telephone number, in case the medication is lost or stolen. The medicine should be in the original prescription bottle in order to avoid questions at security or Customs inspections. Carry it in a pocket or a carry-on bag; don't pack it in a checked bag, in case the bag is lost.

How To Minimize Jet Lag

Anyone who has traveled across several time zones is probably all too familiar with the daytime fatigue and nighttime insomnia known as jet lag, which can last several days. While its precise cause is still being studied, exposure to daylight may play an important role in setting our internal clocks. After a time-zone change, the body's "clock" no longer matches its exposure to light, throwing it out of whack. Much recent interest has been generated over the use of the non-prescription drug melatonin for combating the symptoms of fatigue commonly associated with jet lag. Melatonin is a hormone secreted in the brain at night; the drug is used to help reset the internal clock. Since the drug melatonin is not FDA approved, the quality and source of the drug may vary. Preliminary studies suggest melatonin might be effective in preventing jet lag, but the evidence is still scant, and there are contraindications with other drugs and medical conditions so individuals should first consult their physician.

You can minimize the effects of jet lag in several ways:

Try to use a rest room in the airport terminal before departure. On some flights the cabin crew begins beverage service shortly after the Fasten Seat Belts sign is turned off, and the serving cart may block access to the lavatories.

Strategies for Feeling Comfortable During Air Travel

♥ In the days prior to the flight, gradually move your sleep and meal schedules toward the destination time zone.
♥ Eating well and drinking lots of fluid during the flight helps prevent dehydration. Water is best; alcohol, because it tends to cause frequent urination, can increase the likelihood of dehydration. Caffeine users should move their intake to correspond with the new time zone.
♥ If you're flying when it would be nighttime at your destination, try to spend as much time as possible asleep. If flying during what would be daylight at your destination, attempt to remain awake.
♥ Walking the length of the plane every half hour - one good strategy for staying awake - reduces the risk of the swelling and blood clots that can develop over hours of sitting.

Travel Vaccinations

Several vaccines have become available in the last five years for people traveling to less developed countries and who may be at risk for getting hepatitis A or typhoid if they eat or drink contaminated food or water.

A vaccine against hepatitis A is replacing gamma globulin, which was formerly injected a few days before departing on a trip and would only be effective for three to five months. The new vaccine, given as a series of two injections six to 12 months apart, offers protection for 15 to 20 years.

The decades-old typhoid vaccine that caused fever, body aches and pain at the injection site has been replaced by an oral typhoid vaccine (four capsules taken over a week) or a new injectable form. Typhoid fever - a virulent salmonella infection - remains prevalent in many developing countries.

Like hepatitis A and typhoid, people acquire cholera via contaminated food and water, but the incidence of cholera is low - fewer than one in 100,000 travelers come down with it. The cholera vaccine currently licensed in the United States is ineffective; an oral replacement available in Europe and Canada is being reviewed by the Food and Drug Administration.

Until it is approved, avoid eating raw or undercooked seafood and shellfish, particularly in areas of the world where sewage and sea water intermix.

The oft-repeated saying "boil it, peel it, or don't eat it" still holds true when traveling in less developed countries. Some additional safety tips:

  1. if possible, stick to well-cooked and freshly prepared foods;
  2. avoid salads and ice cubes;
  3. use only pasteurized dairy products;
  4. pass up anything containing custard, cream pastry, or mayonnaise, since all are ideal growth media for disease-causing bacteria.

These numbers provide current health and safety advisories for both domestic and international destinations.

Centers For Disease Control Global Health Advisory Hotline, (404)-332-4559; fax (404)-332-4565

International Association For Medical Assistance To Travellers (Iamat) Advises travelers on climate, food, water, and diseases abroad, and, in emergencies, can give information on local doctors over the phone, (716) 754-4883

Moss Rehabilitation Hospital Travel Information Service Suggests resources to help travelers with disabilities, (215) 456-9600

State Department Office Of Overseas Citizens Services Travelers' Hotline, for accessing health and security advisories and consular information sheets for individual countries around the globe, and for reporting emergencies involving U.S. citizens abroad, (202) 647-5225; fax (202)-647-3000;

Department Of Transportation International Travel Advisory, for information regarding airport security concerns around the globe, 202-366-2220


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