YOU BE FLYING NOW?
You Should—and Shouldn't—Take to the Skies
R. Fedin, The Wellness Concierge®
Chances are that if you’re sick, you may choose to fly anyway. But
taking off with even a seemingly minor health problem can turn a
normal flight into an endurance test. For those with special health
conditions, taking to the skies can present some unpleasant —and even
Before you book—or board—a flight, take stock of your current
health as well as your itinerary. (Many people run into problems while
flying because they have undiagnosed conditions, such as diabetes and
heart disease.) If you have a chronic, temporary, or pre-existing
condition and are planning frequent and/or long-haul flying, consult a
physician to determine whether you’re truly “flight ready.”
I’M NOT REALLY SICK!
The idea that you have to be seriously ill or incapacitated to postpone
flying is false. So even if you’re experiencing relatively minor
problems—such as a severe head cold, an upper respiratory infection with
a fever and/or sinus pain, acute sinusitis, or a serious ear
infection—consider postponing a flight till your symptoms have
diminished. Flying could exacerbate these conditions and lengthen your
Sometimes, symptoms will seem so insignificant or familiar that you’ll
(incorrectly) discount them as being unimportant. Have painful stomach
cramps with overall weakness, a fever, and nausea? Maybe it’s only
something you ate. But maybe it’s something more serious, like
gastroenteritis or even appendicitis—problems that should be treated
before taking to the skies.
One flyer thought the intense pain in his shoulder blades was a
byproduct of toting heavy luggage, but it turned out to be a heart
problem. Another believed that her back pain was a result of a recent
workout; it wasn’t. It was pneumonia.
Checking out these symptoms beforehand could have spared them agonizing
in-flight experiences. Ask yourself: Are you willing to writhe in
pain for hours with few if any options for relief?
Unsure about the seriousness of your condition? Perusing
Aviation Health Institute’s Medical Contraindications to Air Travel
Guide is not a substitute for a trip to your physician but
it’s a very comprehensive listing of conditions that may require a
change in your travel plans.
Heed the number one rule of healthy travel: If you feel lousy on the
ground, chances are you’ll feel a lot worse once you’re in the air!
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Other candidates for temporary grounding include people who’ve had major
surgery (cardiovascular, abdominal, etc.) and some who’ve had minor
operations (oral, eye, ear, nose, or facial), including some types of
outpatient surgery. Dr. Wayne J. Riley, director of Baylor Travel
Medicine Service in Houston, advises against flying for at least seven
to 10 days after minor procedures and at least 10 to 14 days after major
surgery. If you’re planning a transcontinental or international flight,
the amount of time may increase depending on your condition and
Your risk of pulmonary embolism (blood clot) rises in the two weeks
immediately after any surgery that leaves you immobilized for a few days
or longer. Any extended period of sitting or immobilization (as you’d
experience on a plane) increases this risk.
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If you must wear a cast when you have to fly, ask for a special soft
“air” cast to prevent circulation problems, particularly if the cast is
on a leg. As the body swells up during flight, you could find your
circulation compromised or cut off with potentially serious results if
you’re encased in a traditional plaster cast.
STROKES AND NEUROLOGICAL
Assuming you are not otherwise incapacitated, Dr. Riley suggests waiting
a minimum of two to three weeks after a cerebral vascular accident
before undertaking air travel to ensure that vitals such as blood
pressure, which can be affected by in-cabin conditions, are under
control. Individuals with brain tumors and recent skull fractures are
susceptible to increased swelling and pressure (with serious
implications) that can be triggered by cabin pressure changes.
Frequency and duration of flying can affect the overall health of those
with ongoing or special health concerns. Conditions that warrant medical
consultation and pre-planning include:
HEART DISEASE AND
These are not necessarily a deterrent to regular air travel. People with
pacemakers and those who’ve had bypass surgery, for example, routinely
fly. Individuals with a history of heart disease (heart attack or
angina) whose condition is stable also are generally deemed OK to fly.
However, given the instability of a heart condition, you should watch
for signs—a change in symptoms, such as an increase in pain or pressure,
or severe shortness of breath—that could indicate a need to alter travel
If you’ve had a recent heart attack or any type of heart surgery or
angioplasty, consult your physician as to the period of convalescence
needed before you can fly again.
ROAD RULES: Rest before leaving;
avoid extreme fatigue and stress before your flight and during your
trip. Make sure you allow enough time for check-in so that you’re not
running through an airport with your luggage. Don’t overexert yourself
physically. Don’t carry heavy luggage. Use a luggage cart or get a
porter (even wheelies can be too heavy for those with heart conditions).
Be sure to carry a copy of your most recent ECG and a sufficient supply
of current medications.
TravelDoc.com details specific areas of concern and
how flying affects those with heart problems in
With Heart Disease.
DISEASES, PULMONARY, AND RESPIRATORY DISORDERS
Reduced oxygen levels in the cabin can sometimes lead to a condition
hypoxia, whose symptoms (sleepiness, lightheadedness, nausea,
headache, etc.) are innocuous for healthy travelers, but far less benign
for travelers with cardiac and respiratory conditions and heavy smokers.
If you have trouble breathing on the ground, you’re likely to have even
more trouble once you’re in the air and may require supplemental oxygen.
Air travel is normally considered safe for individuals with lung
diseases provided they can walk at least a block or climb a flight of
stairs without getting breathless. Supplemental oxygen may be required
during flights and on the ground between flights for those who cannot
meet these criteria.
ROAD RULES: Contact the airlines in
advance to arrange for in-flight oxygen (you cannot use your own on
commercial flights) and to arrange for any equipment that you may need
before you leave. You can find out just about everything you’ll need to
know to secure supplemental oxygen for flights at the
Traveling by Air
page of the Breathin’ Easy Web site. A chart detailing the
specific requirements is also available.
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you really want to understand what happens as gas expands in your
body (and how that can negatively affect your in-flight comfort
level), check out this
PDF file from Dr. Dougal Watson’s Aviation site. The file
features illustrations and serious-but-somewhat amusing text.
Easy Web site is a comprehensive guide for those traveling
with pulmonary disabilities. You can find out
purchase oxygen or refill a tank at over 2,500 locations in
1,600-plus cities in all 50 states.
You can purchase The American Association for Respiratory Care’s
Breathin’ Easy Travel Guide by calling (toll-free)
Cabin air pressure causes gases to expand in body cavities (lungs,
sinus, ears and stomach and in dental fillings, cavities, and abscesses,
for example), which can result in increased pain, shortness of breath,
and abdominal distention for people with such conditions as acute
diverticulitis, ulcerative colitis, or gastroenteritis.
ANEMIA, SICKLE CELL ANEMIA
Individuals diagnosed with these conditions (as well as those who are
unaware that they are seriously anemic) already have reduced oxygen
transmission in the blood. Exposed to a cabin’s low oxygen levels, these
flyers may require supplemental oxygen during a flight.
Note: If you regularly find yourself becoming dizzy, lightheaded, or
faint while flying, you may want to be checked for anemia or cardiac or
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The vagaries (which can begin with lengthy check-ins, and may also
include long flights; delays; limited or no exercise or food options) of
flying, which have increased since September 2001, can dramatically
alter a diabetic’s blood sugar levels and medication routines. (And this
doesn’t even take into consideration having to perhaps test your
blood—or worse, inject yourself—while waiting in a check-in or security
Insulin-dependent travelers run the most risk, and diabetic shock or
coma can occur if they do not take action as needed. Seasoned travelers
with diabetes who closely monitor their conditions generally have few
problems. But there’s a whole new crop of individuals, including many
people under-30 as well as baby-boomers, who are being diagnosed with
diabetes each day. These newcomers may know travel but they’ll have to
educate themselves—and practice—diabetes management on the road.
ROAD RULES: Pre-planning and vigilance are
critical. Show your itinerary to your doctor, noting time–zone changes
to determine what adjustments to insulin doses and timing are needed.
Keep well-hydrated: Drink water to avoid feeling faint or dizzy. And
remember, by the time you feel thirst, you’re already dehydrated!
Fatigue and jet lag can make it hard to get correct blood glucose levels
readings; you may have to check more frequently.
Always hand-carry medication and supplies with you. In these days of
heightened security, you will also need to carry your prescription and a
letter from your doctor detailing your need to carry syringes. Policies
may vary among airlines so it’s best to check with them in advance
Don’t expose insulin supplies to extreme heat or cold and do not store
in an overhead bin or near a heat or air source (car, bus or railroad
car). You can use special protective containers and carriers to get
around this challenge.
Most important, always carry a light snack and a sugar source (candy,
sugar cube, orange juice, or glucose tablets) with you. You may need it
quickly and there may be no time or access to make a purchase.
PRE-PLANNING PAYS OFF
Travel-medicine specialists offer the following advice for those
traveling with special health problems:
Drink water and other non-alcoholic liquids to avoid dehydration, which
can worsen many symptoms.
As a precaution, ask your doctor for names of local physicians in the
cities to which you will be traveling.
Take a sufficient supply of any needed items and prescriptions and
factor in extra quantities that might be needed should travel delays
occur; find a local supplier for any special items (such as oxygen)
before you go to avoid being stranded at an airport or hotel without
Take copies of all prescriptions. Always keep your meds in their
original containers never pack them in checked luggage.
Have a doctor prepare a letter (on his letterhead) detailing your
condition and specific needs for medications, equipment, etc. It should
include a contact number for him. Make sure it is dated and signed.
If you require special onsite medical equipment or have special dietary
requirements, contact airlines and hotels in advance and confirm your
request in writing. Always have a contact name and phone number in
case there’s a problem.
Wear a special medical-identification bracelet or medallion.
Carry a wallet card that explains your medical conditions, lists your
current medications, and has the contact numbers of your physician(s)
and other relevant health-care providers along with the name of someone
who can be responsible for medical decisions if you are incapacitated
and cannot make arrangements for yourself.
Having such information readily available can save valuable time should
a life-threatening emergency occur.
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