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WHO Disease Outbreaks



Travel Health Online (Shoreland)

CDC Travel Health Info

BA Health Services

Healthy Flying (D. Fairechild)

Intl. Assoc. for Medical Assistance to Travelers Health

MCW HealthLink

Passport Health

Travel Medicine

Travelers Medical and

Vaccination Centre (Australia)

World Health Organization


The One Thing You Must Do to Prepare for a Medical Emergency


Travel-Health Makeovers

Stand Up to Summer

How to Avoid Becoming a Heat Casualty

Slumber Strategies for the Sleep-Deprived

Packing Your Personal Medical Kit

Airport Mishaps: Where to Get Help

Should You Be Flying Now?

Eating on the Go: What You Need to Know

Establishing Healthy Habits on the Road

No-Excuse Shape-Up Strategies

Other Columns


June 13, 2002

July 25, 2002


Show 'Em That You Care!

Airplanes Are Not Flying Hospitals!



The Wellness Concierge®

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When You Should—and Shouldn't—Take to the Skies

By Marlene 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 potentially life-threatening—problems.

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.”



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 recovery.

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 The 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!


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 recovery.

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.



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.

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:

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 plans.

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.


CARDIAC RESOURCES: details specific areas of concern and how flying affects those with heart problems in Traveling With Heart Disease.



Reduced oxygen levels in the cabin can sometimes lead to a condition called 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 airlines’ specific requirements is also available.




If 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.

The Breathin’ Easy Web site is a comprehensive guide for those traveling with pulmonary disabilities. You can find out where to 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) 888-699-4360; 707-252-9333.


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.

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 respiratory problems.


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 line!)

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.


The Diabetes Travel Guide is an invaluable road-survival book that includes packing lists, negotiating time zones, and much more. is a treasure-trove of devices and accessories for diabetics that can facilitate on-the-go care.

Traveling With Diabetes offers some savvy advice and useful info such as a chart that details how to say “I have diabetes” in over 25 languages.


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 them.

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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“The only real value that we bring to any other human being on this planet
is our ability to make some of their stress go away.”

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Who is

The Wellness Concierge®?

Marlene R. Fedin



To provide road warriors with travel-health information, resources, and inspiration to ease the stress and strain of life on the road and encourage

healthier life choices.


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