Travel tips from Dr Handford: Flight Health

When planning your trip, consider how to stay healthy and comfortable on your journey.
Arriving at your destination safely will help to ensure a pleasant holiday. Planning ahead and following some simple advice can help to make things go smoothly.

Deep Vein Thrombosis

  • What is a DVT?

Deep Vein Thrombosis (DVT) occurs when a blood clot forms in a vein, usually in the lower leg. This is more likely to happen in certain situations- including during a long journey (usually over 5 hours). Any long journey- not just travelling on a plane- can increase the chance of this happening.

If you have other medical conditions, such as being pregnant, having had an operation in the last 6 months, or having a diagnosis of cancer, you may be even more likely to develop a DVT. Blood clots can also run in families, so if you have had family members who have had clots in the legs or lungs, discuss this with your GP.

  • Why are DVTs important?

A DVT in the leg can cause pain and swelling in the limb. It can also damage the valves in the leg veins, which can lead to varicose veins and chronic leg swelling. The main concern is that part of the DVT clot could break away and travel through the bloodstream to the lungs, where it can get stuck and cause breathing problems. This is called a Pulmonary Embolism, or PE. This can be life threatening.

  • How can I reduce my chance of developing a DVT?

There are simple things that you can do to reduce your chance of developing a DVT. If you are travelling for longer than 4 hours, make sure you get your legs moving every hour or so. Walking up and down, or even doing some simple ankle and leg movements in your chair, will help to keep the blood moving.

If you are concerned that you may be at higher risk of blood clots, for the reasons above, your GP may recommend using some blood thinning medication or an injection before you travel. Have a chat with them and get their advice.

Many chemists now sell 'flight socks' which are gentle compression knee socks, and can help prevent DVTs and leg swelling generally. It is important that these fit well, so check which ones are right for you with your pharmacist.

  • How will I know if I have got a DVT?

Symptoms of a DVT can occur soon after a flight, or sometimes several months later. If you are concerned that you have any symptoms see your GP or a doctor at your destination as soon as possible.

The most common symptom is swelling. Usually this would be in one leg, starting in the calf and sometimes affecting the thigh as well. The calf may feel tender, especially when you touch or squeeze it. It may also feel hot or look red.

If you have any of these symptoms, please see a doctor as soon as possible. Sometimes a simple blood test can rule out a DVT. Usually an ultrasound scan can detect a clot if there is one.

Chest pains, dizziness and breathlessness can be signs of a PE, a clot in the lung. This is a medical emergency and you need to see a doctor immediately.

Jet lag

Starting your holiday tired and worn out can spoil the first few days of your trip, or really affect your return to normal life when you come home.

Jet lag happens when your body clock is disrupted by travel across time zones. This can mean that your usual body rhythms are out of sequence, and can make you feel quite unwell. The main symptoms are tiredness and lethargy. You may also feel hungry or alternatively lose your appetite, as well as noticing changes with your bowel habit and body temperature.

Jet lag causes no long term damage to your health. However, in the short term it can be a real nuisance. The best way to minimise the effect of jet lag on your trip is to try to adjust to your new time zone as soon as possible. Try to eat your meals according to your destination time zone. Being outside and active can help, as daylight will help to reset your body clock. Avoid sleeping on arrival, and try to achieve as close to a ‘normal' bed time as possible for you.

Drink plenty of fluids- but not alcohol- on your journey, and try to have a restful trip- napping during the flight can help you adjust on arrival.

Fear of flying

Many people are nervous about flying, and some are downright terrified. If you are worried about flying but planning a flight anyway, well done. That is the first step. In preparation for your flight, you may consider taking a fear or flying course, either on line or in person. There are several available now and an internet search will give you lots of options.

When requesting your seat, opt for an aisle. This will make it easier to move about on the flight and can make you feel less hemmed in. Give yourself plenty of time to check in at the airport, and arm yourself with soothing music, books and activities to distract you while you wait, and whilst you are in flight. Keep well hydrated, but avoid too much alcohol or caffeine, which can make you jittery and increase anxiety.

If you still feel anxious about flying, speak to your GP. It is not uncommon to provide low doses of medication to help with flight related anxiety. However, bear in mind you must not take these with alcohol, and you will not be able to drive when you reach your destination.

In-flight Problems

  • Ankle swelling

Most people notice some puffiness of their ankles during and after a flight. This is usually just down to being seated for longer than usual. Try to make sure you walk around regularly, and keep your feet and ankles moving even when sat down. If you are concerned that one leg is more swollen than the other, you may have developed a DVT- see the section above for advice.

Keeping well hydrated with plenty of water can help to reduce ankle swelling. Elevating your legs if possible will also help to minimise it. Flight socks can be useful to prevent ankle swelling in the first place- these are available from most chemists. Store your hand luggage in the overhead locker so you maximise your leg room and can stretch your legs out as much as possible.

  • Ears popping

As the plane descends and the pressure in the aircraft changes, you may notice pain in the ears. This can be really uncomfortable. It can help to suck on a sweet during this part of the flight, and blowing out air whilst pinching your nose and keeping your mouth closed can help to equalise the pressure and relieve the pain.

If you have a cold or blocked nose, or suffer from hayfever, you may be more likely to have this painful problem. Consider taking an antihistamine before you fly, or using a nasal steroid spray for a week or so prior to flying to try to reduce the chance of it happening.

If your ears remain painful after landing, you can take some simple painkillers to try to ease it. If symptoms persist more than a few days, see a doctor to check your ears.

  • Travel Sickness

Nausea and vomiting whilst travelling, especially on a plane, is very common. If you know you are prone to this, try to take anti sickness medication well in advance of the journey. Discuss with your doctor what to take if you are already on medication.

Acupressure wrist bands can also be helpful, again, put them on in advance of starting your journey, and leave them on for the duration.

Fresh air is in limited supply on a flight, but certainly cool air moving across your face can help. Consider taking a small battery operated fan with you in your hand luggage.

Sip fluids regularly, and try to sleep as much as you can on the flight. Distraction with films and music can be helpful too.

  • Eating and Drinking

Regular snacks during your flight can help to pass the time, as well as reducing the chance of jet lag on arrival. Eating small amounts often can also reduce travel sickness.

Staying well hydrated is the key to avoiding lots of problems with flight related medical problems, and can help you feel fresh and relaxed on arrival at your destination. Try to avoid alcohol on your flight. Excess caffeine is also inadvisable, as it can cause anxiety and palpitations.

In summary, giving thought to your flight can help to make it as pleasant as possible. Be well prepared, drink plenty of water, and keep those legs moving!

Always consult your own doctor before travelling

These travel tips are intended to provide general information and do not replace a visit to your doctor. If you are planning a holiday you should consult your doctor to ensure that you are fit to travel and discuss any specific health requirements you may have.

About Dr Ruth Handford

Dr Ruth Handford is a GP with over 10 years' experience of working in both hospital and primary care. She is particularly interested in caring for the elderly in the community, child health, and family planning. Ruth lives and works in a rural community, and is kept very busy by her job and young family.

Important Information: These travel tips are intended to provide general information and do not replace a visit to your doctor. If you are planning a holiday you should consult your doctor to ensure that you are fit to travel and discuss any specific health requirements you may have.

Travel Insurance for Medical Conditions

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