Illnesses may make air travel difficult

Q and A

Q&a

March 19, 2006|By ROGER COLLIS | ROGER COLLIS,NEW YORK TIMES NEWS SERVICE

I am having difficulties finding out what illnesses can affect whether someone should fly or not.

My friend has had deep-vein thrombosis, is obese and has high blood pressure. I say we should take the train. Can you help?

The best advice I can give is for your friend to consult her doctor.

Deep-vein thrombosis is a serious health hazard and, in spite of what the airlines may say, there is published medical research to indicate a link between the condition and flying.

It is clear that lack of movement, cramped seats and reduced air pressure in the cabin have a combined impact on blood-clotting mechanisms.

And obesity is an additional risk factor, according to Dr. Richard Dawood, a Londoner who specializes in travel-related medicine.

At an altitude of 30,000 feet, the cabin is pressurized to 8,000 feet, the equivalent of sitting on top of a mountain.

The low cabin air pressure makes your heart and lungs work harder and can be dangerous for people prone to strokes or who have heart problems.

However, a lot of the discomfort you feel in the cabin is not so much caused by air pressure or the quality of cabin air, which is a mix of fresh air and filtered recirculated air, but because you are stuck in your seat. One effect of being seated and immobile is that fluid shifts from the bloodstream to tissues.

At the end of a long flight, you may have as much as four pounds of fluid squeezed from the circulatory system and into the tissues of your legs, Dawood said. Add to this dehydration, the effect of the plane's dry air, which increases the tendency of the blood to form clots.

If a clot forms in the deep veins of the legs, the symptoms - pain and swelling - may not appear for a few days. There is a risk that the clot may dislodge, travel to the lungs and cause a life-threatening pulmonary embolism.

Do not ignore pains in the calf muscles or the chest. The prescription is to stretch your legs as often as you can during the flight.

Get up and move around, drink at least a pint of water every three hours in the air, wear compression stockings and don't take sleeping pills unless you have space to sleep horizontally.

For comfort, avoid alcohol, coffee and tea, which promote dehydration. And eat sparingly. Some doctors advise travelers with circulatory, pulmonary or cardiac problems that pressurization can alter the effects of some medications. Consult your physician.

Carry medications in your hand luggage (with a doctor's prescription). Dawood's Traveller's Health (Oxford University Press) offers further practical advice on avoiding health risks while traveling.

Information is also available from the World Health Organization at who.int/ith.

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