Due to circumstances beyond my control, I had to leave the northeast in February and travel to Kauai, Hawaii for a week. Sounds like fun, doesn't it? Leaving the snow and cold behind. What's not to like? Well, here are a few potential problems and ways to avoid them.
What To Wear
There is the relatively small hassle of what to wear and what to pack. You are leaving winter, heading to temperatures in the 70s, and then returning. Do you wear a coat to the airport? If so, what do you do with it? Think layers whenever you are traveling. Wear a T-shirt or tank top. Wear a long sleeved shirt over it. Cover that with a sweater or hoodie. The plane may be cold, unless you end up sitting out on the runway. Then it may get warm. Take off and put on layers as needed. Wear loose, comfortable clothes. Wear well-fitting shoes. If worse comes to worse, could you wear your shoes down a plane slide? No? Then, guess what?
What bothered me most was the travel time. I had flown from coast to coast. But traveling to Hawaii from the east coast is like two of those flights back to back. How long would I have to sit in one seat? And then sit in one seat again? What were the odds of getting sick? What about jet lag?
Cold and Flu
We know the air on most flights is recirculated. That may sound bad, but at least 50 percent of that air goes through high efficiency filters. The filters eliminate 97 to 99 percent of the dust, bacteria, viruses and fungi. The air is circulated side-to-side, rather than the length of the cabin. That limits exposure to airborne particles. A recent study showed that passengers on flights with recirculated air had the same number of colds as passengers on flights with fresh air.
What does make a difference is how close you are to someone with a cold or the flu. Your risk of becoming infected is more likely if you are sitting within two rows of an infected person on a flight of eight hours or more. Otherwise, the risk is about the same as traveling by train, or bus, or sitting in a classroom. To decrease your risk, especially if someone near you is coughing and sneezing, keep your hands clean. Wash your hands before you eat. Use hot or warm water and soap. You should always do that, right? But it's harder when you're traveling. You can't keep getting up in flight, climbing over people, and squeezing around the flight attendants and their carts. If soap and water isn't available, use your alcohol based sanitizer. In fact, if you go to the airplane bathroom, wash your hands, use your paper towel to open the door on your way out, and use the hand sanitizer when you get back to your seat. And keep your hands away from your face, specifically your mouth, eyes, and nose, during the flight. Wash your hands when you get off the plane. Remember that cold and flu germs can survive a long time on the objects and surfaces around you. Hand washing goes a long way toward keeping you safe.
As far as disease transmission on airplanes, humidity is more important than air recirculation. The air humidity is low at the elevation where commercial airlines fly. Mucus and cilia, (little hair-like structures), in your nose and throat are an important part of your body's natural defense system. Germs get stuck in the mucus and the cilia moves in waves. This carries the virus, bacteria, dust, whatever, toward your mouth. Then you either swallow it or cough it out. Low humidity makes the mucus dry up and the cilia stop working properly. It becomes easier for the germs to sit there and colonize, making you sick.
To combat these effects, stay hydrated. Drinking water helps your mucociliary defense system and your immune system. It may be better to sip water throughout the flight than to drink a large amount all at once. Hot drinks help in a number of ways. They keep you hydrated, as long as you avoid high amounts of caffeine. They trigger your system, and they provide direct moisture as steam.
Get sleep before flying. It sounds ridiculous, right? If it's a long flight, of course you'll spend time sleeping. But your body will ward off infection better if it is already well-rested.
What else should you do? Some recommend using a germ-killing mouthwash in flight. Kills germs and keeps your throat moist. Others swear by a multivitamin or large vitamin C doses. There are no studies that support these but who knows? Can't hurt, right?
Deep Vein Thrombosis
So far this has been all about infection, but what about other dangers? Sitting in one position for a long time can increase your risk of developing a blood clot in one of the deep veins in your leg, deep vein thrombosis, or DVT. This can cause swelling and pain, usually in your calf. The bigger danger is that a piece of the clot can break off and lodge in a pulmonary artery that supplies blood to your lungs. That is a pulmonary embolus. It can make you very sick. It can even kill you and death can happen very suddenly. The most important way to decrease your risk? Walk. Move your legs. If you can, walk up and down the aisle once an hour. If you can't get up, stretch and exercise your legs and feet often while sitting. Don't sit with your legs crossed. Wear loose clothes and shoes. Drink lots of fluids. Don't smoke. Avoid alcohol. A Harvard Medical School recommendation is to take a baby aspirin a half hour before take-off if you're not at risk for bleeding. Speak to your doctor before a long trip, especially if you have any medical problems.
And what about jet lag? Jet lag is what happens when you cross multiple time zones and your body's internal clock has trouble adapting. You may feel very sleepy in the middle of the day, nighttime insomnia, headache, loss of appetite, gastrointestinal problems, irritability, even depression. It takes about a day to shift one time zone. We don't have that kind of time. We want to respond sooner. To do this, you have to regulate your body's exposure to light. Light is the number one factor that cues your body when to sleep and when to wake up. If possible, for a few nights before your trip, go to bed earlier if you will be traveling east. Go to bed later if traveling west. For many of us, these gradual adjustments will not be possible. There are too many other things to get done. I'm lucky if I've finished packing by the time I have to leave.
Most people have a harder time traveling east. You get where you're going and you're wide awake but everyone else is sleeping. To adapt you will need to advance your body clock. You do this by waking up and going to bed earlier than you normally would. When traveling west you will have to delay your body clock. Wake up later and go to bed later.
How are you supposed to do this? Well, did you know that NASA has a fatigue management team? Here are their suggestions.
Traveling east? Advance your body clock by exposing yourself to light early. If you are leaving at night and will arrive at your destination in the morning, avoid light during the flight. Turn off your overhead light and wear sunglasses. Sleep if you can. Keep the sunglasses on when you get where you're going. Wear them until it's an acceptable wake up time, like 6 AM, back home. For the rest of the day the sunlight will help your body reset to the local time.
If you leave in the morning and travel east, expose yourself to light during the flight, and forget the sunglasses. And don't wear them when you arrive either. You want as much light exposure as possible.
Traveling west? It should be easier. Get exposure to bright light in the late afternoon/early evening to help adjust to the new time zone.
Tips for that first night:
- go for a walk that first evening
- alcohol may help you fall asleep but then interrupt later stages of sleep, making jet lag worse, so avoid it
- avoid dehydration by drinking lots of water before, during and after the flight
- stay away from large meals and spicy meals -- your body may not metabolize the food as efficiently as usual
- turn the lights down about an hour before bed since the light can reset your internal clock back
- try to fit into the new time zone as soon as possible, sleeping and eating when everyone else does
If you're planning a trip, keep these things in mind and stay healthy.
Every day... Say NO To Stroke!