AVOIDING PAIN ON THE PLANE The cold season provides fresh opportunities for misery aloft. Here's how to deal with mal de air.
(FORTUNE Magazine) – CLICK! Seatbelt buckled. Settle in. A flight of discomfort is about to begin. Between takeoff and touchdown, your ears may pop, your eyes may smart, your limbs may ache, your nerves may tremble. Commercial flying can be that way: painful, physically and psychologically. It usually hurts most beginning now, the high season for head colds. Dr. William Saunders, who teaches otolaryngology at Ohio State University's medical school, neatly boxes the business traveler's dilemma: ''You mustn't fly with a cold -- but if you must, you must.'' If you must, here's what you should know, along with recent findings on jet lag, dry skin, and more exotic airline ailments: Your middle ear is filled with air and is connected to your nose and throat by the Eustachian tube, which acts as a one-way flutter valve. This valve easily lets air out when the pressure is greater inside your ear than outside, but it doesn't readily open to let air in when the outside pressure is greater. Similarly, your sinuses often have trouble repressurizing to the level of the surrounding atmosphere. An upper respiratory infection or inflammation makes the transfer of air all the more difficult. Cabin altitudes can rise to 8,000 feet on a commercial jet. Going up is no problem, but the trip down can be awful as the cabin altitude returns to the higher pressure of ground level. When the pressure is greater outside, you may suffer anything from mild discomfort to sudden, excruciating pain and even bleeding from the nose. If they can send people to the moon, you ask, why can't they keep the inside of a DC-9 at sea-level pressure? ''You'd end up with a cast-iron airplane,'' says Wayne Willich, marketing program director for Boeing's 737. - Beefing up a typical wide-body to maintain zero cabin altitude at 35,000 feet would add 6,200 pounds -- the gross weight of 31 fare-paying passengers. Pressurization systems are designed to ease transitions; the pilot dials in the cruise altitude, the landing field elevation, the desired rate of climb (usually 500 feet per minute, maximum) and descent (300 feet per minute). Those rates of pressure change shouldn't be noticeable to the ears and sinuses of a healthy passenger. But you're not healthy. What to do? Take a decongestant -- a pill two hours in advance, or drops or spray just before the plane descends. Sudafed will do the job without making you sleepy. Any nasal spray -- Afrin, Duration, Neo-Synephrine, among them -- will too. Don't be caught asleep as the plane starts down. You will need to swallow frequently to open the Eustachian tubes. And practice the so-called modified Valsalva maneuver, holding your nose and blowing gently, to build pressure and flip open the flutter valves. Sit up rather than lying back. The Eustachian tubes work best when you're upright. And don't sit in or near the smoking section. If your ears hurt, don't be embarrassed about looking ridiculous: Ask a cabin attendant for warm, wet cups. Geri Popovich, Western Airline's manager of flight standards and training, describes the procedure: ''We pour hot water over paper towels and squeeze out the excess, put them in two Styrofoam cups, and place the cups over each ear. It works.'' It doesn't ease your predicament that airplane cabins usually are bone dry. Even healthy travelers complain of feeling itchy and generally dried out on a long trip in one of today's flying Saharas. Contact lens wearers are especially apt to be victims as their eyes dry and their lenses seemingly turn to cymbals. Again, economics dictates discomfort. The fresh air drawn in is low in humidity, explain airline spokesmen, and hydrating it would take many hundreds of gallons of water at eight pounds per gallon. Cockpit and cabin crews drink lots of water -- United Airlines recommends a glass an hour -- or soda and fruit juice. Physicians and frequent fliers prescribe no alcohol and no coffee; both are diuretics. Contact lens wearers should use eye drops or take their lenses out. For the skin, try an emollient. ''I slather myself with lots of creams,'' says Diane Teska, marketing director of Whittle & Hanks, a financial marketing group in Chicago. ''Like Lady Macbeth, I'm always rubbing my hands.'' ^ One consolation of high flight is that it usually puts you above the clouds and turbulence. Still, if you're subject to motion sickness you can ensure a smoother flight if you ride in larger planes, which are less sensitive to unstable air, and sit over the wing, where there is the least pitching. Among the prophylactics, Dramamine, Bonine, Marezine, and Triptone are available without prescription. You'll need doctor's orders for Transderm Scop, the newest traveler's friend. This little disk, stuck behind the ear, releases scopolamine into the system and can prevent motion sickness for three days. If you're chronically airsick, you might ask yourself if it's really an unrecognized fear of flying that's ailing you, says Dr. Andrew F. Horne of the FAA's Office of Aviation Medicine. If so, a preflight tranquilizer may be the solution. ''The ultimate fear of flying is the fear of losing control,'' says Houston psychologist Francisco Perez. ''You don't know what's happening up there in the cockpit.'' All bothersome symptoms can be aggravated by another phenomenon of high- speed travel, jet lag. Researchers generally agree on the cause: disruption of the circadian sleep-wakefulness cycle. Your body has flown to Frankfurt, but its clock stayed home in New York. The researchers disagree as to what to do about it. President Reagan believes in the feast-and-famine diet of chronobiologist Charles Ehret of the Argonne National Laboratory in Illinois. Before he boards Air Force One to go time-zone hopping, the President slips into the Ehret routine, several days of alternating big and light meals. The regimen tends to flatten the circadian rhythm, making it easier for the body to reset its clock. Ehret describes many Zeitgebers, or time-givers, that help you adjust, including light, food, and social stimulation. On landing, he advises, ''Don't hole up in a hotel room with room service. Eat with others, alfresco -- you get your light, food, and social cues.'' Dr. William C. Dement of Stanford University, a specialist in sleep disorders, has found that nodding off is most difficult during what he calls the times of maximum alertness -- noon and 8 P.M. If local time is 2 A.M. but your body clock says it's 8 P.M., you're in trouble. He suggests taking a pill to help you get your accustomed hours of sleep for the first day or so -- after that, you should have adjusted. His choice is benzodiazepine, a prescription product that goes to work and clears out of the system quickly. , Among the prescription brands are Halcion and Restoril. Researcher Harris R. Lieberman of MIT has another fix. He reports that the pineal body secretes melatonin into the brain at times when your body clock says you should sleep. This ''very powerful hypnotic,'' he says, slows your reactions and makes you sleepy. Lieberman recommends bright light, preferably sunlight, to suppress the flow of melatonin, along with coffee cup chemistry: ''I use caffeine when I want to be up.'' The Air Force's in-house expert, research psychologist William Storm, advises, ''Common sense is the best way to go. Be as rested as you can the day you depart, don't overeat, fit into the local schedule as soon as possible.'' He reiterates Ehret's advice about quickly establishing those social cues. WOULD-BE TRAVELERS with known or suspected cardiopulmonary problems should see their physicians before they fly in pressurized planes. ''We feel an 8,000-foot cabin altitude is completely safe for the normal passenger,'' says the FAA's Dr. Horne, ''but some people shouldn't be exposed to 8,000 feet or even 6,000 feet.'' Dr. Donald M. Vickery, president of the Center for Corporate Health Promotion, a health consulting group, issues a final warning for those who often take long trips: ''If you sit through very long flights and don't move around, you increase the risk of phlebitis.'' Get up every hour, he urges, because sitting for long periods is also ''a great producer of hemorrhoids. One relaxes at one's own risk.'' |
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