Stress-free holiday travel Part I: The Preparation

December 23, 2010 by  
Filed under STRESS

Holiday season and traveling. For many people, it’s all about getting stranded or lost somewhere in the chaos. The story of little Kevin of the “Home Alone” series and the current problems in almost all major airports in the northern hemisphere is enough to make even the most seasoned traveler to say “No way will I be caught flying at time of the year.”

Normally we wouldn’t either. But this time it’s different. Family reasons require us to fly down under to New Zealand via Australia and spend the holidays there. For us, however, it is not a trip of duty but a great opportunity. We needed no second urging to say “Yes, we are coming!”.

So here we are, getting ready to fly on the 23rd of December.

Now, holiday travel can be pretty stressful and chaotic but if planned properly, it can actually be a pleasure. So here are some tips to take away the stress from holiday travel

Prepare way ahead.

Book tickets, car rentals and accommodations way ahead. Especially when you are going where it’s peak season. It’s summer holidays down under.

Prepare a checklist.

Over the years, we’ve used a checklist for traveling, starting from the packing to the last minute things like taking out the garbage and turning off all electronics. The checklist has been updated over the years, when nappies and sippie cups have been replaced by play cards and drawing materials.

Secure the documents.

There is nothing more important in travelling than having all the necessary documents. Here is list of important documents to pack:

  • Passports and visas
  • A paper copy of your ticket!
  • Health insurance cards
  • Vaccination records
  • Other relevant medical info
  • A paper copy of important phone numbers and addresses

Pack smartly. Pack way ahead.

If you are making several stops, then pack smartly. Before heading to NZ, we are stopping by for a couple of days in OZ. We have packed a special bag just for OZ. The rest of the luggage stays at the airport storage.

Order foreign currency way ahead.

Going to a foreign country? It’s best to order a small amount in the currency of your destination at your bank. Enough for a bus, train or taxi fare. This saves you the hassle upon arrival of finding a bank machine which hopefully will accept your card.

Opt for early/ web check in.

Avoid the long queues and the fight for good seats. Use web check in whenever possible. Upon booking several months back, we could already choose our seats online. We are only flying today but the luggage has been checked in last night. With our hand-carry back packs, we’ll be taking the bus or train to the airport tonight. No problems with traffic jams or parking.
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Can people with heart disease fly?

August 5, 2010 by  
Filed under HEART AND STROKE

It is holiday or vacation time in many parts of the world and many people are travelling by car, boat, train or plane, with the mode of transport mainly determined by distance. Summer school break is definitely the peak season for flying as people have more time for longer and farther trips. But how safe is air travel for those who have heart problems and other chronic conditions?

The British Cardiovascular Society recently issued a guidance on the safety of travelling on a commercial aircraft that will help both primary health care clinicians and their patients.

But first of all, how does air travel affect our health? The authors explain:

“…the main impact of air travel is the inhalation of air with reduced oxygen content in a pressurized environment, resulting in lower circulating oxygen levels in the blood, known as hypobaric hypoxia. Passengers already at high risk of angina, MI, heart failure, or abnormal heart rhythms might be adversely affected by hypoxia.”

Recent studies have shown however that the blood oxygen levels have little or no adverse effects on the circulatory system, certainly not in short-haul flights.

Based o these new findings, here is what the new guidelines has to say:

Patients after heart surgery

What are the travelling restrictions for those who had just a heart surgery? The guidance states it depends on the type of procedure and the risk profile of the patient.

“For post-STEMI and NSTEMI, those at low risk are advised that they can fly three days after their event and those at medium risk can fly after 10 days.”

Those with high-risk profiles should wait a little longer for stabilization. At any rate, the decision to fly should be discussed with the doctor.

Heart patients with pacemakers and other implants

People are wondering how flying can affect their implantable cardioverter defibrillators (ICDs), pacemakers and stents. The guidance states that  in most cases, flying is safe for people wearing these implants.

“After uncomplicated elective PCI, the guidelines state that patients can fly “after two days.” Likewise, patients with pacemakers implanted are advised they can fly after two days, unless they have suffered pneumothorax, in which case they should wait until two weeks after it has fully healed. The same advice applies to those with ICDs, with the added recommendation that they should not fly after the ICD has delivered a shock until the condition is considered stable.applies to those with ICDs, with the added recommendation that they should not fly after the ICD has delivered a shock until the condition is considered stable.

Deep vein thrombosis (DVT) and venous thromboembolism (VTE)

Many studies have shown that the risk for DVT and VTE increase when flying for long periods of time such as during a long-haul flight. However, the same increased risk applies when travelling by car, bus, or train. The absolute risk for DVT among healthy individuals is 1 in 6000 for a long-haul flight (e.g. more than 4 hours).

“Even those at high risk—those who have already had a DVT, recent surgery lasting more than 30 minutes, or known thrombophilia or are pregnant or obese (BMI>30 kg/m2)—can still fly, provided they consume plenty of fluids, exclude caffeine and alcohol, wear compression stockings, and take a low-molecular-weight heparin.[as blood thinner]..”

Warning: Aspirin as a blood thinner during flying is not recommended!

Traveling tips for families

April 20, 2010 by  
Filed under HEALTHCARE

The volcanic eruption in Iceland has hindered air travel in Europe during the last couple of days. Bad luck for a lot of Swiss families who are scheduled to fly during the start of the Swiss spring holidays. We are one of those families.

And we are among the lucky few who could take off before the Swiss airspace was completely closed last Friday, April 17.

There are however, many people out there who are stranded somewhere. Being an avid travelling, I’m no stranger to be being stuck somewhere. But this has never happened to me when travelling with my kids. I hope this will never ever happen but these are circumstances beyond our control. Today I am bringing you some health tips when travelling, being prepare for all eventualities:

Medications. Hand carry all essential medications enough for a couple of days. In addition, hand carry a clearly written prescription from your doctor. Do not assume you will get access to your check in luggage within a day. Luggage gets lost, planes get grounded. Hand carry optional medications for common health problems such as anti-diarrhea pills, analgesics/antipyretics for pain and fever, and anti-histamines for allergies.

Do not give your children medicine that would make them drowsy (e.g. Benadryl). I know of parents “drugging” their kids so they would sleep on long flights. Such a practice, however, is dangerous and is discouraged by doctors and health authorities.

Ear aches. Give children something to chew/suck during takeoff and landing to prevent ear aches.

Nausea and motion sickness. Some kids would feel nauseous during the flight and throwing up is a common problem. My sons have this problem. There are some anti-nausea medications out there but so far, I haven’t really used them as their side effects might be worse than the original symptom they are treating. The first thing I reach for after fastening the children’s seatbelts is the airsickness bag. Make sure that there is one in the pocket front of you. Keep it easily accessible. All these years, my kids and I got the routine perfectly figured out. The kids are now the ones who willingly check for the bags. Mom is always ready to help. We had two vomiting incidents this trip, without any mess whatsoever. In a previous, when we had one mishap, I was pleasantly surprised how the crew of the airline Emirates handled the situation. They had a vomiting clean up kit ready, complete with gloves, disinfectant, a powder that congealed the mess into manageable form, and got rid of the residual odor. All I had to do was change my son’s clothes. Bravo for this airline.

Change of clothes. Yes, I’ve learned that a change of clothes is always handy to have, not only for the children, but for myself, too.

Thrombosis. Sitting still for long periods of time can play havoc with your cardiovascular health. I am prone to edema in the legs but anti-thrombosis stockings/pressure socks were the one major piece of hand carry luggage I forgot on this trip. I did manage to prevent edema formation by standing up regularly to do stretching exercises. OK, so the other passengers looked at me a little funnily. Who cares? I remember on a flight to Asia once, a group of senior citizens (presumably Chinese) regularly got up, stood on the aisle, and performed Tai chi moves. What a swell idea!

Drink, drink, drink. Finally, keep yourselves hydrated during long-haul flights, not with alcohol or coffee, but with water.

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.