Have a good flight, grandma: Air travel health tips for the elderly

SINGAPORE - Flying can be a drag, especially for people aged 65 and older with health issues. The preparations for getting on a plane - gathering documents, getting to the airport, security checks - can be stressful for older travellers.

They may also experience confusion and disorientation due to turbulence and noise during a flight, said Dr Lim Si Ching, a consultant at Changi General Hospital's department of geriatric medicine.

Inside the cabin

In an aircraft cabin, pressure, oxygen and humidity are low.

Most planes cruise at 28,000 to 45,000 feet above sea level, and cabin pressures are maintained at 6,000 to 8,000 feet above sea level.

This means less oxygen is taken up by the blood and gases in body cavities, like the sinuses, middle ear, gut, lungs, eyes and tooth fillings will expand, said Dr Lim at a recent press briefing to publicise a forum on how to stay healthy while travelling.

When the gases in the stomach expand, it may cause tummy discomfort, nausea and vomiting.

Low oxygen levels may trigger chest pain, heart attack or stroke, said Dr Lim.

Humidity in the cabin is 10 to 20 per cent, compared with 70 to 80 per cent in outdoor Singapore, so eyes, noses and mouths will dry up.

Sitting for too long in a confined space also raises the risk of deep vein thrombosis (DVT), in which dangerous blood clots form in veins deep in the legs.

Elderly folk have a higher risk of this condition, as well as people who have had previous episodes of DVT and blood disorders. The same goes for those who smoke, take contraceptive pills or had orthopaedic or brain surgery recently, said Dr Raymond Choy, a general practitioner at the Raffles Medical Changi Airport Terminal 3 Medical Centre.

Early preparations

People with health issues should make early preparations for travel.

"Seniors are advised to make an appointment with the doctor for travel medicine advice at least four weeks before the trip," said Dr Choy.

It is important to check whether any immunisation is required.

Elderly people should avoid visiting countries with recent epidemic or pandemic outbreaks, as they are more prone to infections.

If oxygen is required for heart or lung problems, arrange for your own supply, Dr Lim said.

"Senior travellers should always take along their routine medication such as those for high blood pressure and diabetes; and inhalers for asthmatic patients," said Dr Choy.

Have a list that spells out health conditions, medication and drug allergies, in case of emergencies.

It is also good to travel with paracetamol for pain or fever; pills for diarrhoea, motion sickness and the common cold; and wound care kits.

Get international medical coverage in case treatment is needed abroad.

On departure day

Elderly travellers can pack a small face moisturiser or cream into their hand luggage to mitigate the cold and dry air on board, said Dr Choy.

Diabetic passengers can also pack a sugary drink or chocolate bar in case of low blood sugar, he said.

Elderly travellers should avoid alcohol before departure as it dehydrates and interferes with sleep. Wear special compression stockings to prevent clots forming in the legs, especially for those at risk. Drink plenty of water and move around often onboard, advised Dr Choy.

When you should not fly

There are occasions when flying is best avoided.

People with cardiovascular diseases such as uncontrolled high blood pressure, or those who have suffered a heart attack or undergone heart surgery recently, should not travel without the doctor's clearance.

Those who have had a heart attack, for instance, should not travel until at least three months later, as the risk of developing another heart attack is higher due to low oxygen levels, said Dr Lim.

Elderly people with lung problems, such as uncontrolled asthma and chronic obstructive pulmonary disease, are also advised to seek medical advice before flying.

Those with acute ear or sinus infections should avoid flying in case of earache, hearing loss, vertigo and tinnitus, she added.

Flying tips for the elderly

Before flying

1. Request for an aisle seat near the toilet for convenience.

2. If possible, travel in a group or with a younger person.

3. Get a pre-travel check-up and go for the appropriate vaccinations.

4. Buy low-dose medication for anxiety and motion sickness, if needed.

5. Get adequate travel insurance coverage.

6. Pack your medication and your usual aids in your hand luggage.

On the plane

1. If you use hearing aids, lower the volume during take-off and landing to avoid ear damage from aircraft noise.

2. Avoid carbonated drinks and gas-producing foods such as onion,cauliflower, cabbage and baked beans.

3. Avoid or limit your intake of alcohol and caffeine during long flights.

4. Move around often. A trip to the bathroom every two to three hours will keep the circulation going.

5. Contract the leg muscles periodically, for instance by flexing your feet, to alleviate discomfort,fatigue and stiffness.

Sources: Dr Raymond Choy, general practitioner, Raffles Medical Changi Airport Terminal 3 Medical Centre; Dr Lim Si Ching, consultant at C

This article was published on April 10 in Mind Your Body, The Straits Times.

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