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Traveling Stress and Economy Class Syndrome (Deep Vein Thrombosis)

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We always knew that economy class wasn't the most comfortable way to travel and can be quite stressful. But now it turns out that, if you're not careful, it can even be harmful to your health on long journeys.

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Three distinguished scientists, Drs. Cruikshank, Gorlin, and Jennet have called the condition the Economy Class Syndrome, otherwise known as E.C.S. I call it leg lag. The underlying medical condition is deep vein thrombosis. The symptoms can appear several weeks after flights as short as three hours, and can-in extremis-lead to death. We do not yet know what causes deep vein thrombosis, but it obviously has something to do with the cramped leg-room in the economy class seats. Economy or charter class seats, also known euphemistically as hospitality class seats, have only half the leg room of first class seats. Yet economy class passengers, on average, have just as many legs as their first-class co-travelers. The longer the journey, the greater the risk is of a blood clot forming in the leg, which could then end up in the lung, with potentially fatal complications.

What is Deep Vein Thrombosis?

A deep vein thrombosis is a blood clot in a deep vein. A clot inside a blood vessel is called a thrombosis. Deep vein thrombosis predominantly occur in the legs and may have no symptoms. The non-specific signs of  deep vein thrombosis include pain, swelling, redness, warmness, and engorged superficial veins in the leg. A  deep vein thrombosis may go away naturally, but the most serious complication is when a blood clot dislodges (embolizes) and travels to the lungs to become a life-threatening pulmonary embolism.

In 2011,  The sudden death of rapper Heavy D was due to a pulmonary embolism caused by deep vein thrombosis, a Los Angeles coroner has decided.  His weight, heart disease and a recent transcontinental jet flight were cited as contributing factors to deep vein thrombosis.

In another example, tennis star Serena Williams appeared on the Today Show March 9, 2011 and gave host Matt Lauer additional details about her recent health scare. Williams was  being treated for a pulmonary embolism which resulted from a deep vein thrombosis. The Grand Slam tennis champ had two surgeries on her foot and she apparently was in a cast for 10 weeks, followed by 10 with an orthopedic boot on her leg. She also was doing a lot of flying during that time as well.

Why is this a potential problem when traveling?

The only way blood can circulate freely from the legs back to the heart is through the pumping action of the leg muscles in motion. The blood in these veins returns most easily when it is not thickened: unfortunately three factors on a plane conspire to turn our blood into sludge. At altitude, the humidity on a passenger jet is drier than the Sahara desert, causing the body to dehydrate. Alcohol also dehydrates the body, as does salty food. To make matters worse, most planes on this continent carry no bottled water for the passengers. The soda water and tonic water both have considerable quantities of salt and sugar, respectively, and thus neither solves the dehydration problem.

What is at stake here is a lot more serious than the minor nuisance of not being able to get back into your shoes after you have taken them off during the flight. In 1986 a three-year study carried out at Heathrow Airport found that 18% of 61 sudden deaths among long-distance passengers were due to blood clots in the lungs, which had originated as deep vein thrombosis in the legs. But this doesn't mean that we all have to win the lottery to be able to fly long distances safely in first class. Now that you know the dangers, you can take some simple steps to avoid the pitfalls of having a  deep vein thrombosis develop in your legs while flying.

Here's an action tip:
Fight leg-lag, otherwise known as Economy Class Syndrome (deep vein thrombosis), by taking the following precautions:

  • Make sure you wear loose clothing. Girdles, tight belts, garters, and executive socks are out. Support hosiery, on the other hand, provides some protection against deep vein thrombosis.
  • Drink lots of water, even if you have to bring your own bottles on board.
  • Avoid alcohol in flight; also avoid sugared drinks and excessively sweet foods.
  • Get some exercise. If you have a bit of time on your hands in the airport building, do a few laps of the concourse instead of sitting in the cafeteria or lounge. If you are held at the gate, choose to stand rather than sit. Once on the plane, Stretch your legs by walking the aisles, or standing out of the way at the back of the plane for at least a few minutes every hour. If you are stuck sitting in your seat try compressing and releasing your calf muscles
  • Don't smoke, as this further impairs the circulation of blood in the body.

Deep vein thrombosis while traveling in cramped quarters (think economy class on a 14 hour flight from San Francisco to Hong Kong) should be a concern to all travelers. If you take control, you can enjoy any flight, and arrive in complete safety.

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Quit Smoking With Nicotine Replacement Therapy But Watch The Coffee

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Have you tried to quit smoking by using nicotine replacement therapy but failed? Well, it may be because you are drinking that morning cup of Joe while chewing nicotine gum or just after putting your nicotine patch on.

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Smoking is an addiction of tremendous power. The bonds between a smoker and his or her nicotine are stronger than the addiction ties to cocaine or even heroine. In order to help fight the battle, an endless number of gizmos and gadgets have been tried, some with greater success than others. A few years ago one promising idea was a set of six cigarette holders, with the widest aperture being used the first week, then each week the opening became narrower and narrower. At the end of the sixth week the smoker could now suck a tennis racket out of an opponent's hand, but they were still smoking.

One of the more effective aids, however, has been nicotine taken in patch form or made available via chewing gum. With a patch or gum, nicotine levels in the blood rise slowly and stay high for more than two hours, while a cigarette would “spike” nicotine levels within 20 to 30 minutes and then lead to a quick reduction, which can be responsible for inducing craving and more smoking. The patch is relatively more effective than the gum in stabilizing blood nicotine levels and may make it easier to eventually quit.

These products provide the smoker with their nicotine fix, and yet bypass the lungs, as well as the rituals involved in the habit. Nicotine replacement therapy can be very helpful to some to stop smoking, but many fail on it.

An image of quitting smoking by using nicotine gum

Now it turns out that the reason for failure may well be coffee, according to a National Institute on Drug Abuse study published in the Journal of the American Medical Association. Researcher Jack Henningfield found that coffee makes saliva more acidic for about fifteen minutes, and this acidity blocks the nicotine medicine in the gum or patch from getting into the bloodstream. Not only coffee can neutralize these nicotine replacement products, one should avoid any substance more acidic than tap water, including cola, chocolate milk, beer, fruit juices, soy sauce and mustard.

Here's an action tip:
If you are taking nicotine gum or a using a nicotine patch to quit smoking, make sure you follow the instructions carefully. Also make sure that you do not have any acidic foods or beverages while you chew, or, if you have, make sure you rinse your mouth clear with tap water before starting the gum.  And if you need more motivation to quit, review this: /post/2011/02/06/Trying-to-quit-cigarettes-Dont-let-your-plans-go-up-in-smoke!.aspx

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