Health hazards during air travel
Dr Harinder Singh Bedi

Recently it was reported that famous tennis player Serena Williams suffered a pulmonary embolism for which she needed emergency therapy in a hospital in Los Angeles . The 29-year-old told on Twitter that she was admitted to the Cedars-Sinai Medical Center in Los Angeles for emergency surgery for a pulmonary embolism which was discovered when she went in for a leg surgery.

So, what is pulmonary embolism — and how did it occur in such a fit athlete?

A pulmonary embolus is a blood clot which has got stuck in the artery to the lung (pulmonary artery). The birth of a pulmonary embolus is most often in a condition called deep venous thrombosis (DVT). Venous blood normally flows up from our legs by veins which carry it back to the heart . Blood has to be in constant motion to prevent it from getting clotted or clumped. If one is sitting cramped for a long time as can happen in a long distance journey, clots can form at various points in the leg as blood flow gets sluggish in the absence of regular movement of the legs.

There are valves every foru or six inches up the leg veins. A small blood clot can form behind one of the valves. The clot itself causes stasis of blood, discomfort and pain in the leg and calf, and swelling at the ankles. The clot may propagate and can produce a life — threatening complication — pulmonary embolism — in up to 25-30 per cent cases. In this condition, a large piece of clot breaks off and travels to the lung. The blood supply to the lungs gets suddenly choked and the patient may collapse or become severely blue and have difficulty in breathing. In some cases, death can occur if appropriate medical care is not immediately available or if the clot is very large and progressive. The condition can be diagnosed with a good clinical examination, X Ray , echo and a CT scan where indicated.

The condition is not very rare. A Melbourne law firm, Slater & Gordon, collected - 2,300 cases of DVT due to air travel — of these, 120 caused deaths. DVT or the so-called economy class syndrome can strike passengers even in the business and luxury class . In the plane the only therapy available is the administration of oxygen which may not be enough. The proper treatment comprises the administration of blood thinners to dissolve the clot. This can be done only under medical supervision. At times emergency procedures, including catheter directed thrombolysis, thrombectomy or open heart surgery may be required to remove the clot. It is estimated that over a lakh people die due to pulmonary embolism each year — this is the equivalent of the disappearance of a city of the size of Cambridge, Massachusetts, US.

The World Health Organization, on the basis of the study of the “WHO Research Into Global Hazards of Travel” (WRIGHT) project, recommends that passengers on long flights exercise their legs and resist taking sleeping pills to reduce the risk of potentially fatal blood clots. Although the danger of developing deep-vein thrombosis is small, it increases if people are immobile for long periods in cramped conditions. The risk of developing DVT doubles after travel lasting for over two hours.

WHO said studies showed the risk of developing blood clots during any form of travel longer than four hours was 1 in 6,000 among the general population. That would translate into one case for every 15 fully booked jumbo jets. So, the risk to an individual stepping on a plane is tiny — but the problem is that vast numbers of people step on planes, and so it’s a tiny risk multiplied by a huge denominator. You have people herded in a metal tube high up in the air for long periods. The standard 31-inch legroom causes knees to bump against the pocket seat already filled to bursting point with thick stacks of virtually unreadable glossies. If someone in the front reclines, you’re making physical contact, not very romantic! And extricating yourself from a window seat needs special yogic skills. Cooped up for hours, you crave to stretch your legs. But the seat in front may have a big bag tucked underneath - the same bag that wouldn’t get into the overhead bin! Seats on the emergency-exit row have more legroom, even one seat less. I always ask my travel agents to book this seat for me.

Another health hazard is dehydration. While the earth’s desert regions have a 25 per cent humidity level, the cabin of a plane flying at cruising altitude has a mere 10 per cent humidity content. In this arid environment, you lose a lot of water . The body draws water from the blood to sustain various organs. This results in blood getting thicker, leading to an increased risk of clotting. It is absolutely imperative that you drink lots of water before, during and after your flight to maintain your body’s fluid reserves. Alcohol, tea and coffee add to dehydration as they induce diuresis (increased urine formation).

Ironically, Serena’s problem happened in March, DVT Awareness month. This is in remembrance of NBC repoter David Bloom (who died of DVT leading to pulmonary embolism while on duty). His widow, Melanie Bloom, is the spokesperson of the coalition to prevent DVT — the coalition aims to make people aware of the dangers and preventive aspects of DVT.

The writer is Head, Cardio-Vascular & Thoracic Surgery, Christian Medical College and Hospital, Ludhiana.Email: drhsbedicmc@gmail.com

Enlarged adenoids cause many problems
Dr Vikas Sharma

Is your child having difficulty in breathing from nose during sleep? Have you noticed him snoring too often? Is he having frequent sore throats and middle ear infections? Is your child a mouth breather? If most of your answers are yes, then there is a great possibility that he could be having enlarged adenoids. This enlargement of adenoids can affect your child’s health in many ways, ranging from recurrent upper respiratory infections to hearing deficits. Homoeopathy has a lot to offer for the treatment of enlarged adenoids. A well-focused homoeopathic treatment can save your child’s adenoids from a surgeon’s knife.

Adenoids are small structures made of lymphoid tissue (this is the same tissue of which throat tonsils are made) present at the nasopharynx (where the back of the nasal passage and the throat meet). Their primary function is to produce lymphocytes. These lymphocytes are a part of our body’s natural defence system and destroy the micro-organisms that enter our system. Thus adenoids are a part of our immune system.

Adenoids tend to get enlarged whenever there is an infection in the upper respiratory area. Once the infection is over, adenoids get back to their normal size. If the infections are recurrent, the adenoids go into a chronic state of enlargement. Although tonsils can be easily viewed in an open mouth, adenoids are not directly viewable. Enlarged adenoids can only be detected by an x-ray or by the symptoms shown by the child. Symptoms of enlarged adenoids are easily recognizable. The most common symptom is that of difficulty in breathing through the nose. This is most predominant at night when the child is sleeping.

Disturbed nasal breathing in children with enlarged adenoids shows up in two ways — snoring and breathing through the mouth. If during day-time the child is showing signs of mouth breathing, the enlargement of adenoids is usually severe. The most worrysome symptom is that of sleep apnoea. Sleep apnoea refers to a condition where the child has breathing pauses during sleep. This sleep disturbance manifests itself during day-time by paroxysmal drowsiness and difficulty in the concentration in children. Other symptoms of enlarged adenoids may include bad breath and dry mouth. An increase in the size of adenoids leads to pressure changes on the Eustachian tube causing hearing difficulties and recurrent middle ear infections. Another complication that usually arises owing to enlarged adenoids is recurrent infections in the sinuses - often called sinusitis.

Whether it be the tonsils or the adenoids, homoeopathic philosophy has always believed in preserving these helpful body tissues. Homoeopathy offers an excellent treatment for enlarged adenoids and complications arising from it. Homoeopathic medicines Agraphis Nutans, Calcarea Carb, Sambuccus Niagra and Calcarea Flour lead the table in treating enlarged adenoids. Agraphis is very handy when along with enlargement the hearing of the child is also affected. While treating for adenoids, the overall immunity of the child needs to be carefully looked at, as recurrent infections can lead the child into a vicious cycle of enlarged adenoids and upper respiratory infections. Frequent infections can be dealt with effectively by homoeopathy by prescribing constitutional medicines.

The writer is a Chandigarh-based homoeopath. Email —clinic@drhomeo.com

Health Notes

Drinking tea daily ‘as good as water in keeping you hydrated’

London: A new study has found that drinking four to six mugs of tea daily is as good as a litre of water for keeping yourself hydrated. The finding disproves the idea that regular tea drinking can dehydrate the body because of its caffeine content.

The research also found no negative health effects from drinking that amount of tea.

In the high quality UK clinical trial, 21 volunteers drank either four 240ml mugs of tea over a 12-hour period — equivalent to just under one litre of tea in total — or a similar amount of plain, boiled water served warm. The tea included 20ml of semi-skimmed milk but no sugar.

The test was also repeated using six cups of tea or plain water, equivalent to nearly 1.5 litres of fluid, to investigate the effect of intakes. — ANI

Eating ‘handful’ of walnuts best bet for healthy heart

Washington: A new study has suggested that walnuts have a combination of more healthful antioxidants and higher quality antioxidants than any other nut.

It positioned walnuts in the No. 1 slot among a family of foods that lay claim to being among Mother Nature’s most nearly perfect packaged foods: Tree and ground nuts.

“Walnuts rank above peanuts, almonds, pecans, pistachios and other nuts,” said Joe Vinson, who did the analysis.

“A handful of walnuts contains almost twice as much antioxidants as an equivalent amount of any other commonly consumed nut. But, unfortunately, people don’t eat a lot of them. This study suggests that consumers should eat more walnuts as part of a healthy diet,” he added.

Vinson found that the quality, or potency, of antioxidants present in walnuts was highest among the nuts. Antioxidants in walnuts were 2-15 times as potent as vitamin E, renowned for its powerful antioxidant effects that protect the body against damaging natural chemicals involved in causing disease.

“There’s another advantage in choosing walnuts as a source of antioxidants,” said Vinson, who is with the University of Scranton in Pennsylvania.

“The heat from roasting nuts generally reduces the quality of the antioxidants. People usually eat walnuts raw or unroasted, and get the full effectiveness of those antioxidants,” he added.

The report was presented at the 241st National Meeting and Exposition of the American Chemical Society. — ANI

Nicotine raises blood sugar among diabetic smokers

Washington: Researchers have found that nicotine is the main culprit responsible for persistently elevated blood sugar levels — and the resulting increased risk of serious health complications — in smokers who have diabetes.

They said the discovery also might have implications for people with diabetes who are using nicotine-replacement therapy for extended periods in an attempt to stop smoking.

“This is an important study. It is the first study to establish a strong link between nicotine and diabetes complications. If you’re a smoker and have diabetes, you should be concerned and make every effort to quit smoking,” said Xiao-Chuan Liu.

The gold standard for monitoring long-term blood sugar levels in people with diabetes is the hemoglobin A1c (HbA1c) blood test. — ANI