TURNING AIRLINE "RAGE" INTO "SAGE" IS GOOD FOR YOUR HEALTH

• Fear of flying now includes fear of endless delays on the ground
• With record holiday travel ahead passengers need to turn rage to sage

By Michael Arnold Glueck, MD & Robert J Cihak, MD

The fear of flying now means the fear of lots of unplanned extra time on the ground, shortage of time between connecting flights, and potential unplanned delays. As physicians who have been turned from fairly rational travelers into shaking psychotic masses of quivering silly putty, we know that airline rage is not good for your health. What then should the airline passenger do to convert rage to sage for the sake of your well-being?

The syndrome of airline rage was first described in Winter,1998. The most notable incident was the case of Northwest Airlines planes stuck on the tarmac in Detroit for hours while the passengers were stranded without food and overflowing lavoratories. Allegedly the cabin turned into a boxing ring and people began to throw things at one another.

Dealing with the airlines is not always a friendly process. These are the same guys who rolled the "hub and spoke" concept over us - and then selected hubs with the worst weather. Many connections are so close in time and long in distance that Olympic champion sprinter Carl Lewis would feel stress. Once an elderly couple, standing next to author one and boarding the same connecting plane, were one step from going into congestive heart failure. And the writer is only a radiologist who can diagnose disease but not treat it.

Airline travel not only takes it toll on your psyche, but on your body. As physicians, we have a number of practical recommendations that can limit the emotional as well as the physical cost of airline travel. In short, turn potential airline "rage" into airline "sage."

GET THE RIGHT ATTIDUDE

Start out with your attitude in line. Once you leave your house, you're on the road, so try to enjoy the ride. You'll get there when you get there, and screaming at the gate agent because of snow delays won't change the weather, just increase your stress level and your blood pressure. You can't change what you can't change. Take a breath instead of venting. You'll probably find the agent will bend over backwards to help the considerate pasenger.

MINIMIZE DEHYDRATION

The poorly circulated air with 4% humidity at cruising altitude is low enough to make your contact lenses crumble! For the 35 million contact lenses users, we recommend always wearing new and fresh disposable contacts the morning of departure. The lack of precipitated protein on new moist lenses avoids the scratchy eye syndrome.

That same low humidity takes it toll on the rest of your body. Avoid alcoholic beverages that further dehydrate your system, and drink water throughout your flight. Carry a bottle with you.

FIGHT LACK OF PHYSICAL ACTIVITY

Getting even minimal physical exercise is difficult while traveling, especially when chained into your airplane seat. Sitting for hours doesn't keep blood moving very well and can lead to blood clots in veins.

Get up and walk, especially on longer flights to avoid "Coach Class Syndrome." Some airlines have published stretches and exercises that can be done even while sitting. We recommend they do it again.

For exercise in airports during those delays, we take advantage of near-marathon length airport concourses by walking them before or between flights. A colleague always carries her walking shoes in her bag and uses the time between connecting flights to take a "power walk" through the concourses. Others may give you funny looks, but your heart will thank you.

AVOID LOUSY AIRLINE FOOD

Find or bring healthy food. All airlines will provide low fat meals on request, and many airports now have juice bars where you can power up on fruit smoothies or shots of wheatgrass before or between flights.

ADJUST TO JET LAG

A recent study from the Yale Department of Medicine notes that melatonin WILL help you sleep at night but does NOT aid in readjusting your circadian cycles. Although melatonin is not very toxic at higher doses, we recommend talking physiologic replacement doses of 300-600 micrograms, if needed. Let other people be the 3000 microgram (3 milligram) and up guinea pigs.

COMFORT DURING TRAVEL

Dress for comfort in all temperatures. You may be travelling from a frigid clime to Hawaii, but who knows what the temperature may be on the airplane. You may be sitting in uncomfortable heat before takeoff, and then find yourself freezing midair. Wear layered clothing so you can adjust to whatever you encounter.

PLAN TO AVOID STRESS

Neutralize the enemy by planning far ahead. This is easier than ever with computers and the internet. Check destination(s), routes, airlines, plane type, hotel, weather, city maps, functions and dress requirements before you book. A few minutes of homework may save hours of ground work. If the weather looks bad, don't go. Some airlines now allow you to download boarding passes on your personal computer from home up to 12 hours in advance.

It is often worth the extra money to fly direct. This also means you can check your luggage with greater confidence that it will actually arrive with you. If everyone checked luggage, boarding and deplaning time could be cut in half.

If possible select the carrier whose hub is most convenient to your destination. For example, one author recently was able to fly direct, non-stop, in half the time and cost to a meeting in St. Louis by finding an airline (TWA) with its hub in that city.

Take early flights when possible. The hub system has a domino effect, so that any delays or problems only become worse as the day goes on. If your flight is delayed or cancelled you have more time to make alternate plans, and the airline schedules When rested you will make better decisions and are less likely to become upset.

By incorporating the above into you travel plans you may avoid becoming a blithering idiot. You will reduce stress, elevated blood pressure, that ulcer flaring, increased insulin requirements, or the requirement for new post flight medications. At least that's our "Vantage Point" (title of the self-serving American Airlines Magazine) from the ground where we seem to spend most of our time when we fly!

Michael Arnold Glueck, MD, Newport Beach, Calif., has written extensively on medical and legal reform issues.