Secrets for healthy flying from doctors who treat pilots: Before booking a flight, at the airport, while in the air

I’m a nervous flyer with a vivid imagination – not an ideal combination. Rocketing along in a crowded, oxygen-strained space for hours can give me all sorts of things to worry about. A random stomach pain can send me into a panic: What if I get sick up here?

It turns out that there’s a whole discipline of preventive health care – “aerospace medicine” – that focuses on treating pilots, aircrews and astronauts.

“We’re trying to keep people healthy in an unhealthy environment,” said Dr Leigh Speicher, an internist and aerospace medicine specialist in Jacksonville, Florida, and president of the Civil Aviation Medical Association.

I asked her and other experts for their best tips on how to stay healthy during this travel season.

AS YOU BOOK YOUR FLIGHT

You can start thinking about your health as you’re looking for flights, said Dr Paulo Alves, the global medical director of aviation health at MedAire, which provides remote medical assistants to airlines, and a fellow of the Aerospace Medical Association. If, for instance, you often get motion sickness, book a seat over the wing, which is more stable, he said.

And reconsider your trip if you have an ear or sinus infection, Alves said. When you’re in flight, he said, congestion can make it harder to adjust to changing air pressure, which could result in pain, bleeding and even a ruptured eardrum.

Untreated toothaches and postponed root canals can be similarly painful during flights, said Dr Meghan Hatfield, an endodontist in Summit, New Jersey. If you notice any pain or swelling, she said, get it looked at before you fly.

Alves added his No 1 tip :If you’re not feeling well in general, avoid flying or clear it with your doctor first. “Many of the heart attacks that we see happening in flight, for example,” Alves said, “retrospectively, the person will say, ‘You know what? I was not feeling well before boarding.’”

WHEN YOU PACK

Bring all your medications in your carry-on luggage, not your checked luggage, Alves said.

People routinely forget to do so, he said. “And then they have a problem like, say, a seizure or an allergic reaction,” he said. “And guess what? Their medication is locked in the hold down below.”

Speicher brings her own water onboard, and not just because it’s important to stay hydrated (ideally, drink 8 ounces, or 237ml, of water each hour). If there is flight turbulence, flight attendants must stay seated – so you could be thirsty a long time.

You can also bring peppermint or ginger tea bags, which can soothe your stomach, Speicher said. If you get stomach trouble, ask a flight attendant for some hot water.

AT THE AIRPORT

Avoid carbonated drinks with meals for at least an hour before boarding, Alves said.

Eating a large meal increases the chance of swallowing air, he added, and all that gas will expand in high altitudes. That can hurt – sometimes so badly, he said, that people think they have appendicitis.

Before you board, take a second to run through a checklist of everything you need for the flight, including snacks and over-the-counter medications, Speicher said. She asks herself: What would make this flight better, safer and healthier?

WHILE YOU’RE IN THE AIR

Speicher tries to move as much as she can during flights to prevent deep vein thrombosis, which occurs when a blood clot forms within the large deep veins of the body, usually in the leg. Clots are more likely when you sit for long periods of time, so getting up at least every two hours is a good idea, according to the Centers for Disease Control and Prevention.

You should also stretch and exercise your feet and ankles while seated, Speicher said. “I try to do this between TV shows, movies or book chapters,” she explained.

And if you want to brush your teeth in the airplane bathroom, use bottled water rather than water from the tap, which is non-potable, Speicher said.

When I told my mother about these tips, she reminded me of one health hazard flyers don’t have to deal with anymore: Smoking. When she was a flight attendant in the 1960s, passengers would park lit cigarettes on their armrests.

“I had to dodge them when I walked the aisles so my uniform wouldn’t catch on fire,” she said.

By Jancee Dunn © The New York Times Company

The article originally appeared in The New York Times.