How not to get sick on airplanes

November 13th, 2019

Over the next few months, Americans will be traveling for the holidays.  Unfortunately, this travel time will also coincide with the peak of the cold and flu season.  During the holidays, we tend to gather indoors in homes that are sealed up, which allows germs to spread quicker than if the activities were outdoors.  Here are some tips that can prevent you and your loved ones from getting sick on airplanes.

  • Get your flu shot (if you haven’t already).  Getting the flu can be devastating, but fortunately, the flu shot provides some protection and can shorten the duration and severity of symptoms.  You should get your flu shot as early as October, but no earlier.  It takes about 2 weeks for the flu shot to be maximally effective, so be sure to get it at least 2 weeks before Thanksgiving.
  • Get adequate rest.  The holidays can be a stressful time with chores, shopping, cooking, and traveling.  Make sure you allow your body to rest.  Your immune system will work the best if you do.
  • Avoid drinking alcohol on the plane.  Even moderate amounts of alcohol reduces your immune system significantly.  Alcohol also worsens jet lag, and in some people the effect of high altitude enhances alcohol, i.e. you can get drunker faster with lower amounts.  Here are other negative effects of alcohol.
  • Wipe down your seating area, tray table, television screen, remote control, arm rests, and seatbelt buckle.  These are usually not cleaned between flights, so they have the potential of harboring several passengers’ worth of germs.  I recommend WetOnes antibacterial wipes as they are TSA approved for carry-ons.  Antibacterial gels are still considered liquids and can’t really remove dirt without a cloth.
  • After using the toilet, wash your hands, dry them, then use the WetOnes antibacterial wipes to clean your hands after you return to your seat.  Having been on many airplanes with tiny bathrooms, it’s almost impossible to avoid touching the lock or doorknob.
  • Avoid drinking coffee or tea on the plane.  The “hot” water in planes usually runs through old pipes which have been found to harbor bacteria.  Furthermore, the water doesn’t reach boiling temperature long enough to kill them.  Ask for bottled water, seltzer, or juices instead.
  • Open the air vent above your seat and point it so it is aimed just in front of your face.  Many studies have found that the air in vents is relatively germ free as the air filtration system is usually decent.  By aiming the air away from your face, you create a current of air that can deflect germs.  Imagine if someone sneezed near you, releasing millions of fine germ particles into the air.  By having the air blown away from you, these droplets would be deflected away from your face and body, reducing your chance of breathing in the droplets.
  • Use antibacterial wipes on your hands just before you are ready to eat.  Even touching the menu or magazines just before you eat can contaminate your hands.  Germs need to enter our body through our nasal passages or our mouth.  Each time we touch something and then our face/mouth/food, is a potential risk for infection.
  • Avoid raw vegetables or meat on flights originating in countries where you cannot drink the water.  Many travelers assume that when food is served in plastic containers they are somehow made “sterile”.  In my experience, I have seen many travelers avoid certain foods, only to eat them on the plane resulting in severe illness.  Save the raw vegetables or meat for when you return home.  Typically, flights that originate in the US should be ok.
  • Opt for seats away from the aisle.  Many people walk down the narrow aisles constantly.  One or two people coughing while walking down the aisles can spread tiny droplets onto the heads of people sitting along the aisle.
  • If you are sick, cough into your elbow, not your hands.  Here are some tips for traveling while sick.
  • Exercise regularly before and after your flight.  Regular workouts can boost your immune system and can also reduce your risk of deep vein thrombosis (DVT) which is a life threatening blood clot.  Here are ways to get exercise on your vacation.

Red Meat Debate

October 2nd, 2019

Today, the New York Times published an article, “Eat less red meat, scientists said.  Now some believe that was bad advice”  The article, which cites a meta-analysis (compiling and interpretation) of other studies published this week in the Annals of Internal Medicine, mainly states that red meat does not cause a significant increase in heart disease and cancer as once thought.

This does not make logical sense.  We know ingestion of red meat, which is naturally high in saturated fats, increases LDL (“bad” type cholesterol) which in turn raises the risk for heart disease, high blood pressure and stroke. In addition, meats are very calorie dense when compared to vegetables.  So even eating the typical four or more servings that most Americans eat every week is likely to be too much.  We cannot deny that there is an obesity epidemic in the US right now.  Over 1 in 3 people have a BMI over 30 (clinically obese) and the incidence of childhood obesity is growing.  We all know that obesity leads to diabetes, high blood pressure and high cholesterol, all three of which contribute to a much higher risk of heart disease.  Given this setting, it is inconceivable that a medical journal with intentions of promoting health and wellness would consider putting out misinformation that could jeopardize the health and wellbeing of millions.

The decision to adopt a healthy lifestyle is never easy and involves a ton of education, determination and commitment.  The article published in the Annals will reduce the credibility of decades of obesity research and recommendations of the medical field.  I fear this will lead to a mistrust of tried and true diets such as the Mediterranean diet, which can reduce both heart disease and diabetes.

How should you eat in response to these findings?  If you choose to eat red meat, moderation is the still key.  Choose leaner cuts of meat with less white “marbling” which is fat.  The recommended serving is a piece of meat no larger than a deck of cards or palm of your hand per meal.  If you aren’t eating meat, I wouldn’t encourage you to start.  The study didn’t find that there was anything wrong with a plant-based diet.  I would still avoid concentrated sweets, sugary beverages, overly processed foods where the nutrition labels read like a list of chemicals, and refined carbohydrates.  Fruits, vegetables, whole grains such as faro and oats, and seeds such as quinoa should still make up most of your diet.

We all must decide for ourselves what foods are good for us.  Think about how you feel after eating certain foods.  Ask yourself, “do I feel sluggish, tired or energetic and alive?”.  Are you gaining weight from eating too much?  Maybe cutting out the meat will help, I encourage you to make the decision for yourself and trust your judgement.  If you are not sure, have your cholesterol checked and have a conversation with your doctor.

Say “No” to Vaping

September 9th, 2019

The CDC recently reported an alarming increase in vaping-related health issues and recommended that people stop using these devices.  Across the nation, people who vape are presenting to health care facilities with respiratory issues that resemble pneumonia (lung infections) caused by bacteria or viruses, but neither of these are found in their lungs.  There is some speculation that the users have either altered the liquid that goes into the devices or the manufacturers of vaping fluid have added newer chemicals which have made them more toxic to the lungs.

As I have mentioned in a previous blog, vaping is not a safe replacement for tobacco.  The “vapor”, which is actually a misnomer because there is no water vapor in the white clouds inhaled by users, is actually propylene glycol, which is a toxic chemical known to cause seizures in humans.  In fact, many emergency rooms across the US are seeing people with no prior history of seizures present with seizures from excessive vaping.  By the way, propylene glycol is often used in rock concerts or dance clubs to create “smoke” effects.  This chemical does not belong in our lungs and while there is no long term data, as we know from related chemicals in the lung such as nicotine, carbon monoxide, or asbestos, our lungs cannot handle foreign chemicals very well.  It won’t be long until we find propylene glycol or one of the other 20+ chemicals in vaping fluid causes cancer.

If you, a friend, or loved one is vaping, please urge them to stop.  Vaping should not be a replacement for cigarettes.  If you need nicotine replacement or medications to stop smoking, contact your health care provider and they can provide safer and more effective treatments.

Healthy Lifehacks

August 1st, 2019

I love learning about “life hacks”, which are ingenious shortcuts to get things done.  There are numerous versions of them on Instagram and Youtube.  They may seem trivial but can really be helpful when you are in need.

Here are some health related “life hacks” that I’ve compiled:

  • After getting blood drawn, immediately put pressure on the area with a piece of cotton and raise your entire arm above your head for about 3 minutes.  You will notice the bruising will be much less.  The pressure against the skin and gravity will prevent the blood from seeping under the skin that would normally lead to unsightly redness and bruising.
  • To remember to take your medications before bedtime, rest your toothbrush on the bottle of medication.  When you go to brush your teeth before bedtime, you will remember to take your medication.  (not recommended if you have children who could reach the area)
  • For medications to be taken in the morning, put the pills in your refrigerator (not recommended if you have children who could get into the fridge).  Most pills can be safely stored at refrigerator temperatures.
  • You can set up reminders on your phone to remind you about when to take medications.
  • To remind yourself to fast before bloodwork (especially when cholesterol or blood sugars will be checked in fasting conditions), put a post it on your refrigerator door so you will see the notice before reaching for food.
  • Dehydrated and need electrolyte replacement fluid?  If you don’t have access to sports drinks such as Gatorade, you can add table salt to coconut water.  This is approximately the same components (potassium and sodium) that you need.
  • Constipated and can’t find a laxative?  Artificial sweeteners such as Splenda can create a laxative effect.  You may need to use more than a few packets or chew a pieces of sugar-free gum, but it can be effective.
  • Take cell phone pictures of your medication bottles.  This way when you see your doctor and he/she asks what medications you’re taking, you have all the info right there.  Better yet, create a folder on your phone with your medical information.  You can even take pictures of your test results.  Of course, if your doctor’s office has a patient portal with a smartphone app, all this will already be at your fingertips 24/7.
  • Take pictures of your insurance card.  Imagine if you were injured and your wallet was stolen.  Having your insurance information handy is essential when you go to seek medical care.  Otherwise, you may get some scary bills in the mail.
  • Have a nosebleed?  Tissues are fine, but if you have a tampon around, you can cut it in half lengthwise and insert it into the nostril.  The string allows you to remove it easily.  Be careful not to pull it out and check.  This often disrupts the clot that forms and results in further bleeding.  Do not keep the tampon in the nostril for more than 12 hours.  If the bleeding doesn’t seem to stop, you should seek immediate medical attention.
  • Keep a bag of frozen peas in the freezer.  These are great for muscle aches and injuries as they wrap around your joints much better than rigid ice packs.  Plus, you can have peas for dinner!
  • If you need an antacid fast, you can take a teaspoon of baking soda and dissolve it in a glass of water.  Drink it slowly. This can also be used to remove mouth odors.

When is snoring more than just noise?

May 28th, 2019

We have all slept in the same room with someone who snores when they sleep.  Most snoring is due to turbulence of air caused by the air being sucked into the nostrils or the mouth.  This usually happens when we are very tired, as this causes the muscles in the back of the throat to collapse.  However, certain types of snoring can be a sign of something much more serious, a condition called sleep apnea.  Literally apnea means “no breath”.  People with sleep apnea are at risk for several serious diseases such as heart disease, diabetes, high blood pressure, accidents, obesity, depression and strokes.

If you or a loved one is concerned about snoring and sleep apnea, here are some warning signs to watch out for.  Sleep apnea can be diagnosed with a sleep study conducted by a pulmonologist (lung specialist) or an ear, nose, and throat doctor (ENT surgeon)

  • You hear the person stop breathing for a few seconds (no sound) and then hear the person gasp or choke for air.  The person may even wake up from sleep after these episodes.  This is a telltale sign of sleep apnea.  The person’s airway is collapsing and literally choking them from inside and the lack of oxygen makes them wake up.  Some people with severe sleep apnea can have 30 or more episodes each night.
  • The person’s blood pressure is higher upon awakening and gets better as the day goes along.  Having the repeated “choking” episodes each night leads to high blood pressure, as the body is under stress.  However, as the person is able to take more deep breaths, the blood pressure will normalize, until the person goes to sleep again.
  • People with sleep apnea will have daytime sleepiness and unrestful sleep even with adequate hours of sleep.  While someone with sleep apnea may look like they are asleep, because they are choking so many times every night, the depth of the sleep is not enough.  Good quality sleep requires many uninterrupted hours of sleep.  Sleep apnea sufferers can fall asleep easily during the day, and will often resort to drinking coffee or eating sugary foods to try and stay awake during the day.  This can be quite dangerous for people who need to be alert such as drivers and train conductors.  In fact, most of the recent train accidents have been attributed to conductors with untreated sleep apnea.
  • People with larger necks are more prone to having sleep apnea.  In general, men with necks greater than 17 inches, and women with necks greater than 16 inches are more likely to have sleep apnea.  Obesity may also be caused by sleep apnea, as  people may eat more sugary foods to try and stay awake.
  • Sleep apnea is more common in people with an overbite (your top jaw/teeth are pushed out more and your lower jaw is pushed back).

Sleep apnea is a serious health condition that requires treatment, which may include weight loss, a CPAP machine, a mouthguard-like plastic piece (mandibular advancement device), raising the head at nighttime with an extra pillow or wedge pillow, and/or sleeping on the side instead of lying on the back.