Staying Safe During Holiday Travel

If you’re one of the millions of people planning to travel over the holidays, we’d like you to do it safely. Whether your plans involve car, plane or train take a minute or two to study these simple steps to stay healthy while traveling.

“One health risk to consider when traveling is simply sitting for too long,” says Clayton Cowl, M.D., an expert in travel medicine at Mayo Clinic. “Concerns like blood clots in the legs from sitting too long, becoming dehydrated from lack of fluid intake or drinking too much alcohol, and not walking much when delayed in an airport or train station can be serious. Driving for hours to reach a destination after a long day at work can be as equally worrisome due to fatigue and eyestrain.”

Blood clots can be a concern when a person sits for too long because leg muscles aren’t contracting and blood can pool and stagnate in the vessels. This can lead to deep vein thrombosis and even pulmonary embolism – a potentially fatal condition, caused by clots becoming lodged in the lungs.  When travelling by car, both driver and passengers should stop every few hours to hydrate and walk. Plan ahead, and pick some good rest stops along your route. How about a park, a mall, or a place of interest?

As an added benefit, allowing children to run or play in a safe environment while traveling will often help curb their excessive energy in a confined space and may help them relax while traveling for longer periods.

When traveling by plane, check the in-flight magazine for tips on how to exercise in your seat and on trips longer than three hours, get up at least once to take a walk to the bathroom or other end of the plane.

And regardless of how you travel, try to avoid crossing your legs while sitting for long periods, because this can inhibit adequate blood circulation.

If you’re the one doing the driving, plan to get a good night’s sleep the day before the trip, to avoid drowsiness during the journey. If possible, take turns at the wheel with other passengers. Take breaks at rest stops and chose healthy low carb meal options, to avoid crashing after a sugar high. Combining meals or rest room stops with a short walk to get fresh air and stretch can make a big difference in staying more alert and refreshed.

While we all want to just get to our destination for the holidays, budgeting a little extra time to account for unexpected weather delays and adequate driving breaks is a really smart plan.

To avoid stiffness from sitting too long, if you’re a passenger try doing some simple stretches, such as extending legs out and back several times and massaging thighs and calves.

To avoid eyestrain and its associated annoying symptoms including sore or irritated eyes, dry or watery eyes, double vision or blurriness, increased sensitivity to light or unremitting shoulder and neck fatigue never drive if you are sleep deprived.

A short nap can significantly relieve these symptoms and non-medicated eye drops can help if eye irritation persists

Whatever your travel method, avoid dehydration. Drink plenty of water and minimize or eliminate alcohol consumption as alcohol dehydrates at a cellular level.

Above all, plan for the worst, and enjoy the best: When severe winter weather hits, many vehicles may become stranded and help may be hours or sometimes days away. Pack a simple emergency kit, including blankets, snacks, water, charging devices, flashlights and activities to keep kids amused.

Thank You for your attention. Now, please fasten your seat belts, place doors to manual and turn off all cellular devices. You’re ready for the holidays!

Bon Voyage.

Taking the Shots out of Orthopedic Surgery

As anyone who’s had knee or hip replacement surgery knows, post-op recovery can be long and painful. There’s the learning to walk again, the physical therapy and the dreaded daily injections in the belly.

While great strides have been made in surgery for degenerative joint disease, preventing post-op complications such as deep vein thrombosis (DVT) and pulmonary embolism (PE) remains problematic. Conventional antithrombotic agents (heparin and low-molecular-weight heparin) have to be given by injection into fatty subcutaneous tissue, usually into the leg or abdomen, for days or weeks after surgery and discharge from the hospital. Not surprisingly, acceptance of, and compliance with, thromboembolic prophylaxis is limited by the need for injections, the bruising and associated risks for bleeding.

Now it seems the days are numbered for injection therapy.  A recent meta-analysis of 22 randomized trials comparing oral factor Xa inhibitors with low-molecular-weight heparin injections in adults who underwent total hip or knee replacement has just been published in the Annals of Internal Medicine.

The results showed that new generation oral antithrombotic agents, including apixaban, edoxaban, and rivaroxaban, that do not require monitoring, actually led to fewer symptomatic deep venous thrombosis.

Furthermore, there was no difference between the groups in terms of mortality, non-fatal PE, major bleeding, or bleeding leading to reoperation. The study authors therefore predict that these oral agents will likely replace low-molecular-weight heparins.

As a likely candidate for future joint replacement, thanks to a family history of osteoarthritis, and joints wrecked by years of gymnastics and running, I for one am very grateful.

Spanx Takes a Spanking

Spanx has been in the news a lot lately. First, Forbes magazine announced that Sara Blakely, founder of the women’s slimming undergarments company, had joined the billionare’s club this year. At age 41, and having started her business at home with just $5,000, Blakely is now the world’s youngest self-made female billionaire.

Last month, Oscar winning actress Octavia Spencer, hit the headlines when she revealed, what she’d not been revealing!  Turns out, when she took home the SAG Award for Outstanding Actress in a Supporting Role for The Help, she’d been wearing three pairs of Spanx under her gown.

Now it seems the trend has spread from the red carpet to the green turf. This week, ConsumerReports.org warned of the dangers of teens in Spanx. The on-line watchdog reported the tale of a 15-year-old high school soccer player who was recently referred to her doctor because of numbness, tingling, and discomfort in her left thigh that had bothered her for a few weeks. The diagnosis: a compressed nerve in her pelvis. The likely cause: Spanx. While doctors have previously warned of the health dangers associated with skinny jeans, such as  fertility problems , bladder infections , and blood clots the doctor in question was surprised that a girl so young and fit would wear Spanx. It turns out that her entire team wears them under their soccer uniforms.

Body slimmers are the latest fad to hit the athletic fields. Sold in an assortment of bright colors, they appeal to teenage girls who play soccer, lacrosse, and softball. However, in an attempt to conceal their spandex, these girls are rolling down the waistline of their Spanx and unwittingly pressing a tight band of Lycra into their groins. The result: injuries normally associated with direct trauma or repetitive stretching and contraction of the groin muscles. The treatment: in this case, the doctor advised his patient to ditch the Spanx, and retire her skinny jeans. Not that Sara Blakely needs to worry, according to Forbes, her billion dollar business is set to at least double in size in the coming years.

The Spare Tire of Business Travel

Uh oh!  More bad news for busy pharma executives, physicians and Word on Health bloggers.  A new study published in the April Journal of Occupational and Environmental Medicine has found that people who travel frequently for business increase the rate of poor health and health risk factors, including obesity and high blood pressure.

Travel is a prominent feature of business life in the United States, with an estimated 405 million long-distance business trips taken in 2009. While there is a large body of literature on health risks associated with business travel, this is almost exclusively focused on infectious diseases and the risks of deep vein thrombosis and pulmonary embolism associated with long-distance air travel.

In this latest study Catherine A. Richards, MPH, and Andrew G. Rundle, DrPH, of the Mailman School of Public Health at Columbia University compared health risks for employees at different levels of business travel. They used data on more than 13,000 employees from a corporate wellness program. Close to 80% of the employees travelled at least one night per month. Nearly 1% were “extensive travellers” which they defined as those who are on the road more than 20 nights per month.Employees who did not travel at all were actually a less-healthy group. Compared to light travellers (1-6 nights per month), non-travellers were about 60% more likely to rate their health as fair to poor.   However, this may reflect a “healthy worker effect”, with employees who have health problems being less likely to travel, suggest the authors.

Otherwise, rates of less-than-good health increased along with nights of travel. Extensive travellers were a staggering 260% more likely to rate their health as fair to poor, compared to light travellers.

Other health risk factors showed similar patterns: obesity was 33% more likely for non-travellers and 92% more likely for extensive travellers.
The same two groups were also more likely to have high blood pressure and elevated cholesterol levels.

Although business travel is often equated with long airline flights, relatively short business trips in personal cars are much more common.   Several factors could contribute to health risks in frequent business travellers, such poor sleep, fattening foods, increased alcohol consumption and long periods of inactivity.

The authors of the study suggest a number of interesting solutions to the problem such as employee education programs on the association between business travel and health and strategies to improve diet and activity while traveling.  They also recommend that companies who reimburses employees for meals while traveling, tie reimbursement rates to dietary quality. A “stick” approach might be to reimburse high–energy density food meals at a below cost rate, while a “carrot” approach might be to reimburse healthy meals at an above cost rate.

Additionally, companies that have arrangements with particular hotel chains could make having a gym part of the criteria for selecting a hotel chain and employees should be given time and perhaps financial incentives to exercise while traveling.

How do you cope with life on the road?  Please share your travel tips with us.

Don’t be a Clot when it comes to DVT!

Two weeks ago my orthopedic surgeon made me look him in the he as he repeated his warning “people die from DVT.”

This was his sobering way of saying “no” to my plans to immediately resume business travel after knee surgery. I’m ashamed to say, I ignored his advice, but pleased to report that I survived unscathed.

However, I’m now realizing how close I came to dodging a bullet!  Just last week we learned that super-fit tennis superstar, Serena Williams, was rushed to hospital suffering from a pulmonary embolus and then a day or so later the Vascular Disease Foundation released figures that suggest someone dies from a deep vein thrombosis (DVT) every 5 minutes!

According to the report, between 100,000-180,000 Americans die each year as the result of pulmonary embolism (PE.) The Vascular Disease Foundation is urging Americans, especially women, to learn about the risks of venous blood clots to help prevent these deaths. While men and women are at equal risk, the risk for deep vein thrombosis varies depending on where a woman is in her life-cycle, her hormone levels, and if she has a family history of clotting disorders.

“Every year, more people die from preventable blood clots than from breast cancer, AIDS and traffic accidents combined,” said Dr. Samuel Goldhaber, Professor of Medicine at Harvard Medical School and Chairman of the Venous Disease Coalition. “It is so important to raise awareness about DVT and PE because although blood clots are common, few Americans have sufficient knowledge about blood clots and how to prevent them.”

SRxA’s Word on Health is therefore pleased to bring our readers the knowledge that might just save their live.

DVT occurs when a blood clot forms in the deep veins, usually of the pelvis or leg. DVT can be dangerous in two ways. First, DVT can be fatal if a blood clot breaks free from the leg veins and travels through the heart and lodges in the lungs causing a PE. Second, because blood clots can permanently damage the veins, as many as half of DVT survivors can experience long-term leg pain, heaviness and swelling that can progress to difficulty in walking, changes in skin color and leg ulcers. This condition, called post-thrombotic syndrome (PTS) or “chronic venous insufficiency,” can significantly impair quality of life.

Certain individuals may be at greater risk for developing DVT, but it can occur in almost anyone.

Risk factors that are more likely to affect women include pregnancy and the six to eight weeks after giving birth, the use of birth control pills or postmenopausal hormone replacement therapy, cancer and its treatment, and major surgery.

Anyone may be at risk for DVT but the more risk factors you have, the greater your chances are of developing it. Knowing your risk factors gives you the chance to do something about it:

• Hospitalization for a medical illness or any illness
• Recent major surgery (especially orthopedic surgery) or injury or trauma
• Personal history of a clotting disorder or previous DVT
• Increasing age
• Cancer and their treatments
• Family history of DVT
• Extended bed rest
• Obesity
• Smoking
• Prolonged sitting when traveling (longer than 6 to 8 hours)

For more information about DVT, its risk factors, signs and symptoms or to take a free risk assessment quiz, click here.

Chastised and humbled, I for one, will be doing just that!