AOPA Pilot Magazine - May 2015 - 26

FLY WELL

Your body in flight

BY DR. JONATHAN M. SACKIER

10 health concerns and how to avoid them
"PLEASE PUT YOUR SEAT into the full upright position."

DR. JONATHAN SACKIER

offers medical
advice for pilots
through this column
and in videos on
AOPA Live This
Week.

26 | AOPA PILOT May 2015

Really? When plummeting into a mountain, do those
two inches really matter? Flight safety has improved
with better equipment, training, sensible rules, and
knowing your limits. But there are aviation risks, quite
literally above and beyond those caused by terror and
fear of metal meeting terra firma.
The three most useless things in aviation? Fuel not
pumped, runway behind, and sky above. Altitude may
be valuable should an engine failure occur, but it has
drawbacks, so take pilot health into consideration when
chosing cruise level. Physiologic impacts from flight are
affected by age, weight, and general health.
1. I harp about oxygen so much that the New York
Philharmonic Orchestra should hire me! With increasing altitude, air is "thinner;" on ascent one leans the
mixture to prevent fuel/air mismatch. In unpressurized aircraft, each breath includes less oxygen and
your resultant respiratory mismatch-hypoxia-impairs
vision, performance, and increases the risk of heart
attack or stroke. Buy an oxygen system, pulse oximeter, and breathe deeply.
2. Scuba divers know about nitrogen coming out of
solution, forming bubbles, and blocking blood vessels-
called decompression sickness or "the bends." With
today's fast-climbing, turbocharged GA equipment, the
same thing can happen. Visual disturbance; headache;
joint, abdominal, or chest pain ("the chokes"); widespread itching, a mottled skin rash, or formication-the
sense of insects crawling on your skin-indicate the
aviation bends. This is very serious, requires urgent
treatment, and largely can be avoided by awareness
and pre-breathing oxygen. Sensible mountaineers do
not climb to 18,000 feet without oxygen and neither
should you.
3. The air up there is not only oxygen-poor, it is dry.
Faster breathing causes more water to evaporate with
each breath and dehydration can follow, so increase
your fluid intake to prevent nosebleed, headaches, and
kidney and heart damage. If you are not using that red
plastic bottle, you are not drinking enough.
4. Pressure from your spouse or job, or rapid altitude
change? The Eustachian tube connects ear to throat and
equalizes pressure between them. With upper respiratory infections or allergies, swelling impairs your ability
to balance pressure, inducing intense pain in your middle ear; this can be avoided by not flying when unwell.

Ask your passengers about ear issues before flight to
avoid them having an unpleasant experience. Plan altitude changes and, if given too rapid a descent by ATC,
remember the magic word, "unable."
5. Here's a clever, but painful way to remind yourself that you have a dental cavity-go flying! Pressure
changes can cause gas trapped in a tooth to expand and,
quite literally, get on your nerves.
6. Why airlines serve carbonated beverages on board
baffles me-200 sedentary people sipping soda in an
enclosed metal tube and then exposing them to pressure changes? First, intestinal gas will expand, inducing
abdominal pain; second, that gas has to find a way out,
having obtained odiferous enhancements from its
colonic course. So avoid drinking the real thing when
doing the flying thing.
7. When I fly I am really cognizant of vertigo risks.
Please review this topic, as it represents a risk to all
of us. Although turbochargers and bigger engines are
power, so is knowledge (see "Fly Well: Oh, No, Vertigo,"
AOPA Pilot January 2013).
8. Altering your elevators and elevating to altitude lifts
our spirits, as well as our bodies. As you punch a hole in
the sky, inspiring delight, did you ever think "that sun on
my face feels so good?" Pilots are twice as likely to contract skin cancer, and with more than a million cases a
year, someone dies every eight minutes. Make sure you
are not one of them; wear sunscreen daily, an AOPA hat,
and a long-sleeve shirt when aloft.
9. Cataracts are the most common cause of vision loss
and exposure to bright sunlight is a major cause. Plain
and simple. Buy yourself some of those fancy sunglasses-look cool and protect your eyesight.
10. As you know, pilots are the highest form of life, but
to paraphrase Orwell, some pilots are higher than others. I am talking astronauts here, and those brave men
and women have additional health threats to consider
from microgravity and radiation exposure-bone and
muscle loss, spinal and visual problems, and changes in
pressure inside the brain. Now, does my harping seem
quite so painful to listen to?
Aviation gives us a magic carpet to ride, but comprehending how your body is affected by flight is as
important as understanding how carb icing occurs. Now
that's magic. Fly well.
AOPA
EMAIL jonathan.sackier@aopa.org

AOPA Pilot Magazine - May 2015

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