We all know that flying can be unpleasant. Changes in air pressure, dry air on board, cramped seats and poor food can leave us feeling tired, stiff and bloated. But what about the hidden risks, especially to those who fly a lot?
Frequent fliers can suffer hearing loss due to constant changes in pressure. Exposure to radiation can increase the risk of cancer. Then there’s the possibility of vein damage caused by blood clotting – even the potentially fatal deep vein thrombosis.
As travellers have become more aware of issues with frequent flying, clinics now offer regular passengers checks to find out if their health has suffered and recommend safer ways to fly. As a business journalist who has travelled a few million miles in the air over four decades, I decided to try them out.
The tests
My first stop was a hearing test with Dr Rony Ganguly, the director and audiologist at Pindrop Hearing. He explained that changes in air pressure during flights can cause eardrum pain and perforation, vertigo and hearing loss. Then his colleague Shivanie Sachdev looked in each ear and performed a series of hearing tests.
Next, it was time for a “vein MOT” with Prof Mark Whiteley, the consultant venous surgeon at The Whiteley Clinic. Sitting still in a confined space for long periods of time means air travellers are more likely to develop a blood clot, which can damage veins – and even prove fatal, if the clot reaches the lungs. His assistant performed a duplex ultrasound (to measure blood flow) on the veins in my legs.
My third appointment was with Prof Ramia Mokbel, the consultant dermatologist at HCA Healthcare UK. I had no idea that, while aeroplane windows block UVB rays, UVA rays can get through and increase the risk of melanoma. She performed “mole mapping” – examining new moles or changes to existing moles which might indicate skin cancer.
This is not a test for the easily embarrassed. It involves standing nearly naked and having lots of photographs taken of you and your moles, which are then displayed on a large screen for human and AI analysis.
The results
Dr Ganguly told me that my ears were physically fine – or my “tympanic membranes and ear canals are intact and in good health,” as he put it. The “pure tone audiogram” test showed “normal hearing on the right and a mild to moderate noise-induced sensorineural hearing loss on the left.” He recommended I see an ENT consultant to identify “why you have a difference in hearing between both ears.” Good advice.
It’s a decent start. What about my legs? Professor Whiteley examined my ultrasound and told me “your deep veins are clear – the valves are working well and there is no scar tissue indicating previous problems.” This matters because deep veins “are the ones inside the muscle that take 90 per cent of the blood back to the heart.”
In the smaller veins leading to the deep veins, I have “the first couple of valves starting to fail, causing minor reflux (blood falling back down the vein with gravity rather than being pumped up the veins towards the heart).” That sounds bad, I say. “This is not significant at present.” Phew.
Meanwhile, there is “minor scarring on the inner surface of the small saphenous vein on both sides. This suggests that you have previously had superficial venous thrombosis – ‘clots’ or ‘thrombi’ in these veins. These have been removed by your body’s thrombolytic system but the inflammation has left scar tissue.” Could these have been caused by flying? “It is usually associated with varicose veins, but can be caused by flying.”
His recommendation? No need to worry or to have surgery but I should call him back if I develop “heavy aching or tired legs, tender varicose veins, swelling of ankles, red/brown stains at ankles.” Noted, Prof. Also, he advises me to do as much exercise as possible. “Veins love exercise.”
In the future when I fly, it’s best to “keep moving as much as you can and keep hydrated. Choosing an aisle seat if travelling at the back of the bus makes it easier to stretch. And on flights of more than two hours, wear properly fitted, below-knee graduated compression stockings (grade 1 or grade 2).” He measures me up and gives me a pair. Not very fetching but needs must.
My final appointment is with Prof Ramia Mokbel. Her mole mapping “revealed a suspicious mole on the back and potentially an evolving basal cell carcinoma on the torso.” She tells me she will use new artificial intelligence programmes “to decide whether we need to have them surgically excised and sent to the lab for histology biopsy.” She does not seem concerned but does tell me that I should do mole mapping once a year. “Skin cancer is one of the easiest to spot early and to treat early,” she says.
My day of tests is over and I feel a bit stupid that I have travelled so many miles for so many years without using compression socks. But I’m also relieved that I now have a pair approved by Prof Whiteley, who tells me that many over-the-counter socks do not compress the legs enough to be useful.
My father, Anthony, died of skin cancer last year, so I’m pleased that Prof Mokbel has found nothing much of concern, but I will take her advice on annual mole mapping. As for my ears, it seems my slight hearing loss may be related to getting on a bit rather than to flying.
I’ll be back in the air this week – Los Angeles, then back to London and on to Cannes – and I’ll continue to go on holiday with my family. But I’ll be drinking more water (and less wine) – and, of course, wearing those fetching socks.