Articles
Dr RICHARD's Desk - July 2010
Are You Medically Fit to Fly ?
ABOUT 16,000 Australians fly internationally every day with another 120,000 flying domestically. There are 12 medical in-flight incidents including 1death per 10 million passengers. Half of those deaths are cardiac. Clearly air travel is incredibly safe.
"Am I fit to fly " frequently pops up. Pregnant passengers usually will not be carried beyond 36 weeks gestation but check with your airline. It is worth reviewing the unusual cabin environment.
Pressurised air is supplied from the engines plus some filtered recirculated air to increase humidity. Cabin air pressure is maintained at a safe minimum of 25% below the air pressure at sea level, or, air pressure found at 8000 feet above sea level. At cruising height oxygen levels are maintained at a safe 17% for a healthy passenger but at a lower oxygen level than at sea level (21%). Ill patients may become a little short of breath at oxygen level 17%.
The cabin environment can be a medical challenge especially on long-haul flights. So, what to do:
• Be medically stable before flying. Delay your flight if any doubt and buy a flexible ticket
• If you can briskly walk 50m or walk up two flights of steps without gasping for breath you will be fine
• Carry regular medication in your pocket. Do not fly if you currently have an asthma attack or any other illness which might cause breathing, ear or sinus problems
• Discuss other existing illnesses especially respiratory illnesses with your doctor. Check if you can carry your own oxygen on board if needed and then only fly if you must
• Carry a letter from your doctor listing your medication
• Do not fly less than 6 weeks post abdominal surgery as a general rule but discuss with your doctor
• If regular medication is necessary e.g. insulin then wear two watches with one set on departure time
• Check your destination: Does it have a reciprocal health care agreement with Australia? What will the local weather be like. Does it currently have e.g. a flu epidemic
• Carry adequate travel insurance
The captain has the final right to refuse to carry a passenger - not a doctor
Tattoo Removal
Your partner Jane is not too keen waking up in the morning looking at " Mary For Ever" in the middle of the heart shaped tattoo on your arm. Suddenly that blast from your romantic
past feels like a bit of body art you could now live without.
About 25% of 18 - 50 year olds have tattoos.
About 50% of those who get tattoos later regret them.
Women are more likely to regret tattoos and want them removed
Tattoo removal techniques are not very successful basically because tattoos are meant to be permanent - the ink is injected out of reach deeply below the top layer of skin. Removal success varies with your skin color and the tattoo's pigments and size. New tattoos are more difficult to remove than old. All removal methods may leave scars.
• Dermabrasion involves sanding down the skin over the tattoo. Poor results usually. May leave a scar over an ugly remnant of the tattoo
• Surgical removal leaves a scar. Possibly OK for small tattoos
• Cryotherapy freeze-burns the tattooed skin with liquid nitrogen. Generally poor results plus a scar
• Laser removal is best but preferably done by an expert who knows which laser to use. The laser searches for contrast between skin tone and ink and pulses intensely on the skin to break the ink into particles small enough for the body to absorb. Black ink on light-skinned people is the easiest to remove, while fluorescent colours green and purple especially are nearly impossible to erase. Variable results and certainly not perfect. Usually little scarring. Expect at least 5 to 12 laser treatment sessions with a month between treatments so the process may take six months to a year.
Not cheap: Probably more expensive than the original tattoo
Painful: One comment was "the noise of the laser burning my skin was like the noise of bacon frying in a pan!" Post laser treatment the skin looks like a healing burn and needs to be watched carefully.
Heavy duty make-up can help hide the tattoo.
It may be better to leave a tattoo rather than end up with an unsightly scar plus a messy faded tattoo.
The strong message: " Think before you Ink !"
Am I Drinking Enough Water ? ?
ANOTHER common query. Water regulates body temperature, cushions and protects vital organs, aids
digestion, transports nutrients to working muscles and organs, helps dispel waste and can help prevent over-eating. A failure to replace lost water means the body can't adequately cool itself and dehydration follows. With one hour of intense exercise the body can lose up to a litre or more of water as sweat.
Inadequate fluid intake causes the body to give signals which can mistakenly be taken as hunger pains, not thirst signals. Consequently you may start eating unnecessarily when you should be drinking. If you are overweight try one or two glasses of water before meals or snacks. This water distends the stomach which inhibits appetite which in turn helps weight loss.
How do you know if you are adequately hydrated? Simple If your urine is clear like water or just barely pale yellow then hydration is adequate. If your urine is a dark colour then you need to drink more water. Dehydration in the Jakarta environment is common with associated headache, inertia and lack of enthusiasm.
Keep a water bottle beside your desk so you can ensure your daily water intake of at least two litres
Is there any hope for humanity ?
New York Doctors threatened strike action over some administration problem and held a small demonstration while carrying relevant anti–admin signs.
The Hospital CEO's rather brilliant response was to say he would find out what the Doctors' demands were just as soon as he could get a pharmacist down to the demo to read the writing on the picket signs! True story !
"Am I fit to fly " frequently pops up. Pregnant passengers usually will not be carried beyond 36 weeks gestation but check with your airline. It is worth reviewing the unusual cabin environment.
Pressurised air is supplied from the engines plus some filtered recirculated air to increase humidity. Cabin air pressure is maintained at a safe minimum of 25% below the air pressure at sea level, or, air pressure found at 8000 feet above sea level. At cruising height oxygen levels are maintained at a safe 17% for a healthy passenger but at a lower oxygen level than at sea level (21%). Ill patients may become a little short of breath at oxygen level 17%.
The cabin environment can be a medical challenge especially on long-haul flights. So, what to do:
• Be medically stable before flying. Delay your flight if any doubt and buy a flexible ticket
• If you can briskly walk 50m or walk up two flights of steps without gasping for breath you will be fine
• Carry regular medication in your pocket. Do not fly if you currently have an asthma attack or any other illness which might cause breathing, ear or sinus problems
• Discuss other existing illnesses especially respiratory illnesses with your doctor. Check if you can carry your own oxygen on board if needed and then only fly if you must
• Carry a letter from your doctor listing your medication
• Do not fly less than 6 weeks post abdominal surgery as a general rule but discuss with your doctor
• If regular medication is necessary e.g. insulin then wear two watches with one set on departure time
• Check your destination: Does it have a reciprocal health care agreement with Australia? What will the local weather be like. Does it currently have e.g. a flu epidemic
• Carry adequate travel insurance
The captain has the final right to refuse to carry a passenger - not a doctor
Tattoo Removal
Your partner Jane is not too keen waking up in the morning looking at " Mary For Ever" in the middle of the heart shaped tattoo on your arm. Suddenly that blast from your romantic
past feels like a bit of body art you could now live without. About 25% of 18 - 50 year olds have tattoos.
About 50% of those who get tattoos later regret them.
Women are more likely to regret tattoos and want them removed
Tattoo removal techniques are not very successful basically because tattoos are meant to be permanent - the ink is injected out of reach deeply below the top layer of skin. Removal success varies with your skin color and the tattoo's pigments and size. New tattoos are more difficult to remove than old. All removal methods may leave scars.
• Dermabrasion involves sanding down the skin over the tattoo. Poor results usually. May leave a scar over an ugly remnant of the tattoo
• Surgical removal leaves a scar. Possibly OK for small tattoos
• Cryotherapy freeze-burns the tattooed skin with liquid nitrogen. Generally poor results plus a scar
• Laser removal is best but preferably done by an expert who knows which laser to use. The laser searches for contrast between skin tone and ink and pulses intensely on the skin to break the ink into particles small enough for the body to absorb. Black ink on light-skinned people is the easiest to remove, while fluorescent colours green and purple especially are nearly impossible to erase. Variable results and certainly not perfect. Usually little scarring. Expect at least 5 to 12 laser treatment sessions with a month between treatments so the process may take six months to a year.
Not cheap: Probably more expensive than the original tattoo
Painful: One comment was "the noise of the laser burning my skin was like the noise of bacon frying in a pan!" Post laser treatment the skin looks like a healing burn and needs to be watched carefully.
Heavy duty make-up can help hide the tattoo.
It may be better to leave a tattoo rather than end up with an unsightly scar plus a messy faded tattoo.
The strong message: " Think before you Ink !"
Am I Drinking Enough Water ? ?
ANOTHER common query. Water regulates body temperature, cushions and protects vital organs, aids
digestion, transports nutrients to working muscles and organs, helps dispel waste and can help prevent over-eating. A failure to replace lost water means the body can't adequately cool itself and dehydration follows. With one hour of intense exercise the body can lose up to a litre or more of water as sweat. Inadequate fluid intake causes the body to give signals which can mistakenly be taken as hunger pains, not thirst signals. Consequently you may start eating unnecessarily when you should be drinking. If you are overweight try one or two glasses of water before meals or snacks. This water distends the stomach which inhibits appetite which in turn helps weight loss.
How do you know if you are adequately hydrated? Simple If your urine is clear like water or just barely pale yellow then hydration is adequate. If your urine is a dark colour then you need to drink more water. Dehydration in the Jakarta environment is common with associated headache, inertia and lack of enthusiasm.
Keep a water bottle beside your desk so you can ensure your daily water intake of at least two litres
Is there any hope for humanity ?
New York Doctors threatened strike action over some administration problem and held a small demonstration while carrying relevant anti–admin signs. The Hospital CEO's rather brilliant response was to say he would find out what the Doctors' demands were just as soon as he could get a pharmacist down to the demo to read the writing on the picket signs! True story !
If you have any suggestions or topics you would like discussed please contact me:
Dr Richard Tomlins
rmtmlins@bigpond.com
If you have any suggestions or topics you would like discussed, please contact me:
Dr Richard Tomlins
rmtomlins@bigpond.com
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