Airline Travel and "Hypnatremia Like Symptoms"

May 15, 07 18:46

Post #1 of 43 (4607 views)

Ok, so yesterday I flew from Ottawa to Shanghai...17 hours in a tin cup at ~9000 ft of pressure and 22 hours door to door travel. I arrived in Shanghai and forced myself out to run for 45 minutes. I find that a run at the end of a long journey sitting in an airplane allows me to adjust to the time zone better and get my body on track.

I did not really "hydrate that much" on this journey, barely taking in 1.5L of total liquid over the entire time frame. However, when I arrived here, I felt that my legs (and the rest of my body) were totally swollen. I went for my run and as usual the first 20 minutes felt like crap...holding a 11 min per mile pace feels like sub 6 on a good day (I am not kidding). Anyway, eventually I got going and finished up the run and lifted some weights in the hotel gym (Ken Lehner and Paulo...sorry for lifting weights...).

Anyway, through the rest of the evening, and nite I went to pee often. It reminds me of 2003 Ironman Lake Placid, when I became hyponatremic and it took me almost an entire 24 hours to get back to my normal weight.

For the docs on this forum, is this related to SIADH (Symtom of Inappropriate ADH which is something that can affect hypervolemic hyponatremia). Is the hypothalmus causing the kidneys to kind of shut down to retain water in a dry environment (aircraft pressurized to 9000 ft with minimal humidity?)

Just interested to know. Maybe just like in racing where I need less liquid than the next guy, perhaps I need less liquid when flying. My genetics are optimized for 90+ degrees temp in 90+ % humidity. Thousands of years of my family tree came from an area of the world where this is daily weather.

Dev

Re: Airline Travel and "Hypnatremia Like Symptoms" [devashish paul] [ In reply to ]

May 15, 07 19:40

Post #2 of 43 (4562 views)

Hey Dev,

I'm not a doc but I had a similar problem last November when I flew to Sydney for LC Worlds. When I arrived, I found my ankles had swollen up to the size of grapefruits. OK, I'm exaggerating a little, but they were really swollen. And I peed like crazy for the next two days. I also peed like crazy during the race - once each lap of the bike (31.5km) on the big downhill.

On the return trip, I hydrated *more* and also made sure get up and walk around a little more frequently and I also massaged my feet and calves periodically (every couple of hours). I had no problems after the return flight.

-Bob

Re: Airline Travel and "Hypnatremia Like Symptoms" [devashish paul] [ In reply to ]

May 15, 07 19:51

Post #3 of 43 (4547 views)

economy class syndrome?

Re: Airline Travel and "Hypnatremia Like Symptoms" [devashish paul] [ In reply to ]

May 15, 07 21:12

Post #4 of 43 (4509 views)

i am curious about this too. it happens to me often - no matter how well/poorly i hydrate when traveling. i also cramp up in a major way (full lock-down charley horse cramps) for the first several workouts after traveling.

i do wear compression stockings when i fly. it doesn't help noticeably, but it has to make a positive impact somehow based on the principle, i'd think...

Re: Airline Travel and "Hypnatremia Like Symptoms" [austin79] [ In reply to ]

May 15, 07 21:16

Post #5 of 43 (4504 views)

can those stockings compress titanium? More importantly how close to being a fish are you now?

Brian Stover USAT LII
Accelerate3 Coaching
Insta

Re: Airline Travel and "Hypnatremia Like Symptoms" [desert dude] [ In reply to ]

May 15, 07 21:18

Post #6 of 43 (4502 views)

In Reply To:

More importantly how close to being a fish are you now?[/quote]That depends... Do fish bench press?

Re: Airline Travel and "Hypnatremia Like Symptoms" [austin79] [ In reply to ]

May 15, 07 21:20

Post #7 of 43 (4502 views)

OK, to put it in perspective, this only happens to me when the flight time exceeds ~ 6 hours. When I flew out to Wildflower on the Thu before the Sat race, it really was not much of an issue, although I did feel like crap on the Friday swim and ride. By Saturday, I was good to go, so I can't use that as an excuse.

Trevor, as for "Economy Class syndrome" I have this entire booklet of Air Canada upgrade coupons that I never get to use on account of me always pushing the travel agent to buy cheaper tickets and not burn through my product line travel budget. So I could be frivolous like some others and spend on high priced tickets to get easy upgrades, but I pay for my own cheapness by sitting in sardine class. I spend my company money like it is my own :-). There is more honour in being cheap and getting the same job done by burning through less $$$ :-).

Anyway, I was wondering if I should just drink a bit less on these long flights as I typically have lower hydration needs than the average caucasian North American.

Dev

Re: Airline Travel and "Hypnatremia Like Symptoms" [devashish paul] [ In reply to ]

May 15, 07 21:27

Post #8 of 43 (4494 views)

It happens to me on most flights, but then I always fly 2+ hours to get anywhere.

It also happened to me most recently driving - when I went out to Tucson. I cramped up into a huge knot as soon as I got there - even though I tried to stay hydrated. I think for me it's a problem of sitting in one spot and not moving/circulating blood for an extended period of time.

Re: Airline Travel and "Hypnatremia Like Symptoms" [devashish paul] [ In reply to ]

May 15, 07 21:37

Post #9 of 43 (4488 views)

Try doing as much walking around the terminal before you fly and during each connection as you can.I never sit still at all until I'm in my assigned seat and then I go for a walk around the cabin after each movie or in between episodes of C.S.I.I've never had cramps or any problems at all but my feet do swell a little but that goes away really quickly after landing.Drink lot's as I'm sure even your relatives on the sub-continent need to hydrate on flights.Just do us all a favour and lay off the curries the day before flying. ; )

Re: Airline Travel and "Hypnatremia Like Symptoms" [devashish paul] [ In reply to ]

May 15, 07 21:44

Post #10 of 43 (4481 views)

I'm not a doctor but these are my thoughts:

1. wear the compression hose (or even tall dress socks). I notice a HUGE difference in how much my legs swell. I can see the line when I take the socks off.

2. The increased urination could have to do with the time zone: maybe you aren't peeing more but at different times than usual. Most of us get on fairly regular schedules which get thrown off when we're eating/drinking/sleeping at different times.

Dan
www.aiatriathlon.com

http://www.aiatriathlon.com

Re: Airline Travel and "Hypnatremia Like Symptoms" [devashish paul] [ In reply to ]

May 15, 07 21:50

Post #11 of 43 (4477 views)

I know you're cheap but...Seriously...Economy Class syndrome... http://www.airhealth.org/athletes.html

Re: Airline Travel and "Hypnatremia Like Symptoms" [Ultra-tri-guy] [ In reply to ]

May 15, 07 21:51

Post #12 of 43 (4476 views)

I guess part of the problem is that I use flight time to catch up as much on sleep as possible. I think over the Vancouver to Shanghai leg, I slept for ~9 hours total. I just stick the earplugs in, put the eye cover on, stick the dorky looking bean bag pillow around my neck and go to sleep. I'm perpetually sleep deprived from burning the candle at every end (why would you sleep when you can train....), so given how boring sitting in one place is, I just use it to sleep. This of course means minimal walking around. Maybe I need a better strategy when I get up from sleeping.

Dev

Re: Airline Travel and "Hypnatremia Like Symptoms" [devashish paul] [ In reply to ]

May 15, 07 22:11

Post #13 of 43 (4463 views)

Mate, my love life sucks so much that sitting in a plane is the closest thing I have to being on a date.Dinner,wine ,coffee and a few good movies makes me happy for 12 to 17 hours depending on where I'm off to.I have to walk around the cabin to the crew area to find a nice girl to talk to though.Sucks to be me! ;(

Last edited by: Ultra-tri-guy: May 15, 07 22:12

Re: Airline Travel and "Hypnatremia Like Symptoms" [devashish paul] [ In reply to ]

May 15, 07 22:18

Post #14 of 43 (4455 views)

Get up an walk around every couple of hours. I'm not sure why, but it helps me even on flights of 3-5 hours. Doesn't make any sense to me, logically, because I'm fairly still for longer time periods each night while sleeping. Maybe something about the pressure, but walking/stretching really helps.

-C

------------------------------------------------------------
Any run that doesn't include pooping in someone's front yard is a win.

Re: Airline Travel and "Hypnatremia Like Symptoms" [Trevor S] [ In reply to ]

May 15, 07 22:20

Post #15 of 43 (4452 views)

Hey Trevor. Thanks. I had a friend that nearly died from DVT in Feb, but it was not airline travel induced, just sitting at his desk at work. This guy was/is a sub 4:30 half Ironman and sub 10 Ironman. He's 44 and the clot ended up going from his legs to his lung. He's still on blood thinner now.

Dev

Re: Airline Travel and "Hypnatremia Like Symptoms" [devashish paul] [ In reply to ]

May 15, 07 23:09

Post #16 of 43 (4441 views)

I have very similar kinds of fun after even 4-5 hour flights.
Getting upgraded does almost eliminate the problem :) I splurged on points to fly business class to Phoenix and will probably do it again when I fly to Hawaii.
I've never actually gained weight on a flight, though, and even when I've slept through the whole trip and drunk nothing, I see the same effects so I'm pretty sure that it's some kind of fluid distribution thing.

Re: Airline Travel and "Hypnatremia Like Symptoms" [austin79] [ In reply to ]

May 16, 07 4:07

Post #17 of 43 (4391 views)

oooh, you've gotta see the new Sugoi compression socks coming out next year, super cool and comfy and perfect for flying. Unfortunately you also look like a dork wearing them:P did a photo shoot wearing them along with a tri suit and the lady who's shop we were shooting in couldn't stop laughing, the photographer refused to shoot on principle and everyone made fun of me... anyways it was pretty funny but they were very cool socks.

Re: Airline Travel and "Hypnatremia Like Symptoms" [devashish paul] [ In reply to ]

May 16, 07 7:43

Post #18 of 43 (4319 views)

I used to have problems like that, now I fly with my children (18 hours to S. Africa from New York, the longest commercial flight) and I'm in motion constantly, have no problems with fluid retention anymore ;-)
If you can actually sleep for 9 hours in a cattle-class seat, I'm deeply envious. On business trips usually I'll wake up every few hours, walk around the plane once, get a glass of water and go back to dozing. This is enough that the symptoms are mild, slight swelling of foot/ankle etc.

"It is a good feeling for old men who have begun to fear failure, any sort of failure, to set a schedule for exercise and stick to it. If an aging man can run a distance of three miles, for instance, he knows that whatever his other failures may be, he is not completely wasted away." Romain Gary, SI interview

Re: Airline Travel and "Hypnatremia Like Symptoms" [devashish paul] [ In reply to ]

May 16, 07 7:47

Post #19 of 43 (4301 views)

unless you are flying first class (in a completely flat bed), you are risking your life if you go running after such a flight.

no joke.

believe me, i know because i do it for a living. if you want supporting evidence, let me know.

Where would you want to swim ?

Re: Airline Travel and "Hypnatremia Like Symptoms" [GregX] [ In reply to ]

May 16, 07 8:30

Post #20 of 43 (4272 views)

Id like to see why?

Certainly walking around helps a lot...very important.

Re: Airline Travel and "Hypnatremia Like Symptoms" [devashish paul] [ In reply to ]

May 16, 07 8:56

Post #21 of 43 (4234 views)

Okay so this is going to sound a bit extreme but it's worked for me as I have the same problem you and Lauren have.

First... wear the oxy socks... they aren't they end all, be all, cure all but they do alleviate, to a degree, some of the symptoms.

Second... get on the plan dehydrated and stay that way. Only enough to wet your whistle every now and again. Every 2-3 hours I'll get up to walkaround for maybe a minute or two (two aisle planes RULE!!!) and usually end up in the back at the lavatories where I'll do a bunch of calf raises for a minute or so. Get some good blood flow down there.

Lastly... when I arrive (mind you my long flights are 5-6 hours) I'll go to baggage claim and lay on the floor and stick my feet straight up in the air on the wall for 15 minutes or so. After all this I'll start s-l-o-w-l-y rehydrating (no guzzling here) and walking about. I know you want to run but seems like kind of a shock to the system after being static for so long.

Best of luck.

36 kona qualifiers 2006-'23 - 3 Kona Podiums - 4 OA IM AG wins - 5 IM AG wins - 18 70.3 AG wins
I ka nana no a 'ike -- by observing, one learns | Kulia i ka nu'u -- strive for excellence
Garmin Glycogen Use App | Garmin Fat Use App

Re: Airline Travel and "Hypnatremia Like Symptoms" [nugget] [ In reply to ]

May 16, 07 9:41

Post #22 of 43 (4203 views)

here are a few examples of what you are playing with:

http://archives.cnn.com/...in.flight/index.html

http://www.usatoday.com/...03-04-11-bloom_x.htm

this is some of the why:

this is why your legs/ankles swell with long sitting:
http://en.wikipedia.org/wiki/Interstitial_fluid

now about DVT, if you sit (or especially sleep) in a seated postion in a plane for a long stretch, you will VASTLY increase your chances of getting DVT (a clot). and if you have clot somewhere in your system, going running soon after landing will increase the chances of the clot going somewhere in your body and permanently damaging skeletal muscle, heart muscle, the lung, or, most deadly, the brain ...

2 suggestions:
never ever sleep in chair in a plane for more than a few minutes at a time. and never ever take a sleeping pill on a long flight. no matter how tired you are, get up often, like every 20 to 30 minutes, that would be the minimum. and never ever go for run right after landing. the only exception to this would be if you fly first class and spend most of the long flight laying down in a completely flat bed. then you are probably ok.

you can ignore all of these and be fine.

but then you gotta ask yourself: how lucky do you feel that day? because you are most certainly playing russian roulette.

Where would you want to swim ?

Last edited by: GregX: May 16, 07 9:47

Re: Airline Travel and "Hypnatremia Like Symptoms" [boco_tri] [ In reply to ]

May 16, 07 9:43

Post #23 of 43 (4196 views)

In Reply To:

Second... get on the plan dehydrated and stay that way.[/quote]i'd really like to know, what's the advantage of this advice? who supports this?

Where would you want to swim ?

Re: Airline Travel and "Hypnatremia Like Symptoms" [GregX] [ In reply to ]

May 16, 07 14:06

Post #24 of 43 (4133 views)

Wow, you guys paint a really grave picture. You'd think that people would be dying left right and centre given the volume of people who fly long distance, so I find some of this a bit extreme to say the least. As for flying and then going running, well, I've been doing this for years. Maybe I have just been lucky, but I find it allows my body to adjust quite quickly to the new time zone as well the general feeling of sluggishness. Ideally, after a long flight, my preference would be a swim if the hotel has a pool (as small as it may be). With respect to sleeping on flights, I can't sleep for 9 hours straight. It is more live several bouts of 1.5-3 hours where I don't get into a super deep sleep, slightly aware of my surroundings. The earplugs and eye covers help. I do have an opportunity to walk around though. 747's are good because you can climb stairs, but they rarely fly out of Canada on the airlines that I am taking.

Dev

Re: Airline Travel and "Hypnatremia Like Symptoms" [GregX] [ In reply to ]

May 16, 07 14:07

Post #25 of 43 (4133 views)

really really interesting...i fly to europe a lot and all over the us for work- rarely have i had swelling in the legs but then i hate flying and tend to get up every hour to use the loo as it is..who knew fear of flying had its advantages! Aspirin before a flight is certainly an easy thing to do - we all take aspirin anyway in my family after my father's heart attack...

now the next question is- how soon after foot surgery would you fly? (broken bone that set wrong)

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