Air Travel Tips for Adrenal Fatigue

By: Michael Lam, MD, MPH

Most of us take air travel for granted. Those with Adrenal Fatigue Syndrome (AFS) often find this a grueling and dreaded experience. The weaker the adrenals, the higher the chance that air travel can trigger an adrenal crash. The following air travel tips serve to prepare you and ensure you arrive in the best shape possible.

Air Travel Tips: Before You Go

1. Always travel with a designated travel companion. As your travel partner, their duty is to take care of your every need during the trip.
2. Make sure your carry-on has wheels for ease of movement. Do not get a backpack for a carry-on. All carry-on baggage should be light. Any excess weight should be in your checked baggage.
3. Travel during the time when you are the freshest.
4. Arrive at the airport well ahead of schedule so there will be no stress.
5. Have your travel companion drop you off at the terminal while the car is parked or returned.
   Try to avoid red eye flights. Your circadian cycle may be altered.
6. Avoid layover flights as much as possible. If you have to stop, it is best to try to layover for 48 to 72 hours allowing the body time to adjust.
7. Make sure to bring a neck or regular pillow, as well as lumbar support for the plane ride.
   Print out the boarding pass ahead of time with the seat assignment on it.
8. Pre-pack the vast majority of your belongings and essentials into your bags a few days prior to your departure date. Do this at a leisurely pace. Remember to pack a variety of pre-packaged snacks in your carry-on baggage.
9. If there is a weight limit imposed by the airline, weigh your baggage prior to your departure to the airport to avoid last minute surprises.
10. Many international airports provide short-term beds and showers at reasonable prices within the terminal. Take advantage of these.
11. Confirm your seat assignment if possible to avoid being "bumped."
12. Make sure your travel documents are in place and that you have copies stored in your carry-on baggage.
13. Take an additional recommended booster dose of your supplement prior to departure.
14. No strenuous exercise on the day before and day of departure, this is to conserve your energy.
15. Bring along pillow, blanket and lumbar support as needed to increase comfort during the trip.

Air Travel Tips: At Check-in Counter

1. Once you are inside the departure terminal, find a place to sit down. Do not stand in line unless there is no choice. Use your luggage as a seat if needed. Wait for your travel companion to meet you.
2. Luggage is best checked-in at curbside. If that is not possible, ask for help from the porter to the check-in counter. Do not lift any heavy baggage by yourself.
3. Ask your travel companion to check-in for you while you rest by sitting on a nearby chair or on the luggage. Try to stand as little as possible.
4. Ask for an aisle seat for convenient access to bathrooms.
5. Ask for the seating towards the front of the plane or close to the bathroom to avoid excessive walking back and forth.
6. Ask for the "meet and assist" wheelchair/golf cart service (this is usually provided free of charge) from the check-in counter to the gate, especially if the walk to and from the gate is long.
7. Make sure you have an empty water bottle with you to bring past the security checkpoint, unopened snacks, and extra supplements accessible at any time.
8. Have your music devices, books, and/or noise cancellation headphones readily accessible.

Air Travel Tips: From Security Check Point to Gate

This is often the most chaotic place in the airport. The brain is bombarded by the noise, x-ray emission, and the many instructions you have to follow to pass through the security gate; including taking off your shoes, belts, hats, etc. The process is extremely energy draining. Use the these air travel tips to reduce the amount of energy spent.

1. Sit down on your carry-on baggage, if possible, for rest if you have to stand in line, or lean against your companion as needed. Do not force yourself to stand for a long period of time as this can drain your body.
2. Sit down if you are tired after you pass the security screening. Do the Adrenal Breathing Exercises. Ask your travel companion to get your water bottle filled immediately. As a precautionary measure, drink some water and eat a snack, even if you may not feel like you need it.
3. Take your time and rest for a few minutes as needed prior to continuing to the gate. If needed, proceed to the bathroom where you can sit down and do the Adrenal Breathing Exercise.
4. Ask your companion to guide you to the gate. Do not get up to look for the gate number unless you are traveling alone.
5. Do not stop to window shop along the way.
6. Walk slowly to the gate. Do not run. Always use any electric conveyer to help get to the gate rather than walk. If you have to take a terminal train, always sit down immediately once inside. If you have to take a terminal bus, always ask your companion or the driver to help you with bags, do not haul it up and down the bus yourself. Once inside, always sit down and do not stand.

Air Travel Tips: At the Gate

1. While waiting in departure lounge, sit at the least congested place possible, away from computer monitors, TV screens, and loud music. Sit close to a water fountain and bathroom.
2. Do your quiet reading or enjoy personal music to keep yourself relaxed.
3. Do not chit chat unless you have to. This can drain your energy.
4. Go to the bathroom immediately before pre-boarding.
5. Do Adrenal Breathing Exercises along the way as much as needed.
6. If you are not on wheelchair service, be the last to board, so you don't have to line up.
7. Purchase a meal at the airport, once you are past the security checkpoint, to bring with you on the plane, so your mealtime is kept the same.

Air Travel Tips: On the Plane

1. Ask for help to put away any overhead baggage. Do not do it yourself.
2. Do not watch action TV or any videos. Enjoy music that you like.
3. Put down the window shade to shield from bright sunlight.
4. Put on eye shades if needed.
5. Stand up, walk to bathroom and stretch as often as needed, but watch the bathroom line. Do not let yourself be caught standing in line for a prolonged period of time.
6. Take lots of fluid frequently as the air is very dry inside the plane.
7. Ask for seat change if your current seat is disrupted by children or infant noise.
8. Tell the stewardess ahead of time not to wake you if you are sleeping but ask her to save your meal, which you can call on at any time.
9. Do not depend on the airline for the proper food. Always bring your own. If you have a tendency to be hypoglycemic, make sure you have a large variety of snacks with you all the time and eat according to your body schedule and not according to the airline's schedule.
10. If you anticipate being tired upon arrival, inform cabin crew who can pre-arrange wheelchair/ golf cart "meet and assist" on arrival.
11. Fill in any arrival forms well ahead of actually landing.
12. Do Adrenal Breathing Exercises at any time and frequently.
13. Fill up the water bottle frequently. Do not allow it to be totally empty.

On Arrival:

1. Unless you are well in front of the plane, let others go first so as not to be rushed.
2. Ask for help retrieving your overhead baggage. Do not do it yourself.
3. Upon deplaning, go to the bathroom and freshen up.
4. If the walk to the baggage claim is long, take some water and eat a snack even though you may not feel the need.
5. Do not stop to shop.
6. It is normal to be excited upon arrival to your destination, but please do try to control your emotions. Remain calm and serene throughout.
7. At the baggage claim, always ask for assistance instead of doing it yourself, if you are traveling alone. Otherwise, ask your travel companion.
8. Upon arrival to your final destination, take a mandatory nap prior to embarking on any other activities.

Dr. Lam's Key Question