Vital Sings: Travel

Premieres: March 23, 2020.

DR. SANJAY GUPTA, CNN Chief Medical Correspondent

00:25 Sanjay Gupta:

There’s nothing quite like hopping on a plane and jetting off to a new destination. This is Vital Signs. I’m Dr Sanjay Gupta.

Whether it’s a family holiday or relaxing on the beach, research suggests that vacations can improve a person’s happiness. But, that boost in mood may not last long after the trip is over. Research suggests that soon after your vacation, your happiness levels revert back to where they were before.

00.50 In fact, it’s the time leading up to travelling and the first few days of your holiday that leave the longest lasting mark.

00.56 Once you’ve boarded the plane and you’re anticipating the exciting days ahead, it’s the flight crews’ job to make sure your time in the air is not only enjoyable, but safe, as well.

01:11 Airline check-in. Security check points, baggage claim. For many people, air travel can be a nightmare. Still, it’s one of the most widely-used modes of transportation for long-distance travel.

01.26 According to the International Air Transport association, approximately 100,000 commercial flights take off and land every day, and between 2013 and 2014 approximately 3.3 billion passengers flew on commercial airlines.

When you’re comfortably in your seat and waiting for refreshments, the last thing you want to think about is a possible inflight medical emergency.

At 30,000 feet, airline staff could quite possibly have a passenger’s life in their hands.

01:58 I visited the Delta Airline training centre in Atlanta to see how flight crews manage medical emergencies.

02.04 Instructor:

Alright, you guys, let’s go ahead and board through the one left door.

02.09 Sanjay Gupta:

Out of all the training that a flight attendant might go through, how big a component is the medical and safety part of it?

JUSTIN EPLEY, Flight Attendant Instructor, Delta Air Lines

02.16 Justin Epley:

The medical and safety part is a heavy component of it, and that’s something the FAA puts heavy emphasis on, because it’s pretty much a guarantee that’ll will happen. If it can happen on the ground, it’s going to happen in the air as well, too. So we need to be able to respond to that appropriately.

02:29 Sanjay Gupta:

Can you give me an idea of what they’re hearing, what they’re walking away from their training with?

02.36 Justin Epley:

As it applies to our medical training, we do put a heavy emphasis on responding with CPR knowledge, using the AEDs and the equipment onboard the aircraft that we have available to respond for basic first aid instances as well, too.

02.48 Sanjay Gupta:

Although rare, in-flight medical issues do occur. A recent study calculated that in every 604 flights reported medical emergencies, or about 44,000 medical emergencies every year. The most common issues are fainting, or feeling dizzy, and nausea or vomiting.

03:07 Delta says they do their best to train flight attendants to handle most medical problems that can happen in the sky.

Anything can happen, presumably, when you’re up there. What kind of training do the flight attendants get, and the rest of the crew and staff?

BARBARA MARTIN, Ge. Manager for Health Services, Delta Air Lines

03.21 Barbara Martin:

The flight attendants are trained as new hires very extensively, and then every year, they have recurrent training that includes emergency response.

03:32 The flight attendants have access to what we call a medical accessory kit and that’s got basic equipment in it for taking blood pressure, thermometers, personal protective equipment.

If there’re a medical volunteer on board, then they’re given access to our emergency medical kit, and that kit has resuscitation equipment, it has IV equipment, medications.

03:58 Sanjay Gupta:

This is the other part of the team. Instead of being in the air, they’re on the ground. Based at the University of Pittsburgh Medical Centre, STAT-MD is a medical communications centre that offers support services for several north American airlines.

DR. TJ DOYLE, Medical Director, STAT-MD

04.17 TJ Doyle:

We basically provide in-flight consultations for in-flight emergencies and we also provide fitness to fly screening for the airlines for people on the ground, in case there’s a question on their ability to go up into the air.

04:29 Sanjay Gupta:

Let’s say someone is having… they feel light-headed and they’re having chest pain, for example, which probably is a more common scenario. Talk me through it. What would the conversation be like?

TJ Doyle:

What would usually happen is that, on the flight, either the passenger themselves will bring attention to themselves and call for help or someone else on the flight might notice or the flight attendant might notice.

And so, then, they usually initiate their airline-specific procedures, and then, hopefully, they fill out the information form,

05:03 slide it under the cockpit door and then the Captain will contact us and the Captain will relay the information from the form and then while they’re doing that, oftentimes they’ll ask for, is there a medical volunteer on board that can assist as well.

05.17 Sanjay Gupta:

If you have a doctor on board the plane, are they in charge, then, are the people here on the ground in charge? How does that work?

TJ Doyle:

Actually, the Captain’s in charge. The Captain’s always in charge. And so, what we do is, we make a recommendation based on our expertise and our experience in this.  I think the key point in this is that if you’re a volunteer, a lot of them think ‘ oh my god, I’m all alone, this is all on me, there’s 200 people on the plane looking at me. They think, ‘what do I do? Often times, whatever the issue is, it’s not what their expertise is, not their specialty, so if there is one thing I can tell them is ‘No you’re not alone.’

05:57 Sanjay Gupta:

STAT-MD considers in-flight birth and cardiac arrest to be the most severe medical emergencies. They say situations like these could lead to flight diversion, but ultimately, that decision is made on a case-by-case basis.

Sanjay Gupta:

You said the Captain’s in charge, which makes perfect sense, but the Captain says, ‘what do I do? Do I divert the plane or do I not divert the plan?’ What are the criteria that you use to help the Captain?

06.23 TJ Doyle:

It varies on the circumstance. What the situation is, and then also based on distance from their destination. If the flight is within 30 minutes from their destination, even if it’s a pretty severe, critical event, there’s really no time benefit from the diverting somewhere else.

We coordinate with the Captain and Dispatch to make sure that the diversion destination that we may recommend is medically suitable, is operationally suitable for the aircraft.

06:51  Sanjay Gupta:

The extreme pressure change in aircraft cabin tends to be the biggest issue for many passengers. According to Delta Flight instructors, there’s a fairly simple solution to staying healthy in the sky.

0703 You’ve been doing this for a while. Has it changed how you fly at all? I mean, do you do anything different now, yourself, to keep yourself healthy or to make it less likely you’re going to have a problem?

0713 Justin Epley:

I definitely stay hydrated, and you feel that, when you’re flying, and you don’t realise, especially in our environment, we work constantly on our feet and it’s easy to forget simple things like that.

07:25  Sanjay Gupta:

Next, on Vital Signs, we meet two long-time friends to show the pitfalls of frequent business travel, and why taking time away from work is good for our bodies and social life.

For many people, travelling for pleasure, taking time off and escaping the daily grind is one of life’s joys. In every country in the European Union, it’s required, by law.

07:48  People in the EU have at least four work weeks of paid holiday time, but the United States is the only developed country without legally mandated paid vacation.

07.57 The result is that one in four Americans don’t have a single paid day off. As people in the workforce age, not having time off can be detrimental. According to the Mayo Clinic, not taking time away from everyday stressors can increase the amount of the stress hormone known as cortisol in the body.

That can speed up the ageing process. In the United States, Americans are focusing more on leisure travel as they get closer to retirement,

08.21  and a Boston-based non-profit is helping their globe-trotting dreams become a reality.

08.31 Meet Francy Hays. The 65-year-old Deputy Director for a DC-based non-profit is also a self-proclaimed workaholic.

08.41 Francy Hayes I’ve been really active in my professional life and that involves being fully engaged at work and with colleagues here in DC, colleagues all around the world.

08:56  Sanjay Gupta:

In Francy’s line of work, she has to travel, often. Usually to underdeveloped countries, and it’s taken a bit of a toll over the years.

FRANCY HAYS

090.5 Francy Hayes:

My identity was really tied up with my profession. I began travelling quite a bit, and that changed family dynamics, because I’d be gone for two to three weeks at a time, and I really valued that.

09:23  And it had consequences, but at that point in my life, that was really, really important to me.

Sanjay Gupta:

Francy is one of millions of people whose jobs require frequent travel.

PROFESSOR SCOTT COHEN, Dep. Dir. of Research, Univ. of Surrey School of Hospitality & Tourism

09.35 Scott Cohen:

What we do is we show how, for the most part, societies tended to glamorise travel, particularly frequent travel, business travel.

09:46  Sanjay Gupta:

Professor Scott Cohen is the co-author of a study in the UK that highlights the downfalls of recurring business travel.

09.53 Scott Cohen:

What we’ve done is we’ve shown the different ways in which that’s glamorised and then we’ve brought to the fore all the different, darker sides of frequent travel that are physiological, emotional, psychological, that people rarely talk about.

There’ s a disruption to the circadian rhythm that you get through frequent jetlag, and that has chronic effects when this builds over time, so it’s not just taking five or seven days to readjust the jetlag, there’s also gene disruption that influences ageing.

10:25  There’s chronic memory impairment, there’s a higher risk of heart attack and stroke as well.

Sanjay Gupta:

In addition are the emotional and psychological problems, mainly, stress. Stressors like long-hauls to other countries, inconvenient delays and departure times and disrupted routines.

According to a recent study, not all business travellers experience stress in the same way.

10:52  Women experience higher levels of stress than men when on the road for business.

Workers in the Asia-Pacific region reported the highest levels of travel stress, while people in Europe, the Middle East and Africa, had the least amount.

And frequent business travellers had higher levels of stress than people who rarely travelled for work.

11.11 Dr Dana Wyner of Emory University says travel-related stress can disrupt other areas of life.

DANA WYNER, Doctor of Psychology

11.17 Dana Wyner:

It can really affect us significantly. Looking at the symptoms of stress, and the ways that it can interfere, you’re looking at self-care, so how does it affect their ability to take care of their physical needs, nutrition, sleep?

It also affects social relationships. When you’re so focused on all of your own stressors, how can you be present, with your family, with loved ones?

11:49 Sanjay Gupta:

I have this conversation with my family members all the time, and I always make the argument, tell me if I’m right or wrong, that there is good stress as well. I think I thrive on a little bit of stress. 

11.59 Dana Wyner:

To a certain degree, we need stress. Why would we get out of bed? Why would we do anything? How would we take on challenges?

However, and what I notice in business folks that I work with, honestly, across the board, is that there is this fantasy that the harder I work, and the mo46re that I just kind of, almost like mentally beat myself up, the higher my performance is going to go.

12:29  In actuality, we have that point at which we fall off. It’s just a fantasy.

Sanjay Gupta:

Like many professionals, Francy spent much of her career living that fantasy, but now that she’s nearing retirement, she says something has changed.

12.48: Francy Hays:

Something switched inside. Which was like ‘I don’t want to do this anymore’. I loved doing it, I was wholly committed to it, but the time has changed. It was something internal that switched and it was a really different change in consciousness. As I embraced that more and more, the pulling back from work has been easier and easier.

13.20 Sanjay Gupta:

67-year-old Louisa Mattson is a psychologist in Washington DC. She’s also a close friend of Francy’s. The two women have known each other for nearly sixty years.

LOUISA MATTSON

13.31 Louisa Mattson:

I definitely consider myself to be active. I play tennis four times a week, I do walking, I like to bike in the summer. Last year I went on my second horseback packing trip to Montana, which was quite rigorous.

Sanjay Gupta:

Over the last decade, Louisa has added global travel to her active lifestyle through a non-profit organisation called Road Scholar.

13:57 Mainly geared towards older adults, the programme provides educational travel tours to different locations around the world. So far, Louisa has been on six Road Scholar adventures, including hiking in Death Valley and spending time in Costa Rica.

14.12 Louisa Mattson:

I had heard people say, as you’re ageing, travel in your sixties, because you just don’t know how physically able you’re going to be for how long.

14:22 And it really was when I turned sixty that I did have the time and the energy and the financial wherewithal to start travelling.

I think as we age, we gain a lot of perspective and wisdom and travelling just adds to the wealth of experiences that can inform our sense of selves and our sense of humanity and life.

14:52 Sanjay Gupta:

Now, Louisa’s adventure is taking her to the Italian countryside of Umbria. For the first time, she’s bringing along her friend, Francy.

15.01 Francy Hays:

Louisa was the energy behind it and she was the one who talked me into doing it and the whole thing is the opportunity to detach from work.

15.16  So, personally, I hope to learn and to find ways of engaging outside my usual comfort zone. In terms of meeting new people and really striking up conversations and not feeling restrained about doing that, also handling what may be a few physical challenges, knowing I have to handle them and being ok with that.

15.50  Sanjay Gupta:

As Francy and Louisa head to Italy, we’ll explore how leisure travel can affect heart health, possibly adding years to your life.

16.00 Vacations and holidays are an excellent way to relieve stress. There’s evidence that travelling for pleasure can also add years to your life.

16.07 Research shows that men who didn’t take annual vacations had a 30% higher chance of dying from heart disease and women who didn’t take vacations were more than twice as likely to suffer from depression as compared to other women.

16:20 That’s likely because activities associated with travel like walking the beach, hiking National Parks or museum hopping are good for our physical and cognitive functions.

Best friends Louisa Mattson and Francy Hays explored the Italian countryside to see just how good an international getaway can make you feel.

16.43 Tour guide:

Eat the truffle, just wash it and scramble it on the pasta.

16:51 Sanjay Gupta:

Long-time friends Louisa Mattson and Francy Hays are on an adventure from the United States to the Italian countryside of Umbria through Road Scholar, a non-profit organisation that gives travellers educational tours to cities worldwide.

This is Francy’s first trip and Louisa’s seventh.

17.08 Louisa Mattson:

Once you get to your location, you don’t really have to think about anything, which is nice. You meet fascinating people who are on the trip, you get an educational experience, you feel cared for, it feeds the mind, it feeds the body in multiple ways.

17:29  Francy Hays:

I think the walking is what I really came for, and the vistas, the views are just so much better than anything I could imagine.

17.42 Sanjay Gupta:

The president and CEO, James Moses, says most of their tours are geared toward adults in their 50s and older.

JAMES MOSES, President and CEO, Road Scholar

17:48  James Moses:

People have begun to understand that learning is a critical part of ageing and that staying engaged intellectually and socially as well as physically, is critical to a healthy older age.

18.00 It’s not about the quantity of years, it’s about the quality of years, and that’s really what Road Scholar has championed all this time. Lifelong learning, we think, is a critical element to a healthy older age.

18:19 Sanjay Gupta:

Louisa and Francy are both in their mid-60s and are focusing on their health as they get closer to retirement. Louisa is an avid hiker and tries to stay as active as possible. Francy is shifting her priorities from work and leading a much more active lifestyle than she has in the past.

18.36 Francy Hays:

I think for 65 years I took my good health for granted and I’ve learned in the past year I can’t do that and I need to pay attention to my health and a big part of health is physical health, strength, well-being. All that’s really important.

18:57  Sanjay Gupta:

The two women have set aside part of their time in Umbria for what’s called ‘adventure travel.’

19.04 Louisa Mattson:

I love being active when I travel and you just feel so good, you feel virtuous at the end of the morning, after your hike, and then you can enjoy the food and you feel, by the end of the trip you feel healthier than when you began.

19:18 Francy Hays:

I think, for me, what’s been especially wonderful is the hiking every morning, because the hiking really puts… I have to be in the moment. I have to pay attention to where the path is going, what rock is going to be in the way for me to potentially trip over and, for me, the physical side always seems like it was going to be a challenge and I was a little bit concerned.

19:47  All my concentration had to be used during the hiking and there is nothing more in the moment.

19.55 Sanjay Gupta:

Remaining physical, even when on vacation, is a large part of staying healthy and fit, especially as we age. But when you’re on a big getaway, there are also potential cognitive benefits.

20.05 Dana Wyner:

If we’re talking leisure, it brings us into a novel situation. When do we do our best learning, right? It’s when we’re open, mindful.

We’re learning that we don’t all operate the same way. We don’t all operate according to the same set of rules and when you come back home, you look at your own life differently. You’ve developed an appreciation for other people.

20:32 Sanjay Gupta: What impact do you think that sort of leisure time has on ageing?

Dana Wyner:

Our brains never stop growing. We’re always developing. We can always learn. I think that was something that wasn’t always believed, but now, we know so much more about neuroplasticity, the ways that we can develop new pathways, the ways that we can learn.

20.53 Sanjay Gupta:

We asked Louisa how she thinks her travels have influenced her cognitive function over the years.

20:59 Louisa Mattson:

The benefits of travel are that it brings you right into the present moment, because everything is new. You literally don’t know what’s around the corner, and especially in Umbria, there’s so many nooks and crannies and so many corners, so you’re constantly in a state of unknowing, a state of surprise and that really brings you into the moment, you feel more fully alive. It encourages you to have a mindset of openness and curiosity and wonder.

21:33  One thing I’m promising myself this trip is, can I bring back that mindset to my daily life, so I’m not living in a kind of trance, of making assumptions about the way life is.

This trip is definitely, constantly breaking my assumptions, challenging them and it’s thrilling, really.

22.01 Sanjay Gupta:

For Francy, her first big travel adventure marks a new era in her life, one that involves an appreciation for travel and its benefits to her health.

22.11 Francy Hays:

I’ve worked really hard, I’ve loved my work, but all of a sudden there was something  that turned inside me and said, ‘that chapter is not over, but the importance of it, in terms of the priority, has shifted, and this trip really meant more to me than just a trip, because it was a beginning, or is a beginning.

22:43  Sanjay Gupta:

Life can often get in the way of a much-needed holiday, but travelling and taking some time off means a healthier body and mind.

When you do travel, walk around during long flights to reduce the risk of blood clots. Stay hydrated and try your best to eat some healthy meals.

22:59  For Vital Signs, I’m Dr Sanjay Gupta.

END