As I mentioned in my earlier post about magesium glycinate, this supplement seems to work wonders against PVCs. And like all magnesium supplements, it provides a useful level of relief of musculoskeletal aches and pains. I'm not sure why, but there is plenty of literature about this, and it certainly seems to work for me. Finally, if it functions like dietary magnesium, then it's also neuroprotective, although I'm not certain as to equivalance in this case. (Although, I have heard that brain surgeons occasionally recommend magnesium supplementation prior to surgery, as a means of prophylactically minimizing damage to healthy neurons.)
However, overdoses of magnesium in any form can cause arrhythmias, hypotension, and confusion. The National Institutes of Health puts the tolerable upper intake at just 350mg for adults. This would be exceeded by a single dose of KAL 400mg (2 tablets of 200mg each). And of course, don't forget to include the amount in your vitamin pill. Note, however, that the NIH article linked above does not place a limit on dietary, as opposed to supplemental, magnesium. This is probably because the body absorbs dietary magnesium much more slowly, resulting in minimal disruption to homeostatis.
Anyway, this is just a quick reminder to not think of supplemental magnesium -- or any supplement, for that matter -- as always better in higher doses. Still, the tolerable upper intake is only a one-size-fits-all advisory for people with all manner of physiological differences. Use it as a guide, but take more or less depending on how you feel, discussion with your doctor, and relevant medical tests. In moderation, it confers significant benefits to many MVP sufferers. It may also positively affect MVPS, considering its involvement with the nervous system.
Fundamentally, I never take magnesium supplements unless I have PVCs or intolerable chest pain. I prefer, when possible, to obtain my nutrients from food. I don't want to train my body to depend on supplements (other than a few super supplements that I must take every day, such as resveratrol, which perhaps I'll discuss in a later post).
Oh, if you're wondering why I thought to write this post, it's because I discovered a long time ago that high amounts of magnesium supplementation seemed to dull my shortterm memory for a few days thereafter. I researched, and found the likely cause.
Finally, as with other supplements which disrupt electrolyte balance, I suggest taking it in tiny nibbles, waiting for 5 to 20 minutes in between. And of course, don't forget that cardiovascular exercise is one of the best ways to keep your heart rhythm in sync, and to lower your dependence on supplements.
Tuesday, April 7, 2009
Sunday, April 5, 2009
Airplane (Plane) Travel and MVPS
If you've ever travelled on an airplane, you know that it's a torture session for MVPS sufferers. While I must confess that there's no cure for the mile-high jitters I'd like to take a moment to share some not-so-common knowledge about plane travel which may help you handle the experience more calmly in the future.
In recent years, various cities have enacted legislation intended to reduce airplane noise. While this is great for peaceful neighborhoods, it results in very steep takeoffs at full power. The idea is to "blast off" as steeply as possible in order to reach high altitude before jet noise can annoy residents living near the airport. Personally, I think that anyone who chooses to live near an airport knows what he's getting into, and should plan accordingly. But nonetheless, we have this policy in practice. McCoy Airport in Irvine, California is one example.
Having taken off from McCoy on numerous occasions, I experienced near-syncope repeatedly. At the time, I had not yet been diagnosed with MVP or MVPS, so I just assumed that all the other passengers must be experiencing the same, but just relaxing and not bothering to mention the severe dizzy feeling. I imagined that the pilot must be wearing "G-pants" characteristic of military pilots, which maintain blood pressure under high acceleration, and thus normal brain function. Little did I realize at the time, this problem was entirely my own. Now, at the very least, I try to drink some mineral water before takeoff in order to ensure adequate blood volume. (I don't drink so much that I drain the electrolytes out of my body.) I usually also take 100mg of magnesium glycinate, which may help my nerves and circulatory system deal with the impending stress, although I would classify this behavior as experimental. During particularly heavy acceleration, I inhale moderately in order to temporarily increase my blood pressure, and thus sustain my brain's oxygen supply.
Since the McCoy days, of course, I've learned about MVPS, and have made substantial efforts to improve my physiological reactions to the stresses of flight. Here are a few of my techniques:
Flight Schedule
Most of us tend to fly for a few hours at a time, rather than across oceans. In the former case, this allows us to select the flight time with substantial freedom.
I like to choose flights in the morning, or if unavailable, then late at night. I avoid afternoon and evening flights whenever economically feasible. The reason is that the sun heats the atmosphere, resulting in a higher probability of high winds in the afternoon, and to a lesser extent, the evening. Higher winds create greater turbulence, and thus a notably less pleasant flying experience. On the plus side, morning and late night flights tend to be cheaper.
Incidentally, on one occasion, I was flying out of a desert city on a perfectly clear day. But, against my advice, this was an afternoon flight, which meant that invisible hot air was convecting up from the desert floor into the atmosphere. About a minute into the flight, the plane was buffetted by a massive gust of wind, which forced us upward. Everyone shouted in terror. But nonetheless, the pilot was able to clear the rough patch in a few minutes. You should realize that the pilots and crew do their jobs every day, and are relatively unphased by events that you might find terrifying. And, if possible, fly in the morning or at night.
I actually prefer morning over night because I like to fly with very little in my stomach, and a minimal safe blood sugar level, as covered in the next section.
Diet Before and During Flight
The day before, I stop eating in the afternoon or evening. The morning of the flight, I get up, often before dawn, and grab a few handfuls of pecans or blanched almonds. I throw in a few steamed veggies for fiber, which matters when one is sitting for hours in cramped conditions. Critically, I eat no significant carb or sugar sources. Then, I eat nothing else until I'm on the flight, or if possible, until I land. This keeps me from being excessively hungry, but also thwarts my body's ability to push the adrenaline button in response to turbulence, etc. Just remember not to try any new foods immediately before a flight, as a plane is no place to discover that you're allergic to something.
During the flight, I try to stick to veggies. If you have low blood pressure, then salted peanuts may be OK as well, but as a rule they're loaded with pesticide and omega-6, and thus have no place in a healthy diet. (Ironically, organic peanuts can be even more dangerous on account of aflatoxin, but some safe brands do exist.)
You may not even realize that most airlines' websites allow their customers to order special meals up to 24 hours before a flight. I make a habit of selecting my meal in this way, and have been generally satisfied with the results. Once, though, I ordered a "diabetic" meal, and received a plate of food loaded with fruit and junk snacks. I suppose they meant "a meal for those who want to become diabetic"!
On longer flights, or if you're headed for a nutcase republic with unknown food standards, pack some nuts or other sensible snacks in your carryon. A small amount of very rough German bread (the expensive stuff sold in the gourmet section) wouldn't hurt, as you'll need some fiber.
Disturbing Noises
As an MVPS sufferer and a determined engineer, I make a concerted effort to detect and understand the sources of in-flight sounds which spook me. Unfortunately, I must admit that I have yet to take a flight in which no plane-related sound is new to me. Planes are immensely complex electromechanical beasts, so you should always expect something new and disconcerting.
1. Jet throttling
Perhaps most disturbing noise on a plane is jet throttling. Yes, I know that the jets are loud and annoying. But any constant noise tends to be ignored by the brain, so it doesn't startle anyone. It's the throttling which can yield adrenaline bursts. You've reached cruising altitude, and are floating along in the breeze, when suddenly, you're pressed into the back of your seat, and the jet noise flares up. Or, worse, you're still climbing on full throttle, when the plane suddenly levels off, and the jet noise simultaneously dampens. It sounds like the engines have failed!
I doubt it. In the first case, while the pilot may already be at cruising altitude, he may want to climb a bit further in order to avoid rough weather that he sees on his radar. Or, he may have been assigned to a higher altitude by nearby air traffic control on the ground. Or he may simply be compensating for a previous loss in altitude due to similar reasons.
In the second case, yes, the jets are in fact throttling down. But that doesn't mean that they've stopped! Nevertheless, dependably, it still startles me when the plane stops accelerating and the jet noise dampens appreciably. At least, I understand why.
Actually, a pilot friend of mine told me that there are, in fact, everyday cases in which pilots essentially turn the jets off and glide. This is common during airport approach. After all, you can't land at 900 km/h! Nonetheless, the gliding alternates with bursts of jet power. You may have noticed this behavior during final approach.
The frequency of jet throttling during final approach is higher than at any other time during a flight, as the pilot must surgically adjust the plane's speed and heading in preparation for runway touchdown. At the same time, he must lower the flaps on the wings, and eventually, the landing gear. Both of these adjustments cause the plane to become less aerodynamic, resulting in greater turbulence. This is why final approach is almost always the most turbulent phase of a flight. In fact, I once landed in the outer bands of a hurricane in a 747, which was certainly the roughest approach I've ever experienced. To make matters worse, we were landing on an island whose geography invited wind gusts to begin with. All I can recommend is that you look at the ground if possible. As you slowly descend, you'll probably calm down.
Incidentally, modern planes are designed to tolerate the failure of one, and sometimes more, engines. My friend was once on board a plane, one of whose engines failed. They made an emergency landing safely.
2. Toilet flushing
No, this isn't the sound to which you are accustomed in your home. For some good engineering reasons, airplane toilets vacuum waste out of the bowl, rather than rely on water alone to drain it. If you're seated near a lavatory, you'll surely hear a loud and sudden vacuum sound, as though a hole has ripped into the side of the plane! But in a few seconds, the sound will cease. Learn this sound, then learn to ignore it.
3. Call button pings
This is the famous "ping" or "bong" sound heard multiple times throughout a flight. Although it's perfect for causing adrenaline spikes, all it means is that someone has pressed their flight attendant call button, likely as not, to request another beer.
4. Cracking sounds
Imagine: you're somewhere north of 30,000 feet, and the pilot comes on the speaker to ask you to fasten your seat belts because there's "15 minutes of rough weather ahead". No sooner do you comply, than the airplane drops several hundred feet in a few seconds! First, you lose your stomach as the plane drops. Then, as it finds more stable air and levels off, you're pushed into your seat. At the same time, you hear distinct cracking and popping noises, of the same sort that you heard when the airplane was taxiing for takeoff. It sounds like the plane is breaking up!
Well, the plane is changing shape. But this all part of its engineering. If you don't know, most of the structure and skin of a plane is made of titanium. Titanium is a metal with an astounding tolerance for distortion: it can be bent substantially, only to snap back into its original form when released. The same happens after an event such as the one above (called "hitting an air pocket"), and also when the plane accelerates or slows in the forward direction, resulting in small changes in its length.
Air pockets are no doubt the most disturbing aspect of plane travel. While rare, you might encounter a bad one from time to time. For certain, it will cause an adrenaline burst, but at least you'll be a bit more relaxed after the fact.
5. Wind sounds
I've noticed, routinely, that wind sounds can get much louder, or much quieter, without the jets throttling. Huge changes in volume can occur in seconds. Most likely, this is due to changes in wind direction as the plane flies. Logically, the sound perceived inside the cabin depends on the direction and speed of the wind outside. Relax. It happens.
6. Galley sounds
If you sit near the galley (kitchen), you'll hear clicking and banging at odd times. This is usually the crew manipulating meals and meal carts before and after passenger service. The worst sound, undoubtly, is the occasional careless flight attendant who uses excessive force to pound the meal cart into its stowage compartment.
Steep Turns
After takeoff, the pilot usually has to turn. After all, it's very unlikely that the runway just happens to be aligned with your destination! Get used to it.
Before landing, the same applies. Depending on the geography, the plane may need to make several complete circles around the airport during descent. Generally but not always, the pilot will slightly increase the throttle during these turns in order to obtain better control. So expect some acceleration, even though this is the decelerating part of the flight.
The other day, I was stuck in the air for about 15 minutes as the pilot circled, but did not descend. This often happens when he is waiting for landing clearance. As a rule, such events are more common around holidays, in addition to the usual airport madness at such times. Consider travelling during less insane and expensive periods.
While steep turns are never comfortable, you can inhale to reduce faintness. And it's always important to ensure adequate hydration in the dry plane cabin, which has the added benefit of helping you maintain sufficient blood pressure during such turns.
Turbulence and Air Pockets
While air pockets are rare but very frightening, remember that airplanes are designed to fly in very rough weather, and pilots have radar to help them avoid the roughest patches.
Turbulence is really no different than low-grade air pockets that occur hundreds or thousands of times during a flight. Most often, it occurs when the plane passes near or through a cloud. The different air densities cause the plane to accelerate or decelerate rapidly in a random direction. If the bump is sufficiently large, the pilot may cause more turbulence by turning the plane back the other way. It's not fun, but it's routine and safe.
Typically, bouts of turbulence last a few minutes, then subside. They can even occur during a full-power takeoff, as the jets push forward, but the wind may be blowing from the side.
However, exceptions exist. My worst turbulence episode (and one of my longest ever sustained adrenaline bouts) lasted about 3 hours. I was on a transoceanic flight, and the turbulence persistently pounded the plane. I wondered why the pilot did not simply turn off course for a short distance, and avoid the bad weather. When I returned home, I found the answer: we had been caught in a storm about 200km wide and 2400km long! At the time, I was oblivious to my MVPS condition, and suffered immensely. 3 hours of frequent shaking, with cracking noises at an altitude of several kilometers, is not my idea of fun! Still, I might as well have slept through it all, as I arrived safe and sound. Hats off to the aeronautical engineers!
If you're particularly disturbed by turbulence, then breathing exercises may help. You may also benefit by chatting about life with other passengers who seem to ignore the bumps. Likely as not, they're frequent travellers who understand that plane travel is very safe, frightening bumps notwithstanding.
Safety Statistics
I wish my physiology listened to my rational mind. But in this case, it often has a mind of its own. At least, then, I can sort of relax in the knowledge that flying is very safe, and that flight crew do it for a living. It doesn't help my stomach any, but it does allow me to fly, instead of spending vastly more time and money on international boat cruises! Still, if you can take the train, try it. You might see a new part of the world up close.
In recent years, various cities have enacted legislation intended to reduce airplane noise. While this is great for peaceful neighborhoods, it results in very steep takeoffs at full power. The idea is to "blast off" as steeply as possible in order to reach high altitude before jet noise can annoy residents living near the airport. Personally, I think that anyone who chooses to live near an airport knows what he's getting into, and should plan accordingly. But nonetheless, we have this policy in practice. McCoy Airport in Irvine, California is one example.
Having taken off from McCoy on numerous occasions, I experienced near-syncope repeatedly. At the time, I had not yet been diagnosed with MVP or MVPS, so I just assumed that all the other passengers must be experiencing the same, but just relaxing and not bothering to mention the severe dizzy feeling. I imagined that the pilot must be wearing "G-pants" characteristic of military pilots, which maintain blood pressure under high acceleration, and thus normal brain function. Little did I realize at the time, this problem was entirely my own. Now, at the very least, I try to drink some mineral water before takeoff in order to ensure adequate blood volume. (I don't drink so much that I drain the electrolytes out of my body.) I usually also take 100mg of magnesium glycinate, which may help my nerves and circulatory system deal with the impending stress, although I would classify this behavior as experimental. During particularly heavy acceleration, I inhale moderately in order to temporarily increase my blood pressure, and thus sustain my brain's oxygen supply.
Since the McCoy days, of course, I've learned about MVPS, and have made substantial efforts to improve my physiological reactions to the stresses of flight. Here are a few of my techniques:
Flight Schedule
Most of us tend to fly for a few hours at a time, rather than across oceans. In the former case, this allows us to select the flight time with substantial freedom.
I like to choose flights in the morning, or if unavailable, then late at night. I avoid afternoon and evening flights whenever economically feasible. The reason is that the sun heats the atmosphere, resulting in a higher probability of high winds in the afternoon, and to a lesser extent, the evening. Higher winds create greater turbulence, and thus a notably less pleasant flying experience. On the plus side, morning and late night flights tend to be cheaper.
Incidentally, on one occasion, I was flying out of a desert city on a perfectly clear day. But, against my advice, this was an afternoon flight, which meant that invisible hot air was convecting up from the desert floor into the atmosphere. About a minute into the flight, the plane was buffetted by a massive gust of wind, which forced us upward. Everyone shouted in terror. But nonetheless, the pilot was able to clear the rough patch in a few minutes. You should realize that the pilots and crew do their jobs every day, and are relatively unphased by events that you might find terrifying. And, if possible, fly in the morning or at night.
I actually prefer morning over night because I like to fly with very little in my stomach, and a minimal safe blood sugar level, as covered in the next section.
Diet Before and During Flight
The day before, I stop eating in the afternoon or evening. The morning of the flight, I get up, often before dawn, and grab a few handfuls of pecans or blanched almonds. I throw in a few steamed veggies for fiber, which matters when one is sitting for hours in cramped conditions. Critically, I eat no significant carb or sugar sources. Then, I eat nothing else until I'm on the flight, or if possible, until I land. This keeps me from being excessively hungry, but also thwarts my body's ability to push the adrenaline button in response to turbulence, etc. Just remember not to try any new foods immediately before a flight, as a plane is no place to discover that you're allergic to something.
During the flight, I try to stick to veggies. If you have low blood pressure, then salted peanuts may be OK as well, but as a rule they're loaded with pesticide and omega-6, and thus have no place in a healthy diet. (Ironically, organic peanuts can be even more dangerous on account of aflatoxin, but some safe brands do exist.)
You may not even realize that most airlines' websites allow their customers to order special meals up to 24 hours before a flight. I make a habit of selecting my meal in this way, and have been generally satisfied with the results. Once, though, I ordered a "diabetic" meal, and received a plate of food loaded with fruit and junk snacks. I suppose they meant "a meal for those who want to become diabetic"!
On longer flights, or if you're headed for a nutcase republic with unknown food standards, pack some nuts or other sensible snacks in your carryon. A small amount of very rough German bread (the expensive stuff sold in the gourmet section) wouldn't hurt, as you'll need some fiber.
Disturbing Noises
As an MVPS sufferer and a determined engineer, I make a concerted effort to detect and understand the sources of in-flight sounds which spook me. Unfortunately, I must admit that I have yet to take a flight in which no plane-related sound is new to me. Planes are immensely complex electromechanical beasts, so you should always expect something new and disconcerting.
1. Jet throttling
Perhaps most disturbing noise on a plane is jet throttling. Yes, I know that the jets are loud and annoying. But any constant noise tends to be ignored by the brain, so it doesn't startle anyone. It's the throttling which can yield adrenaline bursts. You've reached cruising altitude, and are floating along in the breeze, when suddenly, you're pressed into the back of your seat, and the jet noise flares up. Or, worse, you're still climbing on full throttle, when the plane suddenly levels off, and the jet noise simultaneously dampens. It sounds like the engines have failed!
I doubt it. In the first case, while the pilot may already be at cruising altitude, he may want to climb a bit further in order to avoid rough weather that he sees on his radar. Or, he may have been assigned to a higher altitude by nearby air traffic control on the ground. Or he may simply be compensating for a previous loss in altitude due to similar reasons.
In the second case, yes, the jets are in fact throttling down. But that doesn't mean that they've stopped! Nevertheless, dependably, it still startles me when the plane stops accelerating and the jet noise dampens appreciably. At least, I understand why.
Actually, a pilot friend of mine told me that there are, in fact, everyday cases in which pilots essentially turn the jets off and glide. This is common during airport approach. After all, you can't land at 900 km/h! Nonetheless, the gliding alternates with bursts of jet power. You may have noticed this behavior during final approach.
The frequency of jet throttling during final approach is higher than at any other time during a flight, as the pilot must surgically adjust the plane's speed and heading in preparation for runway touchdown. At the same time, he must lower the flaps on the wings, and eventually, the landing gear. Both of these adjustments cause the plane to become less aerodynamic, resulting in greater turbulence. This is why final approach is almost always the most turbulent phase of a flight. In fact, I once landed in the outer bands of a hurricane in a 747, which was certainly the roughest approach I've ever experienced. To make matters worse, we were landing on an island whose geography invited wind gusts to begin with. All I can recommend is that you look at the ground if possible. As you slowly descend, you'll probably calm down.
Incidentally, modern planes are designed to tolerate the failure of one, and sometimes more, engines. My friend was once on board a plane, one of whose engines failed. They made an emergency landing safely.
2. Toilet flushing
No, this isn't the sound to which you are accustomed in your home. For some good engineering reasons, airplane toilets vacuum waste out of the bowl, rather than rely on water alone to drain it. If you're seated near a lavatory, you'll surely hear a loud and sudden vacuum sound, as though a hole has ripped into the side of the plane! But in a few seconds, the sound will cease. Learn this sound, then learn to ignore it.
3. Call button pings
This is the famous "ping" or "bong" sound heard multiple times throughout a flight. Although it's perfect for causing adrenaline spikes, all it means is that someone has pressed their flight attendant call button, likely as not, to request another beer.
4. Cracking sounds
Imagine: you're somewhere north of 30,000 feet, and the pilot comes on the speaker to ask you to fasten your seat belts because there's "15 minutes of rough weather ahead". No sooner do you comply, than the airplane drops several hundred feet in a few seconds! First, you lose your stomach as the plane drops. Then, as it finds more stable air and levels off, you're pushed into your seat. At the same time, you hear distinct cracking and popping noises, of the same sort that you heard when the airplane was taxiing for takeoff. It sounds like the plane is breaking up!
Well, the plane is changing shape. But this all part of its engineering. If you don't know, most of the structure and skin of a plane is made of titanium. Titanium is a metal with an astounding tolerance for distortion: it can be bent substantially, only to snap back into its original form when released. The same happens after an event such as the one above (called "hitting an air pocket"), and also when the plane accelerates or slows in the forward direction, resulting in small changes in its length.
Air pockets are no doubt the most disturbing aspect of plane travel. While rare, you might encounter a bad one from time to time. For certain, it will cause an adrenaline burst, but at least you'll be a bit more relaxed after the fact.
5. Wind sounds
I've noticed, routinely, that wind sounds can get much louder, or much quieter, without the jets throttling. Huge changes in volume can occur in seconds. Most likely, this is due to changes in wind direction as the plane flies. Logically, the sound perceived inside the cabin depends on the direction and speed of the wind outside. Relax. It happens.
6. Galley sounds
If you sit near the galley (kitchen), you'll hear clicking and banging at odd times. This is usually the crew manipulating meals and meal carts before and after passenger service. The worst sound, undoubtly, is the occasional careless flight attendant who uses excessive force to pound the meal cart into its stowage compartment.
Steep Turns
After takeoff, the pilot usually has to turn. After all, it's very unlikely that the runway just happens to be aligned with your destination! Get used to it.
Before landing, the same applies. Depending on the geography, the plane may need to make several complete circles around the airport during descent. Generally but not always, the pilot will slightly increase the throttle during these turns in order to obtain better control. So expect some acceleration, even though this is the decelerating part of the flight.
The other day, I was stuck in the air for about 15 minutes as the pilot circled, but did not descend. This often happens when he is waiting for landing clearance. As a rule, such events are more common around holidays, in addition to the usual airport madness at such times. Consider travelling during less insane and expensive periods.
While steep turns are never comfortable, you can inhale to reduce faintness. And it's always important to ensure adequate hydration in the dry plane cabin, which has the added benefit of helping you maintain sufficient blood pressure during such turns.
Turbulence and Air Pockets
While air pockets are rare but very frightening, remember that airplanes are designed to fly in very rough weather, and pilots have radar to help them avoid the roughest patches.
Turbulence is really no different than low-grade air pockets that occur hundreds or thousands of times during a flight. Most often, it occurs when the plane passes near or through a cloud. The different air densities cause the plane to accelerate or decelerate rapidly in a random direction. If the bump is sufficiently large, the pilot may cause more turbulence by turning the plane back the other way. It's not fun, but it's routine and safe.
Typically, bouts of turbulence last a few minutes, then subside. They can even occur during a full-power takeoff, as the jets push forward, but the wind may be blowing from the side.
However, exceptions exist. My worst turbulence episode (and one of my longest ever sustained adrenaline bouts) lasted about 3 hours. I was on a transoceanic flight, and the turbulence persistently pounded the plane. I wondered why the pilot did not simply turn off course for a short distance, and avoid the bad weather. When I returned home, I found the answer: we had been caught in a storm about 200km wide and 2400km long! At the time, I was oblivious to my MVPS condition, and suffered immensely. 3 hours of frequent shaking, with cracking noises at an altitude of several kilometers, is not my idea of fun! Still, I might as well have slept through it all, as I arrived safe and sound. Hats off to the aeronautical engineers!
If you're particularly disturbed by turbulence, then breathing exercises may help. You may also benefit by chatting about life with other passengers who seem to ignore the bumps. Likely as not, they're frequent travellers who understand that plane travel is very safe, frightening bumps notwithstanding.
Safety Statistics
I wish my physiology listened to my rational mind. But in this case, it often has a mind of its own. At least, then, I can sort of relax in the knowledge that flying is very safe, and that flight crew do it for a living. It doesn't help my stomach any, but it does allow me to fly, instead of spending vastly more time and money on international boat cruises! Still, if you can take the train, try it. You might see a new part of the world up close.
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