Friday, January 29, 2010

Red Wine and Mitral Valve Prolapse

Every month or so, I have a look at my blog statistics, which tell me which keywords people use to find me. Occasionally, the keywords themselves suggest new insights into the MVP(S) phenomena which I had never considered, particularly when I see multiple occurrences of similar word combinations at different times. Today, I found these three entries relating wine to MVP, which accounted for about 6% of this month's traffic from Google queries -- statistically significant, considering that any food might be suspected of causing PVCs, particularly those (unlike red wine) which most people associate with heart disease. Have a look:

1. what is the effect of wine on mitro valve prolapse?

2. wine chemicals mitral valve prolapse

3. "red wine" +"premature ventricular contractions" pizza

In the last case, I would bet that it was the cheese on the pizza. But taken as a whole, these queries suggest that there may be an association between wine and MVP. Even if such an association exists, it might not be causal, i.e. perhaps wine and cheese are indeed commonly consumed together, so people erroneously suspect that the wine is to blame for PVCs, when in fact the cheese is causing the problem (as discussed in previous posts). But then again, maybe not. Maybe the alcohol content in wine results in mild dehydration, promoting small blood volume changes or excessive water consumption that may result in PVCs.

Granted, I'm presuming that the first two queries were entered by people who had noticed a spike in their MVP activity (most commonly, PVCs or the associated head spins). But perhaps there was some other reason for these two. Still, it suggests an association between MVP and wine.

Incidentally, red wine appears to contain several compounds conducive to heart health. Ethanol is somewhat debatable in this regard: On the one hand, it dilates blood vessels, reducing the probability of arterial blockage. On the other, it's frankly a poison which the liver must work to neutralize. It may also serve to amplify the rate of absorption of the beneficial compounds, which are probably more soluble in aqueous ethanol than pure water. And while you could get all the same good compounds from grape juice, you'd also get plenty of fructose, which in my opinion is highly undesirable. For my part, I just pour the contents of a grape extract capsule (from Life Extension Foundation, with whom I have no affiliation) into water, and dissolve them. The result is cold grape skin tea -- not delicious, but an acquired taste, and probably a healthier way to obtain grape compounds than either wine or water.

Anyhow, I doubt that wine in moderation causes PVCs, but the queries are noteworthy. Looking at the very different query styles exhibited above, it appears that they were entered by three different people. So researchers, you might want to keep this in mind for your next study on MVP agonists...

Friday, October 30, 2009

The Art of Hydration, Part 2

As I discussed in The Art of Hydration, good hydration is particularly important for MVPS sufferers. But the catch is that, conventionally, sugar is an essential component.

Sugar intake causes your insulin level to rise temporarily, which in turn signals your cell membranes to open up in order to imbibe the sugar. When this occurs, it's possible to sneak water-soluble nutrients into through the membranes as well. That's why we feel hydrated by fruit with water.

I have no problem with this hydration methodology, in principle. As long as one uses berries for hydration, or exercises sufficiently after eating some other fruit, the temporary rise in blood sugar won't have much impact on longterm health. I would also add that flossing and brushing are critical, shortly after the fact.

But wouldn't it be nice if we could hydrate without sugar at all? In principle, a vitamin pill taken with water accomplishes this feat. But vitamin pills are loaded with excessive iron and manganese, and intuitively it can't be a great idea to subject sections of your digestive tract to ultrahigh mineral salt concentrations. And without sugar, your cells will be less interested in admitting the nutrients. What we need is a fat-soluble vitamin pill that can effuse through the cell membrane -- mostly fat itself -- without requiring the havoc induced by insulin.

Such a pill is the holy grail of low-carb dieters. It means that we can avoid the hazards of sugar, yet fully nourish our cells by feeding them nutrients bound to fat-soluble molecules. The lack of such a pill has been the reason why I've worked so hard to figure out how to hydrate with fruit, in such a manner as to minimize the impact on diabetes and gingivitis. It can be done, but it is, truly, an art.

Recently, however, I found that there is a fat-soluble multivitamin already on the market. I just happened to run across it during my compulsive browsing of nutrition literature. It's called a "sardine"!

That's right, sardines are loaded with nutrients too numerous to mention. Have a look at this data from Nutrition Data. All with zero carbs.

They are also one of the few low-mercury fish, according to Got Mercury. Note that the region in which they're caught also matters, with Norwegian brisling being some of the cleanest on the planet. This is due to their low position on the food chain, and the pristine waters in which they are caught. (You can't avoid methyl mercury in fish entirely. It has permanently entered the food chain, thanks to centuries of coal burning.) My favorite brand, with exceptional processing hygiene and delicious flavor, is King Oscar. The taste is slightly smokey, which probably means that they've been lightly smoked. But I don't worry about such low concentrations of carcinogens, in light of the extraordinary nutrient density. For the paranoid, you can eat them with 300mg of alpha lipoic acid, which loves to bind with free radicals and presumably heavy metals. And -- why not -- some tumeric to add an Indian flair and protect your colon from cancer.

When I eat these particular sardines, which I enjoy with steamed organic spinach and organic shiitake mushrooms, my hunger ceases about 10 minutes later and stays down for hours. It's like my body is saying: "Thanks for the nutritional bounty. I'm loaded." Even when I eat healthy nuts, my hunger takes much longer to shut down. Therefore, I suspect that it's the nutrient diversity, and not merely the amount of any particular one, which accounts for such thorough satiation. Indeed, I like the taste so much that I often crave another can. But for the most part, I just can bring myself to eat more. I'm full.

Now, you may notice that sardines are loaded with cholesterol. "What a shame," you say. I'm not worried in the slightest. Why? Because it would appear that the cause of cardiovascular disease is, among other hazards, oxidized deposits of cholesterol-rich plaque on the artery walls, as opposed to cholesterol in and of itself. The best way to oxidize your cholesterol is to smoke and eat sugar. After all, how could the Okinawan islanders of Japan live well into their eighties, despite eating high-cholesterol seafood in such high quantities? And why aren't French cheese connoisseurs dropping dead in droves? For an exceptionally high quality analysis of the available data, and some other great superfoods, visit Cholesterol and Health.

Take care. I'm gonna have an egg. Meanwhile, take a moment to radically improve your cardiovascular health by learning about vitamin K2, which is found in high concentrations in some cholesterol-rich foods, and prevents arterial calcification that can kill you!

When a Panic Attack, Isn't

A couple weeks ago, I managed to get a fever, which is rare for me. It spiked to 38.3C, whereas my normal is 36.0C. But I didn't bother going to the doctor because it appeared to be a typical seasonal flu. Instead, I stayed home and did the usual things necessary to deal with it.

My temperature slowly started to return to normal. But then, I awakened in the middle of the night with a tight chest and labored breathing. I thought it might be due to the almonds I'd eaten, to which I'm mildly allergic, but hopelessly addicted (which is only possible because I balance their high omega-6 fat content with sufficient omega-3 from other foods).

Whatever the cause might have been, the effect persisted, and I decided that I needed to see a doctor promptly, in case I was coming down with aggressive pneumonia or who-knows-what. It was about 5am, so I called a cab.

Now, a year ago, I had bought a great little pulse oximeter from Nonin Medical. It shows my blood oxygen saturation percentage, and heart rate. The reason was that I have sleep apnea, but sometimes I prefer to sleep without the aid of a CPAP. In that case, I want an alarm to awaken me if my oxygen drops to an unacceptably low level, which for my preference is 91%. So I simply put the laser clamp on my finger, and go to sleep. It has worked quite well, saving me from mild hypoxia on a number of occasions. Although, I do wonder whether it would actually extend life, as I get quite an adrenaline spike when the way-too-loud alert goes off in the middle of a night, which could in principle cause a stroke when lying down.

Back to the taxi. I brought my Nonin along in order to determine whether my groggy state was due to "fever insanity" or hypoxia. Unfortunately, I had dumped the batteries prior to my last plane trip, in order to ensure that the device would not pose any overheating danger while sitting in my luggage. So I had the cab stop at a convenience store. I picked up some batteries, and started monitoring myself.

I noticed that my heart rate was elevated, around 100bpm. (My normal baseline is 48bpm, up from 38bpm a few years ago, when I was doing 134 floors on the stairmaster in 20 minutes.) I figured it was just nervousness, and ignored it. The important thing was that my oxygen was 98% (my new normal, thanks to air pollution or perhaps a chronic mild lung infection, down from 99% a year ago, back in the USA).

When I got to the hospital, after relaxing in the waiting room a few minutes, they took my vital stats. My heart rate had fallen to 91bpm, which the nurse said was "normal". I looked at her, puzzled. I said my baseline was 48bpm. She asked if I was an athlete, and I said yes (albeit much less so than before my MVPS days). I was a bit nervous, but not excessively so, which made me wonder why my heart rate was so high. Maybe I was having a panic attack without being aware of it; I wondered how that could possibly work.

Finally, I got in to see the doctor. I asked him about the heart rate, and he explained that it was a normal consequence of my illness. Apparently, it's a defensive response to infection, just like elevated body temperature. He explained that it would remain elevated until I returned to normal temperature. That is, in fact, what happened.

So just because you're experiencing shortness of breath with a rapid heart rate, does not mean that you're having a panic attack. If you can manage to calm yourself, and the symptoms persist, it's probably something else, such as the flu. I learn something new everyday!

Saturday, September 5, 2009

Gingivitis, Periodontitis, Infective Endocarditis, and MVP

As anyone with MVP should know, infective endocarditis is a serious threat to heart valve health. It can occur when bacteria adhere to the leaflets, cemented in place by platlets, fibrin, and other material from one's own circulatory system. For mechanical reasons no doubt related to the fluid dynamics of the valve, it's evidently difficult for out macrophages (white blood cells) to locate and destroy such deposits. The longterm result can be premature valve decomposition, potentially requiring repair or replacement.

Historically, the American Heart Association (AHA) recommend prophylactic antibiotics for anyone with MVP, to be delivered prior to dental surgery or even cleaning. The theory was that such treatment would preemptively inhibit bacterial infection as a result of septic dental plaque seeping into the bloodstream. Although the theory may have been correct, the AHA recently concluded that the risk inherent in taking antibiotics actually exceeded the risk eliminated by preventing this very isolated, rare source of endocarditis. Antibiotic overuse runs of risk of resistant bacterial infection, liver stress, and the destruction of one's beneficial gut bacteria which serve as part of our digestive and immune systems.

Furthermore, the AHA concluded that "daily activities", taken in the aggregate, constitute a greater risk than occasional dental procedures. No doubt this includes flossing, which as we all know, produces bleeding gums for those of us with gingivitis (gum inflammation) and periodontitis (gum disease). They have since issued a revised recommendation.

Until a couple months ago, I had been fighting gingivitis and losing the battle. Now, I produce only faint amounts of blood when I brush and floss, well within acceptable safety limits. I'd like to tell you how I won the war.

Earlier this summer, I was producing oral blood flows lasting up to 30 minutes after the fact. This is not only a bacterial hazard. At some point, it constitutes a blood loss hazard. Indeed, recent blood tests indicated that my red blood cells were disproportionately young. In other words, my body was struggling to compensate for the blood I was losing orally. It got so bad that at one point, my gums would open and bleed in my sleep, probably due to the dry air in my bedroom. In the morning, I'd awaken with the familiar alkaline taste in my mouth, as blood has an alkaline pH of 7.4. I'd spit up telltale reddish yellow fluid, left to wonder just how much I'd leaked. Yikes!

The first step was to use Metrogyl, a topical oral antibiotic whose active ingredient is metronidazole. You can get this, or a superior alternative product, from your dentist. I just rubbed it on my gums and swished it between my teeth, then spat it out, before eating each meal. After a week of use, my bleeding level had subsided, but it still wasn't what I'd call safe. I was getting worried, particularly on account of the unflattering blood tests mentioned above.

I stopped after the recommended one-week course, as I didn't want to invite the longterm problems of antibiotic use. At this point, I decided to experiment with changes in dental and nutritional habits.

The first change I made was to floss every day, whereas in the past I had been sloppy about my flossing habits, particularly on days when I didn't eat much, or just ate vegetables. Now, I floss once a day, no matter what. I rinse my mouth with purified water after the fact, in order to get the junk out. I also don't brush when my gums are bleeding, as there's all sorts of nasty stuff in toothpaste, possibly including bacteria, that I don't want in my blood. Therefore, these activities are separated by a healing period of an hour or more. And perhaps it's better to brush first.

And when I floss, I make sure to get into both little pockets at the base of neighboring teeth. (Your teeth are curved inward where they meet the gums, creating a pocket on each side of the tooth.) So I go up and down at least twice for every gap that I floss. I'm not particularly gentle, either, as I've heard numerous dentists recommend that we allow our gums to toughen, probably due to the formation of scar tissue at a microscopic level.

While no longer necessary, during my heavy bleeding periods, I would swish concentrated salt water between my teeth before and after flossing and brushing, in order to keep bacteria to a minimum. You can experiment with the salinity; I was using about a teaspoon in 4 ounces of water, which is extreme. You can also gargle salt water to cut down the bacterial population in your throat, which no doubt feeds your gingivitis, to some extent. But don't swallow, and reduce the salinity if you can't do it without gagging.

One other dental tip: I'm careful not to brush my gums crosswise, which causes them to recede, exposing the boney roots of the teeth. I brush firmly in little circles, taking care to push up or down against the gumline -- never sideways.

The second change, to which I attribute most of my success, was dietary. Surprise, surprise, when I cut out sugar (including fruit, except for avocados and tomatoes), the gingivitis stopped within days. If I eat so much as a slice of watermelon, it comes back the same day. So now, despite my love of dragon fruit as I explained in an earlier post, I've switched to tomatoes as my source of quick energy and hydration. Even then, I only eat them when I feel dehydrated, or need fast energy for impending physical labor.

But I cut something else that most people don't consider junk food: dairy. Now, the only dairy product I eat is butter. Yes, it's high-cholesterol, high-saturated-fat food. But it satisfies (meaning that it prevents me from overeating), and is nonglycemic. You see, I found that drinking milk would always result in bad breath the following morning, aparently due to its sugar content. Cheese causes less of a problem, but still contains damaged milk protein due to pasteurization, which stimulates an invalid immune response because your body mistakes the protein for pathogens, resulting in increased systemic inflammation, which certainly won't ameliorate gingivitis. If you haven't heard of this, Google for the problems of dairy. You'd be better off not consuming this stuff, except perhaps for unpasteurized milk, which has its own hazards.

Of course, this leaves me with a calcium, magnesium, phorphorus, and vitamin D debt. (Protein is easily aquired from other sources.) But primitive humans didn't have milk (except as babies) or cheese, and survived just fine. So I get my calcium from brocolli (and to large extent, vitamin pills and Tums calcium tablets, both crushed and mixed with food so as to minimize the negative digestive impact); I get my magnesium from nuts; I get my phosphorus from pumpkin and sunflower seeds; I get my vitamin D from the sun and oral supplementation. I wish I had a better calcium source. Maybe I'll start taking chlorella. I'd rather not chew on fish bones, which might carry mad cow proteins, particularly if they're from farmed sources.

I also increased my uptake of brocolli and avocados, for their vitamin K content. Vitamin K helps the blood clot. If you can get it, parsley is the ultimate vitamin K source, but in most places, it's loaded with pesticide. Good for you if you can find the organic stuff.

Additionally, I started supplementing zinc, although I don't think this did much for my gingivitis, as I increased my intake weeks after it had already improved. Zinc is involved in the skin healing process. Be careful, though, as it's possible to overdose easily, as discussed in the Wikipedia article linked above. On the other hand, it's also very hard to acquire, as the best sources are bivalves like clams and mussels, which are often heavily polluted because they filter the water in their environment. I opt for zinc picolinate capsules, which are easily obtained at GNC or online. I pour the powder out and mix it with my food. As I've said in previous posts, I don't believe in "spike supplementation", i.e. giving the body massive, highly bioavailable injections of nutrients in the form of pills.

I made one other dietary change which won't apply to most of you. You see, my diet is so healthy, that my blood takes a long time to clot. (This is desirable because it reduces the probability of heart attack, stroke, and veinous thromboembolism.) The problem, clearly, is that at a certain point, my blood is so "thin" that my gingivitis refuses to heal up. And certainly, I need to discuss this with my doctor prior to any surgery. It also doesn't help if I get banged up in an accident! The change was this: in addition to increasing vitamin K intake, I cut back on grape extract and olive oil, both of which I love to consume, but which suppress plasma clotting factors, and thus platelet aggregation at the site of a wound. In parallel, I decreased my omega 3 intake, and increased omega 6, resulting in an increased clotting tendency. After my gingivitis subsided, largely due to my low-sugar diet, I increased my intake of these generally beneficial substances once again, to the maximum possible level short of inducing gingivitis. (I still moderate my olive oil intake, as it tends to dehydrate me, despite its benefits.) Indeed, most people in the industrialized world suffer from blood which clots too readily, so these measures probably do not apply to you (except perhaps for a week or so while attempting to close your gum wounds more rapidly, while you decrease sugar intake or apply topical antibiotics).

On the rare occasion that I need fruit, I floss and brush immediately afterward. Needless to say, this reduces my appreciation of the fruit to begin with, so I only do it when I need a massive burst of energy.

By the way, watch out for hidden sugar sources, such as the infamous high fructose corn syrup found in everything from ketchup to "healthy" wholegrain bread. Craving carbs? Have a bowl of lentils, spiced and buttered to taste!

By following these steps to combat your risk of infective endocarditis, you'll improve your health generally, and no doubt save money on dental work. To your health!

Thursday, May 21, 2009

Might MVPS Originate with Sleep Apnea?

As I speculated in this posting, MVPS and sleep apnea may reinforce one another. But when I recently discovered this report from 2005 by David L. Detrick, M.D. of the High Desert Sleep Disorders Center, I started to question whether, in fact, MVPS is the visible manifestation of sleep apnea on the sympathetic nervous system.

It's not the most readable document for the lay person, but anyone with basic physiology education will understand from the numbers and charts that, in fact, MVPS has substantial overlap with the neurological symptoms of sleep apnea. Granted, sleep apnea is primarily due to physiological impairments which affect proper breathing during sleep. However, as the report illustrates in substantial detail, the resulting intermittent hypoxia induces increased sympathetic nervous system function -- not merely related to individual hypoxic episodes, but increasingly persistent into daytime physiological stress metrics, including blood pressure, oxidative stress, and hormone levels.

Granted, not all MVP sufferers have MVPS. But for those who have the latter, I would highly recommend a sleep study in order to look for sleep apnea. (Because it is a diagnostic procedure like an xray, you insurance may cover most or all of the cost.) Sleep apnea is a stealth disease, in the sense that it may result in few detectable symptoms early on. It's also very treatable, with or without surgery. But when ignored, it's a serious risk factor for cardiovascular disease, stroke, and accidental death due to impaired alertness.

I definitely believe that MVP and sleep apnea are separate diseases with different causes. But when they coexist in a patient (which I suspect occurs more than randomness would dictate, on account of their mutual reinforcement as detailed in my earlier post), then the latter may produce the physiological syndrome which we know as MVPS. In the absence of MVP, the syndrome is simply regarded as the physiological side effects of sleep apnea.

My original thinking was that MVPS and MVP are parallel results of a single set of genetic errors. But, to summarize, I now suspect that MVPS may be the result of sleep apnea. We only think of it as being directly related to MVP because -- I suspect -- that MVP is coincident with sleep apnea more than randomness would dictate.

Some experiments would need to determine whether (1) to what extent MVPS sufferers have sleep apnea, vs. control and (2) to what extent MVPS symptoms subside pursuant to a few months of CPAP use. (A CPAP is a respiratory assistance device for the treatment of sleep apnea.)

If I'm completely wrong, then hopefully I will at least save a few lives by encouraging people to detect and treat sleep apnea before they suffer a stroke or heart attack.

Tuesday, April 7, 2009

A Brief Warning About Magnesium Supplements

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.

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.