My employer ruptured his eardrum last weekend and is scheduled for a flight this coming Saturday for business - can he fly with a ruptured eardrum?
Dr Jules Eden replies: He can fly with this problem. Because the drum has a hole in it, the air that expands as the plane goes up freely moves out of the middle ear through the new hole. Likewise on descent, air will be pulled in through the perforation so equalising the ear. After a drum rupture, it can take any length of time to heal, depending on how big the rupture is and any superseding infection - from a week to many months. To prevent infection, he must keep it dry, so no swimming or diving, and when in the shower a wax plug is useful to prevent water from dripping in.
We are booked to go to Morocco next month for two weeks, and I have just found out that I am pregnant. Are there any precautions I should take when travelling, and are there any particular health risks to pregnant women in North Africa?
When you go to Morocco, you will be in the first trimester of pregnancy. This is the period of the first third of foetal development, and a time when there is most risk. Take steps to ensure that you do not contract food poisoning. So it is a good idea to avoid any soft cheeses, soft eggs or egg whites. You must make sure you are rubella immune, too. And drink at least three litres of fluid a day to avoid dehydration.
Do you have any tips for avoiding jetlag. It ruined the first week of my last trip to Bali, and I don't think I can face the tiredness again.
Jetlag is simple really: every 15 degrees of longitude is one hour. Fly to and from the US and you gain or lose five or more hours. Add this to the real time of the flight and up to 13 hours can be the difference. But when you fly west and gain time, it is easier to cope with this difference. Simply stay up as late as possible, hit the sack and set your alarm for local time in the morning and you will be fine in a day.
Going east is harder, because with fitful sleep on a plane, you can lose a night's kip, leaving you shattered on arrival. So here's my tip: on departure, set your watch for local arrival time. Think what you should be doing if that were the time of day at home. Would you be asleep or active? Active is easy, sit in your seat and wiggle your toes. Sleeping is harder: if you can't drop off naturally, try a sleeping tablet such as Zopiclone.
Dehydration can worsen jetlag, so keep a steady input of fluids when not asleep. A litre every couple of hours should do the trick and help stave off Economy Class DVTs, too.
· If you have any questions you want to ask Dr Jules Eden, email travel.doctor@theguardian.com, or write to The Flying Doctor, The Guardian, 119 Farringdon Road, London EC1 3ER.
