Monday 5 December 2016

Dealing with jet lag and problematic warts

Published 19/04/2016 | 02:30

Dr Nina Byrnes
Dr Nina Byrnes

Our GP on what you can do to ease jet leg and on the treatments available to remove a veruca.

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Question: I have started a new job that involves frequent travel to the west coast of the USA. I have been experiencing severe jet lag each time I return home. Help!

Dr Nina replies: Jet lag occurs when our body clock is working in one time zone when we are physically in another. It occurs when we travel either east or west. Northern and southern travel don't involve time changes and so don't result in jet lag. Jet lag is worst when travelling east to west, across more than three time zones because we lose time.

Our body clocks follow a specific 24 hour rhythm. This affects our alertness, bowel motions, body temperature, blood pressure and sleep patterns. The hypothalamus in the brain triggers many of the hormonal changes that occur on a 24 hour basis but it may take several days to catch up with a change in time zones.

Fatigue is the most common symptom of jet lag but it can also result in altered bowel movements, headaches, poor concentration, dizziness and mood changes. Typically, the body clock adjusts at about two time zones per day.

It may be impossible to eliminate all jet lag but preparing for it can help. If your trip lasts less than four days, try to stay on your home time zone for the duration of the time away. This may mean getting up and going to sleep early when travelling west but it can work very well.

For longer trips try and adjust your routine to the future time zone slowly by adjusting sleep time by an hour a day a few days to a week before flying.

Keep flying as comfortable and stress-free as possible. Wear comfortable loose clothes and drink plenty of water. Don't drink alcohol or caffeine on the flight. Avoid working or watching too much TV on the plane and even if you can't sleep, try to rest throughout the flight.

Eat light meals that are easy to digest. Don't take sleeping tablets as these increase your risk of developing a clot in the leg or the lung because they will prevent you from moving your legs during the flight.

When you arrive home try to stay awake that day and go to bed at a normal time that evening. Get out in daylight, especially in the afternoon if travelling east.

Eat your meals according to local time and set your alarm to get up at a normal time the next day, even if you haven't slept well. Sleeping in will just prolong your symptoms. Melatonin is a hormone that the body naturally produces at night. Synthetic melatonin is available over the counter in the USA and on prescription here.

Doses of between 0.3mg and 5mg taken before bedtime in the new time zone may help, although studies have shown mixed benefits. This should only be taken under medical advice as it may not suit everyone and can interact with some medication.

Jet lag travelling west doesn't cause as many problems as going east. When you get to your destination try to stay awake until the local evening time and then try to get up an hour later each subsequent morning. Getting outside as much as possible will help. The brain's sleep-wake cycle is highly sensitive to exposure to natural light and dark. Remember fatigue can slow your thinking and reaction time, similar to drinking.

Question: My son has a verruca on his foot that has been there for a while. It doesn't seem to be bothering him. Do I need to do something about this or will it go away on its own?

Dr Nina replies: Verrucae are warts occurring on the soles of the feet. They can be more problematic than other warts as the weight of the body tends to push them into the skin, making them a little harder to treat.

Most people develop warts at some stage and they are thought to occur in about one in 10 people at any given time. They don't do any harm and most will resolve themselves over two years, but they can be unsightly and bothersome.

You should not pick, bite or peel a wart. This increases the chance of spreading the virus to your hands or other parts of your feet. Verrucae can be contagious in open wet areas so it is worth wearing special shoes or covering it in public or shared areas such as showers and pools.

Applying duct tape can be an effective treatment. Apply the tape. Leave it for six days. Take it off. File the skin then leave it off over night and reapply the next day. Over the counter products containing salicylic acid are an option. This needs to be applied every 24 hours and the dead skin filed off each day before reapplying. Your GP may be able to freeze the wart.

This is called cryotherapy. Liquid nitrogen is sprayed from a short distance on to the verrucae until a frozen halo appears. It may take several treatments to fully treat the verrucae. Complications include blistering, scarring or changes in skin pigmentation and feeling.

When deciding what, if any, treatment to use it is important to consider the side effects and consequences. Cryotherapy can be painful and wouldn't be the first choice in young children. Watching and waiting is also a reasonable option if the verrucae are small or superficial.

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