I’ve got two beautiful boys, and we are very close. I can’t help but to hug and kiss them all the time. This past week, though, I shouldn’t have. Both of my kids were out of commission with some kind of virus, coughing, fever, sore throats. Inevitably, I have caught the same thing, but rather than sleep it off in bed I’m on a long plane flight to Italy. It can’t all be sunny beaches and Prosecco.

Illness on a flight is nothing new. I’ve traveled on transatlantic flights with the flu, migraines, broken toes, massively pregnant, and possibly the worst, once with a bladder infection. I actually passed out on a flight some years ago–it was full of elderly French people and the cigarette/body aromas overwhelmed me, sending me face down on the floor.

Flights are uncomfortable on a good day, but miserable while sick. I am in coping mode today and thought I’d share my strategies for dealing with being sick on a plane.

I must preface this by saying that I’m giving you advice from my many years of personal tour guide experiences. I’m no doctor, I actually fainted at the sight of blood during biology in high school and have no talent for the medical sciences. Take my advice with a grain of salt, at your own risk. There is nothing scientific about any of this, just my personal observations.

Here are some symptoms, with strategies to deal with them.

Symptom: Stomache Ache and Nausea

Getting car sick or plane sick happens to everyone. It can be caused by lots of different things, sometimes nothing obvious, often by plane food. Don’t even think of researching the occurrence of food-borne illness on airplanes– you’ll never eat airplane food again. If you’re feeling barfy on a plane, ask for Ginger Ale when the drinks cart comes by. Ginger is soothing to the belly and the fizz will help relieve pressure in your stomach. If you’re frequently queasy in flight, bring some ginger candy to suck on. Any fizzy drink will help if there’s no Ginger Ale to be had.

The other, easiest strategy is to open up the plane’s air vents all the way and point the blowing air at your face. There is, in my observation, a link between motion sickness and over heating. I’ve noticed my tour members are less likely to have motion sickness on the bus if I keep the temperature on the chilly side and the air circulating. Take off your jacket, cool down and get some air.

Symptom: Dizzyness, lightheaded, seeing sparkles, nausea leading to a blackout

This is most likely a lack of blood to your head. When we sit on planes, blood pools in our legs, not recirculating as freely as it does when we are in motion. This is particularly bad in women over 40 who have had kids, or so my doctor once told me.

I have this problem often on long plane rides, but it’s easy to fix. For a minor case, get up and walk around frequently, lifting your knees high. The goal is to get that blood back to the heart, so lifting your legs over your heart is ideal. If you’re feeling very faint, go find a space to lay on the floor and prop your legs up a wall. I know, airplane floors are small and usually a teeming cesspool, but fainting is worse. If you feel faint, it’s ok to go into the galley or anywhere there is room and lift your legs. The airplane crew would rather let you raise your legs than get out the oxygen bottle…or so they told me once when I fainted.

Symptom: Twitchy legs

Similar to the symptom above, rather than feeling faint, some people get twitching or cramping in their legs on a long flight. In this case, walking can help, but the muscles may need more action.

For calves: stand up, then go up and down on your toes, really clenching the muscles as you do it. You can do this seated as well, just alternate pointing your toes.

For thighs: if you can find a wall, a good technique is to do a “wall sit”. With your back to the wall, slide down to a sitting position and hold it for a few seconds, then repeat. If there isn’t any wall space, while seated, try squeezing your thighs together or rock your knees back and forth towards the seat in front of you (if there’s space).

If you’re an active person, go for a workout before you head to the airport. I like to try and get a run in before making flights, my legs are happy for the rest on the plane.

Symptom: Head pressure, ears won’t pop

You can tell who is suffering from cabin pressure, it’s all the kids screaming on take-off and landing. They have reason to scream, cabin pressure can be excruciating if you can’t pop your ears. It’s happened to me a couple of times, most recently today as I’m nursing an ear infection. There are several strategies that can work.

Gum: Chewing naturally helps our ears pop by moving the jaw and by making us salavate and swallow. I like super spicy cinnamon gum for this, it clears the sinuses too.

Meds: Benadryl is the easiest way to preempt a pressure problem, and as a bonus, it makes you sleepy. The down side is that you have to take it in advance. A more immediate solution is to have a Vapor Inhaler on hand. That was my magic trick today. Clearing out nasal passages, even if they don’t seem to be blocked, will clear out ears too.

Earplugs: For those who are chronically bothered by the cabin pressure issue, special earplugs called Earplanes allow the pressure to level on its own.

Hot Towels: If you’ve got a serious pressure problem and haven’t brought anything to deal with it, you can engineer a solution with the cabin crew. Ask for a towel soaked in steaming hot water, put it in the bottom of a cup and press it to your ear, sealing it around your ear if you can. The steam will ease the passages open in your ear. I vividly remember when I was a kid, flying back from Ireland. I was screaming my head off from pain, and some heroic Aer Lingus stewardess clamped cups tightly over my ears. She was the angel of mercy. If you’ve got a lesser problem, ask for a cup of hot water and hold it near your ear.

Symptom: Sore Throat/Cough

If you feel a sore throat or cough coming on before you leave home, you can be sure it will get worse on the plane. Bring a big supply of throat lozenges and keep them in a spot that’s easy to find in your bags. If you take cough medicine, remember to take it before you get on the plane.

For a sore throat that gets worse on a plane, the best tactic is to get some hot water. You have a few options on how to use it. My parents would tell you to pour salt in and go gargle salt water in the bathroom. They swear that salt water gargles cure all.

I like to slowly sip hot water with a slice of lemon, which any plane will have. If I’m especially uncomfortable, adding Jack Daniels whiskey to that mixture cures a number of ailments.

The Best Tip for Healthy Flight

Overall, the best way to avoid feeling sick on a plane is to stay hydrated. Drink lots of water before you head to the airport. Take all the water that you are offered. Yes, I know, that will make you use the bathroom often, but that’s part of the strategy! Getting up and walking to the bathroom will alleviate twitchy legs and get your circulation going. Try to avoid wine and beer, that will end with a headache.

I’m on the ground now and fully hydrated, feeling much better. I hope you all have healthy travels, but if you don’t, share your experiences and solutions here.