SOURCE: Pennsylvania Medical Society

Feb. 21, 2002 -- You expected to be a bit apprehensive about flying - who isn't after September 11? But you didn't think it would be like this: your head is throbbing, your stomach is churning, your legs are cramping.

You're emotionally and physically exhausted ... and you haven't set foot on the plane yet.

While most travelers are patiently following the new stricter airport screening regulations, the long waits, security checks, and random searches can add up to a nerve-fraying experience capable of ruining a long-awaited trip before it even gets off the ground.

Preparing yourself mentally and physically for the added stress, however, can help you stay calm and collected during the extended check-in process. The Pennsylvania Medical Society offers several tips for avoiding ``airport anxiety.''

• Know what to expect. Get information about the new airport rules from your travel agent, the airline, or online travel sites. ``If we know in advance what the new procedures are, we feel more in control and less frustrated by the difficulties we encounter,'' says Lawrence L. Altaker, M.D., a Wormleysburg psychiatrist and Medical Society member.
• Don't prime the anxiety pump. Why work yourself into a frazzle before you even reach the airport? Give yourself plenty of time to get there - allowing for normal delays like traffic jams and road closings, as well as new ones like restricted airport access - so you arrive well before takeoff. ``If you're not all flustered from racing to the airport, you'll be better able to handle the inconveniences during the check-in process,'' says Alan A. Axelson, M.D., a Pittsburgh child psychiatrist who also belongs to the Pennsylvania Medical Society.
• Accentuate the positive. Instead of resenting the delays and bother, consider the upside. ``Remind yourself that these precautions are in effect to safeguard you and your family,'' says Stephen L. Schwartz, M.D., clinical professor of psychiatry at Thomas Jefferson University Hospital and president- elect of the Philadelphia County Medical Society. ``By taking the situation personally, in a positive way, you'll be reassured rather than apprehensive.''
• Come equipped to wait it out. If you or a traveling companion has trouble standing for long periods, lighten the load with a walker or foldout canvass seat, or arrange with the airport to provide a wheelchair.
• Pack snacks in a carry-on bag to appease the munchies, which can stoke irritability. If you need special dietary snacks because of low blood sugar, diabetes, or other medical conditions, be sure to have these on hand. You may not be allowed to scurry easily from the check-in line to the food court.
• Carry your prescription medications with you in your carry-on bag or luggage. That way, if you get delayed or your luggage is lost, you can be sure to have your medication with you.
• Kid-proof your planning. Post-9/11 air travel can be even more disquieting for youngsters than adults, so prepare them for the realities. If they pack their own bags, make sure they don't bring along items such as a water gun or Scout knife that might alert security. Explain beforehand what the new airport procedures involve, so they won't be frightened by the inspections.
• Avoid negative comments they might overhear. ``Traveling is normally an adventure for kids, and they're going to be enthusiastic unless they pick up on their parents' fears or frustrations,'' says Dr. Axelson.
• Don't forget to take along snacks and activities for the kids to prevent boredom and keep them occupied. And remember the spare AA batteries for games and CD players.
• Get physical. Instead of sitting the whole time before reporting to the check-in line, take the opportunity to get up and walk around. You'll feel more relaxed and less confined. Once in line, tighten various muscle groups and periodically stretch to keep the blood flowing and relieve fatigue.
• Replace stewing with chewing the fat. Use the wait time to talk with fellow passengers about your occupations, avocations, and destinations. ``Humor can defuse anger, so it's healthy to stay on the lighter side when waiting or standing in line,'' says Dr. Schwartz. Just don't joke about threats or dangers. That can get you in trouble. ``This is a shared inconvenience, and communicating with others in a positive way can develop a sense of camaraderie,'' adds Dr. Axelson. ``This is no time to be isolated.''
• Use appropriate prescription drugs if necessary. If you can't cope with anxiety any other way, talk to your doctor. For some people, medication may be appropriate. ``We much prefer people using a prescription drug specially designed for this purpose rather than using alcohol or over-the-counter relaxants,'' says Dr. Axelson. For those who may benefit from medication, he recommends trying out the medication at home, prior to the trip, to prepare for reactions such as grogginess and impaired coordination. Be sure to ask your physician about interactions between prescription drugs and over-the-counter medications, such as those taken for airsickness.
• You can also seek professional help from a psychologist or psychiatrist to learn relaxation exercises and other techniques that reduce tension and worry.
• Channel your energy. You may feel better knowing that you have some control over your situation at the airport, so be alert. Keep an eye on your bags and, more importantly, your children. If you spot any unusually suspicious activity, feel free to report it to airport authorities.
• Check fear with a reality check. The visible signs of stepped-up airport security emphasize the threat, unnerving some travelers. Focusing on the immediate facts can turn that thinking around, says Dr. Schwartz. ``If we examine flying before September 11 and after, we're far safer now with the baggage checks and other new security measures.