Q: I take 100mg of fludrocortisone & 10mg of hydrocortisone on rising each day (6.30) and 10mg hydrocortisone in the evening (6.30). I am flying to the U.S.A later this year and want to know how do I go about dealing with the change of times? With reference to flying, if I suffer from air sickness will I have to use my emergency injection--I have a fear of needles--help!

A: I advise my patients with adrenal deficiency who are crossing time zones to take an extra 10mg of hydrocortisone each 6 hours until they arrive with a final dose within an hour of arrival. They should then take their normal tablet regimen according to the local clock time.