Modern medicine: Cheap air fares may cost you extra


We all look for fares on low-cost airlines to carry us to our previous homelands. As ex-pats, we do tend to spend a greater number of hours cramped up in planes than the average person from our home countries. What with visa runs and trips to other SE Asian countries for business and trips back home to see the folks each year, we seem to be always listening to the hostess telling us what to do when the plane ditches in the water and we can pull the tag firmly, be inflated and float away to safety with our light blinking while blowing on our whistle. If it were only that simple! MH 370 does not fit into the items on the safety card on the back of the seat in front of you.

However, even if the plane makes it safely to the destination, you may still suffer, especially if you are an avid reader of the popular pulp press from home. A new bogeyman awaits us, called the “Economy Class Syndrome”.

The scenario is simple – after hours of being cramped in-flight you succumb to a clot in the veins of your legs and suffer a Deep Vein Thrombosis, which we medico’s call a DVT. This condition can wind up producing all sorts of problems, including emboli (clots) in the lungs and other wondrous conditions, some of which can kill you. (Have I got your attention now?)

Yes, you will be cramped because that is how they can offer cheaper fares. Instead of 400 passengers, you fit 450 passengers in the same space.

In theory, sitting twisted in the minimal “economy class” seats can predispose to the formation of these blood clots, and tales of people having one after a plane flight are eagerly snapped up by the press. What the press doesn’t tell you is that many, many people get DVT’s who have never stepped into a plane in their lives.

In fact, the highly esteemed medical publication The Lancet (first published in 1823), published a study to show that they were unable to show an increased risk amongst plane travelers, and especially those in el cheapo seats. Actually, heavy smoking is a much greater prognosticator of the risk, but the newspapers are not so keen on calling it, “The packet of Ciggies Syndrome.” Funny that. Has nothing to do with tobacco revenue, I am sure.

So what can you do to minimize any risk when flying? The secret to health in the air is purely to maintain good circulation and avoid dehydration. However, that is not quite as easy to do in practice as you would imagine.

To maintain circulation to the lower legs you should get up and walk around the plane once every hour. That is the interior of the plane. Simple – but it does mean you have to clamber over a couple of people to get to the aisle if you hadn’t requested the aisle seat. Rule 1 – always ask for an aisle seat, or the seat in front of the exit where there is nobody in front of you.

Dehydration is easy to fix – drink more water, but it is another difficult thing to do on planes. The fluid to drink is water of the H2O variety, not water that comes in green bottles or has been distilled.

The ambient cabin humidity is much less than you experience on the ground, so you are more likely to dry out, and then there is the alcohol part of the equation – the copious amounts of booze don’t rehydrate you – they dehydrate you! Believe me.

You can also wear ‘plane sox’ which put pressure on the lower legs and keeps the circulation going.

That’s it in a nutshell. Water and exercise fixes the Economy Class Syndrome. Of course, you could always fly first class instead I suppose! And pay the incredible financial syndrome!