Sunday, September 23, 2001		Article

"The best of air travel makes your spirits soar, but the worst? It’s reality with a bump . . . ."

DVT (Deep-Vein Thrombosis) is in the news these days. There are recent reports of 30 British victims of DVT suing a number of airlines; the passengers on long-haul flights in crowded economy class.

Most air travellers experience some swelling in the feet, ankles and legs after a long flight. When circulation is impaired for a long time from seated immobility in cramped conditions, the blood can stagnate in the veins and clot. According to John Scurr, consultant vascular surgeon at London’s Middlesex Hospital, one in 10 older air travellers may develop small symptomless clots, that they’re not even aware of, which dissolve naturally.

But occasionally, hours or days later, small pieces of clot may detach and move to the lungs, where they can impede blood flow to the rest of the body. This potentially dangerous, even fatal at times, pulmonary embolus is known as DVT. Besides the elderly, pregnant, or obese passengers are especially susceptible to DVT.

Airline seats in economy class look like getting smaller while our behinds are growing larger — courtesy watching too much television. Anyway, people everywhere are getting taller, bigger. On the other hand, everything in planes is tiny: tiny food, tiny liquor bottles, tiny pillows, tiny bathroom, tiny sink, tiny soap. There’s always a "small problem", "slight delay", or being a "bit late".

You have people cocooned in an unsanitary metal tube at 35,000 ft for several hours with a few hundred strangers. And airlines have configured coach class so tightly that anything less in the shape of elbowroom may well lead to fist fights. Then the dilemma of knees, especially for the long-legged, with that standard 31-inch legroom. Knees bump against the pocket seat, filled to bursting point with thick stacks of virtually unreadable airline magazines, price catalogues and entertainment guides. If someone in front reclines, you’re breathing that person’s hair. And extricating yourself from your seat in that situation calls for acrobatic skill.

Cooped up for hours, you crave to stretch your legs. But the seat in front may have a big bag tucked underneath; the bag what wouldn’t get into the overhead bin. If one is lucky to have an aisle seat, you can occasionally stretch a leg out into the corridor. But then you keep a wary watch on a trolley trundling by.

For passengers riding coach, conditions deteriorate sharply when a plane is choking full, and nowadays this is a common occurrence on long international flights — with the hub system well in vogue. Limited flights between India and Europe almost always spell a full plane.

The standard treatment for DVT is an injection of Heparin followed by an oral anti-coagulant. To avoid such extreme measures, try to get up and walk in the cabin as often as you can, to rev up blood circulation in your legs. Try to keep your legs elevated during your trip. And you can also stimulate blood flow with a few exercises, which you perform sitting without disrupting other passengers.

From a sitting position, raise your feet slightly off the floor in front of your seat. Flex your left foot while you point your right. Then switch: point the left and flex the right. 10 to 25 repetitions every hour are advised.

With your legs still elevated slightly, rotate both your feet outward in a full circle from the ankle. Then switch: rotate them inward. Try to perform 10 to 25 repetitions every hour.

Another health hazard is dehydration. While the earth’s desert regions have a 20 per cent to 25 per cent humidity level, the cabin of a plane flying at cruising altitude has a mere 10 per cent humidity content. In this arid environment, your skin evaporates as much as eight ounces of water per hour. That’s why your eyes burn, your lips dry out, and you generally feel sluggish. The body draws water from the blood to sustain various organs. This results in blood getting thicker.

It’s absolutely imperative that you drink lots of water before, during, and after your flight to maintain your body’s fluid reserves. Even if you don’t feel thirsty, drink up. Thirst doesn’t necessarily precede the symptoms of dehydration, which can set in without warning. Experts recommend you drink at least half a litre for every two hours you spend in the air — in addition to the beverages you drink with meals. Coffee and alcohol are diuretic, and so cause the body to lose more water, through urination, than the intake. Actually for hydration no beverage rivals water, as none else is 100 per cent water.

It may be a good idea for airlines to hand over to every economy-class passenger one big bottle of water. If they find it cumbersome to carry and distribute these in the plane, they can as well dole these out at the time of boarding.

Airlines have developed Frankfurt ("If Christ ever came down to earth he’d have to change planes at Frankfurt," says a wit), London, Paris, Copenhagen, Chicago and several other airports as major traffic hubs. The system means fuller planes and greater profits for airlines, but also greater inconvenience for travellers — having to change planes at the hub.

Learn to love your hub. Try to organise yourself at that place, finding out the facilities and the hassles, the less crowded toilets and the less crowded areas for sitting or dozing off. Often, the toilets at entry and departure points are far less crowded than those located in the central shopping and waiting areas.

As to securing slightly more comfortable seats in the coach class, here are a few tips.

Seats on the emergency-exit row have more legroom, even one seat less. Usually assigned at the airport on first-come-first-serve-basis, but can also be booked in advance if the configuration of the plane known. Travel agents have the configuration of every plane on their computers.

If travelling two, ask for window and aisle seat. Possibly there’d be none in between — on the "dreaded third seat". In any case, that person could be asked to exchange for a window or aisle seat, and rarely would anyone refuse.

On wide-bodied planes, try for an aisle seat in a centre section towards the back of the cabin. As these seats are assigned last, chances are you’ll secure one.

Look for empty seats in the rear, and take some immediately as the plane door closes.