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Should "Economy Class Syndrome" Worry Both Jet-Setters and Armchair Travelers?

It seems that today's airline travelers already have plenty to worry about — long security lines, baggage searches, x-raying of shoes, and being pulled out of line for special searches. It doesn't seem fair to also tell someone heading off on a long airplane flight that they may also be facing a very real health risk. But that certainly is the case.

A Potential Health Problem for Travelers and Non-Travelers

A few years ago there was a considerable amount of press related to "economy class syndrome," the term invented to describe the problem of blood clots that seem to develop in the deep veins of the legs after long periods of sitting in cramped conditions, such as on a long airplane flight. But while there has been less recent press attention, the condition, and the often serious health problems it can bring, has certainly not gone away.

Although the problem of developing these leg blood clots is most often linked to airplane travel, the truth is that it can occur in any situation where someone is seated for a long period of time with little or no leg movement. While cramped economy seating in airplanes are the most common example of conditions that can lead to this problem, anyone who spends long periods of inactivity in a seated position may face the problem. Extremely long car drives, jobs that require long periods of sitting with few opportunities to get up and move about, or semi-invalids with medical conditions that make getting up from a chair and walking around a difficult task, are all examples of people in non-flying situations that still could face economy class syndrome. All of these situations can result in a lack of leg movement that results in the slowing of circulation of blood in the legs, encouraging pooling of the blood in the lower legs and feet, and allowing small blood clots to form in the deep veins of the legs.

While there are no firm statistics as to how many people might develop such blood clots during a typical, long distance airplane flight, many experts believe it is not an uncommon condition. In most cases, however, once the person gets up and begins moving again, the clot dissolves and any pain that may have been associated with the clot disappears. Indeed, most people who may develop such clots and the accompanying calf muscle pain that is the most common symptom, usually dismiss the problem as just a minor muscle cramp since it disappears soon after they begin to walk around. Some experts believe that most airline passengers who experience economy class syndrome are probably unaware of what the problem really was.

Blood Clots That Can Lead to a Variety of Health Problems

However, there have been numerous cases of serious consequences from these deep vein clots when they break loose and move to other parts of the body. One of the most common problems is when the clot travels to the lungs and cause a pulmonary embolism. For some people the result is simply mild chest pain with perhaps some coughing that may be mistaken for a mild case of the flu or some other respiratory illness. In some cases, however, the pain may be significant enough that it may appear to be a heart attack and may lead to initial treatment for such an attack. And in the most serious cases the blood clot may actually block the pulmonary artery, leading to severe heart complications or even death.

Taking Steps for Prevention

While all of that may sound somewhat frightening, the reality is that economy class syndrome can easily be prevented for the average person with some very simple steps. Many airlines now even include instructions in their flight magazines or seat-back information cards on how to minimize your risk for this condition. The simplest steps include:

  • wearing loose-fitting clothing that won't restrict circulation
  • avoiding alcohol and caffeine, both of which can help dehydrate your body
  • drinking plenty of non-alcoholic and non-caffeinated beverages before and during long flights
  • periodically getting up from your seat and taking a short walk
  • while seated, clenching your toes and rotating your feet at the ankles to help exercise the muscles of your calves and increase blood flow.

If At High Risk for Blood Clots, Talk To Your Doctor

For someone who is at higher risk for developing deep vein blood clots, there are additional actions that can be taken. Some factors that increase the risk for the development of blood clots include being overweight, smoking and estrogen therapy, as well as a history that includes cancer, the past development of blood clots, or prolonged recent periods of bed rest.

For such travelers, it's a good idea to consult with their personal physician before traveling on a long airplane flight. A doctor might recommend taking aspirin to thin the blood or some other medication that might reduce the risk for developing blood clots.

Graduated compression hosiery is another option that is often recommended to reduce the risk of economy class syndrome. Such hosiery, available these days in a variety of fashionable styles for both men and women, help provide gradually reduced pressure from the ankles up to the calves, helping to keep the blood vessels from relaxing during periods of inactivity and thus helping to prevent the pooling of blood in the legs that makes blood clots more common.

So while the pressures of extra security, longer lines and more crowded planes may be making long airplane trips less enjoyable than they once were, worries about economy class syndrome should not be among the burdens of travel you have to face. Simply staying well-hydrated, doing some simple leg exercises, getting up periodically and wearing compression hosiery can all help ensure that this is not a health problem you will have to face.

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