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A Possible Reason to Fly First Class: 'Economy Class Syndrome'


Another problem: Plane air is dry, and fliers can easily become dehydrated. "When you are dehydrated, your blood becomes thicker, increasing risk of clots," he says. So try to drink an eight-ounce glass of water every two hours and avoid alcohol and coffee when flying, as they are dehydrating, he says.

Adelman wears compression hose when he travels and suggests other fliers do the same. They are available over-the-counter at surgical supply stores and cost about $15 per pair. Such support hose work by keeping blood from stagnating.

Taking an aspirin before flight may be of some benefit as well, he adds. Aspirin is a known blood thinner.

But some medical experts, including Louis D. Fiore, MD, an assistant professor of medicine and public health at the Boston University School of Medicine and School of Public Health and the chief of oncology at the VA Boston Health Care System, have their doubts about economy class syndrome.

"There are multiple risk factors for developing blood clots in the leg," he says. "There are genetic risk factors and then superimposed on that are environmental risk factors such as having surgery or a trauma," he tells WebMD.

But "flying is a very minor risk factor," Fiore says. "Immobilization in the absence of illness is a low risk for deep vein thrombosis. If immobilization on a airplane flight is enough to put you over the edge, something else will do it will first."

In other words, "if you don't have problems with blood clots, disregard the syndrome. It's unnecessary anxiety. If you have a history of blood clots, then prolonged immobilization from any cause should be avoided," he says.

There's a sector of the population that is genetically predisposed to developing blood clots in the leg, Fiore says. While there are genetic tests to see if you have these high-risk genes, "they are expensive and not worth the money," he says.

Other ways to prevent deep vein thrombosis while flying include the following:

  • Book a seat in an exit row, a bulkhead seat, or an aisle seat; walk up and down the aisle about once an hour.
  • Wear loose-fitting clothing.
  • Don't smoke.
  • While in your seat, contract your calf muscles from time to time by clenching your toes. One exercise, suggested by British Airways, is to bend your foot upward, spread your toes, and hold for three seconds, then point your foot down, clench your toes, and hold for three seconds.
  • If you are at high risk of blood clots, ask your doctor if you should take aspirin before flying to inhibit blood clotting.
  • Don't cross your legs or sit on the edge of your seat; these positions can reduce blood flow in your legs.

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