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Preventing DVT In Economy Class Seating  
User currently offlineboacvc10 From United States of America, joined Jul 2006, 624 posts, RR: 0
Posted (4 years 3 weeks 2 days 3 hours ago) and read 7503 times:

I think for frequent economy class travelers, the issue of sardine-can seating has not been addressed by the airline industry adequately. Apparently a small change to seating configuration (low-cost) could reap benefits for healthy travel. What other ideas are floating out there, (publicly announced) that are different from this Israeli invention?


Up, up and Away!
22 replies: All unread, jump to last
 
User currently offlineJER757 From United Kingdom, joined Jun 2006, 350 posts, RR: 0
Reply 1, posted (4 years 3 weeks 1 day 23 hours ago) and read 7332 times:

I think you have to take this one with a pinch of salt. Long haul travel is indeed a risk factor for the development of DVTs, but it's not just economy airline travel. In fact any period of sitting immobile will increase your risk. This includes First Class travel, coach, car and train travel, as well as sitting on your a**e in front of the TV for hours at a time.

DVTs are unlikely to occur de-novo, i.e. out of the blue with nothing else to cause them. So those that do develop them are likely to have a fair few other risk factors that have caused them (obesity, pregnancy, smoking, cardiovascular disease, hormonal contraception etc etc). Even then you have to be fairly unlucky to develop a clinically significant DVT.

This new invention by NewSit looks all very good on the surface. But I take issue with a few things on their website.

In a typical year, 2million people (nationally) are treated for DVT, 1million of these are caused by air travel.

Is this link proven? Working at a busy acute hospital, where we see a fair few DVTs, I can think of only a few where the patient has been on a long haul flight within the past few weeks... Even then it is fairly uncertain that the cause was the actual air travel.

"Complications from DVT kill up to 200,000 people a year in the U.S. - that's more than AIDS and breast cancer combined!"
and then on another page on the site:
Annually, nearly 2,000 people die from DVT, according to the NHLBI

Hmmm.

Then there is the fact that the efficacy of the seat to prevent DVTs is not proven. They have a single 'expert opinion' that states the seat will reduce DVTs... Anyone who knows anything about epidemiology ("the study of patterns of health and illness and associated factors at the population level") knows that expert opinion is the lowest of the low in terms of credible 'evidence'. The only way to test this effectively would be to put the seats in a certain number of planes and then count the number of people coming off them with a DVT compared to those sat in normal seats.

However the seat does look quite comfortable and I reckon I'd prefer it over a normal airline seat. However if it's any better at preventing DVTs than doing a few 'calf-pumps' every half hour or so I don't know. In fact to me, it looks as though by having your legs hanging down you would actually obstruct the veins, causing more blood to pool in the legs... causing more DVTs.



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User currently offlineComeAndGo From United States of America, joined Mar 2005, 1041 posts, RR: 0
Reply 2, posted (4 years 3 weeks 1 day 17 hours ago) and read 7147 times:

I suffer from vascular desease and am subject to DVT in flight. My mom actually had a DVT after a transatlantic flight. My doctor told me that problems occur on flights longer than 4 hours. It has to do with 2 factors: sitting with sharply angled legs and an overly dry cabine environment. On flights less than 8 hours I should take a full strength aspirin, wear compression stockings to the knee, drink plenty of water or beer (because it hydrates better than water) and do foot and leg exercises. Also sit in a relaxed position and stretch legs under the seat in front of me. On flights longer then 8 hours I should take a shot of Heparine a blood thinner instead of the aspirin.

I think there's something else at work that hasn't been discovered yet. Maybe it has to do with some kind of combination like super dry environment + prolonged sitting + anxity. I can spend hours sitting in front of the computer with legs angled sharply and get absolutely nothing.


User currently offlinecpd From Australia, joined Jun 2008, 4881 posts, RR: 37
Reply 3, posted (4 years 3 weeks 1 day 15 hours ago) and read 7062 times:

Quoting ComeAndGo (Reply 2):
I can spend hours sitting in front of the computer with legs angled sharply and get absolutely nothing.

But in this situation, you can get up readily and walk around. Sitting in front of a computer, you have more room to stretch your legs, you may also be sitting on a perfectly designed task-chair that is very comfortable.

On a plane, economy seats are usually very uncomfortable, cramped, have limited adjustment (sometimes none at all) and getting up is often difficult (you have to climb over other people) or people frown at you thinking you might be up to something suspicious.


User currently offlinekiwiandrew From New Zealand, joined Jun 2005, 8632 posts, RR: 13
Reply 4, posted (4 years 3 weeks 1 day 14 hours ago) and read 7049 times:
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Quoting ComeAndGo (Reply 2):
drink plenty of water or beer (because it hydrates better than water)

I would suggest you get a new doctor if your current one advises that beer hydrates better than water ... that is utter nonsense , beer , as with all alcoholic beverages , dehydrates .



Moderation in all things ... including moderation ;-)
User currently offlineJER757 From United Kingdom, joined Jun 2006, 350 posts, RR: 0
Reply 5, posted (4 years 3 weeks 1 day 10 hours ago) and read 6923 times:

Quoting ComeAndGo (Reply 2):
drink plenty of water or beer (because it hydrates better than water)

Who told you that? Dr Budweiser?



Gale force fog... don't you love it?
User currently offlineBD338 From United States of America, joined Jul 2010, 740 posts, RR: 0
Reply 6, posted (4 years 3 weeks 1 day 10 hours ago) and read 6892 times:

Quoting boacvc10 (Thread starter):
I think for frequent economy class travelers, the issue of sardine-can seating has not been addressed by the airline industry adequately. Apparently a small change to seating configuration (low-cost) could reap benefits for healthy travel. What other ideas are floating out there, (publicly announced) that are different from this Israeli invention?

..the video on the link shows a rather petite lady swinging her legs with the seat in the elevated position. So two things: 1) I am 6' 4" so to get my legs into a position sitting in an economy seat to be able to swing them my knees would need to be around my chin 2) to actually swing my legs I (and many others not even my height) would need a lot more leg room than the miserly 31-32" typically on offer (even less on many ULCCs). I think this looks like many of the inventions in the Skymall catalog...ultimately useless  

That said the issue of sardine can seating does need to be addressed. slimline seats are helping but then they seem to trade some seat comfort for a small amount of extra space. A real winning formula is still out there for someone to exploit (and no, buying a J ticket is not an option, the gulf between Y and J is too vast (for me) to afford)


User currently offlineYYZALA From Canada, joined Nov 2009, 155 posts, RR: 0
Reply 7, posted (4 years 3 weeks 1 day 8 hours ago) and read 6809 times:

Quoting JER757 (Reply 1):
DVTs are unlikely to occur de-novo, i.e. out of the blue with nothing else to cause them. So those that do develop them are likely to have a fair few other risk factors that have caused them (obesity, pregnancy, smoking, cardiovascular disease, hormonal contraception etc etc). Even then you have to be fairly unlucky to develop a clinically significant DVT.

Totally agree with you, however. Sitting down for a long time occludes, slows down the blood flow - perfect environment for a thrombus formation. Healthy or not. Couple that with CHF, diabetes and all those other risk factors you got a recipe for DVT.

While those seats are a great idea the question is how willing are airlines to install them, based on the fact that there is no real hardcore statistics for DVT and air travel. Ultimately, I think there is a correlation, so are airlines responsible if you do get one?


User currently offlineAirNZ From , joined Dec 1969, posts, RR:
Reply 8, posted (4 years 3 weeks 1 day 8 hours ago) and read 6749 times:

Quoting boacvc10 (Thread starter):
I think for frequent economy class travelers, the issue of sardine-can seating has not been addressed by the airline industry adequately

DVT can occur irrespective of whatever class is travelled, so a little bit 'sensationalist' in describing "sardine-can seating".

Quoting ComeAndGo (Reply 2):
On flights less than 8 hours I should take a full strength aspirin, wear compression stockings to the knee, drink plenty of water or beer (because it hydrates better than water)

Eh??? I'd say you need to do some checking (or perhaps your 'doctor' should).....alcohol dehydrates, and especially at altitude! Also, a full 325mg of aspirin is not required to prevent a thrombosis!


User currently offlineexFATboy From United States of America, joined Jul 2003, 2974 posts, RR: 9
Reply 9, posted (4 years 3 weeks 1 day 6 hours ago) and read 6689 times:

Quoting kiwiandrew (Reply 4):
I would suggest you get a new doctor if your current one advises that beer hydrates better than water ... that is utter nonsense , beer , as with all alcoholic beverages , dehydrates.

I think a lot of the confusion comes from studies like this one that when not read closely, suggest beer can hydrate better than water.

The trick is that the beer drinking subjects drank 16 ounces of beer and as much water as they wanted, while the other subjects drank only water. The researchers believe that the advantages of beer - electrolytes, carbonation, etc. - along with water consumption more than offset whatever small diuretic effect a single pint of beer might have.

I've also seen studies mentioned in the media that suggest that low-level beer consumption (a pint an hour or so) does not lead to dehydration at normal temperatures and activity levels, since beer - especially weak American beer   - has a much lower amount of alcohol relative to the amount of water you get in one serving than wine or a typical mixed drink, and one beer an hour isn't going to have that much of a diuretic effect.

The dry air of a plane is naturally dehydrating to some extent, so I'd say beer by itself isn't a good choice but, unless you're an individual with other factors that increase your DVT risk, a few beers on a long flight combined with drinking a healthy amount of water is fine. (And between the beer and the water, you'll get up and walk to the lavatory more often, combating DVT.


User currently offlineVC10er From United States of America, joined Feb 2007, 2989 posts, RR: 13
Reply 10, posted (4 years 3 weeks 1 day 2 hours ago) and read 6586 times:
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At the age of 34 I got a DVT from flying and it came very close to killing me. 34 years olds are NOT supposed to get blood clots like that. Trust me when I tell you I know more about this than vascular doctors.
I have a letter to my employer that I must carry: No flights in coach for more than 3 hours. I MUST walk a few times around the ac - which was easier before 9/11. Flights over 3 to 8 hours in C with my legs UP. Far less chance then when feet are fully down it slows the blood. The closer the leg is level with the heart, the far less chance for a DVT as blood flow is better. Over 8 hours F class. But now that airlines like UA have flat seats, that should be ok - and MOST important is are surgical socks. A long acting 85mg aspirin can help if you are off Cumadin. And yes, avoid booze.

The "doesn't matter what class" is entirely 100% UNTRUE. indeed legs higher up show a much, much reduced risk. The 6 foot male jamed in coach unable to move his legs for 6 hous is at much higher risk.is at far greater risk than anyone in C or F. Nobody has studdied angled seats in C as nothing about them is good.

The only thing that hydrates better than water....Gatorade. Ask a EMS worker! Until an IV consisting of the same thing as Gatorade is put in you arm. (I used to work for Gatorade- it's a scientific fact)



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User currently offlineaa61hvy From United States of America, joined Nov 1999, 13977 posts, RR: 57
Reply 11, posted (4 years 3 weeks 23 hours ago) and read 6505 times:

Quoting VC10er (Reply 10):
(I used to work for Gatorade- it's a scientific fact)

There are more drinks/pills you can take that hydrate better than Gatorade. IE: Coconut water or electrolyte pills. (also works wonders for hangovers)



Go big or go home
User currently offlineQuokka From , joined Dec 1969, posts, RR:
Reply 12, posted (4 years 3 weeks 22 hours ago) and read 6475 times:

The seat looks wonderful, I am sure. However, for the person sitting in it to be able to swing the legs around like the woman in the video would be quite impossible in a 31" - 33" pitch. It might fit in J, but most international J seats already give plenty of support and room to stretch.

So for most travellers in Y, simple exercises like toe and heal stretches, circling of the ankles, similar movements and the occasional walk to the WCs will continue to be the norm for those who wish to exercise.


User currently offlineMir From United States of America, joined Jan 2004, 21875 posts, RR: 55
Reply 13, posted (4 years 3 weeks 21 hours ago) and read 6433 times:

Quoting cpd (Reply 3):
On a plane, economy seats are usually very uncomfortable, cramped, have limited adjustment (sometimes none at all) and getting up is often difficult (you have to climb over other people) or people frown at you thinking you might be up to something suspicious.

Too damn bad. If I'm on a long-haul flight, I will get up and walk around at least a couple of times during the flight. If it's a widebody, I'll make a full circuit of the Y cabin. I normally combine this with a trip to the lavatory. If I have to climb over someone, I will (unless they're asleep).

-Mir



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User currently offlinespacecadet From United States of America, joined Sep 2001, 3673 posts, RR: 12
Reply 14, posted (4 years 3 weeks 21 hours ago) and read 6383 times:

The seat at the link provided is ridiculous. Anyone short enough to be able to even elevate their legs like that in economy, much less swing them, has a very low risk of DVT to begin with. Taller people are at greater risk to begin with because they have less room to move their legs (regardless of the type of seat), and it's that movement that creates blood flow.

I'm 6'4" and like someone else said above, this seat would do absolutely nothing for me. Also, putting what amounts to a blood flow obstruction behind your knees is not a good idea.

There are four things I do to make sure I don't get a DVT in economy:

1. I choose which airline to fly based on the amount of legroom offered. This is why, for example, I fly JetBlue JFK-PDX, even if they cost more than a competitor (and sometimes they do).

2. I always sit in an aisle at the very least, and if I can, I get an exit row. On a 14 hour flight to Japan, I basically *have to* have an exit row to not go absolutely insane, so my wife and I always get to the terminal 3 hours early.

3. I drink a lot. I don't care what it is. I don't drink to be hydrated, I drink to force myself to get up and go to the bathroom; I figure hydration will take care of itself if I'm drinking that much. I usually have at least one alcoholic drink, actually, but then I drink a lot of water and juice too. I never refuse a drink if asked by a flight attendant, and I take the bottle of water they give out at the start of the flight and usually have another one of my own. This forces me to get up about once an hour.

4. There is a very simple exercise that you can do to stave off DVT, and that's just to slowly and repeatedly push down alternately on the heels and the balls of your feet, sort of rocking back and forth. This causes your muscles to clench in a way that acts as a blood pump, forcing blood back up your leg and not allowing it to clot. I do this about once every half hour at least - you only need to do it a few times and you don't need any extra space to do it.

I guess my point is that there are things an experienced flyer can do that are way more effective at staving off DVT than the seat at the OP's link. Even just the exercise I mentioned as #4 would be enough for most people 99.9% of the time. (And btw, I learned that from an on-board ANA instructional video on how to avoid DVT. That instructional video would probably prevent a lot more DVT's than this new seat idea.)



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User currently offlineaerorobnz From Rwanda, joined Feb 2001, 7396 posts, RR: 16
Reply 15, posted (4 years 3 weeks 21 hours ago) and read 6368 times:

pumping in and cycling fresh air from outside the cabin, as used to happen when smoking was still allowed. This has been proven to be a major factor in prevention...

User currently offlineTomFoolery From Austria, joined Jan 2004, 529 posts, RR: 2
Reply 16, posted (4 years 3 weeks 20 hours ago) and read 6368 times:

Simple, Get up and walk. nearly every airline recommends it, if you pay attention. It is often in the magazine as well.

If you are stuck in a non asle seat, most people will let you out if you ask, or better yet, wait for them to get up to go to the loo, and make your escape then.

Drink lots of water, and watch drinks like coffee, tomatoe juice, alcohol, coke, etc. Tomatoe juice is typically high in sodium; alcohol, coffee and coke make you dehydrated, reducing body fluid. As a rule, 2 servings of water to each serving of alcoholic or caffinated drink.

Tom



Paper makes an airplane fly
User currently offlineCXB77L From Australia, joined Feb 2009, 2694 posts, RR: 5
Reply 17, posted (4 years 3 weeks 15 hours ago) and read 6244 times:
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Quoting TomFoolery (Reply 16):
Simple, Get up and walk. nearly every airline recommends it, if you pay attention. It is often in the magazine as well.

Not in my experience. Most airlines recommend in-seat exercises that can be done while seated with your seat belt fastened. To recommend passengers get up and walk would be contrary to the recommendation for passengers to be seated with their seat belts fastened even when the seat belt sign is not on, in case the aircraft encounters unexpected turbulence.



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User currently offlineTomFoolery From Austria, joined Jan 2004, 529 posts, RR: 2
Reply 18, posted (4 years 3 weeks 7 hours ago) and read 6121 times:

Quoting CXB77L (Reply 17):
To recommend passengers get up and walk would be contrary to the recommendation for passengers to be seated with their seat belts fastened even when the seat belt sign is not on, in case the aircraft encounters unexpected turbulence.

This recommendation seems to be generally directed at seated passengers, and I have not come accross any specific recommendation to remain seated from any national authority. While it has been a number of years since I really paid attention to the fine print, it could be that things have changed. Afterall, we cant have 300+ passengers milling around the asles any more, can we.



Paper makes an airplane fly
User currently offlinefrmrCapCadet From United States of America, joined May 2008, 1744 posts, RR: 1
Reply 19, posted (4 years 3 weeks 7 hours ago) and read 6100 times:

It has been referred to, but alcohol and caffeine dehydrate. But they are generally delivered in a heavily watered form. Coffee itself is not dehydrating - more than enough water to compensate. Alcohol beverages vary, and I do not know at what ratio they balance. Beer balances in favorf of peeing, straight spirits dehydrating, in between?


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User currently offlineVC10er From United States of America, joined Feb 2007, 2989 posts, RR: 13
Reply 20, posted (4 years 3 weeks 6 hours ago) and read 6041 times:
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Quoting Mir (Reply 13):

It's your life. DVT's are extremely painful (gods way of saying get your ass to the ER) if the pax next to you grumbles that you keep getting up. Then ask them if they would rather have the pilot land the plane to take you to a hospital. Also, a DVT can form in 15 minutes of stopped blood flow. If the clot disloges and goes to your lungs or brain your dead in 15 minutes. If you drink alcohol, have fun ( I still do) but if I get a DVT --- I can't blame United! Also I find UA E+ to provide enough leg room for us tall guys.



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User currently offlineComeAndGo From United States of America, joined Mar 2005, 1041 posts, RR: 0
Reply 21, posted (4 years 3 weeks 1 hour ago) and read 5898 times:

I say it's a combo:

Prolonged sitting
Overly dry environment
Low levels of oxygen


User currently offlineLDIkaros From United States of America, joined Apr 2007, 181 posts, RR: 0
Reply 22, posted (4 years 2 weeks 5 days 22 hours ago) and read 5841 times:

I had a DVT at age 35, from prolonged sitting in front of a computer. That was a wake-up call like no other.
That did not stop me, though, from flying, including quite a few long-distance flights such as SFO-HKG (about 15 hours).

I think the biggest issue is that many people are not aware of the potential for DVTs or think it might not hit them. Since my episode I do the following when flying:

- use compression stockings for all flights over 8 hours
- always book an aisle seat so I can get up at least once every 2-3 hours and stretch
- drink lots of water on longer flights both to avoid dehydration and to force me to get up and go to the restrooms once in a while
- try to avoid night flights when I might fall asleep
- try to stay awake during the entire flight.

Before long flights I also try to do a moderate cardio workout (treadmill, bikes, running, etc).

I still drink wine at the beginning of long flights but not more than 2 glasses, followed by lots of water.

So far this strategy has helped me to avoid another DVT.


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