Aisle seat, please.
March 24, 2012 6:58 PM   Subscribe

"Economy class syndrome" is a myth -- but stay away from that window seat.

There is no evidence that a seat in economy class raises your risk for deep vein thrombosis, according to guidelines issued last month by the American College of Chest Physicians. A window seat, however, does increase your risk of DVT by limiting your mobility.

(But passengers opting for the aisle seat should note that it may raise their risk of a head injury from falling luggage.)

The American College of Chest Physicians report also declared open season on in-flight cocktails, finding no evidence that alcohol or dehydration elevates the risk of DVT.
posted by dontjumplarry (45 comments total) 4 users marked this as a favorite
 
A window seat does not "limit your mobility", unless, of course, you are wearing your male velcro traveling clothes and it happens to be a female velcro window (try to break free from THAT situation!).
posted by HuronBob at 7:16 PM on March 24, 2012 [2 favorites]


So I'm supposed to take the middle seat? THAT IS A TERRIBLE IDEA.
posted by maryr at 7:16 PM on March 24, 2012 [5 favorites]


So, sitting still for a 3-4 hour plane flight limits one's mobility and might cause DVT...

Why haven't we had a zillion reports of people suffering from DVT during any showing of any of the three Lord Of The Rings movies, then?
posted by hippybear at 7:28 PM on March 24, 2012 [11 favorites]




I hope the media makes people fear the window seat since that means more window seats for me!
posted by birdherder at 7:33 PM on March 24, 2012 [4 favorites]


More room, better seats, great available range of movement.
posted by mce at 7:33 PM on March 24, 2012 [2 favorites]


Anyway, I couldn't find an example of a DVT after a movie, but here's one after "long gaming sessions"

admittedly, he had 20 hour sessions, which is slightly longer than most movies
posted by deliquescent at 7:36 PM on March 24, 2012


I just got back from an awful lot of flying around in planes and I was far more concerned with falling luggage (I sort of get, but don't really get how someone can travel with a bag that they can not personally lift or maneuver) than DVT. I enjoyed these two short articles on topics I hadn't really known much about. And I love the word antithrombotic!
posted by jessamyn at 7:37 PM on March 24, 2012


admittedly, he had 20 hour sessions, which is slightly longer than most movies

So like watching all three LotR movies then?
posted by cjorgensen at 7:44 PM on March 24, 2012


More room, better seats, great available range of movement.

If limited mobility is the risk factor, it is a curious that economy class seats (which clearly hamper movement) are not associated with DVT. For example, it is much easier to get out of a business class window seat, or do calf exercises, or stretch one's legs.

But maybe it's all offset by business class pax staying still for longer because they are more comfortable?
posted by dontjumplarry at 7:48 PM on March 24, 2012


I always pass out before wheels up. One of the days, I guess I won't wake up.
posted by bpm140 at 7:59 PM on March 24, 2012


I would risk dvt to have a good view of take-off and landing. I still love to watch.
posted by jb at 8:24 PM on March 24, 2012 [6 favorites]


I got all worried about my flight and called the airline and asked them if they had DVTs and they said no, just blu-raze.
posted by twoleftfeet at 8:39 PM on March 24, 2012


Is a link to the evidence buried in the article somewhere? I'd be interested to see what population factors they controlled for between business/1st class and economy class passengers.

HuronBob writes "A window seat does not 'limit your mobility'."

It does compared to an aisle seat where one can fully stretch out one or both legs into the aisle space.
posted by Mitheral at 8:41 PM on March 24, 2012


I'm keeping "my more" room window seat, less chance of that swollen, squirmy, sweaty jackass next to me actually touching me.
posted by Confess, Fletch at 8:48 PM on March 24, 2012


I assume malignancy as a risk factor means something other than evilness and an intent to cause harm.
posted by ChuraChura at 8:59 PM on March 24, 2012 [1 favorite]


How on earth is a window seat supposed to limit mobility? I suppose you're marginally less willing to get up and walk into the aisle, but it's not as if on a long flight you can actually cease using the bathroom, or as if the majority of people in the aisle seats actually get up and power-walk up and down the aisles. I'd have thought the most limited on mobility is the person in the middle seat--social constraints keep that person fairly rigid unless they're sitting next to a family member or significant other.
posted by yoink at 9:04 PM on March 24, 2012 [1 favorite]


yoink: the aisle seat passenger is disturbed every time those in the other two seats want to move. By contrast, the window seat passenger can be completely motionless the whole flight. (Sleeping is also much easier in the window seat).
posted by dontjumplarry at 9:10 PM on March 24, 2012 [1 favorite]


Sitting in the window seat is good for my mental health and that's more important than my physical health.
posted by madcaptenor at 9:14 PM on March 24, 2012 [2 favorites]


For years and years, my standard flying MO has been to always try and get an aisle seat. I hate being penned in. Gotta be mobile, man, easily mobile.
posted by flapjax at midnite at 9:26 PM on March 24, 2012 [1 favorite]


Better the seat that might kill me than the seat that will get my shoulder whacked every time the drink cart goes by.
posted by Blue Meanie at 9:53 PM on March 24, 2012


A company I used to work at designed the electronics for a portable pneumatic leg cuff for preventing DVT while flying, but I don't know if it ever went to market. I imagine there are similar products on the market that one could buy, then you could sit in the window seat for the entire 12h flight without moving. We weren't really sure if it actually prevented anything, but we had it inflating and deflating the cuffs as required.

Somewhat relatedly someone close to me suffered a major bone breakage lately and is now confined to bed. She has had the breakage set but now during the recovery she will be immobile for a long period and so now the major danger is formation of blood clots. She has to wear one of these pneumatic cuffs, but it's not really a portable one.
posted by Joe Chip at 10:58 PM on March 24, 2012


It does compared to an aisle seat where one can fully stretch out one or both legs into the aisle space.

So you're the jerk I'm always tripping over
posted by ook at 11:04 PM on March 24, 2012 [1 favorite]


I imagine there are similar products on the market that one could buy, then you could sit in the window seat for the entire 12h flight without moving.

A bonus would be increased catheter sales!
posted by hippybear at 11:07 PM on March 24, 2012


Your mobility in the window seat is limited by how much of a pest you're willing to be to your aisle mates. If you're traveling with friends/family maybe less of a constraint. In my experience the window/middle folks usually only get up if they absolutely have to. I always get the aisle if possible, and I'll get up for a stretch at the slightest whim. I like to think the person on the aisle is the captain of that particular row.

Also, on long international flights, I'm quite fond of camping out in the bathroom as if it's my own private little vip lounge.
posted by billyfleetwood at 11:19 PM on March 24, 2012 [4 favorites]


So i've got a serious question. How come dvt doesn't happen when we sleep? We don't move for 8 hours or so, is it because we are vertical or that our legs can move without our knowing it?

Also, 20 hour gaming sessions? Amateurs. ;) I've done that for over a month, depression is fun! :P
posted by usagizero at 11:31 PM on March 24, 2012 [1 favorite]


As a veteran of more transatlantic flights than I can count, I can tell you that no matter what class you're sitting in, it's still exactly as pleasant as you would expect sitting in a chair for 8-10 hours would be.

The extra money spent in business class mostly yields flight attendants who pretend to be slightly nicer to you. Sometimes.

(Call me paranoid about DVT, but I have started popping a baby aspirin and wearing compression socks on long flights - and I frequently get up and walk around.)
posted by grajohnt at 11:41 PM on March 24, 2012 [1 favorite]


I always take the window because I try to sleep for the entire flight (usually 10-12 hours for me). Like Jessamyn I am way more concerned about falling luggage on my head, since this has actually happened to me, than DVT, which has not happened to anyone I know.
posted by lollusc at 1:28 AM on March 25, 2012


re DVT in your sleep: both.
1. you usually sleep lying down, which makes it easier for your heart to maintain circulation through your legs because it is not fighting gravity
2. people twitch in their sleep, and many people roll over or more in their sleep - think of the stories of people stealing blankets from a partner, waking up on the other edge of the bed, etc.

But DVT is not something that was invented with air travel, and I believe (too lazy to search now, but wikipedia supports this a little) that it was previously known as a problem for people confined to bed with injuries/illnesses.
posted by jacalata at 2:17 AM on March 25, 2012


Better the seat that might kill me than the seat that will get my shoulder whacked every time the drink cart goes by.

Word. I will take the middle seat to avoid this, I kid you not. Seriously, you all can have your aisle seats and I will just sit here between you and that other guy over there to not get my elbows mangled by the drink cart and every passerby who trips into my arm when tottering to the bathroom during turbulence.
posted by sonika at 5:29 AM on March 25, 2012


It happens. No genetic factors, no history (family or personal), fit & athletic: 6 hour flight from East to West Coast of US. Window seat, a bit dehydrated but not overly so but I didn't get up for the entire flight. Ended up with a DVT & double PE. After searching extensively for any other possible casuses, immobility was all that was left.
I'd recommend getting up at regular intervals and a pair of fuglies (compression stockings).
posted by CaptainCaseous at 5:50 AM on March 25, 2012 [1 favorite]


I can find about half a dozen radically different positions to fit myself in an economy seat and sleep. Do people really just sit completely still in their seat when they fly?
posted by Meatbomb at 6:17 AM on March 25, 2012


DVTs prior to flights - my parents tell me that when they first qualified as medics in the 1970s the commonest DVTs that weren't related to illness were in people who took long coach journeys for holidays. Since flights were more expensive then, far more people did 10, 12 hour and even longer coach journeys - and similarly ended up with DVTs. Probably fewer than with similar flights, as those sorts of journeys did have stops where everyone would get off and walk around.

Nothing about height in there - depending on the airline, in economy class if I don't get an emergency exit seat I can be physically wedged into my seat. This does motivate me to get up and move about more, but when I'm sat down I can be totally immobilised.
posted by Coobeastie at 6:26 AM on March 25, 2012 [1 favorite]


Count me among those who always tries for a window seat. I fly on average just short of every other week, but despite all the hassle the thrill is still as vivid for me as my first trip on a DC3 when I was 7 years old. Of course it helps that many of those trips end me up the arctic. If you haven't seen the slopes of Denali or the Brooks Range or a cloud-free Aurora Borealis from an airplane, you're missing out. But honestly, I still find it exciting to see Indianapolis from the air. I hate everything else about flying these days. But actually being 30K feet above the earth for 6 or 8 hours? How many thousands of generations of humans have dreamed of it, and now we take it for granted.
posted by spitbull at 7:14 AM on March 25, 2012 [6 favorites]


And the common frequent flier etiquette, by the way: if you're in a window seat, make sure you take a piss before you board, go easy on the coffee, and wait until your seatmates (either one of them) has to get up to go. Among frequent fliers, nothing needs to be said. When one gets up, the entire row heads to the back. You're good for 2-3 more hours.
posted by spitbull at 7:19 AM on March 25, 2012 [2 favorites]


Well, the next time I'm in an aisle seat on a long flight, I'll make sure to check on my row mates regularly to see if they need to stretch. I wouldn't have really thought to ask normally. (though I don't fly much, either)
posted by empath at 7:20 AM on March 25, 2012


Take a preflight aspirin and drink water every two hours during the flight. Alcohol in moderation can also decrease the coagulopathic potential of long term sedentariness.
posted by Renoroc at 7:29 AM on March 25, 2012 [1 favorite]


Also, move your feet! If you're of average height, you should be able to wriggle your ankles and flex your calves without moving too much otherwise. When I fly, I try to do this every 20 minutes or so when I'm awake, and I get up in the middle of the flight regardless of my seat mates. Not to put too fine a point on it, but their absolute freedom from standing up is not more important than my freedom from DVT. Also, it really isn't that awful to have to stand up a couple of times during a flight to help a seatmate - on most flights, you're talking getting up a couple of times at most. This whole business of "I must not ask someone to stand up to let me go to the bathroom, oh the intrusive horror of it" is a bit silly. I stand up all the time at work; it's not as though I'd normally be spending 3 hours completely immobile.

I prefer the window seat for the light, the view and the ability to lean more comfortably. I move far more when in the window seat than in the center or aisle.
posted by Frowner at 9:04 AM on March 25, 2012 [1 favorite]


I'll take the window seat every time. What's going on out there (and down there) is INFINITELY more interesting than what's going on inside the plane.

... which I'm pretty sure would kill you if you take more than 4 flights a year. Not even counting the TSA.
posted by Twang at 10:02 AM on March 25, 2012


When one gets up, the entire row heads to the back...

That's what I always do. Coz I can never sleep on flights and my back hates sitting for very long, it's an aisle seat for me every time. On long flights I now try to get one of the aisle seats in the center block somewhere down the back, because I find I'm most likely to get a free seat next to me.

I still remember the ghastly flight, JFK to London, where I checked in late, got given a window seat, and then had the most gigantic guy next to me. I swear that it took a couple of months for my spine to get unbent from being squashed into the window...
posted by 43rdAnd9th at 12:49 PM on March 25, 2012


Before taking aspirin and wearing compression stockings, RTA! From the first link: "For long-distance travelers who are not at increased risk for DVT/PE, the guidelines suggest against the use of GCS [graduated compression stockings]. In addition, the guidelines suggest against the use of aspirin or anticoagulant therapy to prevent DVT/PE in long-distance travelers." I understand that these practices *were* once the standard, but now the new guidelines change standards of care. /librarian rant over

And window seats forever, DVT be damned.
posted by holyrood at 2:49 PM on March 25, 2012


I can find about half a dozen radically different positions to fit myself in an economy seat and sleep. Do people really just sit completely still in their seat when they fly? -- Meatbomb

I posted the original comment regarding ROM and position. I am not a large man (6'/190lbs) but I am proportioned.... differently. I swam as a kid and I look it - very short legs, very very long back. The kind of back that means I get to buy my pants in the jr dept and my shirts at the big & tall shop.Riding in the back of most cars means slouching or my head hit the ceiling. I can scratch my nose on the ceiling of my gf's 2009 rabbit, in the front seat.

When I sit down on a plane, usually domestic flights, the head rest pokes into my shoulder blades.
I can open, and fetch my jacket from, the over head luggage without standing up though I will admit that I couldn't get it closed again. Sitting tall, so as to avoid more back pain, in the window seat of most commuter flights, means that the curve of the fuselage will force neck cramps or leaning. Any lumbar support, should there ever be any, is never in the right spot.

I am not a large man but I certainly don't have many tolerable positions available on most flights and I wouldn't think I am the only one. The sort of fidgeting required to avoid pain while sitting anywhere else just doesn't seem to be an available option here.

*also? fuck any designer who decided that molded/fitted/'ergonomic' seating accouterments (like the aforementioned headrests) were at all appropriate for public use without far more adjustability than is likely to be afforded in a sardine tin.
posted by mce at 4:37 PM on March 25, 2012


Meatbomb: "I can find about half a dozen radically different positions to fit myself in an economy seat and sleep. Do people really just sit completely still in their seat when they fly?"

Well, I'm 6'1" and the average (domestic) economy class seat has me jammed in position, with my knees hard against the back of the seat in front (praying the person in front doesn't recline their seat) and the only thing I can move is from the knees down. I can't even fit a book in the seat pocket, because it pushes it back too far. With that limitation, there are not that many choices of positions that I've been able to find. Unless the plane has the newer style seats with adjustable headrests, I have nowhere to rest my head because the top of the seat is at neck height and I can't slide down the seat because my knees are already hard against the seat in front. I do move my feet around and flex/unflex my calves, but that's about the limit.
posted by dg at 8:56 PM on March 25, 2012 [1 favorite]


Funny, in a thread about window/middle/aisle, front/rear, seating no-one has an opinion of which is best for passenger-assisted anti-terrorist activities.
posted by porpoise at 11:04 PM on March 25, 2012


Funny-strange or funny-whatareyouonabout?
posted by maryr at 10:54 AM on March 26, 2012 [1 favorite]


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