Lymphoedema & Flights
Taking appropriate precautions to reduce the risk of developing lymphedema always makes sense. Travelling in aeroplanes with pressurized cabins at high altitudes, especially on long-haul flights, may have deleterious effects on unmanaged lymphedema. However, individuals affected by, or at risk for lymphedema should not avoid air travel due to fear. Being aware of the possible physical stresses on the body during air travel is important and enables patients to take appropriate precautions.
This article addresses suggestions to help reduce the risk of triggering lymphedema and prevent existing lymphedema from progressing during and after airline travel.
Effects of Altitude on Air Pressure:
1. The air’s pressure is caused by the weight of the air pressing down on the earth, the body, and the ocean as well as on the air below. The pressure value depends on the amount of air above the point where the pressure is measured; if altitude increases, the pressure falls.
2. The exact pressure at a particular altitude depends on weather conditions. As a rule of thumb, the air pressure drops about 1 inch of mercury for each 1,000-foot increase in altitude or about 0.49 pounds per square inch (psi).
3. Cabin Pressure (Cabin Altitude): Commercial aircraft are capable of flying at altitudes that are incompatible with human life, but passengers and crew are generally not negatively affected because of the onboard environmental and pressurization systems.
Cabin Pressure and the Effects on Lymphedema:
1. Many patients report that their extremities started to swell during air travel.
Inactivity during flight, especially in cases affecting the lower extremities, maybe the most reasonable explanation for swelling.
Inactivity in combination with compromised lymphatic drainage can have serious consequences.
Inactivity, with the legs in a downward position coupled with the subsequent pooling of venous blood, can lead to an increase in tissue fluid in the lower extremities. This may trigger the onset of lymphedema in those patients with latent lymphedema or worsen already existing lymphedema in the legs.
The reduced pressure in cabins may allow more fluid to be filtered from the blood capillaries into the tissues, which can trigger the onset of lymphedema or increase swelling in individuals with compromised lymphatic drainage.
Ways to Avoid Swelling during Flight:
Compression therapy, such as wearing compression garments, is the most effective measure to counter possible negative effects on lymphedema during air travel.
Performing in-flight exercises is highly recommended. These can include reaching up toawrds the ceiling of the plane, moving your feet in circles, standing up and walking when allowed, back twists while sitting, squeezing a ball for e.g.
Useful Tips for the Airline Traveler:
Plan ahead:
Seek the advice of your physician and your lymphedema therapist if there are any questions.
Carry your medication with you. If your destination is located in hot or mosquito-infested areas, take precautions (sunscreen, insect repellents, and antibiotics).
Bring your skin lotion; the air in pressurized cabins is extremely dry.
If possible, request an exit seat, which gives you more legroom. Definitely request an aisle seat so you can get up periodically without disturbing the person sitting next to you.
Allow ample time to check in and reach your departure gate.
Wear loose, comfortable clothing and comfortable shoes that have been worn previously. If you have lymphedema of the leg, do not take off your shoes during the flight.
Make sure that you can manage your luggage. If you travel with another person or a group, ask someone else to carry the luggage for you. Should you travel on your own, take a smaller suitcase (preferably one with wheels). Don’t lift your luggage from the baggage carousel with your swollen arm.
Check the quality of your compression garment. If you have more than one garment, take the extra one with you as a backup. Remember, if your destination is located at high altitudes, you need to take the same precautions as for your flight. Take extra bandages (short stretch) with you.
In-flight:
Relax and enjoy your flight.
Eat lightly.
Drink plenty of water
Do not place anything under the seat in front of you so you can stretch and exercise your legs.
Stand up and walk around the cabin periodically – make sure to observe the fasten seat belt light.
Ask somebody else to place your carry-on luggage in the overhead compartment.
Make sure to perform some easy-to-remember “muscle pump” exercises (roll your feet; lift the heels and toes alternating, etc.). Ask your therapist about recommended exercises during the flight.
Elevate your arms as often as possible if you have upper extremity lymphedema.
Wear your compression garments!
If you have a stocking with an open toe, you may apply bandages on your toes and any other part of your foot that may be exposed.
It is necessary to wear a glove in addition to your arm sleeve. If you have a gauntlet without finger stubs, you should bandage your fingers.
It is also a good idea to wear an additional short-stretch bandage on top of your garment to counter the effects of low cabin pressure – talk to your therapist!
Upon Arrival:
Do not remove your garment and any additional bandage materials before you reach your final destination.
Upon arrival at your hotel, etc., rest should be your top priority. Make sure to have your limb elevated. A few more exercises with your garments in place would be beneficial.
Additional reminders:
It is important to continue following general risk reduction practices for lymphedema, whether at home or on vacation.
In summary, while air travel can pose challenges for individuals with lymphedema, being aware of the risks and taking appropriate precautions can help minimize potential complications.
https://www.lymphedemablog.com/2023/04/17/lymphedema-and-airline-travel/
Based on an article by JOACHIM ZUTHER
