Good morning frequent flyers — may we have your attention. In the next few
weeks many of you will be traveling over the Easter and Passover holidays,
during Spring break, and to warmer destinations to visit relatives,
friends, significant others and complete strangers. The skies are ready,
ripe and red-hot for a brand-new airline rage episode!

The fear of flying now means the dread of lots of unplanned extra time on
the ground, shortage of time between connecting flights and potential
unplanned delays. As physicians who have been turned from fairly rational
travelers into shaking psychotic masses of quivering silly putty, we know
that airline rage is not good for your health. What then should the airline
passenger do to convert rage to sage for the sake of your well-being?

The syndrome of airline rage was first described in winter 1998. The most
notable incident was the case of a Northwest Airlines plane stuck on the
tarmac in Detroit for hours while the passengers were stranded without food
and overflowing lavatories. Allegedly the cabin turned into a boxing ring,
and people began to throw things at one another.

Dealing with the airlines is not always a friendly-skies process. These are
the same guys who rolled the “hub and spoke” concept over us — and then
selected hubs with the worst weather. Many connections are so close in time
and long in distance that Olympic champion sprinter Carl Lewis would feel
stress. Once an elderly couple, standing next to one of your faithful writers and
boarding the same connecting plane, were one step from going into
congestive heart failure. And the writer is only a radiologist who can
diagnose disease but not treat it.

Airline executives are the same scholars who never acknowledged that smoke
in row 20 of the smoking section somehow drifted to row 19 of the
non-smoking section. They alternated smoking and non-smoking sections so as
to ensure the smoke was fairly distributed. For 50 years they loaded the
front of the plane first until the first writer’s 10-year-old niece
pointed out that, by loading the back of the plane first, it saved one hour
of everyone and their excessive luggage from tripping all over each other.

Airline travel not only takes its toll on your psyche, but on your body.
Here are a number of practical recommendations that can limit the emotional
as well as the physical cost of airline travel. In short, turn potential
airline “rage” into airline “sage.”

Get the right attitude (and altitude)

Start out with your attitude in line. Once you leave your house, you’re on
the road, so try to enjoy the ride. You’ll get there when you get there,
and screaming at the gate agent because of snow delays won’t change the
weather, just increase your stress level and your blood pressure. You can’t
change what you can’t change. Take a breath instead of venting. You’ll
probably find most agents will bend over backwards to help the considerate

Minimize dehydration

The poorly circulated low oxygen air with 4 percent humidity at cruising altitude
is low enough to make your contact lenses crumble! For the 35 million
contact lenses users, we recommend always wearing new and fresh disposable
contacts the morning of departure. The lack of precipitated protein on new
moist lenses avoids the scratchy eye syndrome.

That same low humidity takes its toll on the rest of your body. Avoid
alcoholic beverages that further dehydrate your system, and drink water
throughout your flight. Carry a bottle with you.

Fight lack of physical activity

Dozens of articles have been written lately about deep-vein thrombosis,
also called traveler’s thrombosis and DVT, which has been linked to the low
mobility created by long-haul flights and other forms of protracted travel
in cramped spaces, such as train, bus and automobile trips. It was
originally but inaccurately nicknamed “economy class syndrome” because it
was attributed to the cramped conditions in coach class.

The truth is that DVT has taken place in passengers riding in business and
first class — and even in people who sit for long periods at their office
desks. But, don’t tell that to the trial lawyers who have launched
thousands of lawsuits from the United States to London, Australia and
Japan. They are asking that the earth be made smaller and the
continents pushed closer together. We recommend avoiding DVT in the first
place because you’ll never see or be shown any of the money! Thanks to
legal troubles some airlines now require you to sign consent forms.

We admit getting physical exercise is difficult while traveling, especially
when chained into your airplane seat. Get up and walk, especially on longer
flights to avoid DVT. Some airlines have published stretches and
exercises that can be done even while sitting. For those with predisposing
illnesses to DVT you may want to think twice about going on long flights —
or at the least consult your doctor.

For exercise in airports during those delays, take advantage of
near-marathon length airport concourses by walking them before or between
flights. A colleague always carries walking shoes in her bag and uses the
time between connecting flights to take a “power walk” through the
concourses. Others may give you funny looks, but your heart will thank you.

Avoid unhealthy airline food

Find or bring healthy food. All airlines will provide low-fat meals on
request, and many airports now have juice bars where you can power up on
fruit smoothies or shots of wheatgrass before or between flights.

Adjusting to jetlag

A recent study from the Yale Department of Medicine notes that melatonin
will help you sleep at night but does not aid in readjusting your circadian
cycles. Although melatonin is not very toxic at higher doses, a safer
recommendation is to take physiologic replacement doses of 300-600
micrograms, if needed. Let other people be the 3,000 microgram (3 milligram)
and awake guinea pigs.

Comfort during travel

Dress for comfort in all temperatures. You may be traveling from a frigid
clime to Hawaii, but who knows what the temperature may be on the airplane.
You may be sitting in uncomfortable heat before takeoff, and then find
yourself freezing midair. Wear layered clothing so you can adjust to
whatever you encounter. As an aside do not wear synthetic fabrics which can
flash-ignite in an emergency.

Plan ahead to avoid stress

  • Neutralize the enemy by planning far ahead. This is easier than ever with
    computers and the Internet. Check destination(s), routes, airlines, plane
    type, hotel, weather, city maps, functions and dress requirements before
    you book. A few minutes of homework may save hours of groundwork. If the
    weather looks bad, don’t go. Some airlines now allow you to download
    boarding passes on your personal computer from home up to 12 hours in

  • It is often worth the extra money to fly direct. This also means you can
    check your luggage with greater confidence that it will actually arrive
    with you. If everyone checked luggage, boarding and deplaning time could be
    cut in half.

  • If possible, select the carrier whose hub is most convenient to your
    destination. For example, one of us recently was able to fly direct,
    non-stop, in half the time and cost to a meeting in St. Louis by finding an
    airline with its hub in that city.

  • Take early flights when possible. The hub system has a domino effect, so
    that any delays or problems only become worse as the day goes on. If your
    flight is delayed or cancelled you have more time to make alternate plans,
    and adjust to the airline schedules. When rested you will make better
    decisions and are less likely to become upset.

  • Take earplugs to minimize babies crying and inconsiderate noisy adults.

  • One last bonus tip: Unless you have no way out, avoid connecting flights
    through Dallas Fort-Worth Airport in bad weather.

    Thus prepared by incorporating the above survival strategies into your
    travel plans, you may avoid becoming a blithering idiot. You will reduce
    stress, elevated blood pressure, that ulcer flaring, increased insulin
    requirements, deep-vein thrombosis or the requirement for new post-flight
    tranquilizing medications. At least that’s our “Vantage Point” (title of
    the American Airlines Magazine) from the ground where passengers seem to
    spend most of their time when they fly!

  • Note: Read our discussion guidelines before commenting.