Y. Mark Hong, MD

Airlines: Guilty of Cruel and Unusual Bladder Punishment

By markhongmd on April 13, 2015

Where the bladder meets thin air

You're strapped in at 30,000 feet.  The flight attendants have finished serving you a round of water/cola/coffee/beer.  The call of nature starts to itch, but turbulence suddenly makes any step into the aisle a scene from the TV show Cops, broadcast overhead for all the hear.  "Please stay in your seats and keep your seat belt firmly fastened.  Yes, I mean you in the striped shirt squeezing your thighs."  The minutes tick on and the bladder itch turns into urgency which turns into burning pain.  By the time the bell goes off overhead to allow free cabin movement, you are unstrapping your seat belt but five others have started heading towards the rear.  So you decide to wait but as soon as one returns to their seat, another two get up to join the ever constant line.  So why is this cruel and unusual?  Because there are two bathrooms for 150+ people.  Let's break this down.  They feed us liquids.  They tell us not to congregate in lines around the bathroom.  They provide one bathroom for 80 people, and Heaven grant you Mercy if you are disabled, elderly, or have a child.  Or if you need to go #2.  By the way, it's a much tonier 12:1 first class traveler-to-bathroom seat ratio beyond that thin veil separating the bladder have's vs. have not's up front.

Why does this outrage me?

Bladder health should be a right, not a luxury.  Just because we're in economy doesn't mean our bladder health is not as important as those in first class.  How about a system similar to TSA priority lanes where first class passengers have the right to cut the line, but the front bathroom is otherwise available for all passengers?  And if first class don't want people lining up next to them, design planes with the front bathroom behind first class.  I know the newer planes are now offering this configuration, but why not allow a culture where bathrooms are efficiently available for all, with special privileges for those who have deservedly paid more for immediate access?

What to do if you're stuck in the back

So you're still squirming in the aisle or your seat, hoping you don't have a 6 mile-high accident.  What can you do short of calling your urologist? (sorry, I'm in line ahead of you, buddy)  First take a deep breath.  Seriously.  Meditation helps takes the sting out of the urgency, as does focusing your mind on your breathing rather than on your bladder.  It worked for me 20 minutes ago on this tortuous U.S. Airways flight.  Second, try acupressure.  Studies have shown some efficacy in using the Kidney 3 acupoint.  Cross your leg, find the midpoint of your inner ankle and the Achilles tendon, and put firm pressure on that point for several minutes.  You can also try the Spleen 6 acupoint, sanyinjiao, a very important point in Chinese medical theory.  Find this by measuring four finger-breadths above the inner ankle and pressing down just behind the shin bone.  If you already know you have overactive bladder, you may need to skimp on the fluids, especially coffee, tea or soda, during the flight.  Although this goes against other medical advice to stay hydrated in the dry airplane environment (lose, lose, I know).  Avoid alcohol or other diuretics including caffeine.  In severe cases, we may need to give you medication that can get you through the flight.  Let's start talking to the airlines, letting them know that bladder health and your comfort are important in this era of cramming more passengers into less space.  Good luck and safe travels!

About Dr. Hong

Dr. Hong is a Phoenix urologist who has had too many patients have miserable airline experiences to be satisfied with the current state of flying.  His recent experience is repeated, or tolerated, thousands of times a day across the nation and world.  Contact us to see Dr. Hong in person and discuss your next bladder adventure.  


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