How to pick the best seat on a plane when you live with MG
In choosing among aisle, middle, or window, I've found what works for me
Do you prefer a window seat or an aisle seat when you travel?
Before I got sick during my deployment to Iraq (2009-2010), I used to love to travel. I never had to give much thought to flying. I always went with the cheapest ticket or the best deal.
When I was medically retired from the Army in 2011, I all but gave up the idea of traveling solo; my health was just too poor. Gradually, with the formal diagnosis of myasthenia gravis (MG) in 2018 and continued improvement of my treatment plan, the idea of traveling started percolating in my noggin once more.
In May 2023, I flew to Denver to spend a long weekend with my mom at a work convention. It was my first solo trip in nearly a decade. For this flight, I relished the window seat. Unfortunately, it was a less than stellar experience because of my physical disabilities and my PTSD. For the next 18 months, I put in the physical and mental work so that if an opportunity presented itself to travel again, I’d be ready.
As luck would have it, just such an occasion presented itself in the form of a post-traumatic growth (better known as PTG) workshop held at the Travis Mills Foundation, a veterans retreat center. I jumped at the opportunity and made it happen. But when I got the travel itinerary showing a layover, I started second guessing myself.
Research and experience
With that in mind, I started doing a deep dive into some research to appease my concerns. In the process, I found some wonderful information about how an airplane is designed — and specifically, how the cabin air is circulated.
According to the information on the International Air Transport Association website, the cabin air itself is better than most indoor environments. That’s because of the high efficiency particulate air (HEPA) filters used on board, as well as the cabin air refresh rate, which is around 20-30 times an hour.
These statistics were published during the COVID-19 pandemic. When combining the HEPA filtration and the air cabin circulation, the bacteria/virus removal rate was 99.993%!
In the passenger cabin area, the airflow itself goes from the top, then to the aisles and walls, and then underneath the seats before going back to the air-mixing and filtration area.
So what does all this technical mumbo jumbo have to do with picking a seat when you have MG and you’re looking into flying?
If you’re on immune suppressants, a lot.
Making my selection
One of my main concerns was getting sick because I’m on the immunosuppressant Imuran (azathioprine) as well as prednisone. I don’t like wearing a mask for a handful of reasons, the primary one being that I find it hard to breathe because of my diaphragm weakness. Armed with the knowledge of the cabin airflow, I selected an aisle seat.
I used to think that an aisle seat would be worse for me for a couple of reasons: first, being exposed to everyone walking by, and second, having to get up if my row mates needed to use the bathroom. Turns out, I was wrong.
Yes, everyone walks by, but the air flow keeps the germs from settling. So fear numero uno was laid to rest. But what about having to stand for my row mates?
I had to stand and go to the bathroom when I flew to Denver and chose a window seat. I also had to stand and let my row mates out during my flights from Maine back to Wisconsin, where I now live. I was shocked to realize that sitting in an aisle seat made standing up easier because I had more room and objects to use as supports.
Another benefit that I didn’t realize until just now is that I didn’t have to speak as loudly for the flight attendant to hear me. That prevented any hoarseness that may have come from my fatigued vocal cords.
With these two experiences under my belt now, I can confidently say that an aisle seat is better for me, a traveler with myasthenia gravis.
Note: Myasthenia Gravis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Myasthenia Gravis News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to myasthenia gravis.
About the Author
Jean-Pierre Jacquet
My choice of seat is not based on that interesting analysis of the cabin air flow. My choice is based on possible urges to use the toilet, my cocktails of meds having wreaked havoc to my gastrointestinal system. So I pick an aisle seat as close possible to the restrooms.
Shawna Barnes
Thank you for sharing your reasons for how you pick your seat when traveling Jean-Pierre! - Shawna
George Tvardy
As one with generalized MG, and one who has had to travel frequently the last 4 years since being diagnosed, your recommendation of an aisle seat is on target, especially if you experience significant muscle weakness. I am personally fortunate that my muscle weakness is relatively mild, so I still sit at a window seat, but that's because of my personal preference of looking out of the window during a flight to enjoy the view. But definitely, if a person has moderate to severe muscle weakness, the aisle seat is definitely the way to go. It is definitely easier to get out of an aisle seat than to have to climb over two or three chairs while ducking under the overhead bins!
I would also add a couple of other suggestions as well. First, if at all possible, I would try to pick a seat near the front of the plane (less distance that you have to walk down the plane's aisle and less distance to tote your carry-on bags.
If financially feasible, if one can upgrade to a seat with extra legroom, that also helps with leg and other muscle fatigue.
Finally, if you have to change planes, make sure that you leave a minimum of two hours in between flights. I cannot emphasize that enough! That way, you do not have to rush from one gate to another location, sometimes entirely across an airport. I had to rush to a connecting flight in Charlotte a couple of years ago, and it helped to put me in an MG crisis a couple of days later. (As an aside, in my opinion Charlotte is one of the most non MG-friendly hubs out there). Take your time getting to your connecting flight... if you're late, it's OK. You can always book another flight. You can replace the money that you may have pay extra for that later flight, but you cannot replace your health!
I feel very fortunate and blessed that I can still travel with MG. Once I get on my plane. I find flying as very relaxing. And, visiting other parts of our country and our world can be relaxing as well, which can lower your stress level. Lower stress = less severe MG symptoms, which is a good thing!
Shawna Barnes
I agree with your suggestions/tips, George! I upgraded on one segment to have increased leg room and it definitely helped with comfort. The extra time was also something I made sure to have. Thank you so much for sharing your experiences! - Shawna
John Arnott
Thank you for the info on cabin air. I was always concerned about that. Now if I could only find a way to overcome the stress of the turmoil and wait times in airports
Shawna Barnes
Hey John. I have trouble with PTSD and was pretty anxious the first time I flew solo when I went to Denver. This time around, when I went to Maine, I asked for a wheelchair attendant ahead of time so someone was always there for me to assist. I have my own wheelchair so that helped with my comfort levels. It may be worth looking into, to request the attendant/wheelchair service to help alleviate the stress of traveling so you can better focus on other things. - Shawna
Maria S
How did you handle Denver? We went in September and with MG causing a weak diaphragm, I was very affected. I was very limited by the shortness of breath. Once I got back home, I was so much better. Our son lives there. Elevation is 5500 in Castle Rock, where he lives, south of Denver. At our home we are at 500;feet of elevation.
Shawna Barnes
Hi Maria. I was actually surprised at how well I handled the altitude at Denver. I took my bipap and used it when I got to the hotel, stayed on top of taking my meds at set intervals rather than waiting until I felt like I needed them, and was very aware of how much energy I was using. - Shawna
FRANK H SCHULTZ
Dear Shawna,
This is great information, as are all of your articles! Thank you.
I've also learned that though the air circulates fast, as you said, while the plane is in flight, it's much slower when the plane is on the ground. Luckily I can wear a mask so it's no problem to wear one for the time before the plane takes off. Also, I make sure to bring plenty of hand sanitizer or wipes to clean every surface near me, especially those I know I'll be touching: the armrests, seat belt and buckle, window shade "handle," light & call buttons, tray table, any screen and control buttons, and the button for leaning the seat back. If I'm in the window seat, which I like for sleeping, I often clean the window, too since I may be leaning my head against it. Plus the sanitizer/wipes are very helpful if, gods and goddesses forbid, I have to use the plane's bathroom!
Thanks again,
Frank
Shawna Barnes
Thank you for the kind words, Frank! I'm glad you find my articles helpful. I also wipe all contact points off, use the air/fan and have it pointing towards me and blowing out towards the aisle. The first time I flew after my MG diagnosis I sat in a window seat so I could use it as a head rest. But I quickly discovered it was a HUGE pain for me to get by to use the bathroom on the longer flight.
-Shawna
Tom
Thanks for putting the aircraft air filtering system information out there for everyone to know. Many folks are really worried about the air quality in the aircraft and worried about the spread of germs. I always have an asile seat now that I have MG. Much easier to use the restroom, no climbing out of the row. Having to do it couple of feet during a long flight is embarrassing and inconvenient for my fellow travelers. At large airports you can get the shuttle cart that is used for handicapped and elderly passengers. Some gate changes or to get to baggage claim can actually be a mile long and with MG that can be a real problem. So DON’T BE HESITANT to take it, that’s what it’s for !! Do not let your MG hold you back from flying out to visit family and friends or that nice vacation… Stay Safe