Flying With a Leg Cast Long Haul

Emma - 22 February 2015

With characteristically bad timing, I recently broke my ankle when rock climbing on a Friday evening. On the Monday morning I was due to fly from the UK to America. Trans-Atlantic flying with a leg cast wasn’t high on my list of travel experiences, but I didn’t want to miss the company meetings I was flying to the States for. Having decided to go, there were a number of things to consider and parties to contact.

Doctor

Your first priority should without a doubt be speaking to your doctor. Flying with a leg cast increases your risk of DVT, which gets scarier the more you read about it. On top of that, there’s considerable strain on your already battered leg and body, which will not help the healing process. To be honest, my Trauma Ward doctor wasn’t delighted by the idea of me flying two days after breaking my ankle, but talked me through what needed to be done to make sure the trip was as safe as possible.

Splitting the Cast

Your doctor will almost certainly require you to do this, especially if you’re flying within a week of having the cast put on. Splitting / cracking the cast means sawing all the way through the cast down the front. This is because the foot can swell on a plane due to the changes in pressure and being immobile for long periods of time. Having a swelling limb encased in an uncompromising shell is not desirable. They cut mine at the hospital, using a terrifying looking handsaw. The saw is actually completely safe and uses vibrations to cut through hard cast while leaving skin untouched (although it does get very hot!)

Once the cast was split, they strapped it with bands to hold it together. A split cast begins to fall apart a lot quicker than a complete one; within a day I had loose cotton wool trailing from the split.

A split cast - essential for flying with a leg castA split cast – essential for flying with a leg cast

Anti-Coagulants

These were the worst bit! In order to reduce the risk of blood clotting in the leg, I needed to inject myself with blood thinners / anti-coagulants daily, which was an incredibly unpleasant process. This was necessary even if I wasn’t going to be boarding a plane, but the fact that I was flying meant that it was essential I grit my teeth and do them. Of course, this is only my own experience – medication will vary from patient to patient.

The rest is up to you…

Prescribing medication and armouring your leg are all the doctors can do for you. The rest is up to you. I took my doctor’s warnings seriously and meticulously took my blood thinning injections, drank lots of water on the flight, ensured I moved my leg around frequently, and put as little strain on it as possible. I also made sure to contact the airline I was flying with to ensure I was taken care of by them.

Psyching myself up for my daily jabPsyching myself up for my daily jab

Airline

It is essential that you contact your airline to let them know that you will be flying with a leg cast and in need of assistance. There is usually a number you can call for a disabilities desk or something similar where you can inform the airline of your needs. I flew with United, whose brusque but efficient disabilities desk sorted out wheelchairs for me at all airports. Airlines ask that they be notified 48 hours prior to departure, but due to the short notice of my injury I gave considerably less notice than this and there weren’t any problems.

Getting to the Airport

This is a time to call in favours! While it is possible to get public transport to the airport, it will be getting from the door of the train / coach to the check-in desk that is the difficulty. If you are on crutches, you will not be able to pull a suitcase. You just don’t have enough hands. So either hope against hope that someone takes pity on you and offers to take it for you, or beg a lift from a friend / relative. I wouldn’t advise a big backpack either, as your balance won’t be great…

At Check-In

Once at the check-in desk, don’t hold high hopes of an upgrade. While it’s always possible, I was disappointed every time. Then again, United is famously difficult to be upgraded on. What you do want to do is request a seat with extra leg room. Often there are better seats than others within the economy cabin (if you’re in Business or First, you can skip this step…). Bulkhead seats (those at the front of the cabin) often have considerably more leg room, which is invaluable! If these aren’t available I’d recommend an aisle seat, where you can stretch your leg out in the gangway.

You’ll want to arrive as early as you can, at least two hours before the flight, to have a higher chance of being moved to a preferential seat. These seats generally come at no extra cost.

Getting to the Gate

Getting to the gate can be an extremely long and arduous process, with gates a 15-20 minute walk even for those with two functional legs. I can’t emphasise enough that it’s a good idea to book wheelchair use for these stages of the journey. You may feel ridiculous being pushed along, but it is necessary. The wheelchairs can often skip queues or go in ‘fast lanes’ (depending on the airport), so it can help you reach your gate on time. Bear in mind that it can also hold you up if your wheelchair hasn’t arrived, or if you need to wait for them to fill the buggy service to your gate. Half the wheelchair services I used were farcically disorganised and inefficient, but the other half were timely and business-like. It seems to be pot-luck.

Don’t assume your wheelchair driver knows exactly what they are doing, as I often found the opposite. However, you can trust that they know their way to the gate. Don’t assume, either, that the ride will be a comfortable one, what with the rattling, folding wheelchairs and the people slyly examining your injury, and the small talk with the person pushing your chair. But then again, it is a free service provided by the airline and certainly not something it feels fair to complain about.

Another consideration is tipping. It never crossed my mind that this might be a tipping service, and certainly at Heathrow I never felt like it was expected. But in US airports there was a momentary pause after they dropped me off and I thanked them which indicated to me that perhaps I should be reaching into my pocket.

How you go through security depends entirely on the airport. Once I was taken through in my wheelchair, another time I was given a wooden cane to walk through with, and another time I went through on my crutches. Each time I needed to be swabbed and thoroughly searched. One warning I would give is keep an eye on where all your possessions are when they’re being loaded into the scanner. When there’s someone else helping you put stuff in and out of the trays, it’s a lot easier to lose track of something and accidentally leave it behind.

Although the wheelchairs seem to be provided through the airport, you must book the service through your airline by phoning them up. It is free of charge, and all you need do is ask.

Boarding the Plane

When boarding, most airlines call passengers with disabilities to board first. Unfortunately, so rarely does someone board at that time that they move on to the next wave of priority passengers in almost the same breath. Make sure you’re up at the front to make yourself visible. I found that by the time I had packed away my book, stood up, and sorted out my crutches, they had boarded half the plane. You do want to try and be an early boarder, as crutches can be tricky once in a confined space.

Also, depending on the flight you’re boarding, you may have to navigate steps onto the plane. Despite having told my airline that I could not manage stairs, I was expected to navigate steep and snow-covered steps in Washington D.C. to board the regional plane. Larger jets usually have a ramp, and so are less difficult. All I can advise is that you devise a tactic for dragging yourself up steps beforehand, as the best time to find a viable technique is not with a crowd of cold passengers waiting behind you.

On Board

Most, if not all, airlines will take away your crutches for take-off and landing, as they don’t fit into the overhead bin or under the chair. I found the airline stewards and stewardesses to be attentive on board, and other passengers went out of their way to assist me.

During the flight, flex and circle your leg as much as possible, lifting the foot above hip height if it begins to go numb. Keep active to help your circulation. Drink lots of water, as this will help fight against DVT. An unfortunate but inevitable side effect of piously drinking water at all opportunities is being forced to use the facilities on board. It’s up to you whether you want to hop along the aisle and use the seats for support, or use crutches. I opted for the latter as I found myself slow, unstable, and putting too much weight on my cast otherwise. You’ll need to ask for your crutches back – I have heard that some airlines stow them for the entire flight, but United gave them back to me as soon as I asked.

As you navigate the narrow aisle, look as pained and pitiful as you can so that people helpfully move legs / arms / shoulders from your path, and aren’t too annoyed if a little gentle turbulence sends you toppling onto their tray table.

My bulkhead seat, with plenty of legroomMy bulkhead seat, with plenty of legroom

Collecting Baggage

This is the most difficult bit – waving goodbye to your wheelchair assistance and having to get to your destination with suitcase in tow. Though not officially supposed to, I was kindly given assistance past the baggage claims at both final destinations (Nashville Tennessee and London Heathrow) but this can’t be relied upon. Try to have someone waiting for you in arrivals to assist.

Some General Advice when Flying with a Leg Cast

◾Wear clothing with pockets so you can quickly access and put away essentials (boarding pass, passport, etc), rather than having to hold up queues as you red-faced take forever to access or put away items you could usually hold in your hands.
◾That said, don’t feel bad about holding up queues. People are always in a rush in airports, but everyone was understanding and sympathetic. And curious…
◾You will be asked 100 times ‘how did you do it’. Get used to answering and try to have a good story!
◾Learn how to manage steps just in case there’s no ramp. You don’t want to be ignominiously carried up the plane steps
◾Don’t be too attached to habits. You won’t be able to pick up that coffee, as you can’t carry it. You won’t be able to sit in a window seat. Accept it and move on.

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