I always bring a down pillow to cushion my hand since I'm so sensitive to vibrations. I start a steroid pack a day or two beforehand. I use Lidoderm patches and all my regular pain meds.

That's a VERY long flight. If you haven't booked yet, and if it's not a direct flight, I'd book 2 flights and stay a night at an airport hotel... If you respond well to sympathetic blocks, I would undergo one--the last time I flew internationally I did not have a block--it was miserable. The time before that, I had a block that helped tremendously.

Also take extra Vit C and maybe zinc, if you're not already, to help your immune system. Hot patches if you like the feel of them. Slipper socks. Layers if you have temp regulation issues.

Get to the airport EARLY. The least expensive way to upgrade is to do it right before the flight. It is quieter, you have more room, and the seats are much more comfortable.

Good luck.