Surviving an airline flight

from CNN Paging Dr. Gupta by Dr. Sanjay Gupta, Chief Medical Correspondent
By Dr. Sanjay Gupta
Chief Medical Correspondent
http://www.cnn.com/HEALTH/blogs/pagi...ne-flight.html

The recent story of Carine Desir, a 44-year-old woman who died on an American Airlines flight from Haiti to New York, has a lot of people thinking: Could that happen to me? Well, it could. But it's not likely and there's no reason to panic.

What happened to Desir? She reportedly complained of not being able to breathe and received oxygen, although a family member has complained that the oxygen was delayed. Doctors and nurses aboard the flight stepped in to try to help, including using an automated external defibrillator, but their efforts were not successful. The medical examiner's office said Desir died of complications from heart disease and diabetes.

But what should you be thinking about before you get on an airplane? There are times when you should rethink flying, but it's not always a simple decision. Here's how flying is most likely to affect your health and some things to think about when you're deciding to fly or not to fly.

First off, it is worth noting that two important things happen on a plane shortly after takeoff. One has to do with pressure. If you are on a small plane that flies below 10,000 feet, the plane may not be pressurized. Larger planes that fly 30,000 to 40,000 feet above the earth will be pressurized, but because of the differential, the cabin altitude will still feel like you are about 8,000 feet in the air. Most people can tolerate this just fine. The oxygenation is also slightly lower in airline cabins, again not a noticeable difference for most people.

Still, there are people who are at most risk from these changes. People who have sinusitis, pneumonia, other respiratory illnesses as well as ear problems probably shouldn't fly and will feel pretty miserable if they do, because of those pressure changes. The cavities will expand and may cause pressure and pain.

Also, if you have had recent abdominal surgery, eye, ear or face surgery, dental work such as an abscess repair, you should stay grounded. Anyone who's had a recent concussion or colonoscopy should also wait at least a day before taking to the air. Obviously, a communicable disease such as TB (like Andrew Speaker had) should preclude you from flying. Another tip: Let's say you're out skiing and break an ankle or leg. Tell your doctor you want a soft cast or splint if you are going to be on a plane. The swelling can be awful.

There are some things you should always do on planes. Drink plenty of water and lay off the alcoholic drinks. While blood clots in the legs have not been shown to be caused by cabin conditions, they can be caused by simply sitting for long periods of time, especially with your legs crossed. Get up and walk around.

You know, I was most curious about the everyday cold. How about waking up the day of a flight with the sniffles? What do you do then? There are no absolute rules here. If you are really feeling miserable, the flight will probably make you even worse. However, actually catching a virus on a plane is no more likely than catching it at sea level in crowded conditions like a bus or office space.

As things stand now, it is up to the consumer to disclose whether he or she is too sick to fly or have a communicable disease that could put other passengers at risk. Do you think the airlines should have more specific rules about people flying with an illness?

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