I recall reading that flying can trigger symptoms. Does anyone know anything about this or have experience of flying with PCS?

My symptoms got bad after a flight that I took. So I would say yes, although none of the doctors I saw thinks this is true.

Can you elaborate at all? How long did you fly for, how bad did your symptoms get and how long did it take for them to reduce to normal levels?

About 3 months ago, a few days after my injury, I flew for about 1.5 hours, connected flights then flew another 1.5 hours. My symptoms really haven't gotten any better since then. I was relatively symptoms free the day before I flew. I have disorientation, memory problems, depression/anxiety, weird visual disturbances. It may have been a coincidence that my symptoms appeared after the flight, or it was the flight itself. I guess there is no way of really knowing.
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There are a number of factor that can trigger PCS symptoms from flying.

The most difficult to avoid is the difference in altitude. Studies have shown that a prolonged altitude of 8000 feet will cause an hypoxic effect (lower amount of oxygen) to the brain that will cause PCS symptoms. This same problem is rare in persons without a concussion history.

Commercial airline flights routinely have cabin altitudes of 8000 feet. Most aircraft are designed with 8000 feet as the max cabin altitude.

Some airlines are starting to experiment with 6000 foot cabin altitudes with some of the newer aircraft that can handle the pressure differential. Their studies show a noticeable improvement in passenger comfort with a cabin altitude of 6000 feet.

The noise can be a problem for some. I need to have good ear plugs. The noise/vibration combination can also be a problem.

Dehydration is also a factor. Be sure to stay hydrated. In the dry air of an aircraft cabin, you will lose hydration quickly with the air you breath out. Your red blood cells that carry oxygen need to stay properly hydrated to function best. Otherwise, they become viscous and slow moving.

The congested seating can be claustrophobic or overwhelming to some. I have had consistent problems with this. I need to sit at the bulkhead so I do not have a seat back at 8 to 12 inched from my face.

You have a right to claim preferential seating according to the Air Carriers Access Act. Do some research on the ACAA to get the scoop.

The problem with the ACAA is the time requirements. You must request the accommodation at least 24 hours prior to flight. In my case, the bulkhead seats are usually reserved for assignment at the ticket counter.

The way I get a supervisor to release a bulkhead seat is by claiming I am ACAA qualified. I say I have a visual processing disorder that manifests like claustrophobia. The seat backs are too close to my face.

They will try to deny me the bulkhead seats if they are an exit row (very common) with the concern that if I claim a disability, I cannot sit in an exit row. Once they see that I am able bodied, they will let me sit there.

I have flown over 50 times in the last ten years and have almost always been accommodated. If I am not accommodated, I need to try to sleep or keep my eyes focused on a distant object. I have spent most of a flight looking down the aisle.

My wife would rather drive 10 to 13 hours than have to endure my struggles with airline flights.

Hope these ideas help.

Thanks for all the ideas Mark. I think I'd suffer on a flight because I have had issues with pressure building in my ears, at least thats how it feels. I also felt lightheaded for a couple of weeks after using the London Underground and I made a note of it in my diary on that same day, so it was probably the cause. It did ease though, and it wasn't all that bad but a flight, particularly a prolonged flight would probably do more than a trip underground.

Damn, sorry to hear that. My symptoms didn't start until a month after my injury. I learned something that caused me some serious stress around that time and then the next thing I know my whole world has changed. I don't know if those symptoms were coming all along, or if that stressful news triggered it, because I'd been low since the injury occured.

I guess the only way for me to find out about flying is to do it. It isn't mandatory that I fly anywhere, but i've always wanted to see the world and i don't want PCS to stop me.

If you want to take extended flights, plan for a recovery day. Enjoy your travel rather than push yourself and feel lousy.

I cannot see how the underground could cause symptoms except from the over-stimulation, crowds, chaos, noise, maybe even lousy air.