[postconcussion]

Please any help or information available?


Over the years I have read posts on here about flying on an airplane. Most people are fine, and my neurologist said I was just stressed when I described the intense head pain and ear blocking and cheekbones swelling (Eustachian tube Dysfunction), throat swells too. I understand stress increases headaches, but this is an intense headache pain.Pain starts on takeoff and lasts throughout the flight. Doesn't get better inflight and landing it doesn't get worse.

I went to an ENT and he said it could be a sinus problem. I had no problems ever before on a plane or with allergies or sinus infections. He did an xray that showed clear sinuses. Somehow my sinuses are affected with the pressure since my concussion. How is this possible? I have learned that the sinus headaches are supposed to worse on landing but mine isn't.I have neck injury which affects nerves. I have tried to hold my neck when plane is vertical, didn't make a difference in pain.

The pain is extreme. I live in Hawaii and have taken a short flight to the outer islands to test out my headache. Only 30 minutes and in extreme pain. I don't know if I can ever go to the mainland again to visit family.I stay home when everyone else goes. It will be four years for me since my injury and I still have this flying problem.

I tried ear plugs, special ear planes ear plugs, bose headphones- made it worse on plane. Pain meds, hydration, deep breathing helps to make it through. This is not just anxiety because it does not feel like a panic attack. Worse symptoms is extreme headache. I can usually tolerate my high level of pain daily so I am not just being wimpy.

Please me help me understand why this happens.It means so much to me, I have been testing this for years! I have missed out on so much. Any thoughts would be helpful.

Please! and thank you.

I have researched and found this... some commenters have had previous concussions:
http://neurocritic.blogspot.com/2010...-headache.html

Also, I had barotrauma or Airplane Ears my last short flight, I had some cold symptoms previous to my flight. But had no cold symptoms before on two other short flights and still had pain, ear block on both sides. I also did an elimination diet before my flight to rule out any food allergies I may have. Anything else I can do? Thoughts on nerves or blood vessel, low oxygen problem? No one else can help me, anyone with any experience please share your opinion?

ENT said to take nose spray Afrin, and sudafed. But I never had this before my concussion! How is this related? How can this be only due to sinuses, ENT said there is no structural damage to sinuses on xray or examination. He did say that because it is so bad on short flight, my ears could rupture on a mainland flight. I don't mind that but he said I could lose my hearing if they don't heal properly. I read that if your ear ruptures it will be painful but then the pain will stop when it ruptures. I don't mind that but the head pain is so bad, it must be something related to the nerves. Also, feel extreme nausea on flights.

Zofran helps nausea and i just don't eat anything hours before flight. Please any thoughts?

[Mark in Idaho]

Anxiety does not need to include an anxiety attack. Take a blood pressure kit with you on the short hop to see if your BP increases. You should get used to taking your BP occasionally to get a sense of your normal BP. Then check it when you have a head ache or head pressure.

There are some sinuses in the brain that may be subject to pressure changes.

Here is what Mayo Clinic has to say: http://www.mayoclinic.com/health/headaches/AN00751

[postconcussion]

Thank you, I know how to check my pulse and have checked it on the flights. After years of being an athlete, I can check it easily without a clock. It is normal and normally my BP is low. 100-110/68ish.

Should I take a migrane med?
Pain med? Benadryl to sleep?

I can only take small amounts of medicine and only one type at a time. I just wish I could find out what the issue is. What do you think it is?

I do not feel nervous on the plane, just the pain. No claustrophobia. It would be really nice if it was just anxiety, I would say that yes I am a bit worried but I am at the point where I want to not miss out on life any more. I am not scared to rupture my ears if necessary or feel really nauseated and have some pain, but I would just like help understanding why this happens. It is def related to the pressure changes though, as your article mentioned. There is not really a medicine for that, or is there?

Thank you so much. What should I do?

[postconcussion]

Mark, this is what I have done:

Nov 09- injured
About 2 years later when able to be out most of day:
Honolulu to Kauai: Flight about 20 minutes.
Foam earplugs, Bose headphones, Zofran for nausea. Didn't eat before. Headache felt like migrane 10/10 on takeoff and stayed about 2 hours after landing.then went back down to my usual pain normal.

1 year later
Honolulu to Maui: 30 minute flight
Foam earplugs, Bose headphones, Ibuprofen and Zofran. Migrane and pressure headache. Also came during takeoff. Not as nauseated this time, I think due to improvement of PCS.Pain 8/10 but handleable for short time.

Last month: Honolulu to Kona. 50 minute flight.
Wore earplanes. http://www.google.com/search?client=...UTF-8&oe=UTF-8

No pain meds to try out. Pain less of migrane, more behind eyes and forehead.On return flight, pain 10/10 tried sudafed right before.

PLease help thank you. I thought because my PCS has improved so much I would have no problems flying by now.

[Mark in Idaho]

It is your Blood Pressure you need to check. Your blood pressure can elevate with normal pulse rates. You need a BP cuff to measure your blood pressure. You can buy them at the drug store for $30 or so. The arm cuffs are more accurate than the wrist cuffs.

You may not feel nervous but your body/brain may be reacting to the situation in ways where only your BP elevates. Aircraft have sounds and vibrations that can over-stimulate your brain. There are visual clutter that can cause a problem with visual over-stimulation.

But then, the Mayo Clinic does validate air pressure related head aches.

[postconcussion]

Thank you very much. I will check my blood pressure. Are you thinking that if it is high I could take a medication to lower it while in air?

The doctor said if I take Sudafed I will increase my BP and feel wired. That is kind of the opposite of relaxing on the plane. It is hard to decide what to take. Because if it is a sinus headache Sudafed is supposedly wonderful for flights.

I am trying to narrow it down.

Could be some sinus problems (decongestant)this is what is advised and ENT prescribed:http://www.amazon.com/review/R3HU5Y14YGRQ40

combined with pressure problems (? don't know what to take)
and nerve issues ( pain pills to kill the nerve pain)


Another headache study:
http://www.ingentaconnect.com/search...ize=10&index=9

Any other thoughts. I appreciate this so much. Thank you.

[berkeleybrain]

I thought I would share my recent (3 weeks) experience.

I have PCS with vision and vestibular issues. When I fly (twice now) prepared with Afrin/earplugs/sudafed, I still get eustachian tube dysfunction.

After intense ear pain, I take antibiotics. I thought it was related to my inner ear issues.

THe ENT at UCSF said it wasn't the sinus/inner ears per se for me, but rather the brain. The brain was interpreting all these signals incorrectly, and then they would manifest by impacting the inner ear/eustachian tube.

I was diagnosed as Vertigo associated Migraine, that gets manifested as sinus/ear pain/vertigo. So I have been put on nortryptiline (30mg).

It's helped a lot. No vertigo. No dizziness. No migraines. No ear pain. for 3 weeks. Knock wood.

You may want to talk to your doctor about increasing your threshold for migraines through medicine and see how that impacts the flying.

Best of luck!

[postconcussion]

Thank you berkley brain!
I am so happy to hear something about this. Yes, it seems to be all connected somehow.Are your ears in pain in the flight? And for how long after? Migrane increase? Was it hard to swallow?

How long were your flights? Do you get the pain on takeoff? Did you try the earplanes or flightmate ear plugs? Did your doctor say it was fine to fly? The ENT doctor told me that he didn't recommend me to fly but he couldn't stop me.

thank you!thank you! This means so much!

I think that we may have this because of our whiplash history.

[berkeleybrain]

Yes-it very well might be!

My two flights were around 6 hours each way (CA-HI and CA-NY). Intense ear pain, plugged feeling, sinus swelling, migraines, dizziness/nausea were the main symptoms for the first 24-48 hours of flying to the destination.

The flights home, however, I lapsed into a 2 week sinus infection/ eustachian tube dysfunction that was very painful. It was like the flu but located in the inner ear.

I ended up getting antibiotics and then cortisone shot to try to relieve the ear pain.

I think if I knew then what I know now, I wouldn't fly. I hate to miss out of family fun, but both times I was out in bed for 2 weeks at a time when out home.

It's a hard call-if you can relieve the migraine symptoms, perhaps the flights wouldn't exacerbate the sinus pain.

Best of luck-one trip was to Hawaii which I really love (and well, maybe the flight was worth it!)

[postconcussion]

Thank you!

Ahh yes. The same thing happened to me on my last flight home. I got this sinus infection ear block thing after the return flight. I still have it a bit actually a month later. My ears are still making crunchy nosies. I had to get eardops antibiotics plus steroids and take pain meds until it healed a bit. My cheekbones were so swollen.There was fluid and infection in both ears. The migrane plus sinus headache was a bad combo.I was driving a few days later and had to pull over I was so dizzy.

I took the short flight to test it out because i wanted to go on the mainland flight the next week. But instead I was in bed for a couple of weeks like you mentioned. I went to the Big Island and it was very voggy in Kona. I think that it contributed to the problem. The sky was dark gray in the day, maybe you should stay away from vog and volcanoes in the future

Thank you for understanding and telling me what your opinion is. Will you please answer some of these questions?

Do you think you will wait until headaches are all gone to fly again?
Did your Dr. say that this is temporary? Has he seen other post-traumatic headache patients with this or pcs patients?

Say as long as I'm having my daily migrane I can expect it?
Or even if headaches go away the flight might trigger it?

What was your protocol for your Sudafed and Afrin? Please share I will probably bookmark this thread forever

How did you get through the flight?

Did you feel the headache on takeoff. Usually I'm fine then right when the plane acsends rapidly the headache does too!

Do you have any allergies? Were you congested at all before the flights?

Could you swallow on the flight? I had to swallow so hard in order to drink juice because my throat swelled up.

Do you get carsick more easily now? I notice I do.
Do you think you would get seasick if you went on a cruise? I am 27 and never ever thought I would go on a cruise but if years and years go by and I can afford one later it sounds like it might be the only option to get to the mainland.

Does benadryl take your headaches away?
I will probably try a flight eventually because I want to so bad, but never with a cold.


Thank you so much! You have been wonderful!