James' World

During the recent holidays, I unfortunately caught a head cold during my vacation trip and had to fly several legs with sinus congestion.

It is strongly recommended not to fly as a required crew member or passenger with a head cold, ear infection or sinus problem by medical and aviation experts.

Upon takeoff and especially landing, you cannot equalize pressure between the airplane cabin and the passages inside your ears and sinuses.

As a result, the following injuries can occur:

• pain, sometimes excruciating
• ruptured eardrums and middle ear problems
• damage to sinuses.

The best advice is to either cancel the trip, or take surface transport like a train or boat if possible.

If you’re really stuck flying, here’s some further advice that can help if you’re a passenger:

• short flights under 2 hours can cause less problems, as they typically stay under 25,000′
• You will need a nasal decongestion drug to open your sinuses and ear passages. See an ENT doctor before flying if possible.
• in the USA, take a Benadryl (pseudoephrine) capsule 5 minutes before takeoff and landing (if you have normal blood pressure)
• in some Asian countries, Tremenza (pseudoephrine with triprolidine) tablets are available, but they take longer to become effective than capsules (if you have normal blood pressure)
• Drizine (oxymetazoline hydrochloride) by Schering-Plough is a nasal spray that can also be used.
• carry or request a bottle of water and drink it on takeoff and landing. You will be swallowing more than usual to equalize pressure, which you won’t be able to continue with a dry throat.
• if you’re experiencing pain, especially on a USA airline, notify a flight attendant so that they understand it’s a minor medical issue and not a security problem.

Note that pseudoephrine is a controlled substance in the USA and other countries, so if you have a prescription, carry it with you when going through Customs, or discard the drug in a place safe from children.

I used the above techniques to fly 6 legs as a passenger with minimal discomfort, but I’d imagine luck was also on my side this time.

If you have chronic sinus problems when flying, then see an ENT doctor and request an endoscopic examination to look for blockages from polyps, infection or waxy buildups.