clearing sinuses! [Archive]

Evo7

14th Dec 2001, 18:59

I've just been looking, as I'm taking Sudofed - works wonders - and I'm flying at the weekend (Spamcans, rather than something bigger). I haven't managed to find anything CAA related, but it appears that the FAA don't mind it. Specifically,
http://www.aviationmedicine.com/allergy.htm

says that

The over-the-counter (OTC) medications pseudoephedrine-- the active ingredient in plain Sudafed--and the prescription antihistamines Claritin and Allegra are approved for flight deck use. Other prescription decongestants containing phenylpropanolamine and guaifenesin (as in Entex) are allowed.

Seems OK over there, so it is probably is over hear. Anyone know for sure?

MightyGem

15th Dec 2001, 09:01

Otrovine nasal spray was recommended by the doc when I was in the Army Air Corps

PeterBruh

18th Dec 2001, 18:49

Sorry for the delay in replying.

I've looked and the AIC is Pink 143/1998 entitled Medication and Air Traffic Control. While it is talking about air traffic controllers, it does indeed specifically mention Sudafed at paragraph 4(i) concluding that "Sudafed is not a preparation to be taken when performing licensed duties".

I still maintain it is very good, but must be used very, very sparingly.

mallard

19th Dec 2001, 02:43

Sudafed is clearly controversial.
I took it under the direction of my GP but when I mentioned it to my AME he got shirty and said it could have made me dizzy.
It didn't. Apart from clearing my tubes it had no further noticeable effect.
If you read the notes included with any medication, the possible side effects often look worse than the disease.
I will of course heed the directions of the CAA.
If in doubt these days I will normally call my AME and ask his advice.

Evo7

19th Dec 2001, 12:59

PB

Thanks for checking that.

crackerjack

20th Dec 2001, 05:06

I agree, sudafed works well. But I would also agree with the note of caution struck in some of the posts. Ephedrine or pseudoephedrine a drug that athletes regularly get banned for, it is a banned stimulant in many fields.

For what it's worth, I take a sudafed (or two) during the day and if I am still suffering blocked sinuses, I will pop to the chemist and buy a small tub of menthol chrystals (about £1) and breathe them in over some hot water.

And if that doesn't work, I don't go to work.

cabin lad

21st Dec 2001, 03:08

I too can recommend Otrovine. It's like magic.
If you have a blocked nose these little drops
will make clear instantly and stay clear for upto 12 hours. You can buy it from most supermarkets,
I know Tesco sell it.

brockenspectre

21st Dec 2001, 04:05

This may sound a little gross but if sinuses are blocked then hot steam is good and.....if you make a saline solution and sniff it up + blowing out (into tissues!!) then system seems to clear too, without drugs and possible side effects.

:)

Evo7

21st Dec 2001, 18:45

Straight from the AME's mouth (just had a Class 2 exam).

Pilots shouldn't fly having taken Pseudofed (as PeterBruh said). However, it works its way out of the body quickly - which is why you have to take it every 8 hours - and so it is fine to stop taking it 12 hours or so before flying.

FWIW, he suggested Otrovine, but said that you shouldn't use it for more than about a week at a time.

Turbofan

28th Dec 2001, 16:34

Howdy folks,

Try not to get too caught up in all the 'drugs are REALLY bad' hype. If it's in the rules, stick to them, but if your doc says that one sudafed may make you dizzy (in a healthy individual), or some such dibble, don't take his/her word quite as gospel.

To help solidify my point, consider me... stands and waves for all to see
To aid my bodybuilding endeavours, I sometimes take a mixture of over-the-counter (OTC) drugs to aid in thermogenisis. The stack I usually use (which I started after thorough study) consists of 2 Sudafed, 2 No-Doz (total 200mg caffeine), and one Aspirin. After a couple of days I realised that I could function perfectly normally (although I had to go the bathroom every 20 mintues...), and so if I had to fly then I didn't think twice about being on this stack of drugs. If anything it helped, as I was totally wired ALL DAY (but don't abuse this combination for this purpose), and felt no effects of fatigue.
My sinuses also remained completely unblocked for the entire time.

My point is that while your doctors rant and rave about how this might happen, or that might happen, or how your head may explode when passing through the transition layer with a dose of Sudafed in you, providing you're otherwise (even half) healthy, you shouldn't have anything to worry about.

(Disclaimer - I'm not advocating the use of the drug stack above, if you want to learn more just ask, if you take it and die, well, I guess I told you so... )

While I'm writing, I've found the best thing (in Australia) is a product called 'Spray-tish'. A couple of sprays in the nose has it cleared better than if it was perfectly normal. Not sure if it's still available as I haven't bought any for about 2 years.

That's all, I'm off to bed.
Cheers,

Turbofan

DX Wombat

28th Dec 2001, 23:36

I am rather concerned about the reply given by Turbofan as I feel it is at least irresponsible if not downright dangerous. He (or she) is not, according to the profile, a pharmacist or doctor, nor does he appear to have any medical training. To openly state that he flies after taking such a combination of drugs without prior medical advice is frightening, as is his cavalier attitude to advice given by doctors. Doctors have a duty to inform patients of ANY possible side effects of medication which they are prescribing and if dizziness is a reported side effect then they have to tell the person. A person may or may not experience the side effects, the unfortunate will get them all, the lucky will be fine. Most people will be fine but they need to know what MAY happen. I am not sure what he considers "thorough study" but it is probably safe to assume that it is not the years of university training required for a person to become a qualified doctor or pharmacist. I was hoping to have been able to contact our Pharmacy at the hospital where I work (I'm a nurse) but I'm stuck at home with a ruptured knee-joint capsule and haven't been able to get through to them. By the way, I don't think that doctors are gods, we are all part of a team - which is how it works on our unit. Advocating combinations of drugs when you are not a doctor is dangerous.We have to deal with the results of misplaced advice and drug abuse, some of which can be lethal even when they are used in the correct dosages but dangerous combinations. <img src="mad.gif" border="0">

mad_jock

29th Dec 2001, 23:44

The one that most scuba divers use is Boots decongestant.

It has the advantage that it dosn't have any pain killers or other stuff mixed in with it. It has wads of caffine though. Dosn't make you sleepy and lasts 3-4 hours.

Its in pill form and at 4 quid for 24 is alot cheaper than others.

As for it being legal to use on duty i presume not for flight crew but ATC who knows.

MJ

Floppy Link

30th Dec 2001, 02:34

CS gas works wonders too...a mate of mine was doing his annual stint on NBC training in the "gas chamber" - he got a huge sniff of the cs gas used in the trainer, came outside and sneezed noodles, thus totally clearing his sinuses and removing the need for an operation (for which he had been scheduled)

[ 29 December 2001: Message edited by: Floppy Link ]</p>

Roadtrip

30th Dec 2001, 04:05

Squire - I would highly recommend that you NOT fly as a crewmember with a bad cold or the aftermath. If you've even seen someone with a sinus block or talked with them, you wouldn't do it. Imagine if you will a cabin pressurization problem to boot. A sinus block is likely to become completely incapacitating and impossible to "gut out" - it hurts THAT much. If you can fly with the pain of someone shoving a knitting needle up your nose, you're a better man that I Gunga Din. If you do blow a sinus, it'll ground you for a very, very long time.

Bottom line -- it's not worth it. Go on the sick list and don't take a chance on endangering yourself or others. I know when another crewmember reports for duty with a URI, it pisses me off that they might give it to the rest of the crew and/or cause a physiological incident to boot.
In general, it's been my experience that antihistimins relieve some symptoms, but prolong the full recovery time.

That being said, I do carry a small spray bottle of AFRIN (I don't know what the UK equivelent it)for emergencies. I've never had to use it myself, but just the other day I gave it to the captain who was having trouble on the descent. I would say that it's only marginally effective.

Don't fly with a URI and you won't have problems.

[ 30 December 2001: Message edited by: Roadtrip ]</p>

Elevator

30th Dec 2001, 04:34

Try Acupuncture...works well for short and long term effect. Once you have had treatment, the inflammation goes away and the body will heal itself and return to normal.
A dose of vitamin C and a B group complex vitamin tablet once or twice a day for a week or so to get you over the hurdle. Lot's of liquids, prefer water or a nice cup of tea,(leave the coffee alone) and as much rest as possible all help to alleviate the symptoms and get your body back on track.

For the once off's Sudafed is good, but I would not advise taking at least a few hours before commencing duty.

Otravive is also good FOR VERY SHORT PERIODS ONLY.
Can do all sorts of bad things to the inside lining of the nasal passages and is a dependacy increased doseage drug....you get hooked on it and become too reliant.

Hope this helps> <img src="wink.gif" border="0"> <img src="wink.gif" border="0"> <img src="smile.gif" border="0"> <img src="smile.gif" border="0"> <img src="cool.gif" border="0"> <img src="cool.gif" border="0">

Turbofan

1st Jan 2002, 07:48

Hi DX Wombat,

Your concern is warranted, although I feel a bit misplaced. I wasn't advocating the use of anything except the product 'Spray-tish' which has worked well for me in the past.

And I'm not a doctor. Although I might add that the combination I use from time to time (actually quite rarely) has been proven effective and safe in hundreds, if not thousands, of controlled lab studies, and I have consulted doctors about it in the past.

My point while I was dribbling on about OTC drugs was exactly as you stated...

[quote]By the way, I don't think that doctors are gods, we are all part of a team<hr></blockquote>

It is the nature of doctors to be overly cautious. I've learnt this from a number of years of having worked in the fitness industry, talking to sports doctors (some who have work with pro bodybuilders and use obscene amounts of drugs), and talking to users of legal and illegal drugs (who also use large quantities).

The main issue I've seen with these drug users is long term side effects from long term heavy use, not a one of use as this thread is implying.

So while you were exactly correct in stating that it's a doctors duty to advise patients about any and all side effects, I'd hate to see someone remain in obvious discomfort simply because they think there's a slim chance they may get a minor side effect. (Again, if it's not cleared for use in the company ops or regs, don't touch it.)

At least try a regular dose under a doctors guidance, and for those that are interested, take the initiative to get out there and learn about the drugs that doctors prescribe. Talk to those that have used the substances.
The human body is gifted in that it can tolerate an awful lot of drug abuse and still function quite normally (up to a point of course).

If I haven't addressed your concern feel free to pull me up again.

Regards,
Turbofan

[ 01 January 2002: Message edited by: Turbofan ]</p>

ScoobySnacks

2nd Jan 2002, 18:04

A good Vasocontrictor like AFRIN works well.

DOC.400

2nd Jan 2002, 20:26

Just my experiences which hope will help:

Sinus probs in the descent (both commercial and private!) ARE that painful -I thought my left eyebrow was going to explode!! I've found that if I am flying myself, as long as I don't descend at more than 500'/min, I'm OK. Try telling the skipper THAT on a commercial flight though!!

However, without resorting to drugs I found that a good blast or ten of Vicks Sinex keeps the toobs clear for descent.

Hot water in an inhaler with a few drops of 'Karvol' also works well.

The one time used Sudofed, it merely kept the prob at bay and prevented pain! What I really needed was anti-biotics as it was an infection.

Not nice -wouldn't wish this on anyone!

Gentleman Aviator

2nd Jan 2002, 21:06

Hi all,

Have had the pleasure of 1 explosive barotrauma and 2 sinus operations including an aptly named "frontal sinus drill-out".

1. Sinuses are interlinked cavities that reduce the weight of the skull and are thought to have had some bouyancy aid in very early mammals.

2. If the cavities are blocked and pressure changes occur (climb or descent) significant pain can occur. This can be debilitating to the point where it is physically impossible to operate.

3. If you have a head cold and are prone to sinus discomfort - don't fly!

4. Sudafed works but most aviation doctors will not allow anyone near an aeroplane after using it.

5. Otrivine is emergency use only when in an aeroplane. Long term use causes more sinus problems than it solves.

6. Part of the problem we have is the dry air within the cockpit or flight deck. A saline mist can be purchased in the USA and is very good for maintaining clear cavities.

7. Steam bath on the ground is good, however, nasal douche is better! You'll need a syringe, warm water and salt. Basically inhale salt water whilst squirting the syringe up each nostril. Gets into all sinuses and then snort it out. You will be amazed how much gunk comes out.

8. Flixonase is an aquaeous nasal spray with a low dose steroid in. Prescription only but perfectly fine to fly with. It reduces polyp build up which are often the cause of the blockages.

9. Ultimately surgery may be required for those of us lucky to have repeated problems. It hurts, but it was worth it for me. UK based people may wish to contact ENT Specialist Surgeon John Skipper in Portsmouth. He has an enviable record for getting Service Pilots back in the air again.

Good luck!

GA

hannah

4th Jan 2002, 16:50

Have been told by a friend that is clearly concerned about using any medication that the best thing they ever used was a "ear candle"
Apparently it is a special candle that you can buy from the natural therapy stores. You light the candle, blow it out,then put the bottom in your ears and it sucks out all the junk etc that has built up from time and clears your sinuses like new.It isn't uncomfortable like having your ears syringed,sounds like a shhhh similar to a can of coke being opened.After you take it out, you tap the bottom and all the yuks come out then flame it again ,etc,etc.Never heard of it before, friend swears by it.Maybe worth a try, I am going to practice on my dad, he's a deaf as a door post since his last flu !!!
Apparently some natural therapists can do it also if you are concerned about having a go yourself.
Hope you feel better soon. <img src="smile.gif" border="0"> <img src="smile.gif" border="0">

SkidSolo

7th Jan 2002, 23:22

I've only seen one mention of the Flixonase spray so I will second it.

I was having trouble when a glue forms against the inner wall/ear drum. Its hard to clear. This stuff helps break that down. I guess the Otrivine, Sudafed and Olbas oil does the rest.

Regards
SS

foxmoth

7th Jan 2002, 23:58

151 proof rum! heated in the microwave then inhaled it clears the tubes better than anything else I have tried - but don't fly straight afterwards. <img src="wink.gif" border="0"> <img src="eek.gif" border="0"> <img src="cool.gif" border="0">

Roadtrip

8th Jan 2002, 11:03

My God people. What are you thinking! Talk to someone who's had a sinus block. They'll tell you they thought they were ok to fly, also . . . and in the descent they look like the guy on "Alien" that has the baby monster eat its way out of his chest. Got the imagery yet? If you're still coherent after landing you may need to get a sinal obliteration, like a friend of mine did. Just that word "obliteration" got my attention - sort of like a liposuction procedure for your nose. I don't know about you, but it'd take 3 good size rough blokes and a horse syringe full of sleepy juice to get me on the table for that.

Don't fly with a URI is my motto.

martinidoc

8th Jan 2002, 15:19

The point is that flying with blocked sinuses means that you probably also have blocked Eustachian tubes as well. The reason for not flying is that you may well cause barotrauma, particularly to the middle ear which will put you out of action for a lot longer. (I knoe I did it in the UAS when young and foolish!)

If you have to use a temporary solution try Karvol or menthol and eucalyptus inhalations, broken into a tea towel and inhaled over a bowl of hot water.

These preparations have no adverse side effects and are not proscribed under any AIC I can find.

If you have chronic sinus obstruction you need to get referred via your GP to an ENT surgeon.

Wireless

13th Jan 2002, 16:08

Turbofan,

That is bl**dy concerning to think there is someone flying around with that attitude <img src="mad.gif" border="0">

What other professional advice do you ignore ATC?. Are your passengers/bosses aware that you've taken it upon yourself to risk the aircraft or lives of those on board just because your a bit of an amateur Doctor? <img src="mad.gif" border="0">

[ 13 January 2002: Message edited by: PoleStar ]</p>

DX Wombat

14th Jan 2002, 04:30

Turbofan, thanks for the reply, however I stand by my assertion that your post is dangerous and irresponsible. You clearly added the comment about "Spraytish" to justify the post. Your other comment that you can function perfectly normally after ingesting such a hair-raising combination of drugs is incredible. It is an EXTREMELY DANGEROUS attitude comparable only with that of the "I'm alright I've only had one drink and anyway it improves my driving" school of thought. Tell that to my friends' son who has seen the loss of his friend's mother, two friends and the serious injury of a girl friend, thanks to drunken drivers. All within the last year.
Pole Star, thank you for your support. I too am concerned that someone is piloting an aircraft with that combination of drugs on board. I am not surprised he was not tired. I am only relieved that I am not having to fly out of Perth on a 747 these days, the thought of travelling on an aircraft with a pilot who has taken any form of self-administered, non-prescribed combination of drugs, frightens me. Does anyone in Oz know if this combination is acceptable to your authorities?
I haven't ben able to reply before now as I have had problems with the computer and difficulty getting to it with this knee injury.
Pole Star, would you be kind enough to email me? I can't email you - there's no address.
On a lighter note, steam is always good and a gadget can be bought which looks like a toddler's cup with a face mask fitted. It stops the whole of your face getting hot and eucalyptus oil or menthol crystals can be added to the hot water. The cheapest way, however, is to get an old tea towel (the towelling ones are best), soak it in water, wring it out and the iron it on the hottest possible setting. A WORD OF CAUTION HERE. Gentlemen, please check with the lady of the house BEFORE using what you feel is an old tea towel or you may find that the bunged-up sinuses are the least of your problems.
<img src="mad.gif" border="0"> <img src="confused.gif" border="0"> <img src="rolleyes.gif" border="0">

Wireless

16th Jan 2002, 23:13

DX Wombat,

Sorry for the delay in replying (work, I blame it on work). I tried to e-mail you but my blinking computer has gone round the tree. Just keeps on disconnecting every time I send anything. <img src="confused.gif" border="0">

Anyhow, I've ammended my profile so please feel free to mail me as I can at least read mail even if I can't send it.

Pstar <img src="wink.gif" border="0">

Capn Notarious

20th Jan 2002, 13:25

Well for what it is worth: I use a facial sauna and gently, 1) tap the sinus 2) blow nostrils individually.
This not only does one job: but makes the facial skin soft.
NOW LET US WAIT AND SEE, WHAT COMES AS A RESULT OF THE PREVIOUS SIX LOWER CASE WORDS. :)

redsnail

20th Jan 2002, 16:10

I scuba dived once and blew out a sinus in my forehead. Did that hurt? My oath it did. I once flew with a "touch of hayfever". The pain was unbelievable. I had to hand over to the fellow studend instructor to fly. It felt like someone was shoving a pencil in my ear. Fortunately my ear didn't burst but it ached for a week.
As others have said, don't fly.

Turbo, mate, sounds like you are speeding off your head with that combination. I have found that ventolin will help me in a weights session but I hated the heart palpitations.(mildly asthmatic) Something ain't right if you have to do that.
I once corrected a Dr on the medication that they gave me. I did the research and it turned out I was allergic to it (I worked in a biochem department at Uni). I am not too sure that you are going about it the right way. Remember, aviation Dr's are conservative and there is a very good reason for it.

Al Titude

23rd Jan 2002, 01:28

Use the Vicks Snot decongester nasal spray thing. Works wonders and clears the old sinuses in no time - even used it in the Tincan unpressurized up to it's 24000ft ceiling and worked a treat!

DX Wombat

24th Jan 2002, 04:23

Turbofan, I have finally managed to contact our Pharmacy and have had my worries confirmed. Sudafed contains a stimulant as well as having a decongestant action. You say you take two Sudafed tablets - this is TWICE the recommended amount. In addition to this you also take Caffeine 200mgms and an Aspirin (usually 300mgms per tablet). The antipyretic properties of the Aspirin will help keep your temperature downand reduce the likelihood of your blood clotting due to the dehydration which could be induced by the Sudafed and Caffeine. Caffeine is a diuretic as well as being a stimulant hence your need to empty your bladder frequently. If you really are piloting an aircraft after taking these drugs you are placing other people in danger. You should not be in charge of so much as a push bike with that lot inside you. I agree with Redsnail that if you need to take these drugs then something is wrong. Go and get some professional advice from the medical profession, you obviously need help. Don't place any more people in danger. It is not something to be laughed at or shrugged off lightly. If you continue to take these drugs and fly, then all I can say is that I hope someone in authority catches you before it is too late. <img src="mad.gif" border="0"> <img src="mad.gif" border="0"> <img src="mad.gif" border="0">

flypastpastfast

24th Jan 2002, 19:24

I AM NOT A DOCTOR. (in case anyone gets uppity)

Sudafed, and associated drugs can have a powerful decongestant effect, but after several days use, can actually make the congestion worse if the underlying problem has not resolved (cold etc..). Many ENT people would advocate steam as the first point of call for sinusitis, it's very effective, and some would actively discourage the use of sudafed related treatments. As regards using saline, this actively overstimulates mucous production (its very powerful), that is its primary effect. Never before heard of it suggested to ease congestion!

I only know this as I have suffered from bad sinuses - steam was like a magic cure.