Undiagnosed Medical Condition when Flying

[jamesd888]

Dear Forum members,

I am writing as I am looking for guidance and medical advice on my condition related to flights, which seems rather unknown to most doctors around here, and accordingly no treatment was yet identified.

Here is a description of my symptoms:
Recently, I started experiencing a worrying condition on flights. Relatively quickly (20-40mins or so into a flight) after reaching cruising altitude (e.g., 38000feet), I am feeling the following:

- constant blinking of the eyes and having to refocus for clear vision.
- difficulty/unease to eat/swallow (drinking is fine)
- difficulty/unease to talk (I can, but I quickly feel I might loose control/conscience)
- difficulty to think (it quickly triggers the same feeling of loss of control/conscience especially if it's complex or emotions are involved)
- Looking head down leads to some vertigo/dizziness, so I try to look straight only.
- Overall impression that I will loose conscience/loose control at specific moments within the flight.
- After the flight, there is still a light "strange/tired" feeling in the head for a few hours at least.

Additional background/contextual information:

- I am not sick (no cold, etc) and don't have any medical condition, at least to my knowledge (e.g., low/high blood pressure etc.)
- I have no fear of flying (frequent flyer, at least historically).
- As I am not sure what the condition is, I tried using the following techniques: turn on the direct ventilation during the whole flight, drinking a lot of water during the flight (this seems to help somewhat), eating salty food prior to the flight (not sure about this one).
- This happens on short-haul flights, I have not yet taken a long-haul flight since these symptoms appeared (i.e. not experienced what happens 5-6 hours into a flight)
- The symptoms above are more or less present, depending on the flight. - Some flights are "perfectly" fine, while others are "tough". I have the impression that 30000feet flights are the ones without issues, while 33-38Kfeet are tough (I always ask the captain AFTER the flight about altitude, i.e. I have no info on the altitude WHILE I am flying). I have not tried a dreamliner flight yet, which apparently keeps the cabin pressure at an "altitude" of about 1600m.
- I visited an "altitude/mountain doctor", as I thought it's related to the low air pressure, but he mention the symptoms related to high altitude only appear above 2500m-3000m, after ~5 hours at that altitude, and acute symptoms I am describing appear only at the very high altitudes (e.g.>4000-5000, Himalaya, etc.). Flights are pressurized at about <2400m.
- I did spent 7 hours at 3000m in the mountains to test my ability to deal altitude. I did have some strange feelings in my head up there, but not necessarily feelings of "loosing control". However, the most striking symptom was a 8-hour long terrible(!) headache after my descent. It vanished after 8 hours. However, I felt quite weak mentally for 10 days or so after this event.

Now, it's important to note that I did have an acute medical emergency on a flight last year, before any of these symptoms appeared, but arguably triggered these in on follow-on flights. Here is the full story: I took flights to India with a heavy cold and got issues with my ear drum. I delayed my return flight accordingly to prevent my eardrum to burst. On that return flight, 4am (I was tired), about 2 hours into the flight, while watching a TV series, I suddenly wasn't able to swallow (mechanically impossible). Scary moment. If I drank water I could swallow, but with saliva alone, I wasn't able to swallow. I stood up to inform the steward and then I collapsed (while still keeping conscience). I wasn't able to speak entire sentences, and suddenly I starting panicking (I guess), was lying on the floor and breathing fast to the point that I felt my heart was "exploding" out of my chest... I felt I was going to die. Breathing through a plastic bag helped reduce my breathing pace. Suddenly, I felt numb on the left side of my forehead (between eyes and ears), very scary feeling. This numbness came back on and off every 30mins, for the next 6 hours (!). I vomited 10 times over 6 hours. When I landed symptoms were mostly gone. Was taken to emergency, they didn't find anything wrong with my medical condition. About 8 hours later at home similar symptoms started again (head numb, etc.), but I got them under control after 30mins or so. The next day all was fine. No real impact, but intellectual work was more difficult. I was not able to work more than 4 hours, so I decided to take 10 days off. After that break, I was fine again, could work long hours and since then I am back at 90% of my intellectual capabilities I would say. However, every time I fly since that incident, the symptoms I described at the beginning of this post are felt. It's important to note that these are different symptoms from the ones I felt during the incident, but are probably related.

I am seeking guidance. I am trying to understand what my condition is, and find someone who experienced this as well and especially solved the issue. I am not looking for advice saying I should visit a psychologist/psychiatrist to address a panic attack. Done that already without success. I am rather convinced it's a physical condition.

This issue has potentially some very severe implications for me, so thank you very much for your help.

[Loose rivets]

James, I'm a retired pilot, not a doctor, but I have to say - throwing compassion to one side - that I'm intrigued by your problem. It seems to be that you could be reacting to one or all of three possible causal triggers - but only under certain circumstances.

I will read and re read your post, but in haste:-

You have a point in time that seems to have initiated these severe follow-on issues: flying with an infection/ear problem.

You have a specific set of circumstances for most, though not all of the triggers of these attacks.

You are showing side symptoms that may be a reaction to the main problem.


Tell us first if you have had an extended anti-biotic course.

I'll also try to reach one of our members that is highly qualified but is not able to spend much time on pprune.

I'll be back soon as possible.

[obgraham]

I'm sorry to be like this, James, but you are describing a complex set of neurological symptoms, the causes of which could be many, from innocuous to serious. There's no way to give you advice on a web board.

You need to pursue neurological testing, quite likely at an academic center.