Flying with a cold

[CRAZYBROADSWORD]

I have flown with a cold a couple of times and my ears always give me jip for awhile after, just wondered if others suffered??

[Floppy Link]

yes and no...

When training for the plank IR I stuffed up an ILS because I cleared my ears as we were turning onto the localiser, screwed up my balance no end.

On the other hand..

Went skydiving with a cold once - 12000 to 2000ft in a minute, all I had to do was clear the ears and it was back to normal.

Probably shouldn't have done it, but it was FREE as HM the Queen was paying so I didn't want to miss out.

[Grey Area]

Flew with a head cold once (up to about 5000') - followed swiftly by a nasty sinus infection and 3 weeks grounded. Bad idea.

[Gaseous]

The test to see if you are fit is easy. On the ground, pinch nose, shut mouth and blow. Both ears should 'pop' at more or less the same time, as your eardrums are forced outwards. When you swallow a few times they should go back to feeling normal as they clear.

If they don't you're not fit to fly.

The risk is the pain caused by a sticking ear can be intense and distracting and the physical damage, permanent.

[212man]

I went flying as I felt guilty after being off sick for 3 days with a cold. I felt fine but a bit bunged up. During the descent to land I became incapacitated with the pain and then had a further week off work on antibiotics for the infected torn ear drum.

[b.borg]

Same as Grey Area - Had a slight cold (or so I thought) - up to 7000' - on descent severe middle ear and cheek sinus pain - step descent, blowing and swallowing - ears finally cleared at 1,500'.

Three weeks off work with penicillin for sinus infection, and permanently reduced hearing in right ear (still within med limits though):ouch:

[CRAZYBROADSWORD]

Thanks guys for the replys and there I was thinking I was being a bit wet ?

[RobboRider]

Now for the really bad news.


"Colds" can be from a number of causes and can affect a number of systems apart from just your ears.

Most cold's, 'flu' sniffles, call them what you like - are caused by viruses and there are literally dozens which as part of their spectrum produce nasal congestion (which gives the blocked up ears mentioned. )

Trouble is they also commonly affect other systems. Most significantly the balance mechanisms of the middle ear, the lining of the heart, the heart muscle itself the lungs, the joints and the liver. Specific Viruses tend to have a defined spectrum of systems that they affect while other viruses may affect different systems.

Unless you have tests done ie : blood tests (which unfortunately will take longer to give a result than the illness is likely to last) you aren't going to know if you are infected with a virus which causes these extras or not.

As a somewhat simplistic comment:
If your ears are blocked:
You are at risk of rupturing an ear drum either on ascent or descent. This causes pain, sometimes sudden deafness or loud ringing in the ears enough to make you functionally deaf.

Sudden changes of pressure due to rupturing of the drum can induce sudden vertigo +/- severe unstoppable vomiting.


Some viruses attack the middle ear independantly of the nose blocking stuff. Produces the same vertigo affect but doesn't need the preceeding blocked nose or ruturing of the ear drum. (proper name Acute Viral Labyrinthitis)

A number of cold viruses produce an inflammation of the heart lining (Acute Viral Pericarditis) or an inflammation of the muscle fibres of the heart (Viral Myocarditis) either of which can lead on to poor pump function or abnormal rhytms which can cause cardiac arrest.

As a completely unproven rule of thumb it has been said that if you have a cold/"flu" etc with muscle aches then you are at higher risk of the heart damage varient and should avoid excercise and stressing your heart till it all settles down.

If you have congestion on the chest you are at risk of phlegm blocking some smaller airways and causing decreases in your blood oxygen capacity - enough to make you hypoxic at helicopter altitudes.

If you have ever had a collapsed lung and have a tall and thin body shape then going up to high altitudes rapidly with congested chest you are at risk of another collapsed lung. (or perhaps your first collapsed lung)


Most people with colds obviously don't get these extra problems. Trouble with helicopter flying is it that it does put a big increased load on the respiratory, nervous and cardiac systems. (A number of studies have looked at heart rates, blood pressures etc in pilots and shown helicopter pilots operate at levels similar to moderate to severe excercise for the whole flight and like extreme excercise for approaches.)

Does any of this crap really ever affect pilots I hear the non-believers ask?

The SeaWorld crash from the gold coast in Oz ?maybe 15 years ago. Pilot plus 4 pax. All died. Diagnosis - Pilot was getting over a cold/viral illness with myocarditis (heart muscle damage). The extra cardiac workload thought to have triggered an abnormal heart rhythm. Post mortem showed definite myocarditis.

Here endth the lesson!:sad:

[paco]

And a good one, too! I'm told it takes 6 weeks to get over a ruptured eardrum - not sure I would want to take that risk!

I believe the Canadian government (the labour code guys) have determined that 4 hours helicopter flying is equivalant to 4 hours' hard labour, and double that when longlining. I think I would agree with that, especially when you add the effects of whole-body vibration into the mix.

phil

[flyer43]

I used to live offshore flying the in-field shuttle. Many moons ago, too many to really remember, I continued flying during the last few days of my tour despite having what I thought was "just a cold".
The day after returning home, I collapsed on the way DOWN stairs unable to get my breath. Was diagnosed with Viral Pneumomonia and ended up having my licence medically revoked for 10 weeks!!
Floppy Link has raised a very important point. He suffered a bout of the "leans" while undergoing IF training as a consequence of trying to clear his ears. Luckily for him he was training with another pilot to be "his eyes and ears". Another time, he might have been alone in cloud (inadvertent entry into IMC?) and the outcome could have been more worrying.
Think twice before flying with your head "bunged up" for whatever reason..............

[Sailor Vee]

One other reason for not flying and more impotantly, staying away from the workplace, is so you don't infect the other members of the workforce!!:uhoh:

[headsethair]

A very useful thread - thanks for the wisdom. Once made mistake of flying with a "cold". It was a transatlantic in a 747. Within hours of landing I collapsed with pneumonia. Those few hours at just a few thousand feet cabin pressure can let those viruses run free.

[Sewing Machine Man]

I was wondering about large passenger jets as i believe they have a cabin pressure of 6,000ft. I'm sure I read that in Human Performance and Limitations. So what if your a passenger with a cold?

Mike

[B Sousa]

Sailor Vee, hit the nail on the head........I yelled at the Boss for sneezing and coughing, told him to go home as I knew I was gonna be down......Sure enough I was out for almost a week and almost two months later still coughing........
Flu Sucks, folks with it should stay home.........

[WhirlyGirl Sarah]

What about hay fever sufferers? It sometimes feels like a cold, as the sinuses feel blocked and you can't stop sneezing, but if it's hay fever surely it's not a virus...

WGS

[RobboRider]

Sewing Machine Man:

Yep you're right. The cabin pressure is usually between 6000 and 8000 ft. And yes people with colds suffer the same risks if they fly in those big jet RPT s. When I used to see general practice patients I used to regularly see patients with either painfully stretched or ruptured ear drums aquired on descent in RPT flights. Also the occasional sinus filled with blood.

I was flying on a 767 back to Oz from Hawaii a couple of years ago and the dreaded call comes "Is there a doctor on board?" I stayed put while a couple of other docs put up their hands. A few minutes later comes the call "Is there a Respiratory specialist or an anaesthesiologist on board?" SO I got sucked in to helping out. Turns out it was a woman with fairly bad chest complaint who was OK at sea level and gradually got worse till she couldn't cope and dropped her bundle at altitude. Blue lips, screaming pulse rate couldn't get her breath confusional etc. That's when I found out how crappy those on board medical kits are. Anyway got the pilot to fly lower so the cabin pressure got equivalent to about 5000 ft (they wouldn't go lower cos we would have run out of fuel before we got to dry land) gave her extra oxygen by mask and she coped till we got down. 3000 ft made a huge difference.



WhirlyGirl Sarah:

Two things about the Hay fever question.

If the nasal passages are blocked it doesn't matter what the cause is. The trauma to the ear drums and the potential for vertigo and vomiting is related to the physical obstruction and the subsequent pressure changes due to altitude.

But the good news is that hay fever (allergic Rhinitis) can usually be treated with antihistamines or whatever your favourite decongestant is. That then stops the problem for the duration of effect of the antihistamines - but beware the drowsying effect of some antihistamines. They may make it inadvisable to fly.

The other point is you need to be sure of the diagnosis. Not all runny noses are hay fever they can be the beginnings of a viral infection. But then again a lot of hay fever sufferers know when its the hay fever compared to a cold. They get pretty used to the subtle differences in feeling.

Of course the other thing is that if its hay fever you don't have to be concerned about those other rare things like heart, lung liver complications.

[Gaseous]

Professionally, over the years, I have come across a number of patients who complain of intense dental pain associated with flying. This is usually caused by sinus obstruction. The nerves supplying your top teeth are very closely associated with the sinus lining so if you are bunged up you can add toothache to your list of potential woes. It can be intense, usually commencing on ascent and subsiding on descent.

I have successfully used ephedrine/pseudoephedrine for patients with recurrent problems. This will usually alleviate symptoms in pax and can help with some of the other sympoms of sinus barotrauma. If you are on a booked as pax on a commercial flight and have a cold it is wise to take a bottle with you. It is available over the counter in the UK. It works by opening the passages in your head. It should not be used for more than a couple of days as its effect becomes reversed.

Athletes must not use it as they will be banned if dope tested.

Aircrew should not use ephedrine without consulting the flying Doc first. I suspect he would say "No".