Chest drain & flying

[cats_five]

I had a chest drain for a day this week to deal with pleural effusion. The nurse mentioned no flying for 6 weeks!

If anyone else has had a chest drain, what advice were they given about flying? I realise I need to heal, I understand that changes in pressure could be a problem - but for that long?

Frustrated of Scotland.

[homonculus]

Six weeks is enough to get anyone frustrated but the problem is that the drain has produced a hole in the lining outside the lung called the pleura. The effusion, or fluid, lies between pleura and lung. Because this space is normally at a negative pressure there is a risk of air being sucked in which results in the lung collapsing.

We would not allow a patient to fly for several weeks after a drain unless accompanied by a doctor equipped to reinsert the drain in flight. If you are crew, a longer period is necessary, and although there is no published data on what time period is safe, six weeks is hard to argue about.

The cause of the effusion also needs to be taken into account, depending on what the cause is.....

Hope this helps

[cats_five]

Thanks. It was probably a post-op complication of a gall bladder op that had to convert to open hence lots of post-op pain, probably not enough pain relief and severely restricted breathing - there is no underlying pathology.

Guess I'll have to be patient.

And since I fly a single-seater, taking a doctor that could reinsert a drain is bit tricky! (it was also 'uncomfortable' in nurse speak and not something I want to repeat)

[YSSY]

Six weeks perhaps seems quite long - It sounds like the pleural effusion was reactionary to pathology around the liver post-op (not uncommon but requiring a drain is slightly unusual). I also presume that the drain was a small pig-tail type (diameter not more than a few millimeters) rather than the traditional chest drains (more like a 1cm tube in diameter). So the defect in the pleural would be small. I also presume that they have plans to rpt the chest film to show that there has been no re-accumulation of the effusion.

CASA (regulatory authority in Australia) give no guidance on time off after a pneumothorax but state that it doesn’t preclude recertification. When we put the large tubes in for trauma/cardiac surgery we advise no flight in pressurized cabin for at least 10 days only – which is in line with Qantas’ fitness to fly policies – but that is as a passenger.

Recon you should speak to the CAA wrt getting an accurate time off flight duties – It may all be arbitrary anyway if you are flying at low level in a single without pressurization (below 8,000).

[Sonny Hammond]

Hi,

I had 4 BIG chest tubes a few years back as a result of a lung collapse. I was flying (atpl) 4 weeks to the day after the last one came out.

In retrospect I should've taken longer off but was too young to care at that point and really wanted to get back.

I would recommend getting a letter from a specialist if you know a good one (thorasic) which would outline the medical issue and the treatment you rec'd and importantly that he see no problem with your UNRESTRICTED return to ATPL (or whatever licence you have)

If you get this, make 100 copies and NEVER lose it as everytime you go for a job, wave that baby around and all the boffins breathe easier.

Seriously, This letter got me jobs at 2 of the biggest airliners around.

Private mail me if you want more info....

Sonny.

[cats_five]

Thanks for the thoughts. Yes, I thought 4 weeks might be nearer the mark. However the most important thing is making a full recovery so I'll take the doctors advice.

I should be clear I'm not paid to fly - I do it for fun, in a glider, so probably go up (& down) faster than most other things so rate of change of pressure (which I imagine is the real problem) is bigger. As I'm not an instructor my medical is based on my fitness to drive, and I was advised not to for 2 weeks after the first discharge but that was mostly in case I had to do an emergency stop.

I've no idea what kind of chest drain it was - there was a thinner tube coming out of my chest which was joined to a very robust & uncrushable silicon tube just over 1cm diameter which went down to the collecting vessel.

Certainly I'm not ready to fly yet as I'm short of breath and would run into hypoxia much more quickly than normal. Also I'm not yet ready to rig my glider - it's not the heaviest, but it is heavy - but maybe playing the 'poorly sick' card, or finding a load of visitors at the club would do that. However I'll have to do some dual flying and also my annual checks before I can fly solo again.

I'm also so glad to have escaped hospital again. A lot of what goes on would be considered torture if applied to the general populace - the noise, the lack of sleep, the regimentation, the food....