Severe pain above eyebrow in descent...

[Halfbaked_Boy]

Hi all,

Of course I shall begin with my own disclaimer, stating that any advice on here will be taken purely as informative and more out of interest to see if anybody else has experienced this symptom.

I fly a lot these days (circa 3-6 hours a day, seven days a week depending on various factors), and during the last couple of days have noticed something that's got me worried.

First off, I firmly believe this may be a sinus issue - this is in an unpressurized aircraft, first instance descending from 8,000 feet, second time round descending from 7,000 feet, both to ground level. Descent rate around 1,000/1,500 fpm, so nothing harsh. On both occasions, passing below about 4,000 feet (where the rate of air pressure change increases significantly), I notice a mild numbing pain above my left eyebrow. Getting closer to 3,000', in the first instance, this transformed into blindingly severe pain which then seemed to spread towards my nose, and behind my eyeball.

This actually drove me to the point where I had no option but to put on the power and climb 500 feet or so, and it took a few seconds, but gradually the pain subsided, although at one point I physically had to shut my left eye and I covered it with my hand for fear that every blood vessel in my eye was about to go kaput. It left that part of my face feeling numb. Second time round I was prepared for it, and shallowed off the descent quickly, both resulting in a safe landing. I must make it clear, I only took to higher altitudes a second time as I believed I may have had a 'temporary' blockage somewhere which had cleared overnight, but evidently not...

Sorry for the long post, and again to be clear, I'm not seeking professional advice on here, what I'm really after is anybody else's experience with this in particular.

Thanks to all and best regards. :ok:

[B737africa]

Sinusite it will do it

[Simon10]

Have this issue basicly every time I fly. I use phenylpropanolamine (decongestant) 2 hrs before take off, and onboard I use nasal spray (otrivin or nezeril). I also take two more showers of otrivin before descent.

Worked for me for 2 years now.

[JP1]

I had this issue once in the RAF IAM decompression chamber many years back, when I was a lot younger and very fit.

If I remember correctly we were descending from 25,000 feet at around 4000 fpm.

For me the pain was absolutely excruciating, right above the eyebrow. Confirmed by the IAM doctors overseing the decompression run, sinus related.

Sinusitis - information, symptoms and treatments (http://hcd2.bupa.co.uk/fact_sheets/html/sinusitis.html)

[cjm_2010]

I had exactly the same thing on a recent flight (as a passenger) to germany, about halfway through descent to land (so probably through FL150?)

the pain was unbelievable. I was worried I was having some sort of 'brain explosion' :\. even thinking about it now is making me wince!

I'm 32 and in peak physical fitness. If I do decide to try and go all the way to ATPL, I worry that this might be a stumbling block...

[Denti]

Yup, have the issue too, was confirmed as pan-sinusitis by my MD and treated as such, however no surgery yet. The issue is now manageable, but i always carry some nasal spray for emergency cases, it usually helps quite fast.

[pulse1]

After several very painful experiences my doctor prescribed Otrivine - a couple of squirts in each nostril just before flight cured the problem.

I still use it occasionally if I have had a cold recently.

[Kelly Hopper]

The condition is called "Barometric Trauma." I have experienced it once or twice so know how much pain it can cause. Basically it is due to blocked sinuses so a pressure differential builds up in descent. It is most noticeable in the days following a cold. I suggest some sort of sinus relief but check for drowsiness.

[Old Smokey]

I had a First Officer become incapacitated during descent with exactly the symptoms that you describe.

The diagnosis - Sinusitis

Regards,

Old Smokey

[Loose rivets]

Often no need for drugs per se. Salt has saved me unbelievable pain while down the route. A bad infection should be treated seriously, and the doc may prescribe antibiotics.

Run a Search: Me . . . and salt, and hanging upside down over the bath trying to force saline solution into the cavities.

Boiled water - don't fridge it, use when warm. Salt about the same as the sea. Invert head and shoulders. Fill cavity. Resist all temptation to laugh. Hold nose, and blow. And yes, some does go up the Eustachian tubes, so take care how hard you blow.

First time it squirts in . . . wonderful!! Most often can hear it squelch as it finally enters.

Upright, and sniff like hell. You'll know when it runs out. Repeat the procedure 'till both side pass the fluid freely.

My right tear duct (drain) allows the solution to squirt out. Never the left. Don't know why.

Last time we discussed this, someone said that you can still get the little glass tubes to help pour it in your nose.

[750XL]

I've had exactly the same thing happened the last few times I've flown.

Had quite a bad cold one winter and my sinuses never seemed to clear up, with one nostril being blocked at all times (blowing my nose etc doesn't help, as it just wont blow!).

Flying to Ibiza and back a few months ago I had those exact same symptoms above my right eyebrow, felt like I'd had hundreds of needles poked into my forehead repeatedly throughout the descent! At once stage I could hardly keep my eyes due to the pain, as has been said earlier, it felt like my brain was going to explode :suspect:

[Mr.Bloggs]

Swimming in the sea, immersing your head fully and exhaling forcefully a few times will clear the sinuses. If too cold, try steam rooms and Otrivine, or even sniffing salt water as described above. It does work well.

[aviate1138]

It works for me and quite a few other people.

Google........

Neilmed Nasamist Sterile Isotonic saline nasal spray 75 ml


Fantastic for short term hay fever relief too, IMHO

Plus your nose feels clean and not dried out.

[gingernut]

Blo*dy Boyle's law again. Sound's like it's playing up with your frontal sinus system. Causes all sorts of problems with folk on here, from earache to IBS. Once was resposible for blowing up a packet of egg sandwiches when I flew to Tenerife.:{

The short history suggests it's transient hopefully:)

[obgraham]

Y'all are on the right track.

Easy on the Otrivin spray -- use it when you need to, but overusage can lead to a tolerance developing, or a "rebound congestion" that's worse than what you started with.

And I'm not going to comment on Rivet's plan. I think he has some holes up there that don't connect to all the right places!

[Diver_Dave]

Just to add......

From a comfort point of view...

As a diver this is something that gets me regularly.

If you're in the UK Vicks do a decongestant spray that has
an Aloe Vera component as well (Soother I think it's called)
in addition to the heavy duty decongestant. It makes life a
lot more plesant, and doesn't sting the nasal membranes so
much!

Probably Grandmothers and eggs but.......

Pinching the nose and blowing GENTLY should give
some temporary relief, but, to hard and it's bye bye
oval window or worse eardrum. Normally works quite
well after a shot of decongestant.

If you're in Germany there's a milder one called Privin that
my other half uses, she reckons that's even milder, but, just
as effective.

Hope it helps


DaveA

[Bob the Doc]

Part of the problem is that by the time you have pain, it is already probably too late to do much about it. The pressure differential between the sinus and the outside world just gets too big to overcome. The trick is to clear your ears frequently and before it gets painful. If the pain is present then the best way to manage it is to go back up to altitude and descend more slowly after a decongestant

Otrivine is xylometazoline. Boots do the same stuff but without the trade name and is much cheaper. Would be very wary about using it for more than a few days on the trot as the rebound congestion can be a real problem

There is no one 'cure' but most of the methods mentioned will work to some extent. Keeping the joining passages clear is achieved by reducing swollen tissues with vasoconstrictors (like otrivine) for short term relief and sometimes with steroids for long term management

Keeping the contents of the sinuses (essentially mucus (snot)) thin and watery stops the blockage from getting too bad. This is where the steam inhalations, saline washes and so on come into play. It is worth remembering that maintaining adequate hydration (just by drinking enough) can do wonders for this

Hope that helps

Bob