Flying when you are ill – what to do

A surprising number of people become ill or suffer minor injuries while travelling. It could happen to you. We cover some of the most frequent troubles, and what, if anything, you can do about them.

Copyright DIY Travel Expert

Wisdom teeth that are hurting and need to be removed. The writer’s own experience of this is that being at altitude with an impacted wisdom tooth that needed pulling was extremely unpleasant. The dull ache that had developed earlier in my journey became a harsh pain fifteen minutes after take-off. The reason was that the cabin is only required to be pressurised to 8000 ft, so there is a significant pressure drop. (In a Boeing 767 the pressure corresponds to 6,900 ft and the Airbus A380, currently the “best”, maintains a cabin pressure equivalent to 5,000 ft).

Colds and flu. If your eustachian tube is blocked or your sinuses are congested then you are going to have a problem. Additionally, if three is a lot of liquid build-up in your inner ear then the pressure could lead to the rupture of your eardrum.  This is an immediate medical emergency.

Foot injuries. Ankle injuries in particular are unpleasant to travel with. If you have a sprained ankle and you are travelling in economy class, it is going to be very uncomfortable.

Upset stomach. This speaks for itself in terms of discomfort.

Also, there is the risk of being denied boarding if the airline deems you unfit to travel at time of check in or boarding. Boarding a flight home from London a few years back, I had a swollen foot and was limping. The check-in clerk looked at me with suspicion, but held his peace. It swelled even more during the flight and I took my shoe off, with some difficulty. A stewardess walked past and said, ‘You’re not going to get that back into your shoe! If they had spotted this at boarding, you wouldn’t have been allowed to travel without a medical certificate from your doctor”.

You can also clear your injury with the airline beforehand, or you may be denied boarding, depending on their assessment of your mobility. Bear in mind that the airline has to contend with regulations that require you to be fit enough to evacuate from the aircraft in an emergency. (The hazard of trying to clear it with the airline is that they could say “no”, in which case you are going to be grounded until such time as your condition as improved enough to convince a doctor that you can travel.) As a basic rule of thumb, if you are okay for going up and down stairs, you should be okay for flight. If you have a broken leg in a cast, though, the airline will in some cases allow you to fly but require that you book an extra seat.

What to do about it
Since we are covering conditions that arise while you are travelling, the time-honoured advice of “get it fixed before you leave home” is not going to work. If it happens when you are already in flight then your sole solution is to ask the cabin crew for help. If the condition has developed while you are away from home but before you board then there may be actions you can take. Since this is DIY Travel Expert, we naturally have some practical advice.

Toothpain: Get painkiller drugs from a pharmacist. If there is time to see a doctor, get suitable antibiotics (or get them from a chemist if you are visiting a country where pharmacists are allowed to prescribe medication). The antibiotic will help reduce the pressure by reducing the volume of fluid in the tooth or gum.

Colds, flu and sinus conditions: Use decongestants. You may find that a spray will give you faster relief than medication that you have to swallow. Sprays will not leave you feeling drowsy, and you could take a tipple, whereas if you have taken a decongestant pill the chances are that you will be advised strictly not to use alcohol.

Burst ear-drum: This is a medical emergency. Alert the cabin-crew immediately. The pilot may even have to turn the plane around. Or land at the nearest viable airport.

Sprains: The usual advice for treatment of sprains is “RICE” – Rest, apply Ice, Compression and Elevation. Rest is going to be achievable. You can ask the personnel for ice and a towel (dampen the towel first – you are trying to cool down inflammation, you do not want to make the situation worse by causing frostbite). For compression you should preferably purchase an elasticised bandage designed for the injured body-part, which avoids applying compression inappropriately. For instance, a knee-guard will not apply pressure to the kneecap. As an alternative, have the part bandaged by a trained person the first time, then copy the method exactly yourself thereafter. Elevation is going to be a problem if you are travelling in “coach”. Bear in mind that you still need to take precautions against deep-vein thrombosis, even if you have a minor injury.

Oxygen.  If you have any condition that leaves you short of breath on the ground, it is likely that it will be worse at altitude.  If you require oxygen then will not be allowed to take your own tank on board because home medical oxygen tanks are not FAA-certified.  The airlines will require 48 hours notice if you need oxygen and it will cost you $50-$75 per tank or trip.

Upset stomach. If this happens before boarding, get to a pharmacy (many major airports also have pharmacies) and get something to help the symptoms. This might also be the one occasion that you would like to request a seat close to the lavatory at check-in.

The cabin crew are trained in first-aid, so consult with them if you experience discomfort or any new or unusual symptoms.

For more on in-flight safety, see our article on in-flight safety – hazard awareness and deep vein thrombosis – protect yourself.

Note: The suggestions listed here are not a substitute for proper medical advice. You should determine their suitability in your situation, and you are always cautioned to seek advice from an approved professional.

As reported in the Boston Globe, Marty Salfen, senior vice president of the International Airline Passengers Association, states that “if you have any type of medical condition, see a doctor prior to getting on the plane.  And if you feel sick once you’re on board, contact the flight attendant.  Don’t wait until it’s virtually too late.”

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