Health Watch ...

Flying and your health: should illness keep you grounded?

You've planned this vacation for months. You have been anticipating getting out of the office, out of the house and away from your routine. Then the night before your plane flight, you come down with a cold. Are you too sick to take a plane?

"Adults can almost always get on a plane. There are a few exceptions and a few cautions when I would tell adults to avoid air travel," says Dr. Chris Sanford, clinical assistant professor in the Department of Family Medicine and co-director of the Travel Clinic at Hall Health Primary Care Center, University of Washington.

"I think it's reasonable to travel with a head cold, though you might consider that you don't want to infect everyone on the plane. The risk of a bad problem, such as an eardrum perforation, is very, very low. Generally, you may get pain, but that will resolve after the flight," Sanford says.

There are some things you can try to alleviate discomfort, but success is not guaranteed.

"Using an intranasal decongestant such as Afrin may help. Afrin can be habit forming, so you don't want to use it a lot. But on flight day only, before ascent and descent, it may be of help in opening up the inner tube connecting your ear to your nasal passages," Sanford says. "The second thing to do, in case the Afrin doesn't work, is to simultaneously take Advil or Tylenol."

Oral decongestants like Contact, Dristan, Sudafed, or Actifed can work in similar ways to open up the ears. Children cannot use Afrin, but may be able to take an oral decongestant. Be sure to follow label directions carefully.

"During ascent and descent, babies should nurse or suck on a bottle or pacifier. If they work their jaw during ascent and descent, that can help the eustachian tubes remain open," Sanford says.

If your child has an ear infection, Sanford suggests some caution.

"There is no agreement in the medical literature on a safe time to fly after ear infection. My compromise between all of the views is to fly about two weeks after the antibiotics are started. I have to say that the risk is not eardrum rupture, but rather just pain and crankiness," Sanford says.

If it's OK to fly with a cold, what, then, are the exceptions?

"I would tell adults not to get on a plane if they suffer from serious illnesses such as pneumonia. Elderly persons should not travel by air if they have chronic conditions that are not well controlled, such as angina or chronic obstructive pulmonary diseases, including emphysema and bronchitis," Sanford says.

Some of these chronic conditions affect the way your body takes in oxygen, which is an important consideration. If you have one of these illnesses, try to get it under control. See your doctor shortly before you fly and let him or her know your plans. If you require oxygen and are well enough to travel, U.S. airlines will not allow you to bring your own tank onto the plane. Notify the airline in advance to have oxygen waiting for you.

"There's less available oxygen during air travel. Airplanes pressurize at the equivalent of a mountain's elevation -- 6,000 or 8,000 feet high, so those who don't need oxygen at sea level may need it when they fly," Sanford says.

Sanford says some people definitely should not travel. If you have a highly communicable disease such as chicken pox, stay home. Stay home, too, if you are ill with the flu, pneumonia or recovering from a heart attack.

Women in advanced stages of pregnancy should be aware that airlines may not allow you to fly. The cutoff varies between companies, so check before making flight arrangements, but a common standard is about 32 weeks.

Reach WEA Editor Linda Woo at lwoo@WashingtonEA.org, via postal mail at WEA, PO Box 9100, Federal Way, WA 98063-9100; phone 253-765-7027 (or toll-free outside Seattle-Tacoma: 800-622-3393 ext. 7027); or fax 253-946-7612. We welcome story ideas, letters to the editor and suggestions for improving WE-Washington Education, or WEA Online.