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Air travel and medical Problems… (1)

My nephew holds both British and Nigerian  citizenship. He came back home to Igbere for our Ezumezu festivals last Christmas. Towards the end of the celebrations he developed an “acute chest pain”, which on examination was found to be a pneumothorax (air in the lung).

  He was rushed to Federal Medical Centre Umuahia, where they did an x-ray assisted blind tapping, to remove air from his lungs. He felt better. To travel or not to travel back to London became our dilemma. Against my better medical judgement, I agreed he should travel back to London.

I reasoned that instead of allowing him to suffer more in Nigeria, with our lack of adequate and requisite operational equipment to take care of him, let us take the risk of sending him back to London. Normally someone with pneumothorax should not travel until all air is extracted from his or her lungs.

It happened as I predicted, right from the airport, as a British citizen, they were notified of his medical condition. On arrival at the airport he was the first to disembark, and was wheeled into a waiting ambulance and was rushed to an Emergency Medical Unit – where, before you could say Jack Robinson – intubation, oxygen administration, examinations, investigations were done.

   They did CT-scan, MRI, blood gas analysis, the whole haemogram within an hour of arrival. Eventually they did a computer assisted surgery to remove the remaining air in his lungs.

   Why am I telling this story? Although I am a patriotic Nigerian, with malice towards none. If the reverse were to occur, that is, a Nigerian in Britain with pneumothorax wishing to travel back to Nigeria, and my medical advise sought. Your guess is as good as mine, of what my answer would be. Remember, I am a patriotic Nigerian.

What are the problems of air travel?

• Travelling by air can cause or worsen a variety of medical conditions. Although very few conditions would prevent a person from flying. Those that may prevent flying include ;

1) Pneumothorax – air in the lungs (what my Nephew had.

2) Lung damage from tuberculosis, damaging pneumonitis.

3) Diseases that could be spread to other passengers eg yellow fever, ebola, lassa fever etc.

4) Diseases that even a small expansion of air would damage tissues eg intestinal surgery in the last 10 days

5) Some conditions require planning and taking precaution before flight – example, people who had, had colostomy, should wear a large bag and anticipate frequent filling.

6) Air travel poses problems related to;

   i) Changes in air pressure.

   ii) Reduced amount of oxygen.

   iii) Turbulence.

   iv) Disruption of the body’s internal 24-hour-cicardian clock.

   v) Psychological stress

   vi) Physical stress.

i) Changes in air pressure.

   • Modern jet air planes maintain air pressure inside the cabin – cabin pressure at low levels, equivalent to the atmospheric pressure at 5,000 to 8,000 feet. At #*0 levels, air trapped in pockets within the body, such as lungs, inner ear, sinuses and intestinal tract – expands by about 25%.

• This expansion sometimes aggravates certain medical conditions, such as emphysema, blocked Eustachian tubes, chronic sinusitis and chronic abdominal gas pains. Problems may be particularly severe when an air plane accidentally loses cabin pressure or when the cabin isn’t pressurised, as in the case with some smaller air planes.

• A sensation of pressure in the ears is common during air plane flights. It develops as the difference between pressure outside the ear and inside the ear increases, causing the eardrum to bulge.

• Eventually, the pressure equalises when the eustachian tube -”a passage that connects the middle ear with the back of the nose” allows air to flow in and out of the middle ear.

• Head colds or allergies may produce fluid and swelling that block the eustachian tube, and repeated infections may result in scaring that partially blocks it. Then air becomes trapped in the middle-ear, producing pressure – “barotitis media” and pain.

• Rarely the eardrum ruptures.

• Similarly, air may be trapped in the sinuses, barosinusitis, causing facial pain

Treatment of trapped air during flight.

1) Swallowing frequently.

2) Yawning during airplane descent.

   3) Taking decongestants before or during the flight.

   4) Chewing gum, can prevent or relieve these conditions.

   5) Children are particularly susceptible to “barotitis media”, they should chew, suck hard core candy – sweets or drink something during ascent or descent to encourage swallowing, babies can be nursed or given a bottle pacifier.

   Net week, we shall tie up this “Air Travel and Medical Problems” by discussing ii) Reduced Oxygen. iii) Turbulence. iv) Jet lag v) Psychological stress vi) Physical stress and vii) General precautions. Always be medically guided.

Please follow me on twitter ; @ _ DRSUN.

  

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