BUT I’M NOT REALLY SICK!
The idea that you have to be seriously ill or incapacitated to postpone flying is false. So even if you’re experiencing relatively minor problems—such as a severe head cold, an upper respiratory infection with a fever and/or sinus pain, acute sinusitis, or a serious ear infection—consider postponing a flight till your symptoms have diminished. Flying could exacerbate these conditions and lengthen your recovery.

Sometimes, symptoms will seem so insignificant or familiar that you’ll (incorrectly) discount them as being unimportant. Have painful stomach cramps with overall weakness, a fever, and nausea? Maybe it’s only something you ate. But maybe it’s something more serious, like gastroenteritis or even appendicitis—problems that should be treated before taking to the skies.

One flyer thought the intense pain in his shoulder blades was a byproduct of toting heavy luggage, but it turned out to be a heart problem. Another believed that her back pain was a result of a recent workout; it wasn’t. It was pneumonia.

Checking out these symptoms beforehand could have spared them agonizing in-flight experiences. Ask yourself: Are you willing to writhe in pain for hours with few if any options for relief?

Unsure about the seriousness of your condition? Perusing The Aviation Health Institute’s Medical Contraindications to Air Travel Guide is not a substitute for a trip to your physician but it’s a very comprehensive listing of conditions that may require a change in your travel plans.

Heed the number one rule of healthy travel: If you feel lousy on the ground, chances are you’ll feel a lot worse once you’re in the air!
 

POST-SURGERY CAUTIONS
Other candidates for temporary grounding include people who’ve had major surgery (cardiovascular, abdominal, etc.) and some who’ve had minor operations (oral, eye, ear, nose, or facial), including some types of outpatient surgery. Dr. Wayne J. Riley, director of Baylor Travel Medicine Service in Houston, advises against flying for at least seven to 10 days after minor procedures and at least 10 to 14 days after major surgery. If you’re planning a transcontinental or international flight, the amount of time may increase depending on your condition and recovery.

Your risk of pulmonary embolism (blood clot) rises in the two weeks immediately after any surgery that leaves you immobilized for a few days or longer. Any extended period of sitting or immobilization (as you’d experience on a plane) increases this risk.

CASTING OFF
If you must wear a cast when you have to fly, ask for a special soft “air” cast to prevent circulation problems, particularly if the cast is on a leg. As the body swells up during flight, you could find your circulation compromised or cut off with potentially serious results if you’re encased in a traditional plaster cast.

STROKES AND NEUROLOGICAL PROBLEMS
Assuming you are not otherwise incapacitated, Dr. Riley suggests waiting a minimum of two to three weeks after a cerebral vascular accident before undertaking air travel to ensure that vitals such as blood pressure, which can be affected by in-cabin conditions, are under control. Individuals with brain tumors and recent skull fractures are susceptible to increased swelling and pressure (with serious implications) that can be triggered by cabin pressure changes.

CHRONIC PROBLEMS
Frequency and duration of flying can affect the overall health of those with ongoing or special health concerns. Conditions that warrant medical consultation and pre-planning include:

HEART DISEASE AND CARDIAC PROBLEMS
These are not necessarily a deterrent to regular air travel. People with pacemakers and those who’ve had bypass surgery, for example, routinely fly. Individuals with a history of heart disease (heart attack or angina) whose condition is stable also are generally deemed OK to fly. However, given the instability of a heart condition, you should watch for signs—a change in symptoms, such as an increase in pain or pressure, or severe shortness of breath—that could indicate a need to alter travel plans.

If you’ve had a recent heart attack or any type of heart surgery or angioplasty, consult your physician as to the period of convalescence needed before you can fly again.

ROAD RULES: Rest before leaving; avoid extreme fatigue and stress before your flight and during your trip. Make sure you allow enough time for check-in so that you’re not running through an airport with your luggage. Don’t overexert yourself physically. Don’t carry heavy luggage. Use a luggage cart or get a porter (even wheelies can be too heavy for those with heart conditions).

Be sure to carry a copy of your most recent ECG and a sufficient supply of current medications.

LUNG DISEASES, PULMONARY, AND RESPIRATORY DISORDERS
Reduced oxygen levels in the cabin can sometimes lead to a condition called hypoxia, whose symptoms (sleepiness, lightheadedness, nausea, headache, etc.) are innocuous for healthy travelers, but far less benign for travelers with cardiac and respiratory conditions and heavy smokers. If you have trouble breathing on the ground, you’re likely to have even more trouble once you’re in the air and may require supplemental oxygen.

Air travel is normally considered safe for individuals with lung diseases provided they can walk at least a block or climb a flight of stairs without getting breathless. Supplemental oxygen may be required during flights and on the ground between flights for those who cannot meet these criteria.

ROAD RULES: Contact the airlines in advance to arrange for in-flight oxygen (you cannot use your own on commercial flights) and to arrange for any equipment that you may need before you leave. You can find out just about everything you’ll need to know to secure supplemental oxygen for flights at the Traveling by Air page of the Breathin’ Easy Web site. A chart detailing the airlines’ specific requirements is also available.