Is it safe to fly with (mystery) reflux?

November 25, 2009 3:20 PM

Safe to fly with (mystery) reflux?

I'm not sure that's what I have, but I'm definitely not ill (cold/flu) wise. I don't have (the feeling of) heartburn and have rarely had it. I've been checked out by a ton of doctors over the last year, including a trip to the Mayo Clinic in Arizona for a slowly worsening stomach condition that feels like it just keeps getting bigger - all they've found so far via endoscopy a couple months ago is "it's red and irritated, but we can't see anything else". It's like this 24/7 regardless of what I eat or do not eat. Or even if I eat nothing (maybe 24+ hours of no food from the capsule study wasn't enough time for it to quiet down, if it can). And I've been scoped and scanned and xrayed all over and every which way. Pleasant, eh?

This past weekend, it seemed to have worsened, making breathing more difficult than it was previously, and now I feel like I'm clearing my throat all the time, feel like my throat is perpetually full of gunk, which is typically a symptom of some kind of stomach/gerd/throat thing. I've already done trials of prilosec, nexium, and prescription zantac, and none of them did anything, and have been attempting cpap but have not been successful (strangely, my doc decided on this last visit to take away the machine, and wants me to try to sleep better on 'safe' non-benzo sleep meds before trying the machine again). I've also been working with a psychiatrist on getting a new anti-depressant to help ( i was on Zoloft a few years ago) , but haven't found a good new one yet.

I have been treated for allergies/asthma/Hashimoto's/IBS for years, and drainage out the wazoo - I'm pretty sure this is not those. My nose feels pretty darn clear and I think my chest is ok... it really feels like the throat. I also have a list of all the things this thing might be (and I was going to post it as a 'mysterious-diagnosis-me, mefites' in the next couple of days) - I even wrote a letter to this guy a couple days ago, but the thing right now is, after seeing 4 different docs in the last few days, none of whom said "we must get into an er right now to look at you again", but instead "ok, we'll scope you again in a few weeks as soon as you can get in there", I am supposed to get on a plane tomorrow morning and fly my ass to New York to visit the family.

The answer is probably the obvious one "if you don't feel up to it, don't get on a plane, dumbass". Still, outside of possibly catching something from somebody out there with flu or a cold, which I feel would end up with me needing serious help, is there any reason why just going on the plane, change in pressure, etc, should make any difference? I mean, there could be heat, change in humidity, etc... or perhaps me perceiving that I'm having more difficulty breathing just from making myself do this, rather than an actual problem.

So while I'm not asking for a diagnosis here, unless you feel like it, I'm just wondering if this is a really stupid idea. I have already flown twice in the past year feeling the big stomach pressure, but was not having as much trouble breathing then as I've had the last couple of days. Normally I fly with my little pillbox of tricks in case of whatever might happen, but for this, nothing seems to be making a difference.

posted by bitterkitten to health & fitness (7 comments total)

i would fly, however if you've been to 4 different docs recently, call their service and ask if there's a nurse you can speak to. i realize that it's a holiday weekend and after 5, but you might find one that has someone you can talk to.
posted by nadawi at 4:44 PM on November 25, 2009

Yeah I told this same thing to the multiple docs. None of them seemed particularly perturbed, but i have also discovered that unless you cry in peoples' offices, or fall down with your lips turning blue, aka 'bleeding your eyes out', often I get nothing but a shrug since I have no other notable systemic illnesses that ought to prevent me from flying. This didn't stop me from trying to impart the breathing-sucks problem, though.

Thx tho.
posted by bitterkitten at 4:55 PM on November 25, 2009

I went through the full round of meds for my upper GI problem too and they didn't do anything. Some hippy guy suggested that I take some acidophilus and it changed my life.

Since that won't help for your trip, I just suggest keeping some salty snacks or hardy candy handy to keep your throat from congesting.

Good luck!
posted by snsranch at 6:17 PM on November 25, 2009

IANAD. But is it possible you have acid reflux in your larynx (called reflux laryngopharyngitis)? You don't have to have heartburn. But clearing your throat often is one symptom. You say you've been to multiple doctors but have any of them been ENTs? If not, I'd make an appointment to see one. Are you taking any medication for reflux?

As for flying, having this probably doesn't make you any more susceptible to disease than if you didn't have this condition. And it's certainly not contagious. If you feel concerned wear a face mask during the flight (actually, to be honest, that might be a good idea for anyone flying these days).

While it may feel uncomfortable, apparently your doctors haven't thought you're in any immediate danger. Again, I'm just surmising that based on your description. BTW, if it is a reflux problem, stress can really add to this. I've had this problem and before it was diagnosed I would often say my chest feels "tight." There was no congestion. Turns out that reflux can give you this feeling.

Not to dismiss your concerns at all but try to relax and enjoy. It may help.
posted by Taken Outtacontext at 6:11 AM on November 26, 2009

my family has a history of bad reflux. When my mom first started getting it, she called an ambulance and went to the ER - she thought she was having a heart attack!

Long story short, I got a KOMBUCHA 'mushroom' from a woman who worked at a hippie health food store ... changed my life.

Buying the stuff is ~ $5-6 a bottle; brewing it at home, after the initial investment, requires a few tea bags, a cup of sugar, and a gallon of distilled water.

My mom has started drinking it too, and is much better. If she drank more, she'd be off her meds totally.

also, are you overweight? losing weight helped both of us. acidophilus helped us too. I went to an allergist, and discovered I was allergic to some foods - avoidance of those foods helped me a lot too.

try drinking kombucha. it tastes like apple cider vinegar. it may take a few weeks to see results, and you may feel like crap at first as it flushes toxins from your system.

good luck.
posted by saragoodman3 at 8:17 AM on November 26, 2009

You must be frustrated and scared that this is getting worse, and at the prospect of missing this family gathering.

Please read this answer with my best intentions for you in mind. While I can't say that I know what you're going through, I can share what I've learned in the hope that you can take something useful from it. Even if some parts sound wrong to you, or you already know about them, there might be something helpful in the rest of it.

There are two components to your illness (and every illness!). One part is your throat/stomach/breathing. One part is your nervous system. That means that your nerves, your spinal cord, your neurotransmitters, and your brain are all part of this illness.

We found out from your doctors (and you) these facts about your stomach/throat:

Fact 1: This problem is not life-threatening.

Fact 2: The throat/stomach/breathing part of your problem is not affecting you enough to prevent you from walking around or talking, even if you might not feel like doing these things.

Fact 3: This problem is not depriving you of oxygen. It might make it hard for you to breathe sometimes. It's not turning your lips or fingers blue, giving you a pulse oxygen level lower than, say, 90%, or giving any other objective indication that you're going to get very ill or die.

You might not believe these facts, and or you might only partly agree with them, but let's just assume they're true for a moment.

This leaves us with two options for what is happening with your throat/stomach/breathing. Option one, your doctors are right and there is nothing noticeably wrong with you besides minor irritation. Option two, they're wrong, but not wrong enough for it to be dangerous to your body right now. Uncomfortable, yes, dangerous, no.

I say that it's not "dangerous to your body" because it seems dangerous to you in other ways. It is taking up a lot of your time and energy, and now it's threatening your ability to travel and see your loved ones.

It is making you really anxious because you don't know what's causing it. If you don't know what is happening now, you can't predict what will happen in the future. That feeling of uncertainty is tolerable sometimes, but it is terrifying when it involves your breathing system. This is where your nervous system comes in. Any thought that reminds us of suffocating is scary, and if your body FEELS like it's suffocating, or in danger of suffocating, it sends all sorts of signals to your nervous system that say I'M DYING, DO SOMETHING I'M DYING!! That feeling, panic, makes you feel even more like you can't breathe. Ick. This might be a big part of your problem, maybe even moreso than the throat/stomach/breathing part. It reinforces itself because you start to associate the throat feeling with the fear...and before you know it, you find yourself afraid much more often, because your nervous system is overreacting.

Of course, sometimes your nervous system is on high alert for whatever reason even without a physical problem, and tells you that you can't breathe even when you can. This is one part of panicking (or having a panic attack). If you think this might apply or be contributing with the problem, it's something to bring up with your psychiatrist.

So what can you do with these feelings of fear? There are a few different approaches that I mix and match depending on the situation:

1. Use medication. It seems like you've already been doing this and it's not working as well as you'd like it to (I'll write more about that later).

2. Accept that I will feel fear, that the fear is because my body is overreacting, and that I have to do [x] anyway. The "suck it up and deal" method. Works sometimes but not too often.

3. Distract myself with strong physical stimulus. Check out DBT techniques for mindfulness (one thing I do is hold ice cubes in my hands until they melt, it feels very unpleasant but it also snaps me out of the panicky train of thought)

4. Social situation or a companion, if there is someone with me (or expecting me to be somewhere) it helps keep things in perspective and the social pressure from being with them makes it harder to avoid doing what I need to do.

5. Act as though I am not feeling anxious. Pretend. Put on my clothes like I'm going to go out. Get my shoes on. Dial the number on the phone. Make plans for later that evening. Eat dinner. Go through the motions despite the fear.

So my suggestion for this specific incident is to mix and match these strategies and get on the plane. Maybe ask a friend to take you to the airport. Take it easy on the benzos from now until about an hour before you need to leave so they have maximum effect. Do something physical that will distract you completely (the ice trick I mentioned above, there are others). Prepare your clothes and make sure you're packed and completely ready so you can take advantage of a momentary break in your anxiety.

Benzodiazapenes are great for dealing with panic disorder, especially for curbing panic attacks when they're happening. But you're using benzodiazapenes to sleep, and that will build up a tolerance and keep you from using them for anxiety attacks or situations like this. They also tend to lose their sleep-inducing properties after you get used to them. Your doctor is probably right that they're not safeif you have apnea or a breathing problem, because the same sedative properties that help you sleep depress your breathing.

Which benzo are you using for sleep, and how long is its half-life? Does the problem get worse as it's wearing off? The bounce-back effect of benzos means that while they wear off, you begin feeling anxiety again, worse than you had before. So cutting back on the benzos might help you feel less anxiety about this problem, although that sounds counter-intuitive.

Best of luck.
posted by kathrineg at 12:29 PM on November 26, 2009

Wow! You are me. I went through exactly the same thing last year - the breathing problems, GI misery, and throat gunk. It started out after I trialed high-dose niacin for cholesterol, which irritated my stomach, and then started a new, stressful, long-distance job. I got worse and worse for a long time, saw all kinds of specialists, had the endoscopy, ultrasound, HIDA, and breathing tests, and then ran out of my prescription PPI one weekend. The problem ramped down about 80% over the following week. It took about a year but eventually it mostly just "went away". Go figure.

Went and saw a specialist a while later, and he said it was intense travel/job stress (exacerbated by longstanding mental health issues), combined with an adverse reaction to PPIs. I still get it sometimes when I'm stressed out (particularly the breathing thing) and the following three things help: 1) not eating for at least 4 hours before bedtime; 2) switching to lactose-free milk (helps with the throat gunk); and 3) digestive enzymes. And I am not one of those health food hippy types either -- I tend to be pro-science and pro-medicine.

It's very frustrating to be told something like "it might be stress", which seems like such a copout. But don't underestimate the power anxiety can have over your body - and how it can compound, so that feeling bad stresses you out, which makes it worse, which stresses you out, blah blah blah. Particularly if you already have anxiety/depression problems, you can end up very ill purely from worrying about being ill. And feeling like you can't breathe properly is incredibly frightening. I'm not saying this is your problem - but maybe you could try some strategies to distract yourself/make you feel more comfortable in your own skin, and see if anything works.
posted by media_itoku at 1:43 PM on November 26, 2009