Help me get to New York without a burst eardrum

September 24, 2010 2:10 PM

I'm in the Bay Area, supposed to fly to New York tomorrow morning. For the past few days I've had moderately crappy sinus congestion. What can I do to make the flight as comfortable as possible?

My symptoms are a mild headache, stuffy/runny nose, phlegmy throat, and periodic inability to clear my ears. The latter is what's concerning me the most -- I've heard about burst eardrums during flights and other wonderfully pleasant unexpected events (one previous AskMeFi post refers to a spouse who experienced that and subsequently needed a prescription for Xanax to be willing to fly again).

I've been drinking lots of hot tea, sleeping with my head elevated, and taking hot steamy showers. I have some generic sinus decongestant (it's acetaminophen and phenylephrine) that I plan to take 30 minutes before the flight, but that's pretty much it. What else can I do?

posted by telegraph to health & fitness (24 answers total)

Go to a drugstore with your drivers license and get some pseudoephedrine from the pharmacist (AKA the old Sudafed). Much more effective than phenylephrine IMO. They restrict how you can buy it but it's perfectly legal or have and carry on a place.
posted by GuyZero at 2:14 PM on September 24, 2010 [1 favorite]

I second the Sudafed recommendation and would also suggest a couple of Advil or Motrin to relieve inflammation and general discomfort. I have chronic sinus issues and this is what I do before flights. Please note, it may take a couple hours for the Sudafed to reach full effectiveness.
posted by rw at 2:18 PM on September 24, 2010

While you're at the pharmacy, get an ear bulb and flush those suckers out.
posted by clorox at 2:19 PM on September 24, 2010

go buy a neti pot and start using it today! bring it on the plane and use it in the bathroom whenever you feel like you're getting super clogged or a headache's coming.
posted by lia at 2:20 PM on September 24, 2010 [1 favorite]

Sudafed. Pseudoephedrine is magical. Divers get this in reverse and if you can't clear your ears, you can blow an eardrum when diving, so we take decongestants really seriously. Sudafed is the go-to solution for both diving and flying.

FWIW there is only a really low chance of blowing an eardrum in a pressurised cabin, but you will be much more comfortable if you ears are not clogged. Sudafed the night before and an hour before boarding and the valsalva manouver will see you right. You should be able to successfully clear them an hour after taking the Sudafed.

If your ears have been really clogged, the glorious relief of the moment when you can finally clear them ala Valsava is honest to God holy moly Jesus Mary and Joseph better than an orgasm.
posted by DarlingBri at 2:27 PM on September 24, 2010 [1 favorite]

Pseudoephedrine! That is all.
posted by Justinian at 2:32 PM on September 24, 2010

Are you taking a red-eye (other than your own pair)? I would bring some tea with you so that you can make some that you like. If you let the flight attendants know that you're not feeling well and you'd like some water for your own feel-better tea, you might be pleasantly surprised at how kind they can be. I've been all sorts of sick on planes before, including a raging sinus infection where I thought my eardrums were gonna implode. I lived.

It may suck, but you will be ok. Breathing exercises and some treat or distraction may make things bearable. Lemon, crystallized ginger and real licorice are good choices that will improve the way you feel.

Also, for long flights, I make schedules, like it's a work day. For 1 hour I work on project A. Then, snacktime! Then Project B, followed by email writing or listmaking for 20 min. Then lunch, followed by my special desert treat in my carry-on. Then an hour of magazine reading. You get the idea. The neat thing is...the drink cart, announcement, bathroom breaks, etc. are all unexpected interruptions that eat up the scheduled time. You've broken up the agony of plane flight into manageable chunks and before you know it, you have to put the podcast away and prepare for landing!

Good luck and remember that you are heading towards your bed (or at the very least, a bed).
posted by iamkimiam at 2:33 PM on September 24, 2010 [2 favorites]

Also, stick to herbal tea so you don't accidentally get more caffeine than you bargained for.
posted by GuyZero at 2:35 PM on September 24, 2010

Yes, real pseudoephedrine. When I wanted to be extra sure (returning SFO-NYC after severe, enduring eardrum pain from my NYC-SFO) I also snorted some Afrin before takeoff and landing.
posted by xueexueg at 2:49 PM on September 24, 2010

Putting a few small drops of warmed up olive oil made my ear feel SO much better last time I flew with an ear infection.
posted by Saminal at 2:50 PM on September 24, 2010

When the plane starts to descend, if you have a cold, the change in pressure can make one of your sinuses or ears feel like they are going to explode. It's excruciating. The way to prevent this is to take oral pseudoephedrine instead of phenylephrine, as everyone else already said, AND also use a nasal decongestant spray. It's a bad idea to make regular use of a nasal decongestant spray, but using it for a flight is low in risk and can save you a lot of pain. Take it about an hour before the plane starts to descend. It's miraculous in how well it opens up the sinuses.

Oral phenylephrine is little more than a scam. It's ineffective at the doses usually recommended in the US, and has uncomfortable side effects at higher dosages.

Note that pseudoephedrine can make you feel anxious and therefore more afraid of flying than usual. It's easier to handle this when you know where the feeling is coming from. It's worth it to me, if I have a cold and have to fly.
posted by Ery at 2:59 PM on September 24, 2010

Afrin nasal spray, prophylactically - about a half hour before you board.
Plus, definitely real Sudafed, not the fake crap.
Mucinex or any other form of guafinesin for less thick congestion.
Lots of liquids while flying.
Good luck.
posted by mmf at 3:14 PM on September 24, 2010

Along with sudafed (the real kind, as mentioned above) - my Ear, Nose, and Throat doctor recommended that I "thrust my jaw" periodically throughout the flight, but particularly during periods of pressure change - takeoff and landing. The movement is basically sticking your lower jaw out as far as you can - you can feel it almost pulling down on your ears. This motion shifts and opens the passages between your inner ear and nose and helps relieve the pressure. It's a similar motion that you get from chewing gum, which is usually mentioned as a way to keep your ears open during a flight. But it works much better than just chewing gum. It looks silly but it works. I have had ear infections all my life and struggled with this for a while. Sudafed and jaw thrusts, I tell you.
posted by gyusan at 3:14 PM on September 24, 2010 [1 favorite]

Dunno where this "Sudafed works" idea came from. It has never done a thing for nasal congestion, to the point where I became convinced it's a placebo.

And yes, I was taking actual Sudafed.

Afrin, on the other hand -- that shit is magic. And wildly habit-forming. Go with that.
posted by eugenen at 3:20 PM on September 24, 2010

nthing a *good* decongestant that works for you.

I saw lia's suggestion above and just wanted to point out that, although I have heard good things about neti pots, the idea of bringing one aboard a plane and using it in-flight seems really problematical to me. You can't take water bottles through security, so you would need to buy water after passing the checkpoint and then mix up a saline solution somewhere in the airport. Seems like a lot of trouble to go to at the last-minute.
posted by misha at 3:34 PM on September 24, 2010

Everything mmf said, plus the jaw stick-out maneuver and the one where you hold your nose and then pretend like you're blowing your nose. You'll be fine. I think cabin pressurization has gotten better over the years, because I used to have much more trouble than I do now (I have chronic nasal congestion from allergies).
posted by rabbitrabbit at 3:39 PM on September 24, 2010

Afrin is very effective, but when it wears off your nose will feel like it's worse than before. You'll be tempted to use it again. Do not do it. Reserve it for dire situations (like flights and dentists). Talk to your doctor—I'm sure they have some stories they can relate about heavy Afrin users.
posted by jeffamaphone at 3:53 PM on September 24, 2010

Seconding guaifenesin. I load up on it whenever I fly internationally. It really helps keep my passages clear but also moist. Supposedly, Opera singers use it when flying. I've read that it works by increasing the secretion of a thinner form of mucus.

Unlike pseudoephedrine or phenylephrine, it doesn't appear to have those nasty side-effects of jumpiness or sleepiness.

It's also cheap if you can find it generic.

Mucinex is the brand name version, but it's crazy expensive--I guess they have to pay all those fancy animators.

Cheers.
posted by robabroad at 6:45 PM on September 24, 2010

As everyone else has said - pseudoephedrine is your friend. So is Afrin - the uber-strength "maximum congestion" stuff, and also chewing gum just as the plane starts it's descent. Works like a champ, every time. (Don't overdo the Afrin - they mean it about the "don't use it more than three days" warning on the package. More than that and you're in a world of hurt, as others here have noted)

My source on this: my wife's ENT, who treated her after she ended up bleeding out of her ear from a pressure injury after a international flight.
posted by deadmessenger at 6:53 PM on September 24, 2010

You can't take water bottles through security, so you would need to buy water after passing the checkpoint and then mix up a saline solution somewhere in the airport. Seems like a lot of trouble to go to at the last-minute.

misha, have you never been on a plane? there's hot water in the bathroom taps, or you can just ask attendants for hot water and mix it with cold to the right temperature. all you need is non-iodized salt and water at a comfortable temperature. it's about as complicated as making tea.
posted by lia at 6:53 PM on September 24, 2010

Also, if neti seems difficult/gross, just get some saline mist -- "Simply Saline" or "Ocean" are my favs. They are usually found right next to the Afrin.
posted by mmf at 8:36 PM on September 24, 2010

misha, have you never been on a plane? there's hot water in the bathroom taps, or you can just ask attendants for hot water and mix it with cold to the right temperature. all you need is non-iodized salt and water at a comfortable temperature. it's about as complicated as making tea.

lia, I'm going to assume that you are not just being confrontational so I'll just answer you politely: yes, I have been on a plane, many times, and sometimes the water in the lavatory is clearly labelled non-potable. You should *not* be putting that stuff through your nasal passages. Ugh.

As for the water the flight attendants have, you *could* use that, but it is not recommended.
posted by misha at 5:26 PM on September 25, 2010

Update! Thanks for the great advice everyone. I took a couple of real pseudoephedrine about an hour before the flight and had no problems whatsoever -- not even with anxiety, which was making me very nervous (I've considered Xanax in the past just for nervousness about flying, so taking something that could increase my agita gave me great pause).
posted by telegraph at 7:50 PM on September 26, 2010

When the plane starts to descend, if you have a cold, the change in pressure can make one of your sinuses or ears feel like they are going to explode. It's excruciating.

I see I'm too late to provide any advice to telegraph, but posting this here in case someone else reads the thread:

Try sucking on a boiled sweet ("hard candy"? "barley sugar"? - I'm not sure what the US terminology would be). On Air New Zealand, staff hand these out just before the plane starts to descend. Sucking and chewing on the sweet really helps your ears pop and adjust to the change in pressure.
posted by Infinite Jest at 5:12 AM on September 27, 2010