Flying with asthma

[runcyclexcski]

Hi all --

Has anyone here done research on flying with asthma? My understanding is that planes are pressurized to about 2 km altitude -- is that correct? Another potential issue is the air humidity -- does anyone know if the air is humidified, or is it only heated? If the air is only heated, the humidity must be extremely low (<5%?), since the outside ambient air is at -40C or colder. I have never measured air humidity on the plane, will take a gauge next time (curious). Perhaps, if the lungs are not in good shape prior to the flight, one might consider canceling the flight/hotel at the destination.

I took ~10 flights since the lifting of the pandemic and mostly felt OK. I wore my 3M P3 mask, of course, still no covid! But most recently, when flying back from Switzerland, I was not comfortable, and had to go to AE for steroids straight from Heathrow. The blue inhaler did help on the plane, thanks for that. The likely reason for bad asthma on that flight might have been that I had a cold 2 weeks before the flight which, I thought, was done with, and went skiing. My GP and my specialist would not even give me 10mg pred tablets to make it through the cold, despite my action plan stating that I need 40 mg pred for 14 days on sick days. So I did not do a proper course of preds, and only got on 40 mg after the flight. I then had to cancel a flight to Colorado, too (might lose 2K in hotel reservations now).

[Lysistrata Administrator Community Ambassador]

Personally I am ok with take-off and cruising (besides any existing issues), but the descent is awful for me - I have to use my nebuliser to deal with it. I used to wait till I was off the plane because I thought I couldn't do it during descent per airline rules, but last time cabin crew were fine with it when my friend asked them (quite possibly they were alarmed by the noises I was making, lol).

I found this article which may be helpful - it explains why I have problems anyway: caa.co.uk/Passengers/Before...

Especially this, for me: As the aircraft descends to land, the increasing cabin pressure will lead to a corresponding reduction in volume. Gas within body cavities may cause problems if it is trapped and unable to expand freely or if there is obstruction to the free flow of air preventing equalisation of air pressure.

This makes sense as I've noticed I have some air trapping even when my lung function is otherwise good - not mentioned by my team at all, I had to look it up. Also makes sense that I used to have problems only on some flights and now I have them every single time I descend. Though looks like it would be worse if lungs are already actively twitchy (obstruction to the free flow of air).

I can't advise what anyone else should do, but I admit that I haven't stopped flying... My specialist asthma nurse once said oh maybe you're afraid of flying. Which I'm not, and even if I were, why would I only be bothered on descent? I don't even have to wait for the announcement to know descent has started.

[runcyclexcski in reply to Lysistrata]

The descent part makes sense. It's also bad if one's ear tubes are blocked due to inflammation -- can be quite painful (you know, the ones that connect the mouth to the ears). Overall, anything that has to do with drastic changes in air pressure, temperature, and humidity can have an impact on asthmatics.

The page you sent confirmed my thoughts about humidifity:

"The ambient air at typical aircraft cruising altitudes has very low levels of water vapour and as a result the humidity levels in the cabin are typically in the range 10 to 20% compared to that in buildings, which is in the order of 40 to 50%."

I never asked permission on using my inhalers on the plane, did not realize there could be an issue! And I started wearing a mask on the plane years 10+ years before it was "cool".

I am going to take a humidity gauge with me on the plane next time. I also might take a Geiger counter -- curious if background radiation is higher. Not that I am afraid of radiation, I am just curious. The shell of the plane may block it though (radiation from space).

[Lysistrata Administrator Community Ambassador in reply to runcyclexcski]

I knew that changes in air pressure, temperature and humidity can affect asthmatics - they already affect me on the ground, especially pressure drops like thunderstorms or sudden rain showers, or steamy conditions. I just didn't know why I was ok on take-off but not descent (though I would have thought the air expanding inside me would have been an issue too).

I find they don't care about the inhalers, just official guidance on nebulisers when I looked it up says not to use during takeoff and landing (though maybe they think that you'd need to plug it in somehow, and they wouldn't care about my portable with batteries? I don't know the rationale). In practice they don't seem to mind! I would normally have just used them but I didn't want to have to get into a discussion about it when I can't breathe... On the other hand, the only other option at some airports for me is special assistance, given how hard I find it to get off the plane with a bag unless I use the nebuliser.

[runcyclexcski in reply to Lysistrata]

Perhaps, your lungs are reacting differently when they contract (descent) and expand (climb)? I suppose I am lucky and also quite easily scared: If I could not carry my own bag I would never dare to fly!

[alexa_s]

Hi there, I've only had issues a couple of times, and both times I was recovering from a cold/chest infection. My issues are mainly shortness of breath and chest tightness during take-off and landing. To prevent them when I'm not feeling 100%, I take 2 puffs of my reliever just before boarding, and then 2 puffs half an hour before landing, and that gets me through the flight.

[runcyclexcski in reply to alexa_s]

Thank you, Alexa, for sharing!

[strongmouse]

I wonder of it depends what triggers your asthma? I remember flying with Monarch Airline and I am sure they used some sort of 'airfreshner'. I am particularly sensitive to perfumes and certain chemicals - or else the cabin crew were spraying themelves with Chanel no 5!! That definitely set off my asthma. I used a ventolin inhaler. I did mention it to the staff but they really weren't hugely bothered.

I wear a personal ioniser as I find that helps. Haven't flown since Covid 19 although we have thought about a holiday abroad this year. I will only fly short distances maximum 4 hours, because of various health issues.

[runcyclexcski in reply to strongmouse]

Good point re: the smells. I always wear a charcoal-impregnated P3/N95 mask on the plane for that exact reason -- the charcoal is for the smells (including perfumes), and the P3/N95 is for the particles (viruses, dust etc).

I found that we asthmatics always have to care for ourselves -- nobody will adjust anything if it's one person in a plane. Good thing that they do not allow smoking anymore. Not sure how asthmatics survived before.

Not sure about the ionizer for myself -- it's ozone (O3), from what I understand, and ozone is bad news for my lungs.

[strongmouse in reply to runcyclexcski]

I know some people find that an ioniser makes their asthma worse, but it helps me a lot. x