Breathless upon standing in airplane

[Beefull8]

Hi. Just wondering if anyone else has had weird feeling when standing on an airplane. I’ve had it before I was diagnosed with asthma but only in a long haul flight when I hadn’t been standing for hours. But on a recent trip I had the same symptoms again when in the restroom. It kind of feels like I was walking up a mountain like it took my heart rate and breathing a few minutes before it could get back to normal. Sitting is fine except I do feel like an elephant is sitting on my chest for most of the flight. As soon as we land everything is back to normal.

[Homely2 Administrator]

I avoid flying as I have poor asthma control and need to be in control of the environment around me.

I get your symptoms in the evenings if I lie on the sofa for a while.

My breathing goes when I get up and starting moving about.

I take my inhalers at 9pm which sorts it out.

So for me I have always assumed it is asthma related as taking my inhalers solves it. My consultant though is arranging a check that it is not cardiac related.

Maybe have a chat with your medic about adjusting your inhaler dosage when going on a flight. As having your asthma go seriously wrong when flying would not be good.

Also make sure you know your breathing exercises, so you can use them when flying, that will help whether it is asthma, or stress related, or some form of allergy attack.

[Beefull8 in reply to Homely2]

Thank you! I do get anxious and I think that might be causing the heavy chest feeling along with just the force of taking off. I don’t have issues with asthma normally but my lung function is not normal for my age. I am thinking maybe I am feeling the effects of being in high altitude or maybe the blood rushing when standing. When I went to the restroom the second time, I tried not standing up all the way and that seemed to help.

[runcyclexcski]

The air in airplanes is very dry (5-20%) because of the altitude: planes are pressurized to only 8,000 ft (~2600 m), not to the sea-level. If you feel the same way in the mountains (2500 is pretty high up), it's likely the altitude. Dry air is known to trigger asthma attacks, particularly during exertion, and standing up requires more effort than sitting down and makes the dry air penetrate deeper in the lungs.

I would not fly if my asthma is poorly controlled. If I must fly regardless, I take high prednisone and rescue inhalers before flying. I also wear a proper mask or respirator while flying b.c. of the dust released from the upholstered seats and the chance of catching a bug from fellow passengers. A mask without the exhalation valve might offer additional help b.c. it captures some of the humidity when one breathes out, and re-humidifies the air back when one breathes in.

Anxiety can be a thing, but this is often used by doctors to dimiss one's asthma symptoms. When my asthma is under control, I feel fine flying, even though I still get sweaty palms during turbulence. I know the difference between anxiety and asthma.

[Beefull8 in reply to runcyclexcski]

Great tips! I should have tried the mask. For me it’s only upon standing and if I gradually stand up and don’t stand for very long it seems to be ok. I was wondering if it was a blood pressure thing. As soon as I sit I feel ok.

[runcyclexcski in reply to Beefull8]

There are experiments you can do to get to the bottom of this. If this happens only when the plane has gained altitude, and after spending time in it, to me it sounds like asthma exacerbated by the dry air/altitude. When my asthma is bad I feel acceptable while seated, but get tight chest when standing up or walking around.

[Beefull8 in reply to runcyclexcski]

Interesting! Do you take your rescue when feeling this way? If I sit the whole flight, I don’t notice any difference in breathing.

[runcyclexcski in reply to Beefull8]

If I have no choice but remaining standing for the forseeable future, I would take the rescue. If there is an option to sit, I would rather sit down and not take it. When flying, I take the rescue in advance anyway, before boarding (plus the respirator/mask). The plane is an asthma nightmare due to the dust, upholstered seats, carpets, dry air, smell of perfume from other passengers, altitude, dodgy food, stress etc., so it makes sense to prepare.

[Beefull8 in reply to runcyclexcski]

It’s so interesting because when I ask my doctors about it they don’t seem too concerned about the airplane. I have high allergies to dust but it usually doesn’t affect my breathing. I guess I can try taking my rescue too but I don’t really feel like I need it since it’s almost just like a minute or less that I feel bad and then I’m ok. I also tried to do minimal leg and foot exercises on the plane and that tired me out too. It must be the altitude.

[runcyclexcski in reply to Beefull8]

Are these your GP or lung doctors? I guess based on your other parameters (lung function, blood work etc) they think your asthma is well controlled, thus, they do not consider flying a concern in your case at the moment. For many folks here who have poorly controlled asthma flying is an ordeal.

[Beefull8]

Yes you are right! I haven’t had a flare since 2019 but I still find flying hard on my body. I don’t have normal lung function so maybe that’s why altitude is harder for me.

[Lysistrata Administrator Community Ambassador]

I don't have the problem you describe but I do find flying difficult for my asthma. Or rather, I find *descent* difficult - the rest of the flight is usually about the same as it would be on the ground.

For me, it seems to be the change in pressure in that specific direction - takeoff and change in pressure as the plane climbs/whatever they do with the cabin then is fine. On the way down...well, that's not fun for my asthma! I get much the same effect with thunderstorms - I can feel the pressure change before they start and it's usually a bit dramatic.

I tend to find that if I mention flying problems to my consultant/asthma nurse/doctor they will tell me that I can't have any problems because my oxygen sats are fine. It seems like they can't imagine any problem other than blood oxygen levels, even though oxygen saturations don't necessarily have to be reduced in any situation for asthma to be an issue.

One asthma nurse immediately jumped to anxiety and I pointed out that a) I am not and never have been anxious about flying, though I could do without the fun on descent; b) if I were anxious about flying, why on earth would I be completely fine and chilled about it, including during turbulence, until we start descent?

For my situation specifically, there is very little useful information out there but as far as I can tell, my problem may be due to air trapping and the way gasses behave in a confined space with pressure changes. I've given up asking about it with doctors I see because I get no useful feedback, so I manage it myself. Same with various other triggers I have - I usually find that they haven't heard of it, they dismiss it as a thing, or say it's anxiety, and aren't interested in the details.

[Beefull8 in reply to Lysistrata]

Wow that sounds awful especially since no one seems to be listening or concerned. What do you do in those situations? I do get anxious which is why after about three hours a lot of my symptoms get better except for standing. And I’ve had this for over a decade. Wish we could know what it is and what to do about it! Makes traveling a pain.

[Lysistrata Administrator Community Ambassador in reply to Beefull8]

Well at least mine isn't on the way up I guess - that would be much harder and also alarming for cabin crew! It's not a solution for everyone but I do have home nebulisers approved by my consultant so I use those which really helps - but sensibly, and I would get help if they didn't work. I've learned to start doing it as soon as we touch down or it's hard to get up and off the plane. I should really get special assistance but I always feel like it's not bad enough especially as I don't need it to get ON the plane.

It definitely is annoying for travelling! I hope you find a solution to yours - though I doubt you will get home nebulisers as in the UK they are not keen on handing them out. I didn't get them for this, I just found they helped and if they're not listening to you then they won't see it as an issue which is unfortunate. You could see if the asthma nurses have any suggestions perhaps: 0300 2225800 or WhatsApp on 07999 377 775 Monday-Friday 0915-5pm

[Beefull8 in reply to Lysistrata]

Thank you! I do have a nebulizer which works great for my sons allergies too. My doctor doesn’t recommend using it for asthma though so I don’t have meds for it. That sounds scary what you have to go through just to travel. I’m probably lucky that mines is just while standing and I didn’t have any problems afterwards. I just find it annoying because you are supposed to keep moving on the plane but doing so makes me breathless.

[runcyclexcski in reply to Beefull8]

>>> doing so makes me breathless.

You can experiment next time and take the rescue inhaler prior to boarding, then see if it helps. If the flight is longer than 3-4 hrs, take it again mid-flight.

[Beefull8 in reply to runcyclexcski]

Thank you! I’ll try it next time.