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Hypoxic challenge test

skischool profile image
38 Replies

Hello Folks,Has anybody recently undergone a proper "fit to fly test"as opposed to a chat with your GP/Respiratory nurse and the can you walk 50mtrs and climb a flight of stairs without undue breathlessness questionnaire and a GP,s sign off.I believe the tests only takes about 30 mins and entails breathing in an O2/Nitrogen mix which roughly equates to the rarefied atmosphere of approx 8-10,000 ft which is approx what cabins are pressurised to.

The reason i ask is that i would like to assess if i desaturate sufficiently to require the use of supplemental O2 in the pressurised environment of an aircraft.,Because if i do not it would save me the hassle of having to get sign offs from various airlines who all have different procedures and forms to be completed if i want to use a POC in the cabin.And all those procedures often mean that you end up getting tickets at rip off prices because they have to be done pre booking.

If i am ok i can just chuck said concentrator in hold luggage(sufficiently insured for baggage handlers thuggery)and take it as intended as an assist whilst exerting abroad.

i would even consider getting this done privately as i am sure it would take decades to obtain within my own trust.I appreciate it would not be cheap as i once had a diving medical referee charge me about £50 just to knock on his door.

Love to all best wishes mike

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38 Replies
stone-UK profile image
stone-UK

Hi

Fit to fly is non NHS service,l my GP practice charges £20

birchwoodmedicalcentre.co.u...

skischool profile image
skischool in reply to stone-UK

Thanks for that Stone. though i believe that would be the standard can you walk 50yards question and not a proper scientific evaluation.I appreciate that would pr obably be good enough but the likes of Ryan air.jet2 all state that you must use their individual forms.The whole idea is to ascertain in my own mind if i am safe to travel as a non declared respiratory case.i.e as a normal punter in which case the POC then just becomes my personal usage baggage when i need it abroad.cheers

O2Trees profile image
O2Trees in reply to stone-UK

Since when have we had to pay for fit-to-fly test Stone? I certainly didnt pay though mine was about 8 years ago. I haven't caught up on any charges.

stone-UK profile image
stone-UK in reply to O2Trees

Hi

May be it's just my medical centre, if you click the link they have a nice sideline in private charges.

For photo confirmation was £25 for one signature, for my new driving licence.

skischool profile image
skischool in reply to stone-UK

Stone you are dead right it is definetly non NHS.their excuse is that they have to employee receptionists,typists and pay a massive disclaimer insurance with the BMA.the poor souls my heart bleeds.

cinnammon profile image
cinnammon in reply to skischool

My husband had a fit to fly test early 2016 at St James' Hospital in Leeds, no charge.

peege profile image
peege in reply to O2Trees

O2, I just paid £10 for a fit to exercise note - for my post PR class!

Pam1952 profile image
Pam1952

You could try ringing BUPA....I think that they do it. 😊

skischool profile image
skischool in reply to Pam1952

Pam,looks like they do the real thing,no charges mentioned on web site,guess you have to ring them for quote,only problem is its the Cromwell hospital in London so for us Mancunians a bit of a timely and expensive visit but a good test of our Ambulatory capacity.cheers

Pam1952 profile image
Pam1952 in reply to skischool

Cheadle would be a bit handier! 🤣 Good luck. XXX

skischool profile image
skischool in reply to Pam1952

Pam i checked out hospital, ironically one of their respiratory consultants is the same man who diagnosed my early copd more than 12 years ago.He is also one of 3 who failed my wife so terribly in their diagnosis and treatment of her IPF to such a degree that i will avoid them like the plague,It was worth a try but the wonders of the internet reveal all.thanks anyway

Pam1952 profile image
Pam1952 in reply to skischool

Oh dear! Sorry you had such a bad experience. XXX

skischool profile image
skischool in reply to Pam1952

no problem my dear,you were only trying to help,it was much appreciated,xx

in reply to Pam1952

I know Cheadle well as I lived in Gatley as a child.

skischool profile image
skischool in reply to

Cheshire,its almost like Mayfair on the monopoly board to us poor Mancunians though actually i,m a cockney so i would be old kent road or bow street!xx

in reply to skischool

I know :) I didn't appreciate it when I lived there! I did when I moved away to London especially East London. I used to attend Southbank Uni which is very close to Old Kent Road. I know Bow Street too.

skischool profile image
skischool in reply to

i was born in a slum called great eastern buildings in Shoreditch within the sound of bow bells.After a diet of grittells and warm gruel we emigrated to a new town called Borehamwood in north london/hertfordshire so suddenly we were posh.but only council house posh!

in reply to skischool

Shoreditch! Even Hackney was better than that though it was still muggers paradise :) I was always told that anyone from Shoreditch, Whitechapel and Bethnal Green would aspire to Hackney as it was seen as going up in the world :)

Hackney has been gentrified now you know with the re opening of the Hackney Empire and turning the old warehouses into posh flats. There are lots of wine bars now. It's still the pits though.

skischool profile image
skischool in reply to

this is getting like a familiar Monty Python sketch though ironically to even get a flat/apartment in that part of the world now you would have to be a footballer or Russian Oligarch.

in reply to skischool

My old one bedroom flat there is on Zoopla for £172,000. It's still cheaper than most parts of London.

skischool profile image
skischool in reply to

i would rather move to Cheshire,funny how we have gone full circle.sweet dreams

in reply to skischool

You too. Don't let the bedbugs bite!

DecD profile image
DecD in reply to

And it's still 'Ackney !

in reply to DecD

Sure is mate :)

timCHP profile image
timCHP

Hi Mike

I had a Fit to Fly (A proper Hypoxic Inhalation Test, breathing low oxygen air for 30 mins as you described) for free through the NHS... but it was through my Consultant at the Brompton in London rather than through the GP. I think a GP would charge £20 for setting it up - if it's at your request, rather than theirs if you see what I mean.

Even if you pay to go through your GP, I'm sure it would be a proper test rather than just a walking assessment - if they call it a "fit-to-fly" then that is what it has to assess or they'd be liable in all sorts of ways if you conked out on a plane! So definitely worth investigating rather than going private.

By the way, if you still need your POC to fly, EasyJet are by far the easiest airline to fly with. They don't require any pre-clearance, just that you have a medical certificate (letter from your GP) with you. You just turn up with the POC and let them know as you board. Not had any problems so far. (NB this is for POCs, not oxygen in bottles).

good luck!

googeymac1 profile image
googeymac1

i had a fit 2 fly test last year, my gp gave me a quick check up and said everything was okay 2 fly when i asked for a letter of confirmation, she was'nt willing 2 give it, she said she put it on my record's and that was all that was needed, i did notice at the time she looked uneasy when i asked her

TwinklingStar profile image
TwinklingStar

Dear Skischool

I have had several, what I call, proper "Fit to Fly" tests. I googled "Fit to Fly Test detailed procedure". First on my search was a PDF Document from Bristol NHS. That document describes a test similar to the one which I had done. The test failed because after inhaling the chemical to simulate the oxygen levels during flight they were unable to take any blood samples. During my test they were trying to take the blood from an artery and they were using a needle far too large. They are supposed to use very long thin needles on people who have EDS (Ehlers-Danlos Syndrome). My blood vessels are extremely small and fragile. This test could not be completed.

They then did this assessment:

I sat in a cubicle which is very much like sitting in a shower cubicle and the air quality inside is made to simulate being in an aircraft with oxygen levels reduced to match being on a flight. An oxometer was placed on my finger to measure my oxygen levels throughout the test. I recall having to breathe into a blower several times. I cannot remember if I had something being administered by nasal cannula - I seem to recall that I did. All the devices are connected to a computer system and everything is recorded electronically. During this test no blood samples are taken. This is better for me as I cannot afford for them to destroy any more of my blood vessels just because they choose to ignore the specific document I provide to them which contains specific instructions on how to take blood samples from people who have EDS. I think this test took about 25 minutes. The results are then sent back to my Consultant and usually I return to his clinic immediately following the test to get the results. He then tells me what rate of oxygen I need to have during the flight and confirms this to my G.P.

I believe the first test is more accurate when NHS Staff know the procedure of taking blood from EDS patients. However, to have the first test done regularly would be completely impracticable for me as I cannot afford to "waste" my veins or arteries especially as there is an alternative test. The second test must be far less expensive & is probably just as reliable. For the first test the Consultant had to be present, also a nurse, then they called someone from the blood testing department. When all that failed they called ANOTHER Consultant. I only need one staff member present for the second test and It is certainly far less invasive than having 4 or 5 attempts at hitting my artery.

I have a feeling that the first test I was having done was being done for other reasons and was not the normal test one would have just for a "Fitness to Fly" test. Whenever I ask for a "Fitness to Fly" test it is now always the second test which is carried out. The oxygen levels during a flight are at 80% of what they are at sea level. Most HEALTHY people can cope with this drop BUT you hear of so many cases of Deep Vein Thrombosis (DVT) which is often at least partly caused by this drop in oxygen. I did not move around or talk during either of the above tests so the oxygen levels recorded do not take into account what happens when I talk, eat, use a computer, put things in and out of my bag, remain upright for extended periods, or when I have to get to the toilet. All these things cause my Oxygen levels to drop further than when I am just sitting doing nothing. In my case I think the recommended flow of oxygen is under estimated by around 1 to 1.5 lt.

I have never had to pay for any tests carried out at the hospital. The first test mentioned was ordered by the Consultant & I had to be admitted to hospital for it. This is why I think it was not just about flying. The normal procedure for respiratory appointments: book in at reception, request travel expense form, go to area next to reception to have weight, height and blood pressure taken. Then go to the respiratory clinic place your booking form in the tray, nurse checks file for instructions, sends people off for any tests required which usually include X-ray, Spirometry tests, Full Lung Function tests, AND "Fitness to Fly" test ONLY when it has been pre-booked PRIOR to the appointment. When all is completed go back to clinic and see the Consultant who discusses all the results of all tests & any other issues. After this go back to reception collect travel claim form & go to Finance department to collect travel costs! I live in Scotland. I don't think you will be lucky enough to have things done like this down in England. Probably you get a separate appointment for each individual test - such a waste of money!

When I think I may be well enough to travel I ring my G.P. & if I have had a "Fitness to Fly" test carried out during the last 12 months she provides me with a letter confirming:

1. Oxygen Flow levels required for the flight

2. Refers to my repeat prescription document confirming that I need to carry those medications and I attach that to her letter

3. Refers to the various braces I need to wear as some of these have metal inserts (back brace, ankle braces, knee braces, neck brace, wrist braces etc.)

With Easy Jet I have only ever required a letter. I supplied her with a sample letter of what I needed covered. My G.P. has never charged me for the letter. She has it on computer & just changes the date & oxygen flow rate. Things have changed and now I think there is a form to fill in with Easy Jet. British Airways always required a form to be completed. The forms for both airlines are very lengthy & I think she would make a small charge for filling all that in. I would still require the basic short letter for the other things.

Don't forget to ALWAYS take a valid EHIC card. Take this EVEN if you are travelling outside of Europe! You never know whether your flight will be diverted or changed. I once had to stop in Europe unexpectedly after being forced to take a different flight home. You can read about this travel card here:

nhs.uk/NHSEngland/Healthcar...

Also check out my post for a list of 7 or 8 Travel Insurance companies. Ensure you go to the very bottom of that thread to get the FULL UPDATED list which is available here:

healthunlocked.com/blf/post...

Sorry for such a long post. Once I start I have this problem, caused by my Dyspraxia, that I have to include EVERYTHING! lol Anyway, I hope you find some of it helpful. I think you should not have to ask to have this test done privately. It is useful for your Consultant to see how your condition affects you. Don't take any chances. Enjoy your holiday.

Keep Smiling or in my case I will Keep Twinkling.

Love & hugs from

Twinkling Star

P.S. I must have accidentally deleted my "FULL UPDATED LIST OF TRAVEL INSURANCE COMPANIES". There is a short list which can be found on the above link. It will take me a while before I can get the complete list re-posted.

rogerw117 profile image
rogerw117

I had it done at the Royal Brompton last year, no charge, the Fit to Fly letter was from them not my GP. My GP wouldn't give me a letter, which made me very cross at the time but actually they were right to insist on the test. The Brompton were brilliant and sorted it in 24 hours, though I know I wouldn't have been that lucky this year. I sat in a transparent box for 20 minutes or so with various levels of reduced pressure, then got the letter from my consultant half an hour later. Whether you need oxygen in flight is something you really do need to know. I take a pulse oximeter and keep an eye on my %.

The airline was the least of it. Most have a statement on heir website. Some like Easyjet are very easy and just say you're OK as long as you have a medical letter. Others I think want flow levels etc but a phone call should clarify. At the airport I presented myself with POC and letter at check-in, security and the boarding gate and nobody was the slightest bit interested. The cabin crew certainly took note but they were the only people who even looked at the letter or asked any questions.

skischool profile image
skischool

Thank you for your very comprehensive reply,i think you will need a rest now,xx

carotopgal profile image
carotopgal

I'm from the US, and we don't have to have any kind of test before flying, so I can't help there. But I did want to caution you about flying without O2. Before we knew my husband needed O2 at all times, we flew to see our daughter. That was one of the scariest trips ever! I thought he was going to die up in that plane. He turned gray, could barely breathe, was dizzy, and felt that he was going to pass out. I was terrified, as was he. With the O2, this last trip we took was a breeze! I couldn't believe the difference that the O2 made. I hope you can get everything sorted out! Hugs.

JoHarr profile image
JoHarr

Hi, last fit to fly test I had was in 2014 carried out at the hospital free of charge. They did not issue a letter this time as they had done on previous occasion, said they no longer issue letters. Not sure how you would be able to inform the airlines though without a letter but as I passed the test I did not mention it and do not use oxygen. My GP referred me for this test.

Flew to Spain last year without bothering with a test and no problem on plane. I did mention on booking that I may need assistance getting onto the plane from the waiting lounges and a wheelchair and someone to push me were supplied by the airline free of charge. Good luck and best wishes, JoHarr

JoHarr profile image
JoHarr in reply to JoHarr

PS oxygen level was tested by taking small blood sample from my ear which was then promptly examined in the lab.

skischool profile image
skischool

thank you all for your replies.xx

Sued1958 profile image
Sued1958

I had the hypoxic challenge test at the Royal Stoke University Hospital which cost me £68. As a result I have to have O2 to fly !!!

TwinklingStar profile image
TwinklingStar in reply to Sued1958

I'm glad I don't live there! I would never be able to afford to go on holiday. lol Xxx

skischool profile image
skischool

thank you for that.

The test in question is also known as a hypoxic challenge test. The tests are performed by many NHS hospitals around the country with pulmonary function /lung function /larger cardiorespiratory departments. Testing is free if requested by a consultant at the hospital but if you're not under the care of a hospital consultant many hospitals will accept you as a private patient/G.P.patient with a charge. Prices are not standardised and testing procedures often differ slightly but Liverpool Heart and Chest Hospital and Whythenshawe hospital in the North West charge around £150.

skischool profile image
skischool in reply to Bigbreathinandblow

Thank you for reply,i have finally managed to see my consultant and i now have an appt early august to do the Hypoxic challenge test,Thankfully my consultant is based at UHSM Wythenshawe where the test will be done under the NHS,,,cheers

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