This was submitted by one of our readers:
My mother has bullous emphysema. i want to know how safe it is for her to fly commercial from tennessee to australia where i live for a visit. she was recently told that she might not be able to fly by a nurse. are there any special precautions she can take or things to do in this circumstance? I would really like to get her here for an extended visit if possible as she has not seen her youngest grandson yet.
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Safety flying is, of course, relative. There are several things to consider, such as the severity of her emphysema and her need for oxygen. Airplanes are pressurized, but not to "normal" sea-level atmospheric pressure, so even if she is not "hypoxic" at rest normally, she may become so while flying. There are equations that can predict the need for oxygen while flying. If she does require oxygen, this would need to be arranged with the airline ahead of time.
As to other risk, I suppose the risk of a pneumothorax is present (again, because of the decreased atmospheric pressure). I don't know if this risk is quantifiable, but my concern would be increased in patients with severe "bullous" emphysema.
Finally, all people are at risk for venous thromboembolic disease during long flights, so she would need to make sure to get up and walk around a bit during the flight.
I would recommend that she discuss these risks specifically with a pulmonologist. They are not necessarily prohibitive, but they do exist.
I agree with Jeff. I think she should discuss the situation with a pulmonologist. Sometimes people are even labeled as having "severe" or "bullous" emphysema on a chest x-ray and they may just be hyperinflated without large bullae.
We had a similar question on air travel following a pneumothorax (collapsed lung - post: http://pulmonaryroundtable.blogspot.com/2006/03/air-travel.html) and for uncomplicated pneumothoraces, air travel can be safe after 14 days from resolution of the PTx.
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