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Having pneumothorax in left lung. Is it safe to travel in flight in this condition? What would you recommend?

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I am a normally healthy 24 year old male that has had a recent episode of a small pneumothorax in my left lung. The last xray was taken on Sunday and showed that most of the escaped air had been reabsorbed and that the small collapse was reattached. I am scheduled to take a transatlantic flight from Minneapolis to London tomorrow evening. It is possible that I could delay departure until Friday. What would be your recommendations? and what is the probability that I could have another problem? It was a bleb. I have discussed the flight with doctors. The ER doctor said she thought it would be okay. The pulmonologist who hasn't actually seen me said wait four weeks. But I can't because I am performing at one of the largest electronic music festivals in the world in Pula, Croatia. This happened on Friday morning. Went to E.R. on Saturday and then a follow-up at E.R. on Sunday. It was most likely from drug use late Thursday night/Friday morning. I am not an abuser...just got caught up at a party.
Posted Mon, 9 Sep 2013 in Lung and Chest disorders
 
 
Answered by Dr. Gyanshankar Mishra 27 minutes later
Brief Answer:
4 weeks is the ideal waiting period.

Detailed Answer:
Hi,
Thanks for posting the query on XXXXXXX After going through the query, I would like to comment the following:

1. You need to 1st stop smoking in all forms.

2. The 2 Xrays uploaded do not show any pneumothorax but a right sided subcutaneous emphysema is there which seems to be resolving.

3. It is ideally recommended to wait for 4 weeks (following recent episode of pneumothorax) prior to taking a flight since the pressure changes associated with flight places you at a risk of recurrence of pneumothorax.

4. It will be risky to take a flight within 4 weeks of pneumothorax. However if you plan to go ahead with the risk then an onboard doctor, facility for management of pneumothorax management and oxygen supply should be there for managing a pneumothorax.

5. My advice would be to not take the risk.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: Having pneumothorax in left lung. Is it safe to travel in flight in this condition? What would you recommend? 25 minutes later
What is the probability of something happening in flight? And what would be the worst case scenario on board? I have been getting mixed answers and am needing to make a decision shortly. A trauma surgeon and critical care doctor told me he thought it would be fine. So has a radiologist and the E.R. Doctor. I am needing to know the true risks if I decide to go. Thanks.
 
 
Answered by Dr. Gyanshankar Mishra 3 hours later
Brief Answer:
Recurrence in flight could be difficult to manage.

Detailed Answer:
Hi,
Thanks for the follow up.

1. As mentioned already due to the inflight pressure chamges chances of recurrence of pneumothorax are there.

2. Also the in flight time is pretty important i.e. the duration of journey. A shorter duration should have less chances.

3. If the pneumothorax happens then it needs to be treated and the options are oxygen therapy, needle aspiration and tube insertion as per the severity of pneumothorax. Since your underlying lung seems to be normal, even if pneumothorax develops it sahould reexpand easily with proper management.

4. This is what the guidelines say exactly "There is no evidence that air travel precipitates recurrence of a pneumothorax, but recurrence during a flight may have serious repercussions. The BTS Air Travel Working Party stress that patients may travel safely 6 weeks after a definitive surgical procedure or resolution of the pneumothorax on the chest radiograph.". Also "Commercial airlines currently arbitrarily advise that there should be a 6 week interval between having a pneumothorax and travelling by air". We advise a minimum of 4 weeks.

5. If it is secondary pneumothorax then the period of flight abstinence is one year! If you can get your HRCT Thorax scan done then that can help the physicians decide if the underlying lung is normal or not, and hence whether the risk can be taken or not.

6. Since you also had subcutaneous emphysema , an HRCT scan thorax would let us know if there was any concurrent pneumomediastinum or not.

7. Thus if you are deciding to take the risk then, an HRCT thorax needs to be done in supervision with your pulmonologist.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
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