When I fly (private, commercial, military transport) and especially on descent I will get a very sharp pain behind one or both of my eyes. Something dealing with air pressure and sinuses? What can I do to relieve/prevent this? I consider my self in excellent physical condition otherwise. Had ear trouble as a kid but that's it. Thanks for the help.

Feels like a sharp needly being jabbed right between and behind your eyes? Sounds like a sinus block - I've had them a couple times and I know they can be excruciatingly painful. I'm sure F16PilotMD can give you all the technical medical jargon on why it happens, but basically it has to do with the pressure not equalizing in your sinus cavities.

One remedy is to slow or temporarily stop your descent to try to let the pressure equalize. Also, as a short term remedy, I always carry Afrin with me in my G-suit pocket when I fly - given to me by the flight doc. If I feel a sinus block coming on, I'll take a squirt of it, which generally helps out. If you land after taking it, you need to go see the flight doc before you fly again (ie you have self-medicated and have to DNIF yourself).

Toro,

Typically, how long will you be DNIF after taking a couple shots of Afrin?

Originally posted by Dirt Beater:

Typically, how long will you be DNIF after taking a couple shots of Afrin?

The couple times I've done it, I was only DNIF until I saw the flight doc. He documented it, asked me if I was okay and if I was still feeling the effects along with a couple other questions, and cleared me to fly again right away.

Toro, M.D. !! Good advice.

Required technical medical jargon below.

You likely have chronic sinusitis...your sinuses are chronically inflammed from allergies, etc. This causes the opening to your sinuses to be blocked. As you ascend, the air pressure gets lower and the air in your sinuses can escape past this blockage. As you descend, the air pressure increases and it can't get back into the sinuses past the blockage. The resulting vacuum causes pain.

Decrease the inflammation: this is what Afrin does. It causes the lining of the sinus to "shrink" temporarily....not a cure, it just will help "get you down". Also, you can use any number of medication (Flonase, Allegra, Claritin.....) Problem....most are not allowed for aviators. Civ rules are different from military.

Valsalva on DESCENT ONLY. Start early, just before descent and keep it up every few hundered feet. This will allow you to valsalva gently. Doing it (sts) too hard (sts) will INCREASE the inflammation and be counter productive. If low performance aircraft, you can typically keep up if you chew bubble gum during descent. It keeps you jaw moving, etc...usually works.

If you can't control this, see a doctor. There are more sophisticated treatments, including surgery, but they are very much specific to each individual.

Speaking as a fighter pilot and not a flight doc...I went/go through Afrin like sh*t through a goose. If you have this problem, don't leave the ground without it.

thanks for the helpful replies - would this be something detectable during a flight physical? Would I need to mention it or should I just stay quiet about it and deal with it as I fly? F16PilotMD, I've also typically had some difficulty with the valsalva - some say it's a matter of practice, but doesn't seem to easy for me. Any thoughts? thanks

What "trouble" are you having with valsalva? One ear won't "pop" or what...

Sinusitis or allergies are a 'problem' with a class I physical. My standard advice is to answer direct questions honestly. You don't carry any diagnosis (yet) so I wouldn't volunteer that information unless asked directly about your symptoms.

Sorry for being unspecific - trouble being that my ears a lot of times won't pop but when they do it will hurt. I should mention that it is not every time - I have had success with the valsalva so I know that it is possible...frustrating! thanks for the info

You almost certainly have chronic sinusitis. Sounds like the story of someone flying with a head cold. DO NOT FORCE YOUR EARS TO POP. What you need is an Otolaryngologist (ear, nose, & throat doc). You likely need medication or surgery.

[ 21 March 2004, 10:31: Message edited by: F16PilotMD ]

My dad has a friend who's son wanted to be a pilot for the Navy, but he said he had some kind of sinus problem which DQ'ed him from becoming a pilot. Not sure what the problem was. I sort have a sinus problem too. It's caused by allergies, but I am taking shots and have a prescription for some sort of nasal spray. I'm only allergic to a couple minor things but usually only one of my nostrils are clear and the other one is half clear, sometimes even fully clogged up (one nostril that is), never are both my nostrils clogged up, there's always at least one fully clear. Would this problem DQ me from getting a pilot slot? Btw, how would they ever know I have this problem?

[ 22. July 2004, 12:39: Message edited by: Jon C. ]

If you say "allergies", you're done. I can't tell what you "have" based upon the above info. If you are just doing trial and error medicine with your medications...that's not a diagnosis. If, on the other hand, you've been formally diagnosed and are undergoing treatment for allergies...you'll have trouble getting through the physical.

How do they check or test your sinuses during MEPS or the FC1?

Mostly just based on the history you give them. Some physical exam findings may support this diagnosis but most are not specific.

Thread Revival:

So my buddy just got back from Brooks and asked me to post a question here...

When he got the usual dental x-rays, a marble sized cyst thing was found in his sinuses. He doesn't really have allergies and maybe mild sinus problems (nothing he was really too worried about), but now he's a little concerned. Flight doc took a look at it and didn't really comment on it, nor did he order any further testing. Does AETC generally look past this or do they order more tests? Should he expect any problems from this? He's just kinda lookin for what to expect in the coming weeks.

Thanks.

salokin

Thread Revival:

So my buddy just got back from Brooks and asked me to post a question here...

When he got the usual dental x-rays, a marble sized cyst thing was found in his sinuses. He doesn't really have allergies and maybe mild sinus problems (nothing he was really too worried about), but now he's a little concerned. Flight doc took a look at it and didn't really comment on it, nor did he order any further testing. Does AETC generally look past this or do they order more tests? Should he expect any problems from this? He's just kinda lookin for what to expect in the coming weeks.

Thanks.

salokin

While I am not a doctor, I am a pilot, and I have had to deal with more than a fair share of sinus problems. If it was found on dental x-rays and looks to be a symetrical round cyst, it's most likely a mucous retention cyst and is most likely not a big deal unless its symptomatic.

A lot of people in the general population have them, and they aren't found because they are causing problems, they are found in things like dental x-rays.

I wouldn't worry as long as he is asymptomatic. On the other hand, some people (like me) can have problems with the retention cysts, although scar tissue from a previous sinus surgery was a contributing factor. It's no biggie, if antibiotics and other medications don't work and he keeps getting sick (like I did) they'll go in and remove it endoscopically, I was in and out in about 45 minutes and back on flying status in 2 weeks.

So thats how it works if you are already a flier, not sure how it works for people going through their FC1.

My .02

Ok, If you have an undeveloped maxillary sinus, and it has never caused you any problems, is that disqualifying for a pilot slot?

A4.2.8. Any anatomic or functional anomaly of head or neck structures, which interfere with normal

speech, ventilation of the middle ear, breathing, mastication, swallowing, or wear of aviation or other

military equipment.

If that's not you, forget it. As long as you can valsalva, you're fine.

Has anyone recently been DQ'ed during their FC1 for having the surgery to unblock their sinus's?

No problems when I went. Doc asked me if I have any issues since and I told him no. He said drop your pants.

Good news about the sinus's, sorry to hear about the pants

Just out of curiosity, how many people that are pilots use any form of sinus rinse? I noticed that I can sleep a lot better (also, when my youngest son doesn't wake up in the middle of the night) when I do use it and would like to continue using the rinse if this will not affect me down the road for pilot selection. Is this brought up in a medical exam? I have no reported allergies or sinus issues. Thank you.

You should be fine.

I had the flight doc recommend it to me to help with allergies. That being said, there is a difference between what is fine and what is not before and after wings

Thank you. I am assuming that I shouldn't voluntarily mention that I use a sinus rinse?

You shouldn't ever voluntarily mention something to a flight doc, especially before you actually have your wings

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