Ask Captain Lim

Hi Captain Lim,

Just so you know, I DID search high and low for your thoughts (or Dr. JB Lim's) on flying after a pneumothorax (collapsed lung), but alas, could find no mention of the possible dangers. While reading this you'll ask yourself why I didn't ask my pulomonologist, yet I did, and his response was "probably." Um, I'm not fond of that answer, so I*m pursuing it further.

I have been flying on planes since the age of 6 months, mother was a flight attendant, and I was a Corporate Travel Agent for 10 years, who has quite literally traveled around the world (but haven*t had reason to fly anywhere in the past 6 years), by no means have I been a fearful flyer, until now...

Problem is, I had a "primary spontaneous pneumo" a little over 3 weeks ago (coincidentally, I was due to fly from BWI (Baltimore-Washington) to Manchester, England 2 days BEFORE the lung collapsed, but cancelled my reservation 2 days before departing because I was so strangely agitated~ intuition?) The pnuemo was caused by the rupture of a "bleb", of which a CT scan confirmed and that I have them bilaterally, and some rather large (due to old scarring, I may have had a small pnuemo in the other lung as well, but likely ignored it as a muscle pull)

So anyway, I am holding a non-refundable ticket, good for a year. Problem is this, I have a 50% chance of having another pnuemo, and from what I understand, if this occurs on a plane (due to the 8000-8,500 ft pressure change) it could be, well, let's just say really bad... Emergency landing kinda bad, which over "the pond" I assume would be a tad difficult or hopefully having a Dr. on board who could put a chest tube in during flight.

I know for a pilot or crewmember, corrective surgery is done on the first pnuemo. But for those not in the industry, the Dr.'s wait until a lung collapses a 2nd time to proceed with the rather painful procedure. Thus, I'm stuck trying to figure out what I should do. Do I risk it and take my trip to England (if it collapses on the way I*ll end up in a U.K. hospital that won*t accept good old Blue Cross/Blue Shield Insurance~ and unable to fly home for 2 weeks AFTER the pneumo is resolved) or simply bag the idea for a couple years, write a letter to the airline with all the medical documentation attached and ask for either a refund or a voucher to be sent for the friend in the U.K., so she can fly here for a visit?

Sorry if I've blabbered on, but this is something that seems to be quite difficult to get a definitive suggestion on. I mean if it*s enough of a concern for a pilot or crew member to prompt immediate surgery, there has to be some risk for the rest of us not so frequent, high altitude, bleb carrying flyers, right?

Thank you for your thoughts, concerns or comments.

Nancy

Hi Nancy,

I am sorry I am unable to add much on an issue that I am not qualified on, but luckily, we have the expertise of Dr JB Lim who has kindly taken his time to give us a very detailed write up on flying after a collapsed lung.

As usual, I have asked him to give us a summary to the answer below...

Dr JB Lim's short answer:

Quote: The risk of developing spontaneous pneumothrax for air passengers depends on his or her history of lung disease and similar respiratory problems. There were cases of pilots and deep sea divers developing this problem due air pressure changes into lung cavities or blebs (blisters) in weakened areas of the lungs. Air may flow from lungs into the thoracic cavity and vice versa when air pressure changes.

When blebs rupture, air enters from the lungs into the pleural space and thoracic cavity. If air was trapped in the pleural spaces due to previous history of pneumothorax, it will then expand against the lower pressure in the lungs when the cabin pressure is lowered to about ? that of the normal atmospheric pressure. This may cause the lungs to collapse at certain areas.

Medical scientists are unable to evaluate the risk with certainty because they have little data to work on due to limited studies on air passengers who faced this problem. Passengers who have history of spontaneous pneumothorax previously are advised to have their lung strength and functions tested by their own respiratory physician before they fly. Unquote:

We wish you all the best in your future air travel :-) .