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A Gentleman’s Guide to Flying With a Cold

Sure, you might risk partial deafness, but most importantly, DON’T LET YOUR SEATMATE KNOW YOU’RE SNEEZING

If your body is in anything but perfect condition — and hell, even then — soaring through the skies in a large metallic tube is going to be a bad time. Such is the case when you have the common cold, since the resulting congestion, combined with the fluctuating air pressure in an airplane, can cause your head to feel like a balloon on the verge of popping. In fact, boarding a plane with a cold can result in ruptured eardrums, as Gwen Stefani proved a couple years back. Besides, as one traveled redditor notes, “Stabbing pain through your head while trying to land is not ideal.”

Trouble is, when you booked a flight months back and only have so many approved vacation days, not taking your flight is rarely an option. Not to mention, plane tickets are expensive and rebooking a flight can be a huge pain, if it’s even possible. Then again, getting on a plane and proceeding to sneeze and cough your brains out makes you the bane of every other traveler on that flight.

There are, though, at least a couple things you can do to improve your travels for yourself and everyone else cramped in the cabin with you. So do everyone participating in this travel season a huge favor and post this article literally everywhere, please.

Ugh, I feel like absolute shit. I hate to do this, but can I just cancel my flight and get my money back?

Unfortunately, the only way to find out is to call the airline and explain your situation, and even then, the chances of getting your money back are slim. “Sometimes, in rare cases, an airline may issue a refund if the passenger produces a note from their doctor,” says captain Ross Aimer, CEO of Aero Consulting Experts. “But there are no guarantees other airlines would do the same.”

But will they even let me on the plane, considering the sick mess I am right now?

That also depends, but chances are, they will. “There are regulations for crew members against flying while sick,” Aimer explains. “Unfortunately, nothing for passengers, especially for the common cold. Now, if a passenger is visibly very ill, the crew can refuse boarding.” On the plus side, if you are refused, you have a better chance of getting your money back, so you know, maybe play it up a bit if you really want that cash.

Sounds like I should just suck it up and fly, then. Is there anything I can do to avoid being the asshole who gets everyone on the plane sick?

Obviously, if you have no choice but to fly with a cold, it would be nice to wear a mask and gloves, as folks in Asia do,” Aimer suggests. While this might seem like a feeble attempt at keeping your germs to yourself, as my colleague Magdalene Taylor just recently found out, wearing a surgical mask really does help prevent the spread of germs, at least somewhat.

What about taking Airborne or another one of those immune support tablets?

Honestly, those are downright bullshit. “I hate to say it, but most of those cough and cold preparations fall into two groups: One group is composed of vitamins, supplements and homeopathic remedies, and the other is a wide assortment of only a few ingredients in multiple combinations and permutations,” says primary care physician Marc Leavey. “I don’t recommend either.”

“In my experience,” Leavey continues, “Vitamin C, Echinacea, ginger and the like do nothing for the common cold. In fact, about 10 years ago, the makers of Airborne settled a suit for more than $23 million and stopped claiming their product would cure colds — without admitting wrongdoing or illegal conduct. There’s just no evidence that any of these products modify the duration or severity of the common viral upper respiratory infection we so lovingly call a cold.”

So what can I do to feel less like shit?

Leavey recommends taking real medications. “For aches, pains and fever, in most people, acetaminophen, commonly known as Tylenol, works well,” he says. “An alternative can be ibuprofen (Advil) or naproxen (Aleve). Some people have underlying conditions, which interact with either or both of these medications, so in this and all other cases, you should consult with your physician before starting any regimen or taking any over-the-counter products. Aspirin in particular should be avoided if there’s any chance of the illness being influenza, due to a serious potential side effect of aspirin taken with that disease.” 

Specifically, Aspirin used with influenza, better known as the flu, has been linked to a greater risk of developing Reye’s Syndrome, a disorder that can cause horrible swelling in the brain and liver.

Anything else?

“You should remain well-hydrated,” Leavey adds. “Water is fine, but chicken soup is great. A study some 20 years ago showed that chicken soup (homemade is better) really does move that mucus and help a cold. If you’re traveling by air, realize that the cabin of an aircraft is at low humidity, so you should push fluids to prevent dehydration.”

Chicken soup, okay. What about my ears, though? How can I prevent them from collapsing in on themselves like a pair of waxy neutron stars?

Decongestants are your best friends above 30,000 feet. As you probably already know, sinus congestion is one of the most common cold symptoms, and since the sinuses and ears are connected, that congestion can increase the pressure in your ears, hence them feeling clogged when you’re sick. Then, since the pressure inside the plane cabin drops, particularly during takeoff and landing, the pressure in your ears tends to increase even more, which can be excruciatingly painful (or worse, as we noted earlier). Now, normally your ears would pop, which is a sign that the pressure is equalizing between them and the cabin, but the added pressure from your congested sinuses can complicate that process.

Which brings us back to decongestants: They work by narrowing the blood vessels in the nose, essentially reducing the cold-induced swelling that otherwise tightens up those airways. In turn, this reduces the pressure all throughout your sinuses, and therefore your ears, preventing them from feeling like they have the weight of a hydraulic press pushing down on them through the duration of your flight. 

That said, while decongestants can obviously be helpful when you have a cold up in the skies, they should be used in moderation. Oral decongestants can help, although they can raise blood pressure in sensitive individuals,” Leavey explains. “Pseudoephedrine is the most effective, and must be purchased from a pharmacist. It’s not displayed on the shelf. It should be taken at the lowest dose for the shortest time.” 

Technically speaking, pseudoephedrine is displayed on the shelves, but the actual tablets are kept behind the counter, and you have to show some kind of photo identification and sign a log in order to purchase the medication, since too many people were using the stuff to make meth. Speaking of meth, too much pseudoephedrine can increase your heartbeat and lead to problems like anxiety and, as Leavey notes, dangerously high blood pressure.

If you’d rather stay away from the hard stuff, saline sprays are also a great option to help with sinus congestion, and you can use them freely without worry. A stuffy nose can be treated with saline nose drops or sprays, which you can use as often as needed,” says Leavey. “While you can use a decongestant spray, if not otherwise contraindicated, such as Afrin (oxymetazoline hydrochloride spray), it shouldn’t be used more than twice daily for three days maximum. Using it longer than that can lead to a condition called rhinitis medicamentosa, with the spray perpetuating the condition.” 

Essentially, rhinitis medicamentosa is congestion caused by decongestant sprays.

Tylenol, decongestants and chicken soup, check. Anything else I should have?

“Bring some packs of tissues with you,” Leavey emphasizes. “Wash your hands after you cough or sneeze, stay hydrated and use some of the above tips to deal with symptoms. If you treat a cold aggressively, you can usually relieve the symptoms in about seven days.” If not treated and instead fueled by booze and a general lack of sleep, you can expect to have that cold for quite a bit longer.

Time to go buy eight bottles of chicken soup at the duty-free store!