Doctor's column: how to fly properly with illnesses and medications. A life-saving article

Anesthesiologist Dr. Yuri Suponitsky explains how to prepare for air travel with chronic conditions. The article covers risks from pressure changes, dry air, and prolonged immobility. Practical advice includes discussing the trip with a doctor, arranging extended insurance, and carrying a surplus of medications in original packaging in hand luggage. Special attention is given to drugs banned in various countries.

Anesthesiologist and intensive care specialist Dr. Yuri (Uri) Suponitsky publishes a column on air travel rules for people with chronic conditions. The article is prompted by two recent events: the Flydubai flight terror attack on September 30 and the arrest of an Israeli at Minsk airport with 170 oxazepam tablets. The author explains flight physics: cabin pressure is 550 mmHg versus 760 on the ground, with oxygen content around 150 mmHg. This is not critical for most chronic patients but dangerous for those with severe heart or lung disease, significant anemia, or those already requiring oxygen support. Gases in body cavities expand with pressure reduction, so recent eye, sinus, middle ear surgeries or laparoscopy may be contraindications. Low cabin humidity creates problems for respiratory patients, and prolonged sitting in an uncomfortable position increases thrombosis and thromboembolism risk. Dr. Suponitsky offers seven practical recommendations: discuss the trip with a family doctor as no general guidelines exist (citing two patients with the same 20% ejection fraction, one disabled and the other climbing a 4,000-meter mountain in Switzerland); avoid flying with uncompensated conditions (fluctuating blood pressure or sugar); allow two weeks after changing treatment regimens; consult a doctor after recent hospital discharge; do not skimp on insurance and arrange it in advance, honestly disclosing all issues; carry all chronic medications in hand luggage with a surplus (two weeks' supply for a one-week trip) in original packaging with a doctor's letter. Special attention is given to banned drugs: codeine (in Zaldiar and Dexamol Cold) may be considered a narcotic; pseudoephedrine (in Sinufed) is used to produce methamphetamine; Valocordin and Corvalol contain phenobarbital, which in Western countries is prescription-only. The author recommends not taking questionable medications abroad, limiting oneself to paracetamol and nasal drops.