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Thread: Ear Pain During ASCENT AND DESCENT

  1. #1

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    Ear Pain During ASCENT AND DESCENT

    Hello,

    I have an elderly friend who complains of ear pain on commercial flights during both ascent and descent. I know how to deal with pain during descent but don't know what to tell her about ascent. Any suggestions?

    -- Art Z.
    -- Art Zemon, Saint Charles, MO, USA
    -- Building: Bede BD-4C
    -- Cheerful Curmudgeon blog

  2. #2

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    It's exactly the same. Chew gum and clear one's ears.

    I had the same problem once and it turned out I had too much wax buildup in my ears! It only really hurt on ascent, which was weird.
    The opinions and statements of this poster are largely based on facts and portray a possible version of the actual events.

  3. #3
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    What Frank said plus place thumb and forefinger on nostrils, squeeze closed, blow hard through nose, repeat, swallow hard, repeat.

  4. #4

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    Quote Originally Posted by Floatsflyer View Post
    What Frank said plus place thumb and forefinger on nostrils, squeeze closed, blow hard through nose, repeat, swallow hard, repeat.
    Valsalva maneuver works on the way up? Thought that is for descent?

  5. #5

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    Thank you, everybody. I will pass your suggestions on to my friend.

    -- Art Z.
    -- Art Zemon, Saint Charles, MO, USA
    -- Building: Bede BD-4C
    -- Cheerful Curmudgeon blog

  6. #6

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    Quote Originally Posted by Mike M View Post
    Valsalva maneuver works on the way up? Thought that is for descent?
    Yes, it works both ways.

    Most people don't have pain on ascent, though.
    The opinions and statements of this poster are largely based on facts and portray a possible version of the actual events.

  7. #7

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    You haven't been given good complete information on the problem. Most people don't have problems during ascent because of the physiology of the middle ear and the Eustachian tubes which are designed to ventilate the middle ear space, ensuring that its pressure remains at near normal environmental air pressure. During ascent, pressure inside the ear escapes to the outside lower air pressure through the Eustachian tubes. Swallowing (e.g. chewing gum) can provide significant assistance in allowing this overpressurized air to escape. Yawing can be even more effective at opening the tubes. Several small muscles located in the back of the throat and palate control the opening and closing of the tube. Swallowing and yawning cause contractions of these muscles located in the back of the throat and help regulate Eustachian tube function. The Valsalva maneuver is ONLY recommended during ascent if those methods do not provide relief. During the Valsalva maneuver, you close your nose and mouth and GENTLY (repeat, GENTLY!!!) blow air into your passageways. By doing this during ascent, you're forcing even more air into an already overpressurized cavity, which if done briefly and cautiously can help "pop" your ears and relieve the excess pressure, but only as a last resort during ascent. Personally, I've never needed to do that during ascent and would not expect it to be needed unless there's an ear infection, congestion, wax build-up, or other aggravating cause.

    It's a different story during descent. Air pressure increases as the plane lowers. The increased air pressure pushes the eardrum inward and can also compress the Eustachian tubes, making it even harder for air to enter the vaccuum within the enclosed chamber of the middle ear. Chewing and yawning may help, but they are not as effective going down as they are while your going up. If not effective, here is where the Valsalva maneuver is recommended. You will be forcing air through the tubes into the vacuum, equalizing the pressure and relieving the pain that may go along with pressure changes if you allow the pressure change to reach a significant differential. Taking corrective action frequently and in small increments is much better than waiting until a large differential exists. Again, the emphasis is on blowing GENTLY. If you blow too much air in, you will overpressure the chamber and get your ears confused to the point that you won't know whether they are overpressurized or underpressurized.

    There are multiple reasons why I continue to stress blowing gently. The most common problem that can occur due to too strong a Valsalva is to rupture your eardrum. However, there are more serious results that include a detached retina or even heart irregularities. I've been flying to high altitudes for over 40 years and frequent, gentle Valsalvas are almost always necessary to get me down. I've never had a problem and it is a highly effective maneuver.

    Another thing to understand is that the pressure does not change with altitude in a linear fashion. It's a curve. You'll have a larger pressure variation at the lower altitudes for the same amount of altitude change than at higher altitudes. So, the last couple of thousand feet will require the most attention to keep your ears clear.

    Finally, a tip for those who always have a problem handling pressure changes. Taking a decongestant or using a decongestant spray just prior to flying and just prior to beginning a descent will act to shrink the membranes and help those Eustachian tubes remain open and effective. If you have a chronic and repeated problem, see your doctor.
    Last edited by dusterpilot; 04-18-2015 at 01:57 PM.

  8. #8

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    Thanks, dusterpilot! My friend will certainly appreciate the detail. I had given the other posts to here yesterday and she was kind of disappointed. She is the kind of person who wants to understand the why's and wherefore's.

    Cheers,
    -- Art Z.
    -- Art Zemon, Saint Charles, MO, USA
    -- Building: Bede BD-4C
    -- Cheerful Curmudgeon blog

  9. #9
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    As posted, it's the idle to sea level descent that has the most potential to be painful. That type of descent is more common with lighter traffic, the busier airspace one gets stepped down more gradually, with intermediate leveloffs.

    Going up usually isn't a problem, landing in Denver helps too. Modern cabins maintain a lower altitude while at cruise, which helps.

    The 1st step is to try not to fly with a cold or stuffy head. I've never understood the ear plug idea, unless they are for noise.

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