Steep decents

Yesterday my son helped me wash the airplane and afterwards we did the only sure technique known to thoroughly dry the plane. We went for a ride. Because of the cloud build ups and bumps underneath we went up to 7500' to get on top for the short 45 or so mile flight to get gas. (You gotta love RV's. Could you imagine climbing this high from sea level in a Cessna or a Cherokee for a 45 mile trip?) When we got 20 miles out from the destination I started a rather steep decent of around 1000 fpm and both of us were having a blast. As I entered downwind my son started complaining that his right eye felt like it was going to pop out of his head and that his sinus cavity and right ear felt like they were going to explode. He is 17 years old and has never complained about anything like this before but he was convincing me this was real and was getting serious. As I turned base his head was leaned forward and both hands were cupping his face and he was moaning. I asked if he needed to go straight to the doctor when on the ground he said no, but he was in terrable pain. I showed him how to clear his ear on the right side which helped some, but he was still in pain. While filling the tank I started realizing that maybe instead of landing I should have went back up to altitude to let his head equalize and then come back down slowly. With this in mind when we left I went to 4500' for the way home and had him chewing gum, yawning, and stretching his jaw open which seemed to help even more. I didn't go up to 7500' which I'm wondering if was a mistake or if it would have made a significant difference to help him. This time when decending I came down at 300fpm and he did much better. However, when he went to bed last night he was still complaining of some pressure in his head. He does not have a cold, and no apparent allergies or sinus problems, at least not prior to this flight.

This situation was new to me. Not only did I not know what to do, he brought it up at a time when I was trying to slow down from a 1000 fpm decent while on downwind and had my hands full. (This airport was in podink, nowheresville and had nobody else in the pattern) It is amazing how flying seems to expose things every once in a while that our passengers should have the benifit of our knowing about, even when the thoughts have never crossed our minds. This was certainly one of those cases. With this in mind, I owe it to anybody else who is willing to sit next to me in my RV to know what to do if this ever happens again.

So fellow RV'ers, please educate me. Other than not decending so quickly what can we as pilots do to help a passenger with sinus pain in flight? Is it dangerous for the person experiencing this or just extremely uncomfortable? Will going back up to altitude and coming back down slowly help? Is there anything that we can have the person do that will help them through this?

All advice greatly appreciated,

Bryan,

Way back when I was young, I made my living as a diver, and by some quirk of nature, I have eustacion tubes like sewer pipes, and can even clear when I have a cold. That said, there have been a few times when even I get stopped up - it just happens, even to folks that have never experienced it before.

A clearing problem on descent is similar to a diving descent (increasing external pressure) - once you feel a blockage, you generally will not be able to clear unless you lower that external pressure. this means going back up. If you're diving, this means that in the worst case, you just abort the dive. In aircraft, soon or later, you're going to have to come down, so one thing you don't want to do is REALLY force the block into place. By continuing the descent, that is kinda what you did. You probably needed to get back up to the maximum altitude before the blockage really got forced, got him cleared, and then done a gentle descent.

As I said, however, sooner or later, you're gonna have to come down. The best thing you can say for that is that generally speaking, the ear/sinus will eventually equalize - but yeah, it is going to be painful. There are a number of techniques that can be used to clear other that a straight valsalva or chewing gum, but they are hard to describe- I know that the FAA has AC's on airman's physiology, and they should describe them. One thing to do that I CAN describe (for an ear block) is to lean the head AWAY from the blocked ear and try to valsalve - this effectively straightens and stretches the affected tube.

Ear blocks can be bad, but sinus blocks can REALLY hurt!

Paul
(ex PADI Master Instructor)

Ear ache / sinus pain

Bryan - take this issue seriously and if he is not better when you read this take him to A&E.

When I was 10 or 12 we were skiing in Switzerland for 10 days or so and living at close to 6000'. When the holiday was over we drove down the mountain, I complained of pain particularly in the hotel that night, my father said "shut up and go to sleep". Next morning the pillow had quite a bit of blood on and parents were terrified. I had less pain! We went to a Swiss Dr he looked in ...ruptured ear drum. Because I was young it healed up and my hearing is fine. I have always been prone to head colds - parents smoked perhaps 100 per day between them - and to this day I have to work at pressure equalisation. Flying, the answer is slow descents, chew or eat, talk to your passenger about yawning, no I mean yaaaaaawning. Just thinking about it makes you do it. Yawned yet? And if you do have a bad cold dont fly or stay below 2000'. Moving your jaw l r helps also. If you have to go back up I would suggest only part way to relieve the pain, but you have to work at getting down.

Hope your son is fine. It can hurt like crazy!

Steve.

Climb

When this happens, you've got to climb back up, as Paul says. Once things equalize, descend slowly. Normally that will take care of it. If you are flying, and this happens to you, take your time getting back down. It's hard to fly an aircraft safely when your sinuses feel like they are going to implode.

I feel the pain too

Bryan,

I can completely relate to your sons symptoms as this has happened to me many times. Even on decents in airliners. I finally had sinus surgery in 2000 that has made a tremendous differnce, but now I am starting to have some of my old symtoms comming back. What I do when I feel the pain coming on is squeeze my nose and equalize the pressure in my head. This drives the pressur back up deep into the sinus cavities. This is just what you would do when diving to equalize the pressure while decending. It helps very much although it can still be painfull, but usually much reduced and for a shorter period of time. A MRI will show the condition of the sinuse cavities if you feel further action is nessesary.

Slow desents and equlising the pressure even before any pain is felt can help to manage the discomfort.

See me again in two weeks.

earblock

Having been a flight surgeon in a former life, I pulled out my dehart text and reread the chapter on ear blocks. All good sugestions have been made. Another one is to spray each nostril with neo-synephrine nasal spray, wait several minutes and then respray. Then a valsalva might work better as the neo. has opened the eustacian tube, and reduced the swelling around its opening.
Be advised that the block can cause vertigo, enough to cause at least one crash , that i have read of , in high performance aircraft.
You might consider some "afrin" in your flight bag for emergencies.

dennis giammarco
Rv7 empennage

dennis said:

Having been a flight surgeon in a former life, I pulled out my dehart text and reread the chapter on ear blocks. All good sugestions have been made. Another one is to spray each nostril with neo-synephrine nasal spray, wait several minutes and then respray. Then a valsalva might work better as the neo. has opened the eustacian tube, and reduced the swelling around its opening.
Be advised that the block can cause vertigo, enough to cause at least one crash , that i have read of , in high performance aircraft.
You might consider some "afrin" in your flight bag for emergencies.

dennis giammarco
Rv7 empennage

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Dennis,

Every couple of years when I take my altitude chamber ride, the guys running the chamber show us this one quart squirt bottle like you'd see in a locker room, filled with liquid. I've seen them use it to help folks with ear blocks by snaking the tube up their nose and giving it a squirt. I can't beleive it is pure neo.....seems like they put too much in - would you suppose it is a dilute solution, or somthng else entirely?

(Just seeing the bottle makes me keep my ears clear - it doesn't look like a fun procedure!)

Paul

Bryan,
For years I have had the same problem as your son. I discovered the best way for me to stop this problem was to use Hydrogen peroxide to clean the ear canal before flying. You can get an ear wax removal kit at any store that will help also. This is my theory. I was a swimmer for many years and I guess my body would produce fluids in the ear to combat the constant drying out effects of chlorine. I stopped swimming in pools as I got older but my body kept producing the same amount of fluid. I think this fluid built up and caused my ears to block up. One time I was in so much pain from a flight that I went to the Doctor, they cleaned my ears out with Hydrogen Peroxide and it relieved the pressure almost immediately. Now before going on high altitude flights I will use Hydrogen Peroxide beforehand. Also, I try not to descend to rapidly either.

Steep descents

Never, never do a descent with over 400 fpm when anyone is on board other than you unless you are prepared to go back up to altitude. Ear drums have been busted on many unsuspecting people by doing what you did. It comes from either a cold or the lack of exposure to the 'up and down' event that occurs with flying. The tube that runs from inside the drum to the throat area to relieve pressure build-up is not releasing the pressure at the lower end. Always brief your pax to inform you ASAP so that you can go back up to the highest altitude and make a very very slow descent while clearing the ears...........

Sudafed

Mornin' everybody,
I too scuba dive and an early experience taught us that in order to be "ready" for a dive trip with no aborted dives (since we had invested so much money (as in Palau / Pacific ocean) we took sudafed for a week to "clear up" and it worked for us. Equalization was easy but when flying, I still figure my descent starts using 500 FPM (or less) in order to be safe from pain/earhurts, and sometimes still hold-the-nose-and-blow technique,

Treat your pax carefully!

I have had this issue for years and often use a nasal spray available from the local chemist when I fly. When I fly commercially I also take Sudafed, but this is banned in Australia for the PIC. These days I manage my symptoms and know how to clear my ears but it has not always been the case. On one commercial flight into New Zealand I blacked out on descent because I was in so much pain. My wife has ruptured an eardrum on a commercial flight as well so this can do your friends real damage!

IMO, the RV will teach you some very bad habits being a sport aircraft. Decending in excess of 500 fpm is bordering on poor airmanship with inexperienced passengers on board. Not only can it frighten them, but it is very painful if they experience this issue.

You should warn passengers on the preflight if they feel uncomfortable to let you know "straight away". Be prepared to climb if their ears/sinus hurt and descend slowly at least until you have taken them up a few times and know they are comfortable.

If their ears pop on the way up or they appear to be in pain, be especially careful as it is much worse on the way down.

Another point is to warn them that the engine will get quiet when you descend. More than one of my passengers was scared to death by the "silence" before I realised that they thought the engine failed.

Of course every situation is different and I hope I do not offend, but hopefuly some will be made aware of the issue. If your passengers enjoy themselves on the first flight they will come back a second time.

rwtrwtau said:

IMO, the RV will teach you some very bad habits being a sport aircraft. Decending in excess of 500 fpm is bordering on poor airmanship with inexperienced passengers on board. Not only can it frighten them, but it is very painful if they experience this issue.

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While I totally agree about keeping your passengers informed, comfortable, and happy, I don't agree with your 500 fpm rule.

Most of us are taught this perfectly round number, 500 fpm, while flying airplanes that are doing 100 KIAS in a descent.

Slap me in an RV that indicates 175 KIAS in a descent. Now...for the passenger with ear problems, sure, keep the descent rate to a minimum. But for the average passenger with no head cold and no problem equalizing, 1.75 x 500 = 875 fpm...to produce the identical descent "gradient" as your 500 fpm descent in a 152. The nose isn't pointing down any steeper.

Trust me, I'm sensitive to the ear issues. My wife has trouble equalizing, and on a flight two weeks ago she had a head cold that had us descending to sea level from 10,500' MSL at about 200 fpm (on the return trip we flew over the treetops the whole way). But barring a circumstance like that, I don't believe in the 500 fpm rule.

Thanks

Thanks for you responses. This certainly has taught me a lot about what to do to help with this situation. However, "Bad Airmanship" seems a bit harsh. We have built Sport planes and it isn't unreasonable to fly them that way sometimes IMHO. The passenger was also my son who has never had these problems when flying before and showed no signs until arriving at pattern altitude. On a trip carrying a passenger and bags, or a lunch flight with a co-worker or neighbor, a flight with gentle turns, gradual decents, etc. is very reasonable and probably should be the norm. On a "Weekend hop to get the juices flowing" as I remember hearing on the Van's sales Video "The RV Story" the flights looked more like what my son and I were doing Saturday.

I think the real issue was that I didn't know what to do after this happened. Frankly, I didn't know that it was really this much of an issue and as common as it appears to be. I'm learning very publically, and hopefully others can benefit from it. Hence the forum this was posted in.

dan said:

Slap me in an RV that indicates 175 KIAS in a descent. Now...for the passenger with ear problems, sure, keep the descent rate to a minimum. But for the average passenger with no head cold and no problem equalizing, 1.75 x 500 = 875 fpm...to produce the identical descent "gradient" as your 500 fpm descent in a 152. The nose isn't pointing down any steeper.

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I'm not sure I follow your reasoning. A 500 foot pressure change every minute is going to be the same whether you are doing 50 knots or 500. How does a higher airspeed lessen the effects on the ears of a 500 foot change in pressure every minute?

Steep descents

Bryan Wood said:

...We have built Sport planes and it isn't unreasonable to fly them that way sometimes IMHO. ...

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Agreed. I sure don't plan to restrict my descents to 500 fpm in my RV8!

skydiving descent?

Naturally, I'm now curious about the descent rate of a skydiver, say at 120 mph, 2 miles a minute, or 176' per second.

Here's a link with a bit of info regarding the ears...

http://www.uspa.org/publications/parachutist/online archives/2004/09.04/allergies0904.htm

L.Adamson

Still need a guinea pig?

Bryan....
Carefull what you ask for (given some of the comments on this thread).
& thank you for taking it in the good spirit you did...

But .. going back to your original post... Are you still looking for someone to "experiment" on?
Pick Me! Pick Me!! (.. and, I've never had ear problems...)

Lorin D - San Jose
9A Wings
(N194LD reserved)

I went skydiving with a mild cold once leaving the plane at 14,000 and opening at 3,000.

The ears cleared on the way up, but not on the way down. It felt like a vice was compressing my head once the parachute opened. Not looking forward to being disabled while under canopy I took the drastic measure of plugging my nose and mouth and blowing. I really had to lean into it, but when the pressure released it felt like an explosion inside my head.

I did not rupture any eardrums, but I had a severe sinus infection for several weeks. I do have one lingering effect; I lost much of my sense of smell and taste.

Dan, For once I do not actually agree with your logic. The issue is the rate of change in altitude not the gradient. I do agree the nose attitude in a 800 fpm is the same as a Cessna

My original comments were mainly directed towards carrying first time passengers. I think it is fair to say that Bryan's son was not a first time passenger and had never had a problem before, hence his obvious surprise and original question. I'm sorry if it was taken the wrong way and I should have stuck to the original question ... no offense intended.

My post was no intended to offend, just to indicate that these things can occur and if you carry passengers often enough you will occasionally find one that has bad ears. If people don't believe in the 500 fpm "rule"/recommendation that's OK, but they should be on the lookout for the possibility of passengers getting uncomfortable when they exceed that. Pretty much anyone can deal with this figure unless they have a head cold at the time.

I like flying with other people and have learn't that a quiet and sedate flight ensures that my first time passengers come back. Obviously if your passenger for the day has been up in light planes before and wants you to do aero the rules are a bit different, but most people I have met are pretty timid the first time round.

ironflight chamber ride

paul,
In all my chamber rides i've never seen the bottle. I imagine that it can't be pure neo , but a dilute solution in the nasopharynx will be stronger than the afrin spray that will probably get partially trapped in the nasal passages.
I also scuba and never go without some antihistimine or other.


dennis giammarco rv7
rudder finally rivetted tonight!!!

Private Message

Lorin Dueck said:

Bryan....
Carefull what you ask for (given some of the comments on this thread).
& thank you for taking it in the good spirit you did...

But .. going back to your original post... Are you still looking for someone to "experiment" on?
Pick Me! Pick Me!! (.. and, I've never had ear problems...)

Lorin D - San Jose
9A Wings
(N194LD reserved)

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Lorin, I sent you a private message.

BJohnson said:

I do have one lingering effect; I lost much of my sense of smell and taste.

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Not to make light of your situation, but I can't help thinking you'd be the perfect guest for dinner with my in-laws!