It’s Just a Cold… Until Descent

Have you ever had that moment on descent when you think: That’s it. This is how I go deaf.
You swallow. You chew gum. You spray your nose again. Nothing.

Or are you smarter than me?

Because I wish I could say this happened once. It didn’t. It happened several times before I finally learned my lesson. One of those flights ended with more than two weeks off sick because of ear barotrauma. Not exactly the kind of break you want.
The strange thing is that most crew have flown with a cold at some point. A blocked nose, maybe one ear already feeling strange, but the trip looks manageable and calling in sick somehow feels bigger than the cold itself. You convince yourself you will manage.
Sometimes you do.
Sometimes, descent reminds you that the human body is not built to negotiate with physics.

Behind the eardrum is a small air-filled space called the middle ear. That space has to stay at the same pressure as the air around you. The structure that helps make that happen is a narrow passage connecting the middle ear to the back of the nose. It is called the Eustachian tube. You use it all day without noticing. When you swallow, yawn, or chew, the tube opens briefly and lets air move through. That equalises the pressure on both sides of the eardrum. During descent, the pressure in the cabin gradually rises. The middle ear has to let air move through that little tube so the pressure inside can keep up with the pressure outside.
When everything works well, you feel a small pop, and that is it.

But if you are sick, that’s where things start to go sideways. The tissues inside the nose and throat become swollen. Mucus builds up. That narrow passage becomes irritated and sticky. Instead of opening easily, it struggles to open at all.
Now the pressure outside the eardrum increases while the air inside the middle ear cannot equalise quickly enough. The eardrum starts bending inward, and the surrounding tissues stretch.
For some people, it feels like pressure. For others, it becomes sharp pain that spreads through the ear and jaw. Hearing becomes muffled. You might feel dizzy too. Doctors call this ear barotrauma.
It is more common than people realise. Many cases are mild, but that does not make them insignificant. Most of the time, the pressure eventually equalizes and the ear settles. But not always. If the tube stays blocked long enough, the pressure difference can irritate the tissues, cause fluid or small bleeding behind the eardrum, and, in rare cases, even tear the membrane.

When we fly with a cold, the thinking usually goes like this: it is only one flight, I will push through, it will be uncomfortable but manageable. Most crew know the tricks. Swallowing, yawning, chewing gum, drinking water, and gently blowing with the nose pinched. These actions can help because they encourage the tube to open.
Sometimes they work perfectly.
Sometimes the tube is simply too swollen, and we have to go through that uncomfortable, sometimes painful feeling that can last for hours.
And this is where flying sick stops being about toughness.
Crew culture values reliability. People show up. People push through discomfort. Nobody wants to be the person who pulls out of a trip because of a cold.
But aviation is different from most jobs. Someone working in an office can power through a blocked nose or sinus pressure and still get through the day. The crew cannot do that in the same way, and aviation management must be educated on this.

Calling in sick when you are genuinely unwell is not a weakness. It is a professional judgement.

Because in the air, a blocked nose is not just a blocked nose. It is a pressure problem. And physics does not care about your roster.

Call in sick when sick.

Ivana