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Dr. David
Dr. David, Board Certified MD
Category: Medical
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Experience:  Board Certified Physician
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Dr David, this is from my last question, a

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Hi Dr David, this is a follow up from my last question, a quick recap on my situation - I am currently in India and on Monday was admitted to hospital to have a bartholins absess drained - I was administered an epidural and the operation lasted for 30
- 40 minuets. I was given the green light to check out of the hospital the next day and was told by the doctor that I was safe to fly back to my country to heal and seek further care. I subsequently booked a first class (so that I can go the journey in comfort
and laying down) flight for this coming Monday (a week after the operation). I have now developed a severe headache that affects me most when I sit or stand up - and I have relief from when I lay down. I believe this to be a post dural puncture headache, i
went back to the hospital to have this confirmed today. At first the doctors completely dismissed me saying I was fine and that I should just got home - but I insisted they take my symptoms seriously and they went to talk to an anaethiatist and after that
changed their tune saying that I needed to monitor my condition for 48 hours and if the headache does not disappear get a blood patch procedure done. They said as soon as the blood patch is done I will then be fit to fly, but if my head ache disappears in
the next few days I can fly anyway. I have been very disappointed with my hospital and doctor care here, it has all been quite traumatic and do not want to stay in India - I very much want to go back to the UK. But now with the possibility of the PDPH I am
concerned. I imagine three possibilities - my headache goes and it was not a PDPH so I can fly. my headache remains and I need the blood patch - but then how soon can I expect to be able to fly after the procedure? The Indian doctor said straight away, but
as he has ill advised me before I am not sure - is this correct? Or my headache goes away but It WAS a PDPH and I fly because it's gone and the doctor says it's fine to fly if it goes - are there risks I could bring the condition back by flying? Lastly I delay
my flight to minimise all risk - but by how long should I delay for? My apologies for there being so many aspects to my question - I have really had so much conflicting advice here I'm very confused.
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. David replied 1 year ago.
This is Dr. David
wow, look at you teaching these doctors a thing or two about Post-dural-puncture headache
http://www.hindawi.com/journals/cria/2013/253218/
you should print out this article and give it to your doctors to read.
there is no right answer about when you can fly after a blood patch.
you can fly a day or two after a blood patch
if you still have headaches during or after the flight back to the UK, you might need to see other doctors and get a repeat blood patch done.
flying most likely will not bring back the PDPH
there is no right answer in how long you can or should delay your flight to decrease risks.
there is no way to know.
the reason you are having so many conflicting advice is because there is no right answer in your situation.
flying only slightly decrease the air pressure around you when you go up.
the cabin is pressurized for your comfort and safety.
there is no air in your CSF space so changes in atmospheric pressure doesn't have a big effect on your brain or CSF. more affect on your inner ear and sinuses where there is air.
ask for a blood patch and I bet that will help your headaches.
once your headaches are better you can fly.
let me know if you have questions.
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 44340
Experience: Board Certified Physician
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