Sickle Cell Disease in PAX

[Oblivion]

@bbchien I have a question for you that google has turned up little on, if I may.

I have a daughter with SS-type SCD. She's thankfully had no complications/pain crisis yet, though her older full sibling has endured a few already (the girls are in the 4-6 age range if it matters). I was wondering what effect altitude and the relatively 'sudden' changes thereof in unpressurized flight may have on her. She's really into planes and I'd love to take her flying, but of course not at the risk of hypoxia or pain crisis. Am I correct in being concerned? Is there a hard altitude limit? Relative limit above home field elevation (~850')? Or just plain not worth the risk?

I am, in fact, taking her to her hematologist in a couple hours for a regular checkup and intend to ask him the same questions, but would love all the information I can gather.

Thank you in advance.

 

[AggieMike88]

Found this.... http://sicklecellwarriors.com/tips-for-flying-with-sickle-cell/

 

[Oblivion]

Found this.... http://sicklecellwarriors.com/tips-for-flying-with-sickle-cell/

Thanks, I did turn up similar for commercial travel and the hydration tip is good for everyone, but especially important here. I'd still like a little more guidance specific to bug-smashers, if available.

 

[EdFred]

Thanks, I did turn up similar for commercial travel and the hydration tip is good for everyone, but especially important here. I'd still like a little more guidance specific to bug-smashers, if available.

Commercial cattle tubes pressurize to 8000' MSL. As long as you're staying below that, and based on your location you should be. I'm no expert, but I wouldn't think going up to 2500 or 3000 is going to be much of an issue. You're still 2000-2500 lower than Denver.

 

[AggieMike88]

Another passenger comfort idea would be to keep climbs and descent rates to a lower than normal. Providing more time for your passenger to acclimate to the changes.

 

[azure]

Found this.... http://sicklecellwarriors.com/tips-for-flying-with-sickle-cell/

Considering that commercial airliners are usually pressurized to ~8000 MSL, based on that page it seems that altitude alone, at least the altitudes most bugsmashers fly at, should not really be of much concern.

 

[Oblivion]

Considering that a sickle cell pain crisis can result in a multi-day hospital stay with a morphine drip as well as serious organ damage, and crisis can be brought on by something as simple as getting too cold, it's my job to be overly concerned.

That said, the specialist was intrigued by the question and agreed that 8,000' should probably be OK, but if I wanted to be more conservative (I do, it's my child I'm talking about), I might want to limit to 'Denver altitude,' which he rounded down to 5,000'.
He also (as did the link from @AggieMike88) recommended staying on top of hydration, paying extra attention to signs of hypoxia, and making sure she is dressed (and/or the cabin is heated) appropriately.

Thanks for engaging in the discussion, folks.

 

[AggieMike88]

and making sure she is dressed (and/or the cabin is heated) appropriately.

Come visit us in Texas this week... no extra cabin heat required!

(( I have mad respect for the instructors who are out there in the 152's and Cherokee's trying to teach Flight when the OAT is approaching 108°F. Yeah, the lapse rate will help, but not enough as your bumping around 3000ft AGL. ))

 

[bbchien]

Pulse oximeter during climb - except with SS homozygous there is no normal hemoglobin to read.

Sickle crises are so awful- that I would suggest something fairly radical- like O2 above 3,500 feet MSL. I would not want to have a HbSS crisis on my conscience as a dad.



Then there's this....(att) for which you and they are NOT ready.....

 

[Oblivion]

Many thanks, Doctor.

We (mostly my wife) have been watching the research closely and her hematologist is one of the leaders of it, but she's (good and bad) not a candidate for any of the 'cures' yet.

I appreciate your more conservative guideline and will definitely take it to heart. It's a tough balance managing/avoiding crisis and trying to let her have a normal childhood. When something as simple as swimming in the lake with your cousins is policed with a stopwatch, it's tough.

Thanks again.

 

[Oblivion]

I wanted to add that although this is only about Sickle Cell Trait, our doctor told me about Vance Marchbanks, of whom I was unaware: https://airandspace.si.edu/stories/...tion-public-health-policy-sickle-cell-disease