How to know if you’re too sick to fly

You’ve finally made it to the day before your trip and can officially check-in online. Though you couldn’t be more excited for your vacation, you’re pretty sure you feel some kind of bug coming on and are not sure what to do—should you go and tough it out or stay home until you’re well enough to travel?

While it’s an expensive decision to make, as airlines typically don’t provide a credit or refund unless it’s an emergency, there are some dangers to flying if you’re too sick. In addition to impacting those on your plane (especially babies and the elderly), a flight can take your sickness from bad to worse, fast.

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Cabin pressure changes, and that stale, dry air can wreak havoc on your immune system, says Dr. John Brian Bronson, M.D., and primary care director of the Travel Advisory services at Kaiser Permanente in San Diego. Bronson says several parts of your body are impacted 30,000-feet up. “Health issues include reduced oxygen and air pressure, which can result in ear pain; dry air, which can cause dehydration and dryness of the mucus membranes that keep bacteria and viruses out; prolonged sitting, which can result in edema or even deep-vein thrombosis (DVT); and jet lag, which can result in headaches, upset stomach and nausea, difficulty concentrating, and trouble sleeping.” Put all of those possible ailments on top of a fever, a cough and a runny nose, and you can pretty much bet you’ll be miserable from take off to landing.

As much we hate to say it, if you’re exhibiting any of the following five symptoms, you may not actually be well enough to scan that boarding pass and get out of town:

A fever is a no-go
No one wants to postpone a trip (especially if it’s to those crystal-clear Caribbean waters that always seem to be calling), but Bronson warns that if you have a fever above 100F (38C), it’s probably time to call up the airline. “A high fever can be a sign of infection which may be contagious and may worsen during the stressors of travel,” he says. If you’re able to get your fever down to normal (97.6F) then you might be fine to get on the plane, but using your best judgement is key. As Dr. Bronson says, only you can know if your body is on the upswing and about to kick an illness or if the congestion is just beginning to seep in.

Chest pain needs immediate medical attention
If you’ve ever had the unfortunate experience of being in an emergency room, then you know any sign of heart trouble gets attended to first. This is because any condition that threatens to keep your heart from beating is considered life-threatening and has to be treated, ASAP.

Dr. Cedrek McFadden, MD, a clinical assistant professor of surgery at the University of South Carolina, Greenville, says there’s no room for chest pain on board a plane. “If a person is feeling pressure or a squeezing sensation in the chest, they could be exhibiting a sign they are not well enough to fly,” says McFadden. “Angina is defined as chest pain that occurs when the heart is not getting enough blood flow, typically from blocked arteries. So, if the body demands an increased blood flow from a surge in adrenaline as a result of a flight, and the body heart cannot meet the demand because of a coronary blockage, a myocardial infarction [heart attack] can ensue.”

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An upset stomach doesn’t fly well
Ever gone out for dinner the night before your flight and suddenly, something isn’t sitting well with you? Maybe it was the sushi or the wine, but if you’re vomiting or experience diarrhea, then you could have a foodborne illness. With this type of sickness, Bronson says traveling can become more difficult and maybe more importantly, really uncomfortable and unpleasant. Until you have your tummy tamed, it’s better to stay on ground level.

If it’s tough to breathe, see your doctor. Now.
Especially with a cold or flu, you might struggle to take deep, cleansing inhales and exhales. Due to congestion from the sickness, your airways are partially or fully blocked or that not-so-nice drainage is causing your throat to tickle. Whatever the cause, if you’re experiencing shortness of breath, Bronson says to avoid flying. Why? Once you’re up in the air, it will be increasingly more difficult to give yourself extra oxygen if needed, posing a threat to your health and putting a stress on crew members and fellow passengers, should anything go wrong.

If you’ve recently had surgery, don’t get on a plane
Recently had a procedure? It’s in your best interest (and fellow passengers’) to get checked out by your doctor and allow him or her to give you the seal of approval to fly, McFadden says. Because they understand your condition, your body and know you personally, they can be your best defense against getting on a flight when maybe you should stay home. He notes that a 2004 study says certain conditions pose more of a threat when you get on a flight, including, a recent heart attack, stroke, coronary bypass grafting surgery, uncontrolled hypertension, severe congestive heart failure and more.

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