To consider bailing out of this holiday for medical reasons?

[stargirl04]

Hi MN-ers,

Hope you wise ladies can help me decide what to do.

I suffered a punctured lung after a lung biopsy where a needle is inserted into my lung.

It was my third such episode after two previous biopsies (for unknown abnormal tissue), but this time it was worse - I was kept in hospital and had a chest tube to reinflate the lung.

Before all this, I had booked a four-day break to Iceland in March with friends from Denmark - we are meeting up in Reykjavik.

One doctor has told me I can fly six weeks after lung collapse resolution, and two others at the hospital said that I can fly two weeks after resolution, but that I am fit to fly. (Reduced cabin pressure means that a repeat lung collapse mid-air would be problematic.)

Yet I am still suffering breathlessness and chest pain similar to when I had the collapse - though the symptoms have improved and are nowhere near as bad as two weeks ago.

The biopsy showed no cancer but then they wanted to investigate possible TB.

I got the results on Wednesday , no evidence of TB was found and a chest x-ray confirmed that I was not suffering any late onset of lung collapse.

I asked this doctor (a different one to the ones who advised me before) about flying, saying I didn't understand why I still had symptoms when my x-ray is showing no recurrence of lung collapse. (During the previous two episodes I felt no symptoms upon resolution but these were smaller air leaks that didn't need a chest tube).

He did a lot of chin scratching and um-ing and ah-ing then said: "I don't want be the one to tell you not to go on holiday, but lungs take time to recover from this type of thing.

"There is a 99 per cent chance you will be fine and suffer no adverse symptoms on the flight. The worst case scenario is that one lung goes down mid flight. You will be in pain and breathless but you won't die because you can breathe through the other lung. You will be in hospital in Iceland. That's the worst case scenario."

If I felt great (as I did before the biopsy) I would still go to Iceland which will be 7 and a half weeks after my lung was resolved, so easily past the 6 week waiting period for flying. But because I have these symptoms, if I was travelling alone, I would just cancel it. What's stopping me is that I will have to let my friends down.

I know that sounds ridiculous. Maybe that's because it IS ridiculous. I really hate letting people down. And maybe my symptoms are down to anxiety.

Statistically, I "should" be okay. But my friend (who has cancer) tells me if it was her that had heard this from a doctor, she wouldn't want to take the risk and that I can go to Iceland anytime - that I should wait until I'm feeling better, get my lung sorted out and that I shouldn't give a second though to letting my friends down.

What would you do?

Some house insurance policies have travel insurance included. Could you check if yours does?

I remember your previous posts. Glad that there was no sign of cancer but also sorry that they've not been able to come up with a more definitive answer for you.

Too late now, but I'd always recommend that folk buy travel insurance as soon as you book as it will then cover conditions that arise in the intervening period before the holiday.

Your holiday plans sound amazing and, if it was me and if I had insurance, I'd be sorely tempted to go. The risks of something happening are realistically very low. However, without insurance, no, I wouldn't go but I'd be very disappointed about it.

Get insurance quotes to cover you with the condition. See how you stand then.

Then give it another week to see how you feel, warn the friends just in case. Good friends would def understand.

Yes, I agree that I should have taken out the insurance at the time of booking. Lesson learnt!

My RL friend, who has been a nurse for 25 years said she thought there was a risk I could suffer respiratory distress mid-flight, and the fourth doctor was doubtful too. So I will sleep on it.

Dinosnores, nice to hear from you. Yes, it was good news on the cancer front, thank you!

I wouldn't go. Your friends will understand. It's totally reasonable.

Is this the same nurse friend from before?

Of course there is a risk, no one is ever going to be able to tell you that there is no risk, but as the fourth doctor says, if something did happen, you would be in pain and short of breath (and, yes, that would be distressing) but no risk of death. Oooh, I'd be so tempted to go. Insurance might not be as expensive as you think, particularly as you wouldn't be flying against medical advice

Toss a coin. Let the coin decide. You'll either be relieved not to be going or excited and then you'll know your gut feeling!

Really hope that things improve over the next few days/weeks before you have to make a decision.

Oh Dinosnores, you are funny - like a little devil sitting on my shoulder! ha ha

I did a quick search for travel insurance quotes covering medical conditions, and I am looking at paying anything between £50 and £500.

The trip will/would be amazing: taking in waterfalls, geysers, volcanoes and glaciers and then searching for the northern lights at night. Sigh....

I just wish these pains in my chest would go away

stargirl, you can go another time perhaps?

Dino "if something did happen, you would be in pain and short of breath (and, yes, that would be distressing) but no risk of death."

to me, death isn't half the issue - if I'm dead, I won't care! but I've been hospitalised abroad and it was awful. Also, the idea of just being short of breath from an asthma attack on the plane is bad enough. and if something happened to OP and there was no pain control....I'm wincing just thinking about it.

Yes, Lorelei, I can go another time - all of those things will still be there.

Dinosnores - Yes, it is the same friend as before!

Well yes they'll be there but I was thinking more of the cost. Your health is the most important thing of course.

I would go. But I would make sure I was covered on insurance first.

I would go. I honestly would. But I'm a nurse so I guess I see a lot of conditions and balance it all out. You have two lungs for a good reason.

Have they considered doing pleurodesis? A mixture of talcum powder and saline can be injected into the pleural space, which irritates the lining of the lung and makes it sick to the rib cage. Then it can't collapse.

From the health point of view, I'd probably go if it wasn't going to cause any permanent damage - but I have a slightly cavalier attitude to my own health.

However, I wouldn't be going unless I could get travel insurance for the lungs - I have a rather less cavalier attitude to my finances, and if it went tits up you could end up with a substantial bill - while the EHIC card does work out there, the costs of repatriation can be very substantial. I know how frustrating this can be - very few insurers will cover me, and last time I went on holiday (one week in the EU) it cost me £120 just for the insurance - which I didn't need to claim off anyway

Cancel.

Good news that the hotel is refundable up to 5 days before the (16 March) booking, you may feel much better then so I do 't see a need for a decidion yet. At least EHIC is valid there and they should be able to treat in situ rather than need to repatriate. In your situation I'd go but I have had episodes of chronic asthma (couple of hopsital emergency admissions) and prefer to adapt plans rather than drop them and let my bloody lungs hold me back.

The official guidance suggests fit to fly

www.caa.co.uk/Passengers/Before-you-fly/Am-I-fit-to-fly/Guidance-for-health-professionals/Respiratory-disease/

Up to you to weigh up insurance costs, possible cancellation of the hotel and lost flight costs.

Thanks all. It is tempting to think that I can go.

Today, I was thinking: "Why don't I just go?" (subject to satisfactory insurance arrangements).

Yet, the doctor's comments and ambivalence have spooked me. Then I found this on the Healthline website:

*In severe cases, late treatment may result in circulatory or respiratory failure. Delays in emergency surgery also require longer recovery. This is often accompanied by worse outcomes. Having one pneumothorax (lung collapse) increases the odds for a second.

Thanks for posting that link Divegirl. The recommendations are that I can fly, however, I am wondering if this recommendation is different if it is your third pneumothorax.

I will talk to insurers tomorrow and also to the British Lung Foundation.

Haven't told my friends yet.

Request a fitness to fly test. They stimulate a low oxygen environment similar to an aircraft at 33,000 and test for oxygen levels/lung issues. Given your history I would see this request as reasonable, they can usually be ordered and carried out within a week or two.

Also there are some good insurance companies for lung issues www.insurancewith.com are great for people with existing medical problems.

Equally it is ok to cancel, surely given the circumstances your friends would understand.

That's a good idea Lego - I'm not hopeful of getting such a test on the NHS but I will certainly request one.

Thanks very much for posting the insurance link, too.

Just to update anyone who's interested, I've had more information, all of which points to not going.

My regular insurer - which I use because it covers pre-existing medical conditions and I am asthmatic - said outright they won't insure me because the abnormality in my lung hasn't been diagnosed.

I could possibly find another insurer willing to cover me, but I spoke to my sister, who's recently had surgery for cancer and who's an insurance broker, and she told me this:

"I can't get cover for cancer, but let's say I took a travel insurance policy out to cover me for lost baggage and in case I suffer some other medical problem that has nothing to do with cancer, with cancer is excluded from the cover.

"Suppose I went on holiday to the USA and tripped over and broke my leg. The insurer would then try to imply that I fell over because I was dizzy or breathless because of cancer. If there is a large amount of money to pay out, most insurers will look for ways to avoid paying out that money."

Secondly, I spoke to the British Lung Foundation, and they said that people can fly two weeks after resolved lung collapse without a significant risk of recurrence, unless they have a lung disease. In which case, a person is at increased risk of relapse for at least a year afterwards.

They said asthma is classed as a lung disease so the year guideline applies to me. Great.

Finally, hospital staff where I was treated said they would need more than three weeks' notice for the fitness to fly test and as I've been discharged I would have to get a referral from my GP anyway. Another hospital could do it possibly within the three weeks but I would still need a GP referral.

So I guess I better cancel the hotel and tell my friends. I'm not looking forward to that.

Just spoke to two more insurers that cover pre-existing conditions and they told me the same as the last one. So that's pretty conclusive, then!

Sigh...

Oh, that is annoying for you. Really sorry to hear that.

Thanks, Dinosnores

know you are now not going, but i think that is wise

my lung collapsed almost 10yrs ago due to blood clot that went from leg to lung

12 days in hospital over new year

i was due to fly end of march so 10 weeks later to antigua to get married

doc advised me not to go, but eventaully my gp agreed to sign a letter stating he had checked me over and fit to fly

noway i was going to miss my wedding

so i went BUT i had to pay an extra £300 travel insurance premium - was also on drugs to prevent another blood clot/dvt

know you had a nice trip planned but you can go another time unlike my wedding

your health is more important

Thanks for your message Blondes.

Sorry to hear about the issues with your health just before your wedding - that must have been utterly horrendous.

I really admire your courage in pressing ahead with your big day - I wouldn't have been so brave (but then I'm a big ninny!). Though I can understand why you did, and it's brilliant that everything went smoothly for you.

It's interesting that you were told not to fly after 10 weeks. Guidelines must have changed since then. When I had my first lung collapse in 2005 I lived in Australia and was told by doctors there that I couldn't fly for three months. I was due to fly back to the UK but had to cancel the flight.

I told my friends about the situation earlier tonight and they are really disappointed but totally understand.

I am seriously thinking of avoiding flying for a year, as per the information from the British Lung Foundation. Which seems grim, but the prospect of another lung collapse is even grimmer!

Glad it all worked out for you Blondes and thanks for your support, as in the back of my mind I am wondering if I'm overreacting.