Dr James Mclean - Orthopaedic Surgeon
Dr James Mclean - Ortopaedic Surgeon
Dr James Mclean - Ortopaedic Surgeon

Flying

FAQ – When can I fly after my surgery?

Dr McLean has provided these recommendations as a rough guide. Please keep in mind that this material is a reference guide only and your recovery may be impacted by choosing to fly in the immediate post-operative period or with a fracture (broken bone).

Surgery will impact your physical and psychological ability to transit the airport, tolerate turbulence and sit comfortably in a chair for the required duration of the flight. A broken bone will significantly impact your ability to tolerate turbulence. The following factors should be considered and understood BEFORE choosing to book or board your flight.

Additional information can be found here:

A clearance for flying form is available for the following airlines. Completing these forms is not a part of your routine care – a small, additional charge applies when requesting for this paperwork to be completed by Dr McLean. 

Types of surgery

As a rough guide, before flying, you should allow:

  • 1-2 days after arthroscopic (keyhole) surgery.
  • 1-2 days after a plaster cast has been applied. NB.  If both your legs are in plaster, it is unlikely that you will be able to fly – Contact your travel operator or airline for advice
  • 4-5 days after simple, open surgery (i.e. wrist or hand surgery).
  • 14 days for more complicated open surgery (i.e. shoulder joint replacement surgery).
  • 14 days after surgery to stabilise a fracture (broken bone).
  • 3 months – total hip replacement (hip precautions minimise the risk of hip dislocation in the first 6 weeks after surgery & can not be met in standard aeroplane seats).

Please note – Surgery &/or a broken bone will also affect where you can sit on a plane and your ability to tolerate turbulence. These should be considered BEFORE you book your flight and board the plane.

Restrictions may also apply to flying with other medical conditions. Some general guidelines:

  • Abdominal (tummy) surgery – 4-5 days; and 10 days for more complicated abdominal surgery.
  • Brain or neurosurgery – 6 weeks.
  • Cataract or corneal laser surgery – 1-2 days; and 10 days for more complicated eye surgery.
  • Chest surgery (including coronary bypass graft) – 10 days provided there have not been any complications.
  • Colonoscopy – 1 day provided there have not been any complications.
  • Lung surgery – 3 months
  • Heart attack – 7-10 days provided there have not been any complications.
  • Heart failure – most people who have heart failure can still fly provided that the condition is stable and well controlled with treatment.
  • Pacemaker – People who have had a pacemaker or an implantable cardiac defibrillator (ICD) fitted may travel without problems once they are medically stable.
  • Retinal detachment – 6 weeks.
  • Carpal Tunnel – Read our guide to flying after carpal tunnel surgery.

Things to check before you fly

If you’ve had any kind of major surgery, ask Dr McLean to clarify your restrictions and any help you may require, prior to booking your flight.

Airline – Each airline has its own regulations about flying after surgery. Check with your airline before you fly, particularly if you’ve had complex surgery. Also check the hand luggage restrictions with your airline. No airline will not allow you to sit in an emergency seat. You may have to purchase an extra seat (or upgraded seat) if you cannot sit normally (i.e. can not bend your knee or have a bulky sling on).

Travel Insurance -Check your travel insurance policy carefully, as you may need to inform the insurance company that you’ve recently had surgery. This could impact the cost of your travel insurance. 

Medications – You need to check what rules apply to taking your medicine:

  • On-board your scheduled plane.
  • Out of Australia (if applicable).
  • Into the country that you are going to (if applicable). Different countries have different rules and regulations about the types of medicine they allow to be taken into the country and the maximum quantity you can take in. Some medicines available over the counter in Australia may be controlled in other countries and vice versa – for clarification, contact the embassy for the country you are visiting.

It is a good idea to travel with a copy of your prescription and a letter from your GP giving:

  • Details of your medication, including its generic name (not just the brand name).
  • The name of the health condition that you need the medication for.

Please be advised that your GP Clinic may charge you for writing such a letter, as GPs are not obliged to provide this service by the Department of Health.

General advice – before you fly

  • Pack well in advance.
  • Get plenty of sleep the night before your flight.
  • Wear loose, comfortable clothing on the plane.
  • Check the hand luggage restrictions with your airline.
  • If you have children, bring toys, games and books in your hand luggage to entertain them during the flight.
  • If you have a history of travel sickness or are taking medications that may cause side effects such as nausea or vomiting, speak to your pharmacist about medication you can buy over the counter in anticipation of your flight.
  • If you think you are at risk of developing deep vein thrombosis (DVT), see your GP before you travel. They may recommend wearing compression stockings during your flight or recommend a blood-thinning medication.
  • Plan your route to the airport. Book train or bus tickets, or car parking. Check the travel news before you leave and allow plenty of time to get to the airport.

On the plane Casts

There is a risk of swelling after a plaster cast is fitted, which can affect your circulation. Most casts are applied in a manner that allows swelling to go up-and-down. If you have a complete cast, this should be split prior to flying. 

Most airlines will allow you to fly within 24 hours of a plaster cast being applied for flights that are less than 2-hours duration; or after 48 hours for longer flights.

If you are flying within 24 to 48 hours of having a plaster cast fitted, your airline may require you to have the cast split along its full length to avoid problems with your circulation.  To avoid disappointment, ask Dr McLean to arrange for this to be done prior to your flight. You may need to arrange for a replacement cast to be fitted once you reach your destination.

Your seat on the plane

If you have an upper body sling or your leg is in a cast that allows you to bend your knee, you will be able to sit in a normal seat.

If your plaster cast covers your knee, you will not be able to bend it, so you will need to make special seating arrangements with your airline. Many airlines will require you to purchase additional seats in these circumstances.

You will not be able to sit by one of the emergency exits, where the seats have more leg room. Before you board, ask if a seat with a large bulk head can be provided. Ask about the costs associated with your chosen seating preference.

Wheelchair help

If you have a cast on your leg and need a wheelchair to get around the airport and to board the plane, inform your airline as soon as possible. They can arrange for a wheelchair to meet you at both ends of your journey. There is usually no additional charge for this service.

Using crutches

If you are using crutches to support your weight, you need to inform your airline.

Most airlines will let you take your crutches on the plane. Normally, these can be used to mobilise to the departure gate and then be stored in the hold during the flight.

During your flight

Drink plenty of fluids to ensure you stay well hydrated, but avoid alcohol or caffeinated drinks, such as tea, coffee or cola, because they will make you thirstier.

Wear glasses instead of contact lenses because the dry air in the aircraft cabin can irritate your eyes if you have contact lenses in.

Move around the cabin (if possible). Sitting still can increase your risk of deep venous thrombosis (DVT), so do some simple exercises as you fly. Bend and straighten your legs, press the balls of your feet down hard against the floor, and walk around the cabin when you can. Avoid taking sleeping pills, as these can put you into a deep sleep so you will not be able to move for a long time.

To help prevent jet lag, change your watch to your new time zone when you board the plane, and try to get some sleep during the flight.

Avoid ear trouble

The change in air pressure in the cabin as the plane takes off and lands can be painful as your ears adjust. Yawning, swallowing, sucking a boiled sweet or chewing gum can help. Other tips you could try are:

  • Wake up around an hour before landing so that your ears have time to adjust to the descent.
  • If you are travelling with a baby, feed them during take-off and landing.
  • It is not advisable to fly if you have an ear, nose or sinus infection, as the swelling can cause pain, bleeding or a perforated eardrum. If you have to fly, ask your GP or pharmacist about decongestants to help reduce the swelling in your ears.
  • If you have recently had any type of ear surgery, check with your GP or specialist before flying.

Air quality in planes

Most planes are fitted with air filters that change the cabin air every few minutes. There’s no evidence that the air conditioning systems in planes spread infectious diseases. You can catch infectious diseases, such as the common cold, simply by sitting or standing near someone who is infected, or by touching an object like a door handle after they have.

Travelling with your medicines

Always carry medicines and medical equipment (needles, syringes and so on) in their original, correctly-labelled packages. Carry your medication in your hand luggage with a copy of your prescription (airline regulations permitting – check these prior to travel).

Pack a spare supply of medication in your suitcase or hold luggage (along with another copy of your prescription) in case you lose your hand luggage. Check that the expiry dates of your medicines will be valid for the duration of your visit abroad.

Some medicines need to be kept at room temperature (below 25ºC) or stored in the fridge. If you are travelling to a warm country, get advice from your pharmacist about storing your medicine. For example, to keep your medicine at the right temperature, you may need to store it using:

  • A thermos flask
  • An ice pack
  • A cool bag
  • An insulated pouch

Controlled medicines

Some prescribed medicines are controlled under the Misuse of Drugs legislation. They are sometimes referred to as controlled drugs. This means that extra legal controls apply to these medicines with regards to safekeeping, supply and import/export. Examples of controlled medicines include:

  • Anti-anxiety medicines (i.e. bendodiazepines)
  • Strong painkillers (i.e. oxycodone)

Taking controlled medicines abroad

If you take your prescribed controlled medicines abroad, you should carry them:

  • In the original, correctly labelled packaging
  • In your hand luggage (airline regulations permitting)

If you are planning to be abroad for longer than 6 weeks, you should also take a letter from your GP giving the information below:

  • Your name and address
  • Your date of birth
  • The dates you are departing and returning       
  • Your planned travel itinerary

The letter should also list the controlled medicines that you are carrying and for each medicine it should show:

  • The dosage
  • The total amount you are carrying

Other than medication such as the contraceptive pill, GPs do not usually prescribe more than three months of medication at one time. Patients usually have to get further supplies in the country they are staying in. Your GP will decide this based on the medication and the condition being treated.

Please be advised that your GP Clinic may charge you for writing such a letter, as GPs are not obliged to provide this service by the Department of Health.

Risk of Deep Venous Thrombosis (DVT)

If you are flying after recent surgery, especially on the hips or knees, you are at an increased risk of deep vein thrombosis (DVT – a blood clot in one of the deep veins in your body, usually in your legs).

Other factors may also increase your risk of DVT, including if you:

  • Have had DVT before
  • Have had blood clots already
  • Have a family history of blood clot
  • Are overweight or obese
  • Are pregnant

It is important to note that the absolute risk of developing a travel-related DVT is low, even if you are classed as moderate to high risk.

If you are at high risk of DVT, speak to your GP before flying. They may recommend that you delay your trip.

You can take steps to reduce your risk of DVT, such as drinking plenty of water and moving around on the plane.

To avoid disappointment, ask Dr McLean to clarify your restrictions prior to surgery.

For more information or to download a pdf version of this document, please see our FAQ link at www.jmclean.com.au/FAQ

You may also be interested to know when can you drive after surgery?  

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