Travel Plans After A Stroke: Can I Fly?

Flying after experiencing a stroke is a common concern for stroke survivors. While there is no formal medical guidance on how long to wait after a stroke before flying, there are several factors to consider, such as the type of stroke, the severity of the stroke, and individual risk factors. Most airlines will not carry someone within days of a stroke, and it is recommended to consult with a doctor to determine if it is safe to fly.

How long after a stroke can I fly?

It is natural to be concerned about flying after a stroke. Flying is generally considered safe after a Transient Ischaemic Attack (TIA) or "mini-stroke", but opinions vary on how long you should wait. The Stroke Association recommends avoiding flying for the first two weeks, as this is when your problems are likely to be most severe, and you are at the highest risk of another stroke. However, if your condition is stable, the UK Civil Aviation Authority suggests waiting only 3 days, and some sources say that flying is safe after 10 days. In the case of a severe stroke, it may be best to wait up to three months.

Before booking a flight, you should consult your doctor to determine if you are medically stable enough to fly. They will be able to advise you on your safety and health concerns and create a long-term health plan that will eventually allow you to fly.

If you are flying soon after a stroke, you may need to obtain a formal medical assessment and certificate. You should also check with your airline, as each will have its own rules on flying with medical conditions.

Tips for flying after a stroke

• Wear compression stockings to improve circulation and prevent blood clots.
• Sit in an aisle seat so you can stretch your legs.
• Get up and walk around the cabin when it is safe to do so.
• Request a companion to assist you if you need help.
• Give yourself plenty of time to get through security and to the gate.
• Keep medication in your carry-on bag, and ensure you have enough for your whole trip.
• Carry medical documentation and declare your medication when travelling to a new country.

What are the risks of flying after a stroke?

While it is generally considered safe to fly after a stroke, there are several factors to consider and risks to be aware of. The Stroke Association recommends avoiding flying for the first two weeks after a stroke, as this is when the risk of another stroke is highest. However, it is important to consult with a doctor, as every stroke is different, and they can determine if you are medically stable enough to fly.

Hypercoagulability (Excessive Blood Clotting)

Flying increases the tendency for blood to form clots, which can lead to ischemic stroke when a blood clot blocks an artery in the brain. Long flights can elevate clot risk by 26%. Inactivity in cramped spaces can lead to deep vein thrombosis (DVT), where a blood clot forms in the leg. If a piece of this clot breaks loose, it can travel to the lungs, causing a pulmonary embolism, or to the brain, leading to another stroke.

Reduced Oxygen Levels

The air pressure inside an aeroplane is lower, resulting in reduced oxygen levels in the blood. While this may not pose a significant risk to stroke survivors, it can be an issue for those with breathing difficulties or a heart condition. It is essential to consult a doctor to assess the impact of reduced oxygen levels during flight.

Delayed Medical Treatment

In the event of a stroke during a flight, there may be delays in receiving emergency medical treatment. While emergency landings can save lives, the time to receive appropriate treatment may be prolonged. Some stroke interventions, such as tissue plasminogen activator (TPA), must be administered promptly, emphasising the importance of waiting a certain period before flying after a stroke.

Communication and Mobility Challenges

Stroke survivors may experience deficits in spatial perception, coordination problems, and communication difficulties, which can make navigating an airport challenging. Weakness and coordination issues may hinder their ability to walk long distances. As a result, travelling with a companion or seeking professional assistance can be beneficial.

Co-existing Medical Problems

It is crucial to consider other medical conditions that may impact your health during the flight. Sometimes, new conditions such as diabetes, atrial fibrillation, high blood pressure, or anaemia are diagnosed alongside a stroke, requiring stabilisation of medications. Consulting your doctor to ensure your health stability is essential before booking a flight.

What precautions can I take to fly safely after a stroke?

Flying after a stroke is a common concern for stroke survivors. While there is no formal medical guidance on how long to wait after a stroke before flying, there are several precautions you can take to ensure you are flying safely. Here are some tips to help you prepare for air travel after experiencing a stroke:

• Consult your doctor: Before booking your flight, discuss your plans with your doctor. They will assess your individual situation, including the type of stroke you had, the severity of the stroke, and any ongoing medical conditions. Your doctor will advise you on whether it is safe for you to fly and provide clearance if necessary. It is important to follow their recommendations regarding the timing of your travel.
• Wait an appropriate amount of time: According to the Stroke Association, it is best to wait at least two weeks after a stroke before flying. This is because your risk of a second stroke is highest during this period. For severe strokes, some experts recommend waiting up to three months. If you have experienced a mini-stroke or TIA (transient ischemic attack), most carriers advise waiting 10 days before flying.
• Get medical clearance: Ensure you have medical clearance to fly, especially if you are within the first six months to a year after your stroke. Your doctor will determine if you are medically stable enough for air travel.
• Book in advance: Contact the airline at least 48 hours to one week in advance to disclose any special requirements or disabilities. You may need to provide a doctor's note or certificate. Discuss any necessary arrangements, such as requesting extra legroom or wheelchair assistance.
• Arrange travel assistance: If your mobility is limited, you can request transportation assistance at the airport to help you navigate through the terminals and during boarding and disembarking. You may also consider travelling with a companion who can assist you during the flight.
• Manage your medication: Carry all your medications in your carry-on bag to ensure easy access. Bring enough medication to last your entire trip, and consider keeping some medication in your hold bag as well, in case your carry-on luggage is lost. Don't forget to bring along the prescriptions or a doctor's letter for your medications, especially if they include needles or liquids.
• Stay hydrated: Drink plenty of water before and during your flight to reduce the risk of developing blood clots. Avoid alcohol, which can cause dehydration and increase the risk of clot formation.
• Move around: Get up and walk around the cabin when it is safe to do so. If you are unable to walk, perform simple leg exercises like rotating your ankles or extending your knees while seated. Movement helps prevent blood clotting and improves your blood flow.
• Wear compression stockings: Compression socks improve circulation in your legs and prevent blood clots from forming. Choose knee-high stockings with a compression level of 20-30mmHg. However, do not wear compression stockings if you have peripheral artery disease (PAD), as they can further reduce blood flow to your legs.
• Allow extra time: Give yourself plenty of time to get through airport security and reach your gate without rushing. This will help reduce stress and allow for rest if needed.
• Consider travel insurance: Purchase travel insurance to protect your trip and ensure coverage for any medical expenses abroad. Declare that you have had a stroke when arranging your insurance, and check that you are fully covered for pre-existing medical conditions.

By following these precautions and working closely with your doctor and the airline, you can help ensure a safe and comfortable flying experience after a stroke.

What are the recommendations for flying after a TIA?

While there is no formal medical guidance on how long to wait after a TIA before flying, most airlines advise not doing so until 10 days after the attack. Some airlines recommend waiting 3 months after a TIA if it has left you with residual symptoms.

According to the Stroke Association, it is best to wait at least 2 weeks to fly following a TIA because a person is at an increased risk of a second stroke. It is advisable to be close to emergency medical interventions that can reverse the stroke effects, such as the administration of medications like TPA.

Before flying, it is important to get clearance from your doctor to determine if you are medically stable enough to fly.

If you do fly after a TIA, there are some precautions you can take to reduce the risk of another stroke, such as:

• Keeping medication in your carry-on bag
• Travelling with a companion
• Getting travel insurance
• Giving yourself extra time to get through security and walk to your gate
• Wearing compression socks to improve circulation and prevent blood clots
• Moving around the cabin when possible to prevent blood clotting
• Staying hydrated and avoiding excessive salty snacks to keep blood pressure down

What are the recommendations for flying after a haemorrhagic stroke?

Haemorrhagic strokes are caused by sudden bleeding in the brain. People who have had a stroke may be at increased risk of another, and recovery differs for each individual.

There is no definitive answer to the question of whether a person can fly after a haemorrhagic stroke, but there are several recommendations and guidelines to consider. Firstly, it is important to consult a doctor, as they can determine if a person is medically stable enough to fly. It is recommended to wait until a person is stable and has recovered enough before flying. The Stroke Association suggests waiting for at least two weeks after a stroke, as the risk of a second stroke is increased. The American Heart Association (AHA) also states that the risk of a stroke recurring is highest in the 30 days following the initial stroke.

If a person has had a haemorrhagic stroke caused by a blood clot, they will be given medication to reduce the risk of further clots. This medication should be taken regularly and should be easily accessible during the flight, kept in hand luggage. It is also recommended to carry medical documentation and inform the airline of any special assistance requirements.

Other recommendations for flying after a haemorrhagic stroke include:

• Allowing extra time at the airport to reduce stress and accommodate for any movement problems.
• Staying well-hydrated and avoiding salty or fried foods to maintain healthy blood pressure.
• Moving around regularly and performing leg exercises to prevent blood clots.
• Wearing compression stockings to improve circulation and prevent blood clots, unless there is a pre-existing condition such as peripheral artery disease.
• Travelling with a companion for extra support.

Frequently asked questions