Fear of flying

[Jaquta]

Hi
My mum has a fear of flying due to oxygen debt at altitude and the resultant consequences.
(She believes it took her one year to recover from a one hour 30 minute flight).

I have a brother and sister overseas who she is motivated to visit.
(She also has secondary motives.  She is unable to import her Selegiline, which she uses sparingly, into NZ but has been told that she can obtain a script, etc in Australia.  My older sister refused to do this for her for some reason.  My brother is in the UK and that would be considered more a holiday which they definitely need and deserve.  My mother is interested in the Holocaust, etc and due to my parents health issues I believe this will be one of their last opportunities to travel).

My question is: would a sedative help prevent the consequences of the oxygen debt?
Her doctor recommended a short-acting tranquilizer (she was unsure of the name).  I'm a bit dubious about this process and wonder whether it is worth the risk.  I would not be prepared to take the risk.

J
My mother has documented severe head injuries but I'm not sure whether this (the problem with flying) is neurological or psychiatric.  Possibly both.

[Jaquta]

That's why you're such a good doctor, you like everyone!!

Thanks for the reassurance.  You didn't need to provide it, but I appreciate it anyway.

As much as I like your forum and posting in it we both know it is an avoidance strategy.  Analyzing my obsession with mental health isn't a high priority right now though.

One thing I have learned through my experiences with the mhs is to expect nothing, or if anything, the worst.  Subconsciously I do have hopes and expectations though.

The boundaries and limits you have set have been useful.
Boundaries and relationships are largely uncharted ground for me.  My T and I did some work on these, but not nearly enough before she left.  Boundaries and relationships really confuse me.  Even with my GP which is strictly a professional relationship, I feel it is a friendship within a professional relationship (but with very murky boundaries).  It is difficult to understand the dynamics when the person you are closest too (aside from a brother and phone counselor) is a professional.

On my T's departure, she said it was OK for me to idealize my GP.  She said I needed this in my life.  Possibly this attachment is healthier than no attachment.

When I saw my GP on Thursday he said all my systems were being affected by my stress levels (memory, co-ordination, hair loss, etc).  He said hair loss wasn't an immediate response but something that happened later.  He also said stressful events could be observed by bands in the cuticle.  I knew this because we see this in calves.  He said nails grow at 2 mm per month and based on this one can determine when the stressful event took place.  I got my ruler out when I got home.

My mum.  Perhaps this is something she needs to decide and figure out herself?  I was surprised when she came home from her appointment with her neuro-psychiatrist and felt that a tranquilizer could help her fly.  I think the rationale is that it would slow respiration and heart rate, etc and hence decrease the need for oxygen.
Maybe an ice-pack on her head would work just as well??  They do that for premature babies and some stroke victims.

My mother has had a history of fainting, possibly following an earlier MVA.  She was evaluated for this.
After the last accident (not the last, there have been so many) she started having seizures.  The consultant believed this was being triggered by low oxygen levels.

Maybe a large part of this is psych related.  I don't know.  I know she's had issues with depression and anxiety, especially since moving to this town.  (When she was younger her parents lived in town and her father had an affair with her aunt, then neglected his own family).
Growing up she spoke of suicide and when she wasn't at home after school I would become very fearful.
After our first head-on she was severely injured and kept saying that she didn't want to live, or only wanted to live for another five years.  After the last major crash I felt she might not want to fight it.  Her broken back, etc seem to have made her stronger.  Possibly both mentally and physically.

Anyway, sometimes I think, when she is extremely tired or overwhelmed, that she uses her medical history to her advantage.  There has been at least one seizure/ collapse which I believe has been brought on by an inability to cope.
I have been a little resentful because I too have struggled to cope and additional workloads have put me under increasing pressure.

Sorry for blabbing.  This hasn't really clarified the issue.
If I trust her and accept her issues are real I can't see that medication would suffice.  I would still expect her to have difficulties after a flight.

My brother has a heart murmur (diagnosed last year (during a medical for a consolation prize he won -10 days on a round the world yacht) and other relatives with ?mitral valve problems).  The cardiologist said my brother had pectus excavatum.  From what I read I think it said that was genetic.  I doubt my mum has that.  She has an extra rib though and her spine could be felt from pressing on her stomach.  My other brother probably has a pigeon breast.  Or maybe not.

Sorry this isn't psych stuff.  I'm just thinking (aloud).  It's difficult having a PD that feels like living in solitary confinement all the time.  With nobody to share or discuss things with.

I wish I were as minimalistic with words.

I'm actually procrastinating because I need to go for a run (to benefit my mental health) and to finish scrubbing our roof.
I saw an advert for subjects to participate in an internet clinical trial for depression.  I did the pre-screening and was told I was "too distressed" and something else about mental health and well-being to take part.

J

[Roger Gould, M.D.]

I like your comments, and  I like you, so keep doing my forum for me so I can make short answers, which is my style for this forum. Yes, transference and boundaries...don't want to do the impossible, pretend  treatment in this media, and invoke incorrect expectations...that said,if your mother has a true breathing or cardiac problem, then only her cardiologist can make this call...if is is anxiety, yes a tranquilizer will help.

[Jaquta]

Ultimately it's my mother's decision but I don't think you can ever have too much information.  (Well, maybe sometimes, but I think more than one opinion on a significant health issue is important).

I love my family but I can also really hate them too.  Mental health issues and people's perspectives can be very divisive.
It sounds like you have a great relationship with and respect for your family.

I am flattered by your comments but I think the doctor would be horrified to hear someone say that I am like him.  I could never replace him either, nor would I ever want too.  I find his posts interesting and informative and sometimes very blunt and other times very compassionate.  It intrigues me how succinct he is.

I'm not sure the doctor would consider either me or my posts helpful.  I personally feel he is trying to put distance between himself and me and what I write.  I think he feels that I am messed up (but perhaps I could be helped somewhat with therapy).  I think he feels that he needs to create strong boundaries and limits with me.  I think there are (or were) strong transference/ counter-counter-transference issues there and I feel he is conscious of those and doesn't want to feed into them.
Overall, I think he is probably a very kind, caring and giving man and ... I think he probably has his own self-interests (as do we all) and maybe he comes across as a little impatient at times.  Or maybe that is frustrated??  (Again, who wouldn't when stuff becomes repetitive?  And members, mainly me, remain un-insightful or resistant).
I wasn't planning on doing an evaluation of my thoughts of the doctor.  Perhaps I needed to say them??  I've felt there's been a change in 'atmosphere/ tension' and while I accept something I've said or done has probably created it I haven't known what to do or how to fix it or even whether it should be fixed.
Now I'll just crawl back into my cave and hide.  This was unexpected.

Thanks for your comments.  I'm sure my mum will be fine.
Carrying oxygen onto a plane was another option but that is hugely expensive.  It probably isn't an issue anyway because after they finish their house there will be zero dollars left.  The builder fleeced or took advantage of them somewhat.
They will probably sell, and possibly should, but I hate to think about losing the place I grew up in and are attached too.

J

[MicheleSVL]

Good Afternoon Jaquta.  
It makes perfect sense to me about your feelings and not wanting to take a risk with your mother's health.  Mothers (parents) should be protected and preserved.

Although I don't have an answer for you, I'm certain that the Dr. will be able to help you. You are always so helpful to him in this forum in responding to other patients and offering suggestions and the benefit of your knowledge and experience.  Sometimes it almost seems that you could be the Dr of this forum you are so much like him.  I appreciate all that you are doing.

In any case, I wish you and your mother well, and I am confident that you and your family will be able to work out this problem to everyone's satisfaction.