Effect of altitude : gas bubble

[anjanai]

2+ weeks ago, my husband was treated for a retinal tear by laser treatment followed by the injection of a C3F8 gas bubble in one of his eyes. The bubble is at about 30-40% original volume at this stage.

We had earlier made plans to drive up to an elevation of about 1400 feet for the long weekend. Now, we are not sure if we should take this trip. Our retinal specialist has said that it will probably be fine if we go slowly, but that just to be safe rather than sorry, we should cancel our plans and stay home.

Although I agree with him that we should be safe rather than sorry, I am willing to take my chances if the chance of risk is very low. Does anybody have any opinions on this? Most of the 3-hour trip will involve traveling over elevations of less than 1000 feet. The last couple of miles go from 900 ft to about 1350 feet - we can take this slowly (resting at 900 feet for a few minutes or hours if needed) if that will help.

I am not sure if the RATE OF CHANGE in elevation will cause the problem or the altitude itself is the problem. If it is the first, then we can try and make sure than we take it slowly. If it is the latter, than we cannot do much - unless 1350 feet is not considered to be much of a risk.

Thanks.

[anjanai]

Thanks, KellyComfort.

I am also leaning towards taking the trip. As long as there are symptoms that will indicate that we should turn back, I think we'll take the chance. It is basically our kids who will be very disappointed if they don't go- without them, I would have stayed home without a moment's thought.

Strangely, we weren't told of either the elevation or the nitrous gas expansion by our retinal specialist. It was only when I looked for more information about my husband's procedure that I found out. If I were less of an internet-knowledge-junkie, we could well be flying out somewhere on the Thanksgiving weekend, or going up elevations much higher than what we currently are planning to...

Anyway, thanks again for your advice.

[KellyComfort]

I'll put it to you this way, if it were me or my husband with that bubble I would definitely go.  If it was one of my girls I would be as anxious as you.  The difference is being responsible for someone else and I think that is what has motivated your MD to CYA (or CHA as the case may be) Do what you think is right for you and your husband.

Just another thought, most post vit/gas pts are told of the altitude limitations, did you know that nitrous oxide use during anesthesia can cause the same kind of bubble expansion? Also, if the pressure in the eye became high enough to cause nerve damage I am pretty sure you would FEEL it.  High pressure in the eye is painful.

[anjanai]

What scares me is something like this article: http://linkinghub.elsevier.com/retrieve/pii/S0002939402016318

The person experienced a loss of vision in his eye "During his trip to Mountain Ali with an altitude of 6,210 feet". That elevation is pretty high though and we won't be going anywhere near even half of that.

There are many websites which say elevations of 3000 to 4000 feet are ok. Here are a few:

http://www.ncbi.nlm.nih.gov/pubmed/7817030

http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=4352&nbr=3278

http://books.google.com/books?id=zJES898fXJYC&pg=PA95&lpg=PA95&dq=%22altitudes%22

http://books.google.com/books?id=gEaQ0wiM7JwC&pg=PA52&lpg=PA52&dq=altitude

But then http://www.ucdmc.ucdavis.edu/eyecenter/pdf/post_op_instructions.pdf says not to go above 1000 feet.

So, I'm basically still flip-flopping ..

[anjanai]

Thanks.

KellyComfort: We are pretty close to sea level right now. So the difference in elevation would be about 1300 feet or thereabouts.

[Joan M Pernoud, MD]

I am surprised that your doctor thinks that would be a problem with the gas as dissolved as it is and with the elevation not being more than it is. Still, the doctor who did the procedure is responsible for the outcome and that might be why the ultraconservative opinion.

[KellyComfort]

What you can't do is go on a commercial plane at 30000 feet. I'm pretty sure that even 1350 feet is not enough elevation to cause the gas expansion problems one fears after C3F8;   I have tried to find a magic number for maximum allowed elevation but have so far been unsuccessful.   What is your current elevation?