Headache? – want to fly?

True story: It’s a beautiful; late afternoon with a NE breeze square on our little local slope Silverstream. I have just finished training a group of athletes, and a headache is setting in. As we load the gear in the car I grab 2 headache tablets and off we go!

5 minutes later we unpack, on launch, but I find myself fidigty, first forgetting this then that, run back to the car for my helmet etc. but finally I’m ready, wing up, run, and over the edge. Leg straps a bit tight, so I - WHAATT did I just do??? I buried my brakes to push myself into the seat!! I have never done that in 80 hrs, not even in training, I am always conscious on launch not to do that, and always warn new pilots! Fortunately my Buzz Z5 was not to concerned, as I let up quickly, realizing what I did. One or two turns, I realize I’m not the sharpest tool in the shed today, so I head back and top-land, angry with myself for my stupidity, and bit shaken.

I decide to phone Jo, our local instructor in Durban, knowing that Jo has a vast knowledge of medication, and should have become a doctor rather than PG instructor.

Turns out I took Myprodol…now why is that a problem?

I don’t want to bore the readers, so I keep this simple, and present an incomplete list, but possibly crucial information for pilots.

Painkillers (analgesics) can generally be classified in three main categories:

1. Paracetamol Panado and Tylenol are well-known brand names. Found in many OTC’s - no problem for pilot’s but watch out for liver failure.

2. Aspirin and NSAIDs (non-steroidal anti-inflammatory drugs) Cataflam® Brufen® coxflam, etc. i.e Nurofen. Often found in combination with paracetamol, should not be combined with aspirin. No problem for PG pilot’s but watch out for stomach ulcers, etc.

3. Opioids – Now that just sounds dangerous, something your neighbors washout kid uses, however, these are found in various pain medications, and you often have to study the label to be sure.

The opioids work on specific opioid receptors in the body, which are mainly located in the brain and the spinal cord.

WARNING - NOT TO BE TAKEN BEFORE FLYING!!

Low-efficacy opioids (examples include codeine (codeine phosphate) and propoxyfene) Especially codeine is often found in combination.

Many manufacturers combine these different painkillers in one commercial preparation and aim to block pain at two or three different receptor sites with one tablet (e.g. Myprodol : paracetamol + ibuprofen + codeine; Doxyfene : paracetamol) Don’t ignore sinus and flu medications, many have codeine in, always read the label.

Moderate-efficacy opioids These include dihydrocodeine (e.g. DF118®), tilidine (DF118n®) and tramadol (Tramal®)

Combine these with other central nervous system depressants like sleeping tablets, sedatives, or even alcohol (yes, cough syrup like Solphylex will do the trick) and you may find yourself in serious trouble just driving to launch, never mind flying.

High-efficacy opioids Examples of strong opioids are morphine and pethidine. If you take anything with these in the label, stay in bed.

Examples of strong opioids:

• Morphine: the reference drug of the opioids - cheap and very effective

• Pethidine

• fentanyl (Durogesic®, Sublimaze®), sufentanyl (Sufenta®), alfentanyl (Rapifen®), remifentanyl (Ultiva®):

• buprenorphine (Temgesic®):

• nalbuphine (Nubaine®):

• methadone (Physeptone®):

• pentazocine (Sosegon®)

• dipipanone (Wellconal®)

We have enough safety challenges to deal with, so regardless off your level of experience, hours flown etc. be vigilant when popping those pills!

If in doubt, phone Jo, he often has the right answer when you want to know if a pain killer is safe or not before flying.

PS. Another real life example, back in 2007 I was at work, coming down with a bad flu. I picked up some Sinutab and Solphylex cough syrup from the pharmacy, and went back to my office. I was in a rush, and used the Cough syrup to swallow the 2 codeine loaded sinutabs.

Eventually I decided to drive home, from Lynwood to Centurion.

It was a slow drive, and I stopped for fuel at a garrage close to home............where my wife found me fast asleep in my car, with a bewildered unpaid petrol attendant looking on...........

And then there was the even more embarrassing incident when I swallowed a sleeping tablet with OBS. I then continued to browse PGtraderSA, and found the next morning I advertised my wing (unintentionally) with a whole lot of weird spelling errors and incongruous language, my PG friends had a good laugh.