As a skydiver, you probably take the advice of doctors on health questions involving skydiving with a few grains of salt, right? I mean, if it’s important enough that you’re actually going to bother asking somebody outside of the internet, your fate seems predestined. You’re probably downright certain that the doctor will tell you not to jump under any circumstances. You’re probably also downright certain that the person with the stethoscope has never wiggled into a sport rig and that their understanding of the subtleties of your situation has approximately the same resolution as a textbook would if viewed from 13,500 feet.

If your competition career, your paycheck or your mental health depend on a regular dose of canopy deployments, you might wonder why you’re even bothering to ask. After all, skydiving with a cold can’t be that bad. Can it?

Clearly, you need to ask the right doctor.

Meet Dr. Anna Hicks

Anna Hicks has more than 15 years in the sport and has logged more than 4,000 jumps, many as the outside center for formation skydiving team NFTO (which stands for “Not for the Ordinary,” naturellement). In my head, Hicks’ framed medical degree is flanked by NFTO’s 2018 Fédération Aéronautique Internationale World Championships silver in female 4-way, 2018 FAI Indoor World Cup gold and 2018 European Indoor Championships silver. (I’m fairly sure that fine display does not exist, however, because this lady remains astonishingly humble in the face of all those accomplishments.) Dr. Hicks is also a British Parachute Association Accelerated Freefall Instructor and Formation Skydiving Coach, as well as a skydiving instructor at Britain’s legendary Skydive Netheravon.

Her professional bona fides are comparably awesome. Hicks dashed straight from high school to medical school, joining the British Regular Army for the second half of the latter. She completed specialized training in family medicine, then aviation medicine. “I did that primarily just from the skydiving point of view,” she said, “but it has opened more doors for me, jump-wise. My next job [with the Regular Army] is going to be looking after helicopter crews.”

Fun fact: During a recent sabbatical, Dr. Hicks was the aviation doctor for the latest reboot of “Mission: Impossible,” working directly with Tom Cruise as his personal doctor for the aviation sequence. “On the aircraft, I had Tom on my left, Henry [Cavill] on my right and Henry’s stunt double just on the other side of him,” she said, grinning, “and I was like, ‘Yeah, I can cope with this.’”

This, clearly, is the doctor to whom you should take your questions.

Weigh the Risk-Benefit Ratio

So, how about that pernicious sniffle?

“The first thing to ask yourself when you’re skydiving with a cold,” Hicks admonished, “is simple: How important is that skydive if I burst an eardrum today or if I pushed even more snot into my ENT [ear, nose and throat] system. What would it mean if I made myself worse today by jumping, which is a distinct possibility? What would it mean for my life if I wasn’t able to jump for the next two weeks? Would it mean I couldn’t do tandems or camera jumps? Is it worth having one day off and losing a little bit of money or fun so I can carry on jumping? You have got to think about the balance of the short-term frustration and the longer-term gain when it comes to taking care of your body in skydiving.”

According to Hicks, the considerations—as with any skydive—always start with safety.

“It’s a risk-benefit ratio,” she says. “There’s always a risk of long-term injury when you jump with a cold, and if there isn’t a huge amount riding on a jump, then sometimes it’s simply worth not jumping.”

Risk 1: Pain

Dr. Hicks noted that one of the main risks of choosing to jump with cold symptoms is immediate, sometimes disabling pain. This is true especially if your symptoms involve the sinuses, and especially if you’re attempting to jump through stuffiness you’d describe as severe. The fact is, when you’ve got blocked ears—specifically, mucus in the middle ear that can't get out due to blocked and inflamed eustachian tubes or sinuses full of snot—you’ve got real problems on a skydive.

“I've seen patients who have almost passed out from the intensity of the pain,” Dr. Hicks noted.

On a commercial aircraft, equalization takes place in slow motion, usually resulting in dull, annoying discomfort. In freefall, as the pressure outside the ear and inside the ear attempt to equalize at breakneck speed to keep up with your falling body, the stakes often escalate to searing sinus or ear pain. The resulting distraction, as you might imagine, can play out as a serious safety risk under canopy.

Risk 2: Eardrum Perforation

If you’re especially susceptible—or really, really unlucky—the equalizing pressure decides to find its own way out, right through your hard-earned skin. In other words: The pressure that builds up can snap your eardrum like a wayward balloon.

If you don’t notice the ugly sound or the pain of the pop, you’ll certainly notice the aftermath: either blood, mucus or fluid oozing out of the affected ear. After the pop, the pain symptoms kicked up by the pressure will quickly settle due to the sudden equalization of the puncture (yay!), but you’ll now have a hole in your eardrum (boo!), and you’ll probably still have a landing to take care of (ugh!). Oh: And your hearing will be hobbled (gulp!).

“It takes one to two weeks for the eardrum skin to heal over, depending on the size of the hole,” Dr. Hicks said. “If you don’t give it that and carry on jumping, you’re going to keep subjecting your ear to increases and decreases in pressure. At that point, it becomes what we call a ‘chronic perforation.’ At a certain point, you have to ground yourself—sometimes up to a month—to heal properly before you can start stressing your ears again. There’s always a risk of deafness in the long term.”

Another note: That little hole to the outside world puts you at greater risk of infection as it’s healing, and it makes you more prone to infections in the longer-term. Sometimes, perforated eardrums don’t heal and have to be surgically grafted.

Risk 3: Disorientation

Risking your own health is one thing, but it’s certainly not the only consideration we have as skydivers. After all, we have to watch out for each other, too, and you might not think about the risk you’re subjecting your buddies to when you jump with a cold.

“All the snot and mucus sitting in your ear can affect your balance,” Hicks warned, “and cause dizziness under canopy. I’ve personally experienced it when I’ve been training with a cold. It is a major distraction; you’re essentially jumping disoriented because there’s pressure on your middle and inner ear that manifests as dizziness.”

She added, “It is not just a question of, ‘Am I tough enough to deal with the pain?’ It’s whether it distracts you enough to affect your safety and the safety of those around you.”

Another distracting symptom: nosebleeds, which are perhaps as distracting to your friends, tandem students and teammates as they are to you.

Risk 4: Hypoxia

Never been hypoxic on a jump? Great! Let’s try to keep it that way. According to Dr. Hicks, jumping with a cold can line you up for an increased risk of unintentionally hilarious GoPro footage.

If you’re coughing and sputtering, she explains, you can have a slightly reduced level of oxygen getting to your lungs. There are several lesser-known variables involved in hypoxia: among them, the fact that you’re already technically hypoxic at 12,000 feet even when you’re in normal health, and the fact that any stress you’re under increases your oxygen requirement, as does smoking or even not getting enough sleep. If all the variables line up and you decide to jump with an uncomfortable little cough, you might find yourself in a pretty compromising position.

Getting Through It

Have you squared up to the risks and decided, “To heck with it, I’m jumping”? Dr. Hicks has some advice to help get you through it.

“If you do decide that you want to jump or need to jump,” she started, “then there are medications you can take, but they are not without risks or side effects. Medication-wise, stuffy skydivers have two over-the-counter options: pseudoephedrine, also known as Sudafed; and nasal spray, specifically Phenylephrine or Xylometasone. They can help to relieve the pressure if you do decide to jump (unless you have high blood pressure, in which case you should not take pseudoephedrine). And neither of these decongestants should be used for more than five days at a time. If you use them longer than that, they can make your body create more snot, which in turn makes your symptoms much worse.”

As a seasoned competitor, the other thing that Dr. Hicks points out is that Sudafed is a banned substance in sports. The ephedrine in pseudoephedrine is a metabolite of adrenaline, which can directly improve your performance, and all oral decongestants include either pseudoephedrine or a derivative. If you take it because you’re determined to compete and you undergo a doping test, you’re going to fail, and you’re not going to get a pass because you tell them it was cold medicine. On the other hand, the nasal spray works locally, and its active ingredients are not currently on the banned list (although you should always check the banned substances list if you’re competing).

Looking for a non-pharmaceutical way to get a few jumps in? Lower your altitude. “When you feel ready—your ears aren’t blocked, and you don’t have distracting pain—going to lower altitude is always an option,” Hicks advised. “If you’re training, go to just 7,000 feet or so. You’ll have less pressure change. You are creating less risk. You’re putting your body through less. NFTO does this in training, sometimes, when someone has a cold. That way, there’s still some training but without risking one of our teammates and their longer-term health when we’re working toward a big competition.”

Some Final Advice

Skydivers are notoriously terrible at giving their bodies a chance to heal, and Dr. Hicks knows that better than most. That said: She insists that empathy for our own bodies is the only way forward—along with a sense of empathetic responsibility for the other jumpers in our communities.

“You have to be aware of these things,” she insisted, “and keep an eye on more junior jumpers, as well. They might think they’re okay, that their symptoms are minor, but that’s where an instructor or more experienced jumper can really do some good. Remind the less-experienced skydivers around you why they want to be in tip-top shape when they jump, because they probably don’t realize what they are putting themselves through, not to mention the risks involved.”

At the same time, remember to extend that empathetic responsibility to yourself, as well. “Allow your body to rest and rehydrate for a day so you can function better in the long term,” she said. “If you keep jumping with a cold because you’ve noticed that your pain settles down as soon as you land, you’re basically guaranteeing that your symptoms will last longer, and you’re rolling the dice for long-term damage.”

The bottom line, as it turns out, is simple indeed.

“If you’re sick and you don’t have to get out of a plane that day,” Dr. Hicks concluded, “it’s always best to not jump.”

About the Author

Annette O'Neil, D-33263, is a multidisciplinary air sports athlete: skydiver, BASE jumper, paraglider and speed-wing pilot. Location-independent, she travels the world full-time as a freelance writer and producer. In her spare time, she loves flopping around on a yoga mat and carpetbombing Facebook from Instagram.