No pilot in the Air Force ever enjoys being placed on DNIF (duties not to include flying) status, so we tried to avoid going to the flight surgeon. After coming down with a cold and severe sinus congestion, I finally went to the doctor to get some medication. After about a week I could finally clear my ears with a Valsalva and got off DNIF and back on the flying schedule.
My first sortie back went fine; I didn’t notice any problems with my ears or sinuses. The second sortie was a one-vs.-one dogfight in the F-15, and I had a blast pulling Gs and carving circles through the sky. For recovery, I would be flying on the wing for an instrument landing. There was a solid cloud deck from 600 feet agl up to 3,000 feet agl, and it was clear above that. Above the cloud deck, I flew abeam my flight lead maintaining 1 mile separation. I set up my instruments for the approach then tucked in on his wing as we entered the clouds. He flew a smooth approach, and quick glances at my altimeter showed us at 2,000 feet, then 1,500 feet, and then 1,000 feet agl, still in the clouds. And that is when I felt the dagger in my head. 
According to the Aeronautical Information Manual, a sinus block occurs when air pressure in the sinuses does not equalize with the aircraft cabin pressure, usually due to congestion around an opening in or near the sinuses. Sinus blocks occur most frequently during descent, and that is what happened to me. In physiology class, a sinus block was described as a stabbing pain, and that was right! It in fact felt like a dagger stabbing me over each eyebrow. My dilemma was deciding what to do. Climbing would have mitigated the problem, but transitioning from close formation to getting on my own instruments and ensuring separation from my flight lead in the weather wasn’t necessarily a simple task. Plus, I still needed to land. Since I knew we were getting close to breaking out I elected to continue the approach. Once clear of the weather, I flew a looser formation, and once on the ground I applied maximum braking using the anti-skid system to get slowed down. I then grabbed the Afrin I always carry with me for an emergency, dropped my mask, and took some puffs. The pain instantly went away.
I am still a little surprised that happened to me on my second sortie after getting back on flying status. I am also surprised that I was only at 1,000 feet agl when it happened. Might this happen in our low-flying general aviation airplanes? Absolutely. I still don’t try to fly immediately after recovering from a cold. And I still carry a fresh bottle of emergency-use-only Afrin whenever I fly.
Larry Brown of Colorado Springs, Colo., is a retired Air Force F-15 pilot who is using the lessons he learned as a fighter pilot as a GA pilot in his Cessna P210. Brown, who has 2,600 hours total time during his 32 years of flying, also was an instructor pilot and flight examiner in the Air Force T-38 and instructor pilot in the T-52, the military’s version of GA’s Diamond DA40.
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