I got caught out on a flight a couple of years ago.
As a child I used to have a lot of problems when descending - ear pain, nosebleeds the works (it's worth knowing that children are more susceptible to these things - I'm always sympathetic if a child cries when the plane goes up or down) but after years of problem free travel, I encountered the kind of excruciating pain you other ladies are describing when descending into Milan.
I was on Buzz, a LCC (with top class service) and it felt like there was a golfball in my head just at the point of exploding. The FA brought me a cup with camphor inside it and a cloth so I could inhale from it and it did so much to alleviate the problem.
I mention camphor particularly because it's someting that can be found in most countries - the brands that have been mentioned aren't always available.
Just wanted to add that flying with a cold can cause it to turn into something worse. I flew with a bad cold and had to change planes twice. I thought I would die, the ear pain was so bad. A few days later, I came down with infections in both ears. The infections were so bad that the doctor could see the red, swollen insides of my ears without using the instrument they use for checking ears. She told me I had two "rip-roaring" ear infections. I was on antibiotics and perscription painkillers for a week. The doctor says that infections in the sinuses can actually be pushed into the ears by the pressure when flying, causing ear infections that might not have happened otherwise. The infections were so bad that I could not fly home from Montana to California! I was with my roommate at his brother's house, and we borrowed one of the brother's cars and drove back to California. I agree with everyone about taking Sudafed, etc. before flying. It does help.
As a pharmacist by training (non-practicing), I can only share my protocol. As I get older I have begun to get these extremely painful experiences more frequently.
I take 60 mg of pseudoephedrine about 60-90 minutes before descent, then a couple of squirts of generic Arfrin in each nostril about 1/2 hour before descent. The pseudoephedrine works centrally to constrict the vessels and the Afrin topically. Since I started this, I have not had a problem.
Drixoral Cold & Flu - drat, I guessed wrong at the pharmacy just now & bought the Cold/Allergy. Guess I'll try grocery store tomorrow. I've got an earache or infection & earliest I can see doc is Mon now. I was hoping there'd be some OTC thing, but pharmacist said no. Grrr.
Ear block is nasty, nasty, nasty....my left ear drum actually perforated on a flight once, years ago, before I ever started flying for a living. It was really one of the worst pains I've experienced - and now I have some permanent hearing loss on that side. Yuck! Take care of your ears!
Yup, I did the same thing - ruptured both ear drums flying with a cold. Took almost 7 years for the pain to stop - yes, I really do mean SEVEN YEARS - every single time I swallowed, I felt sharp pain in my ears. I have permenent loss of low tones in one ear due to the damage. For years I carried a letter from my doctor stating that I could not fly with head congestion and requesting airlines allow me to reschedule flights for medical reasons if needed. Actually used it once long ago - I pointed out to UA that I was probably contagious as well as congested and they changed my ticket no charge. Doubt it would work these days, tho.
But I can't think of a single reason that could induce me to fly with congestion again - doc said next time I rupture an eardrum, I could lose the rest of my hearing.
This was my post last September about flying with congestion, earaches and stuffy noses: For all the flying I've done in the last 50 years, this has not failed me:
When I have to fly with a cold, ie: stuffed up nose, blocked ears, I try to buy some AFRIN, or a store variety, of a nasal spray (buy the 12-hour spray). It does wonders for 12 hours, and the altitude will hardly affect the symptoms. It should start to work within 3-5 minutes in clearing the nose, ears, and headache.
There is a caveat with these nasal sprays though. They are not to be used more than two squirts, twice per day, and no more than THREE DAYS in a row. This should take care of many problems when flying with a cold.