TORONTO - You guessed it right!

Those rambunctious kids running around the airport lounge are now sitting directly in front of you.

Hopes of calm, relaxing entrance into a world of tranquility have been dashed to ruin.

Just wait. It will get worse. As the aircraft climbs to cruising altitude there will be subtle calming of their behaviour, followed by some restless squirming in their seats and an eruption of an ear piercing scream that will go on unabated. Why don’t their parents take control?

They can’t. That’s because barotrauma is fiercely painful. Baro has its origin in the word Barometric.

Trauma means injury. The physics is simple. Boyle’s law describes the inverse relationship of pressure and volume in an enclosed air space.

As the aircraft gains altitude, the cabin pressure decreases until, at cruising altitude, cabin pressure approximates the barometric pressure at 8,000 feet above sea level.

The eustacean tube is a small vent, situated between the middle ear chamber and the back of the nose. If that small tube is blocked by congestion, the middle ear becomes an enclosed air space.

As altitude increases the cabin pressure decreases. With the decrease in cabin pressure, the volume of air in the enclosed middle ear space increases.

The ear drum, rich with nerve ending, screams with unrelenting intensity. When partially blocked, you feel the pressure, a crackle and a pop. When you become uncomfortable you squeeze your nose and swallow, chew gum, yawn or blow your nose hard.

All of these tricks wiggle the opening of the eustacean tube and allows the pressurized air to escape from the middle ear chamber. Flying with acute ear infections should be avoided.

Insurance plans will accept that as a legitimate reason to cancel your flight. If flying cannot be avoided, take a dose of a painkiller at least 30 minutes prior to take-off and landing.

The use of decongestants is controversial and is no longer recommended for small children.

Babies can be breast fed during take-off and landing to reduce the intensity of their discomfort. Occasionally, the barotraumas can be quite severe and the ear drum can actually rupture.

If ear pain persists after arriving at your destination, seek medical help. Antibiotics will often be prescribed to treat secondary infections. You can’t fight the physics. If you have small children, don’t take unnecessary risk.

Plan ahead and have ibuprofen or acetaminophen on hand, just in case.

If you get in to trouble, see a doctor when you arrive at your destination.