Rusty Pilot Coming Back but SI issue

[Surreal]

In 2007 I started flying and got my PPL in 2009 but I stopped flying. December last year I decided to pick it up again but did not research changes into the medical process beforehand. I registered on med-express for a class 3 and went to go see an AME. I was honest with him and told him all medical issues I've had and he told me I will be denied due to my obstructive sleep apnea (OSA). My high blood pressure is treated and I'm 120/80 with meds, 20/30 vision natural vision but 20/20 corrected, nothing else in my past is an issue.


Looking back, I should have just gotten basic med but unfortunately I was unaware that was offered. I do use my machine every night for over 6 hours and it is documented. He asked for all my sleep apnea documentation and he sent it to the FAA on January 3rd. I have not heard anything and I attribute it to the government shutdown.


My question is, did I shoot myself in the foot and now I must wait for the FAA? Is there anything I can do to get back in the air until this sorts itself out? Any advice? Reading past threads and people complaining that it took 4 months for a Special Issuance (SI) is disappointing as I have to add 2 months due to the shutdown. Can I call multiple times so that I can be classified as an "interested airman?" or is that a past trick?

 

[bbchien]

The answer: Get treated. You can be issued short 35 days if you do it right.

 

[Mycroft17]

If you have OSA but under treatment, what are the parameters for getting an SI? Is there a max AHI to qualify for the SI? How does the FAA feel about dental appliance rather than CPAP?

 

[Surreal]

Yesterday I received from the FAA. They are requesting additional information on my fatty liver including current liver function test. They are also asking for a status report from the Doctor overseeing my OSA. I gave the AME this information, do I just forward it again to the FAA or are they asking for something specific?''

The letter states "A current status report from your treating physician indicating that OSA treatment is still effective." The letter I submitted to my AME from the other Doctor states: "Patient continues to adhere to PAP therapy and benefit from PAP therapy. There is no hypersomnia reported at this time and thus he can reasonably and safely operate s plane from a OSA perspective."

Is it possible to call the medical examiner to make sure I give them everything they need?

 

[bbchien]

Yesterday I received from the FAA. They are requesting additional information on my fatty liver including current liver function test.

"I have been taking care of "surreal" since 201X, and his diagnosis is Non alcoholic Steatohepatitis"(NASH). His liver biopsy in 2016 showed....xyz.....he has been cautioned about his excess weight an the long term effects on his health, one of which is in his case, the expression of sleep apnea...."

They are also asking for a status report from the Doctor overseeing my OSA. I gave the AME this information, do I just forward it again to the FAA or are they asking for something specific?''

The letter states "A current status report from your treating physician indicating that OSA treatment is still effective." The letter I submitted to my AME from the other Doctor states: "Patient continues to adhere to PAP therapy and benefit from PAP therapy. There is no hypersomnia reported at this time and thus he can reasonably and safely operate s plane from a OSA perspective."

This letter is not IAW the requirement for 4 statements:
"appears well rested"
"no complaint of daytime sleepiness"
"Complies with PAP daily" - maybe he's got this one, and the big one:
"No stigmata of rt. heart failure on physical exam"
A physician who doesn't know this hasn't read the sentinel AASM article of 2009 and is not current.

Is it possible to call the medical examiner to make sure I give them everything they need?

Even some MEs don't know this. Sigh.

You are also going to need one of these (see first attch) that shows the last 31 days with 75% of nights showing 6 hours or more of use. Not AVERAGE, count the bars in the all important 4th graph.
and one of these (see second attachment).

 

[Surreal]

"No stigmata of rt. heart failure on physical exam"
A physician who doesn't know this hasn't read the sentinel AASM article of 2009 and is not current.

I really appreciate your guidance Doctor Chien. When I spoke to my ENT doctor, he said that statement should come from my cardiologist. I'll see if I can have him put that wording in the status report but it didn't seem like he was comfortable with it.

 

[bbchien]

Cardiologist isn't really the right guy either. A PCP frequently does it, or a Board Certified sleep doc (usually a pulmonologist or a neurologist). If you don't have one, get one because you will need that statement every year......

 

[Surreal]

Cardiologist isn't really the right guy either. A PCP frequently does it, or a Board Certified sleep doc (usually a pulmonologist or a neurologist). If you don't have one, get one because you will need that statement every year......

Thanks once again Dr. Chien.

I spoke with the ENT and he added the language in his report. Pretty much copy and pasted what you wrote. Do you think this is OK or do i find a PCP?

I got my blood work done yesterday and I'll speak with the GI doctor to get everything for my liver in order. I never did a biopsy but I'll make sure to include both my ultrasounds and all his medical documents. I'll also make sure to include the language about Non alcoholic Steatohepatitis"(NASH) in his status report.

Do you think I'll be good to go then?

 

[bbchien]

You still need the 31 day bar graph discribed in post 5, but yes.