Getting to 1st

M

Mancil

Guest
Currently on a 3rd with another 3.5 years of validity. I'm 36. In the midst of training for Commercial and CFI. Obviously, I would like to get the 1st class out of the way before I get too far down the road. I'd also prefer not to get a deferral and halt my current training. A few questions:

1) hypertension. Been checking my BP daily and the big number bounces around from 125-145. And the lower from 80-95. I know anything below 155/95 is a pass, correct? I'd prefer to stay away from the blood work/BP meds if at all possible. But should be workable if I'm "high." I also know they can test 2x during the checkup and I can even come back in later on to show my BP is below the threshold. My reading this morning was 125/78. Seems to go up later in the day and if I eat a lot of salt or my wife is talking to me. I also have higher blood pressure in the office than outside. Let me know if any of that is incorrect.

2) Meds - looked these up on leftseat.com, scary language around them.
a) had a root canal, got a script for oxy. filled the script, never took any, but I do carry a few around in my mountaineering bag in case of broken bones etc. I read about how you shouldn't fly 5x the half life of the med. I don't plan on taking any unless I'm stuck in the back country with a snapped tib/fib. I assume this is ok.
b) diamox (acetazolamide) - when climbing in some high altitudes, one time script. also bought over the counter in south america. I try to avoid using it as I dislike the tinglies and peeing all the time. Will skip on this year's trip as we're not going too high.
c) famciclovir. I get a cold sore once every 2-4 years. finally got a script to make the little booger go away. leftseat says "case-by-case," but everything I can find in the FAA literature says it should be ok as long as there are no side effects (which there aren't)?

All-in-all, It seems like the 1st vs 3rd doesn't really require much different outside of tighter tolerances on vision and an EKG?
 
Overarching comment: HEALTH FIRST, FLY LATER.

1) Hypertension.... This is something you DO NOT want to eff around with. Get it addressed.... NOW!!!! Otherwise, this is going to remain out of control and you will always be feeling just fine until you don't. And by "don't" we mean a significant stroke, MI, or other significant cardiac event. While the FAA does want to know about hypertension, they are more wanting to see that it is in control, and allows many medications to make this happen. What they do not want is you hiding it from them and doing harm to yourself by ignoring it. First class certification is permitted as long as you and your primary doctor demonstrate that hypertension is properly controlled.

Again, DO NOT EFF WITH THIS. Get it fixed.

AME Guide resources to look at:
2) The medications you listed..... I will defer to Doctors Bruce and Lou on how to address these items. Some might require reporting, others may not. But do remember that since you filled the scripts, that data does exist in your big medical database in the online clouds that is searchable by the federal agencies. So if you bend someone or something, the FAA might go looking at those databases. So if something should be declared to the FAA, make sure it is correctly declared.
 
your case is easy and straight forward. Report all but the narcotic, as it is for future use.
 
your case is easy and straight forward. Report all but the narcotic, as it is for future use.

Thanks, just to clarify...I've already had the root canal, I've already filled the script, but I never took any of the oxy. So I shouldn't disclose it on medexpress because I have never taken it?

Regarding the hypertension...I do not nor have I ever been diagnosed with hypertension. I've always been "high," but no doctor has even suggested anything to me about meds. It is exacerbated by "white coat" syndrome as well. Obviously if a Dr suggested I get on some meds for BP, I would do it. But, I've never had that suggested to me.
 
Overarching comment: HEALTH FIRST, FLY LATER.

1) Hypertension.... This is something you DO NOT want to eff around with. Get it addressed.... NOW!!!! Otherwise, this is going to remain out of control and you will always be feeling just fine until you don't. And by "don't" we mean a significant stroke, MI, or other significant cardiac event. While the FAA does want to know about hypertension, they are more wanting to see that it is in control, and allows many medications to make this happen. What they do not want is you hiding it from them and doing harm to yourself by ignoring it. First class certification is permitted as long as you and your primary doctor demonstrate that hypertension is properly controlled.

Again, DO NOT EFF WITH THIS. Get it fixed.

AME Guide resources to look at:
2) The medications you listed..... I will defer to Doctors Bruce and Lou on how to address these items. Some might require reporting, others may not. But do remember that since you filled the scripts, that data does exist in your big medical database in the online clouds that is searchable by the federal agencies. So if you bend someone or something, the FAA might go looking at those databases. So if something should be declared to the FAA, make sure it is correctly declared.
Nice!! Agree, Health first!
 
Regarding the hypertension...I do not nor have I ever been diagnosed with hypertension. I've always been "high," but no doctor has even suggested anything to me about meds. It is exacerbated by "white coat" syndrome as well. Obviously if a Dr suggested I get on some meds for BP, I would do it. But, I've never had that suggested to me.

From your first post,
Been checking my BP daily and the big number bounces around from 125-145. And the lower from 80-95.
and your reply, of "I haven't been formally dx'd so I don't need to worry", I am gonna tough love on you and repeat what a well respected AME around these parts would say....

"You obviously don't get it and that "it" is your health is at risk. And until you do get "it" and take care of your health, you are on your own."​

Your own home monitoring you report in your initial post with no white coats in sight is showing you numbers that you are hypertensive (see chart below). And this condition isn't something that can or should be consistently ignored as it causes significant damage to other systems. So you need to get this treated.... now.

And treatment is crazy easy and the first line medications are very affordable. So why the pushback and resistance? Because you are scared of what the FAA is going to think of you?

The FAA is very okay if someone has elevated or higher BP as long as they are seeking (and following) treatment, and your doctor is willing to write a status letter to that effect.

In the end, it is your body.... if you wish to do harm to it and kill it just because you're worried about reporting a condition to the FAA, you have that right. Even if that is a very dumb idea.

Health first. Fly later. Get your BP treated.

upload_2019-5-16_10-10-1.jpeg
 
Mike, while I agree that he should be checked out, my experience is that some home monitors are horribly inaccurate and technique is everything. Wrist monitors, for example, are terrible, and even the automatic arm monitors can show as much as 10 mm of variation depending on how they're placed on the arm (comparing 2 measurements taken minutes apart. Even some of the "professional" ones are less than accurate - my doc doesn't even use his any more as it's enough different from a cuff/stethoscope.

The standard is a manual cuff and stethoscope.

So, hypertension may or may not be present. See a doc. Get a professional opinion. It is important to one's health, and if it's on the high side, it's likely to get worse with age.
 
My Doc taught me how to use a cuff and the stethoscope. It is not hard to do...
It's not, but one has to do it right. I had words one time with a trained nurse who tried to use the cuff over a sweater sleeve.
 
Straight forwared but unwise.
Here's what happens when you accept "barely adequate" hypertension control:

Left ventricular hypertrophy
Atrial dilation with resultant Atrial fibrillation
Slow erosion of renal function.
Acceleration of Coronary disease.
Higher risk of stroke.

Make no mistake: 155 and 95 are not for you health. They are there to reasonably say you won't have a D. D. Eisenhower-like hypertensive brain bleed during the duration of your certificate. If you bottom number of over 80 with any frequency, odds are you will not be healthy at age 65.

Don't care? The Ame will issue you anyway. The certificate is only good for a short time. But when you get any of the listed items, life will suck and you ability to fly will be problematic.
 
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Following up....I got my 1st class. BP was 155/95 the day before when I went into the lab to get blood work done - I think mainly because the tech girl was morbidly obese and I was about to get poked with a needle.

In the office for my medical with a little white coat anxiety I was 120/75. I went in to the Doc (not AME) for a consult on a procedure I am going to have done and the nurse asked if I have ever been told I have low BP.

Blood work came back well above/below the values they should be at. Moral of the story, don't try a home testing regimen and freak out over it.

Thanks!
 
You don't have low BP, but good hear it isn't high. Time to throw out your device and either invest in a new one or leave it to the pros. I wouldn't want to be on BP drugs either, but if i had a choice between hypertension and drugs, I know which one I'd take. Bruce, as always, is utterly spot on.
 
1) hypertension. Been checking my BP daily and the big number bounces around from 125-145. And the lower from 80-95. I know anything below 155/95 is a pass, correct? I'd prefer to stay away from the blood work/BP meds if at all possible. But should be workable if I'm "high." I also know they can test 2x during the checkup and I can even come back in later on to show my BP is below the threshold. My reading this morning was 125/78. Seems to go up later in the day and if I eat a lot of salt or my wife is talking to me. I also have higher blood pressure in the office than outside. Let me know if any of that is incorrect.

Low carb totally took care of my blood pressure. No meds, etc. Your mileage may vary.
 
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