Steps for renewing medical

Flyboy

Pre-takeoff checklist
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Feb 23, 2005
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Charlotte NC
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Ron Kinney
I haven't flown in couple years due to the economy but I'm starting to get a little ahead and want to get ready to do a some flying.

For the first time since getting my certificate in 1980 I also let my medical lapse. I am a type 2 diabetic (had my class III with it before with no problems) but I had a problem last summer with something setting of my blood sugar levels so I had a lot of tests done since it happened suddenly to see if something was causing it. (MRI, test for gall bladder function, colonoscopy and upper GI scope etc.) I was diagnosed with gastritis and began oral meds for that and the BS went back down. My question is, how should I prepare for the medical exam? With all the tests, should I bring records and final prognosis or just dates and who performed what?

I'd like things to go as smoothly as possible.

Thanks for any advice!
 
Dr. Bruce Chien will be along shortly with more detail and the "laundry list" of things to gather and bring.

First, you're doing the right thing by researching what the reviewers at the FAA are going to want to see. If you do the utmost to "own your medical", as Dr. Bruce puts it, you get achieve your renewal very quickly. By obtaining and providing exactly what the first level reviewer wants to see and demonstrating that the quantifable items are within the limits, then that reviewer can reach for the approved stamp. It is when items are missing, badly organized, or not "formatted" (read worded correctly) that cause delays due to a need to send to an upper level examiner or worse, send a letter to you asking for things that should have been sent in the first time.

Getting the Special Issuance (SI) for Diabetes 2 (DM2) with oral medication is not difficult.

First you need to be stable on the medication and document that you have the HbA1C under control (target is 7.0 or less for a slam dunk).

A status report from your treating physiscian is required. In this letter it needs to say:
  1. DM2 is present and being treated with oral medication.
  2. You have been on this medication for at least 60 days with no side effects
  3. No significant hypoglycemic episodes as a result of the meds
  4. Your documented HbA1C level.
  5. No problems in areas of
    • neuro,
    • renal/nephro (kidneys),
    • cardiac, and
    • ophthamological (eyes).

I have attached a sample letter that I used that was accepted. Make sure to include a copy of the lab report that documents the A1C.

The status letters need to be simple and straight to the point. Make sure your doc doesn't get wordy because he might open up an unneeded can of worms.

In my case, my doc wasn't comfortable to signing off on the eyes. So I printed off a copy of FAA Form 8500-7 and visited a local eye doc. This was also submitted.

For your other conditions, similar status letters and supporting lab results and reports are needed. You can check the AME Guide on the Faa.gov website to find out what is needed. And best of all, Dr. Bruce is very willing to assist via PM to guide you.


When you seek out an AME, don't go to the first one who shows up in the phone book or online search. Call around and try to find a Senior AME who is one of the best in your area. One way to determine this is to ask if the AME is him/herself a pilot. Then ask if they have OKC on speed dial and have solid contacts within AMCD that s/he can reach out to. Finally ask if the AME will go to bat for you and call AMCD and convince them to do an office issuance if you have 100% of the required documentation and it all meets the standards.

Dr. Bruce has pointed out may a time that items that other "not so stellar" AME's auto-defer can be done in office with a phone call. Unfortunately not many AME's are willing to make the effort. Finding one who will becomes a valuable tool in your flying arsenal.


This is a summary of what Sensei Dr. Bruce has taught me over the past 9 months. Do continue to ask questions and we'll be hearing you on the en route freq very soon!
 

Attachments

  • DM2 Letter Template - Generic.doc
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Thew 5 points that Aggie Mike list are what's required. You also need a Hb A1c within the preceeding 60 days, and to avoid the cant-get-approved on the spot debacle, it should be less than EIGHT.
 
I'd recommend you hire Dr Bruce and do everything through him. I've seen too many people do otherwise and seriously regret it later.
 
I'd recommend you hire Dr Bruce and do everything through him. I've seen too many people do otherwise and seriously regret it later.

Very much agree. And the big payoff (besides the pleasure of his company) is that you can walk out with certificate in hand.

This can totally be worth the time and money for the trip to Peoria.
 
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Thew 5 points that Aggie Mike list are what's required. You also need a Hb A1c within the preceeding 60 days, and to avoid the cant-get-approved on the spot debacle, it should be less than EIGHT.

What will he need for the other items he mentioned?
... a lot of tests done since it happened suddenly to see if something was causing it. (MRI, test for gall bladder function, colonoscopy and upper GI scope etc.) I was diagnosed with gastritis...

Single letter saying "we poked and prodded with these methods and determined _____ and it was treated with ______" Or individual letters for each doc and test?
 
Wow, thanks for the info. I have an appointment with my doctor for a follow up on this month so I will discuss it with him then. Previously I was using an AME that was in the old Charlotte terminal building and he did a good job but I'm not sure he's still practicing there.

Athough I'd love to use Dr. Bruce, I think it would be a bit far to drive. :D
 
Wow, thanks for the info. I have an appointment with my doctor for a follow up on this month so I will discuss it with him then. Previously I was using an AME that was in the old Charlotte terminal building and he did a good job but I'm not sure he's still practicing there.

Athough I'd love to use Dr. Bruce, I think it would be a bit far to drive. :D

Ron,

Doctor Lutin joined the reserves as a flight physician and is no longer in Charlotte. For a local AME doctor, I have been using Dr Kane, 704 367 4373.
 
Athough I'd love to use Dr. Bruce, I think it would be a bit far to drive. :D
It may be a long drive, but you might seriously consider checking airfare between Charlotte and Chicago, then making the drive to Peoria from there.

Trust me, Dr. Bruce is worth the effort.
 
It may be a long drive, but you might seriously consider checking airfare between Charlotte and Chicago, then making the drive to Peoria from there.

Trust me, Dr. Bruce is worth the effort.

+1. Though my result was within reason (see threads on AOPA red board), knowing what I know now, I would have travelled there.
 
Ron,

Doctor Lutin joined the reserves as a flight physician and is no longer in Charlotte. For a local AME doctor, I have been using Dr Kane, 704 367 4373.

Thanks, I was wondering about that. I'll give Dr. Kane a call.
 
Update -

First thanks for all the advice. It will be a big help.

As to Dr. Bruce, I just simply can't afford the expense of a trip like that right now. My wife is in College getting her degree, My son just started this fall, and I too and trying to get a degree in IT, something I've worked in for 30 years but learned on my own so I need something to show potential employers. Add to that a daughter in High School and all the expense of normal everyday life on 1/3 the income I had 2 years ago and you get the picture. IF I could afford it it would be a no brainer.

I went for my diabetes follow up today and so we'll wait and see what the A1c is. If it's over 8, I've asked my doc to schedule another follow up in 3 or 4 months.

My bp was fine (120/79) - it's never been an issue. So now I'm waiting on the labs.
 
If you haven't already, scan the Red Board for posts by ComanchePilot. He got dx'd with DM2 in May and really got busy with lifestyle changes to take control over his situation. He dropped some weight, upped the exercise and improved his diet. His reported results are very good and an inspiration.

He got everything in order and made the trip to Peoria and walked out with the renewal and SI in hand versus having to wait. (Not all AME's are willing to issue in the office on DM2. Dr. Bruce reports frequently that this can be issued in the office if you have all the required items.)

Joe's posts are definitely worth the read.
 
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