A reporting dilemma

Discussion in 'Medical Topics' started by 06Vanden Plas, Oct 10, 2018.

  1. 06Vanden Plas

    06Vanden Plas Filing Flight Plan

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    06Vanden Plas
    Question: In being 110 percent focused on getting all paperwork and letters to back up a 2-inch binder of material on Apnea, AFib and Alcoholism, I correctly noted all my medications, including melatonin and occasional use of Sonata, a sleep agent that metabolizes quickly. And i discussed those last two medications and their use with the AME as I quit taking trazadone earlier in the year when I found it was a no-no drug for the FAA. I just realized that nowhere on the now-locked FAA form did I not note treatment for insomnia even though I listed the medications and spoke with the AME. I did not use the words insomnia with the AME, only referencing trouble sometimes getting back to sleep after using the bathroom.

    The binder goes back to the AME for transmission to CAMI at the end of the week or early next week.

    The question: do I write a note for the binder noting the omission, or let the FAA docs figure it out from the drug list or by finding the word insomnia buried in hospitalization lists of diagnoses?

    I’m trying to get back into flying after a 30-year hiatus. My mind was entirely focused on the big three and I forgot to specify the need for the medications.

    Many thanks for guidance on this issue, and for all the previous guidance from the denizens of this forum.
     
  2. bflynn

    bflynn En-Route

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    Hmmm, I have no idea. General advice is to be completely open about everything and it does not sound to me like you are trying to hide anything. My opinion does not matter.

    Does your doctor say insomnia? Or just trouble getting back to sleep? Either way you are no longer taking the medicine. Is that because you sleep better or you are compromising for the FAA?
     
  3. 06Vanden Plas

    06Vanden Plas Filing Flight Plan

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    To respond, the diagnosis insomnia is contained in hospital records because I asked for a sleep aid or reported taking them. I see my doctor tomorrow morning and will get some clarity from him on what he considers the diagnosis to be. I generally fall asleep without trouble. I sometimes have difficulty getting back to sleep when I get up at night to use they bathroom

    I quit taking trazadone eight months ago (not permitted by FAA) and there is no obligation to report that. However, I began using melatonin to accomplish the same thing (get back to sleep after getting up to use the bathroom.) And I have used Sonata, a medication permitted with a required delay for flying, over the years and use it as needed now. That use is within the limits set by the FAA. My sleep amount and quality is unchanged.
     
  4. bbchien

    bbchien Touchdown! Greaser!

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    Hate to be the bearer of bad news. Your reading of the regs is that of a lay person and not of an aeromedical officer.
    Sleep aids are authorizable for a max of 60 days/year and are licensable only for travel related sleep disorder. So saying It's within limits set by FAA is only half the story. If you have chronic insomnia FAA might be looking looking into depression, cognition, sleep apnea. etc. :(
     
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  5. 06Vanden Plas

    06Vanden Plas Filing Flight Plan

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    Thanks, Dr. Chien, for that aeromedical officer view of the situation. You’re not the bearer of bad news, just facts. Even with the ability to fly LSA, I have no desire to do that if I can’t meet the standards. I do have apnea and use a CPAP, but no depression or cognition issues (at least that I can recognize — just kidding). I’ll accurately note that I use this particular drug for travel sleep issues but have also used it if I awake to urinate and can’t get back to sleep. My annual use is within the 60-day max.

    You’re not the one I need to convince, but rather the FAA folks. If they reject me, I strongly suspect the world will continue to circle the sun, which will continue to rise in the east, and my world will not come to a screeching halt. As Robert Hunter wrote in “Touch of Grey” for the Grateful Dead, “I will survive, I will get by.”

    Thank you again for the helpful observation.
     
  6. lbfjrmd

    lbfjrmd Pre-takeoff checklist

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    report your additional medical condition and your few comments in writing to the FAA.
     
  7. 06Vanden Plas

    06Vanden Plas Filing Flight Plan

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    Thanks. I am doing just that in a personal statement to accompany my 2-plus inch book of records, and having my doctor note the issue in his letter that will go into the book tomorrow. If it works, great, if not, I can either take another stab at it a bit later, or watch wistfully from the fence as my touch of grey becomes a few mere whisps! (I’m very grey and losing more each day).
     
  8. flyingcheesehead

    flyingcheesehead Touchdown! Greaser!

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    Bruce,

    Any idea why that is? I occasionally run into the same sort of thing as the OP - I normally sleep very well, but if I wake up I often have a terrible time getting back to sleep. This was caused by a job that I had driving refrigerated trucks - The food warehouses always kept repeatedly waking drivers up and it got to the point where I couldn't fall asleep because I was expecting them to wake me up again right away. :( Unfortunately, that got trained into me and I haven't been able to completely shake it. I heard about Sonata and figured it might be a good option for me, but I guess not?
     
  9. Rushie

    Rushie Pattern Altitude

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    I'm not Bruce but I'll take a shot. Because Sonata is a Z-drug. Technically not a benzodiazepine but very much like bennies in that Z-drugs can be addictive but also can cause undesirable side effects on memory and cognition. Not to mention severe rebound insomnia. And of course there's the "underlying cause" issue, chronic insomnia tends to be associated with other concerning conditions the FAA cares about.

    You could try Dr. Mercola Sleep Support. Six squirts under the tongue and you'll be back to sleep soon. Best thing, no FAA issues. There's also valerian root, taken at bedtime you tend not to wake up but it can cause very interesting dreams and dosing is trickier than the spray.
     
  10. flyingcheesehead

    flyingcheesehead Touchdown! Greaser!

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    Whoa! That does not sound fun. Not gonna go there. Thanks for the explanation.
     
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  11. eliotb

    eliotb Guest

    I, too, await word from the good Dr. C based on his experience with the FAA. Like "Flyingcheesehead," I, too, have been subject to frequently being rousted at odd hours.

    I am puzzled. After Dr. C's response 10/11, I put this question (Sonata for non-travel sleep use, i.e. occasional use at home) to CAMI. Their hotline staff, after looking up Sonata, said it could be used at home if it were within the #/time guidelines and I had documentation from my internist on its use. I submitted that letter with my massive package given to my HIMS AME 10/12 after a 10/8 physical. This AME gave me no contrary advice when I referenced both uses within the #/time guidance, of which I'd learned in a prior call or reading on Sonata and the FAA. I'm curious whether the FAA will disavow the guidance of a hotline staffer. I took careful notes of the conversation.

    If rejected on this issue, I was assured I could seek a review with new documentation from my internist saying I'd gone 3 or more days without it, or had quit using it entirely, whatever the case was. I've done without it about 10 days now and have survived. I will check out the sleep drop suggestion referenced above. While it will take two or three months to get an answer from the FAA on my application because it has a myriad of issues in it (apnea, afib ablation, and alcohol), I will report back on the outcome to offer what lessons my case might have for others.

    It's been nearly 30 years since I was in the left seat. A few more months of waiting is not going to get me excited. It would be nice to be able to aviate again, but if ultimately rejected, I will survive, I will get by.