ADHD COGSCREEN advice? - Houston Area

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mmorales

Filing Flight Plan
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Feb 21, 2024
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mmoraless
21 Years and 8 months old.
Diagnosed ADHD at 18 Years and 2 months

No physically disqualifying conditions, No sleep apnea, heart conditions, etc etc. Except mild tendinosis on my right wrist. This is managed

No history of depression. Never prescribed an SSRI.

Last filled a prescription 1/03/23 for dextroamphetamine, haven't touched the bottle whatsoever. And haven't medicated myself since mid 2022. I do not qualify for fast track as I filled a hydroxizine which was meant for sleep labeled as "take for anxiety" one time only in 2022. typical GP behavior. this will show when my prescriptions are pulled by the FAA, sucks i'm forced to clog the FAA beaurocracy but it is what it is.

Perfect driving record. have driven cross country multiple times

No criminal record/DUI's

Have maintained employment since I was 16 years old. Currently work remote and am excelling at a heavily cognitive role.

1 Broken clavicle hospitalized in a different country in a hospital that no longer exists at 4 years old.

1 Hospitalization at 7 years old for an Eye Stye In the USA. Nothing came of it.

1 Reported concussion at 16 Years old.

Nothing else appears to be relevant, I've already reached out to Dr Bruce twice through his website, no response. I'm not gonna bother cold calling him out of respect to his practice (Plus he explicitly states this from his Feb 13 Update, so don't do it! the man is busy as ****.)

I'm just waiting on some medical records from some clinics around me, can anyone advise on a solid AME/Neuropsych combo that can help me get the best chances of success? Still waiting on a response from Dr. Allison to see if she can administer the Cogscreen. I feel as if she'll give me the best chances of success but if anyone has any alternatives I'm all ears. Willing to fly out, but locally is better preferred. Any good AME's in the houston area that have specialty in cases like mine that can communicate with the FAA in the most coherent way possible?

Got a 3-4k Budget. Thanks in advance, I try not to ******** and be as straightforward as possible.
 
mmorales said:
…I've already reached out to Dr Bruce twice through his website, no response. …
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You may want to check your spam folder. For some reason, a lot of email providers auto-send his emails there.

Other than that, get a good night’s rest before the cogscreen.
 
TCABM said:
You may want to check your spam folder. For some reason, a lot of email providers auto-send his emails there.

Other than that, get a good night’s rest before the cogscreen.
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Thank you sir. I made sure to turn on his Godaddy notifications, checked my spam daily as well.

I'm confident in passing atleast the computer portion as from ages 12-17 I was a video game addict, got to high rankings in CSGO and Rainbow Six Siege I used to play this game called Osu! which if you go watch gameplay you'll understand why i bring it up. Along with knowing that I can talk to myself and use my hands to assist myself in the numbers portion, i can be confident in a pass that as well. I've just been lurking and waiting for my finances to catch up, i'm just about ready as i've been lurking since the very day the new guidelines were released.
 
My advice is to see a doc that provides these tests regularly, and knows what they are doing. That matters!
 
Having taken the full battery twice, I feel like I can confidently say it doesn’t matter who your AME & HIMS Psychiatrist are. The tests are standardized. The HIMS Psychiatrist (or their office staff) is the one who will administer the testing and they have very little, if any, wiggle room for modifications or reinterpretation.

I took the test twice - and wasted thousands of dollars - because I was stupid in that I didn’t take the first test seriously enough.

That said, here’s my advice:
- Live a healthy lifestyle. Get on a good sleep schedule and exercise regularly. Eat your vegetables. If you can, exercise some on the day of before you take the test. Sleep and exercise and the number 1 and 2 indicators for success on these types of cognitive tests.
- Practice and prepare. Try an app such as Luminosity. If you can get something on a PC, even better. I know Luminosity is not technically scientifically proven but this kind of practice is very important. One specific thing that’s important is learn to repeat strings of numbers forward and backward from memory.
- On the day of the test, if you didn’t sleep well the night before, be prepared to reschedule. You don’t want to waste thousands of dollars like I did because you slept poorly. Cancellation fees will always be cheaper than retaking.

One thing I also did was take some caffeine prior to testing (I normally don’t use any), but your mileage may vary and I’m not sure this is a good idea for everyone.

For those wondering, I passed the second time. But I don’t have my medical yet because doctors and government are slow.
 
Those strings of numbers backwards and forwards are hard if you go in cold! Definitely something you can practice beforehand.
 
FatherPilot said:
Those strings of numbers backwards and forwards are hard if you go in cold! Definitely something you can practice beforehand.
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Yeah, the backwards part was always harder for me.

One thing too is knowing what’s coming was really helpful the second time around for me. I could share in greater detail but I‘m unsure if that is frowned upon/illegal. Afaik I didn‘t sign an NDA though
 
FatherPilot said:
Those strings of numbers backwards and forwards are hard if you go in cold! Definitely something you can practice beforehand.
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This is precisely why I said it’s important who administered your test. Did you know you’re allowed to talk out loud during this? It’s quite helpful.
 
What makes you think the faa will pull your prescription history? Now, there is a chance they can ask you for a printout of your prescription history but I do not believe they can just pull it up.
 
Key is to work with an AME that knows, and is willing to, put the packet together at the time you apply, rather than waiting on OKC to respond with what they need. A HIMS FAA neurologist's office will actually do the Cogscreen and neuropsychological evaluation. Based upon the anxiety, a best practices approach will also likely require a neuropsychiatrist evaluation, but depending on who you talk to, you can't actually get a HIMS neuropsychiatrist evaluation until you apply for your medical, get denied and then you are requested to get an eval from the neuropsychiatrist. Sound frustrating? It is. I think one option you have is to go do the Cogscreen from a HIMS Neuropsychologist and see if you pass. If you do, then move forward. You can submit that when you are denied and see if FAA requires more. Also, if your prescription wasn't really for anxiety, have you actually seen all those medical records? If it was truly for a sleep aid, why did the doctor put anxiety? Maybe that was a coding error by a scribe/coder? Can you get that record fixed? The good news is, this will all take so long that you will be able to build your budget up. If you can wait for Dr. Chien, I think that is the route I would try to go.
 
Michael T. Runyan said:
Key is to work with an AME that knows, and is willing to, put the packet together at the time you apply, rather than waiting on OKC to respond with what they need. A HIMS FAA neurologist's office will actually do the Cogscreen and neuropsychological evaluation. Based upon the anxiety, a best practices approach will also likely require a neuropsychiatrist evaluation, but depending on who you talk to, you can't actually get a HIMS neuropsychiatrist evaluation until you apply for your medical, get denied and then you are requested to get an eval from the neuropsychiatrist. Sound frustrating? It is. I think one option you have is to go do the Cogscreen from a HIMS Neuropsychologist and see if you pass. If you do, then move forward. You can submit that when you are denied and see if FAA requires more. Also, if your prescription wasn't really for anxiety, have you actually seen all those medical records? If it was truly for a sleep aid, why did the doctor put anxiety? Maybe that was a coding error by a scribe/coder? Can you get that record fixed? The good news is, this will all take so long that you will be able to build your budget up. If you can wait for Dr. Chien, I think that is the route I would try to go.
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This actually sounds really sensible and is a great response. I really appreciate you, this is exactly what i'm gonna do. I think since my case is a tad bit more sensitive then to immediately respond with all my documents will have the flag immediately filed rather than having to slug through. I'll look into getting that record fixed. I initially went through that visit for an ADHD refill along with something to help me fall asleep at night because I taking an extended dosage during the day at the time and XR's lasted significantly longer in my system harming my ability to sleep. This is exactly why I asked in the form rather than going through an AME that might not know what he's talking about through my specific file, doctors aren't perfect because humans as well, I'll look into getting that record fixed would you have any advice on how to do so?


EDIT : IM IN THE STATE OF TEXAS.
 
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AchillesLastStand said:
This is precisely why I said it’s important who administered your test. Did you know you’re allowed to talk out loud during this? It’s quite helpful.
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Not only talk to yourself. Some Neuropsychs also allow you to count on your fingers for that forward backward numbers section. I don't have the specifics on why that may be allowed (or not) maybe if they don't wanna play nice they might be able to write the report up as fidgeting, you never know but communicating with someone who administers the exam and will interpret the test in a format based on their best judgment seems like the best idea prior than just going into whoever the person is doctors are humans and humans have different personalities this has been studied for many years.
 
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FlyingBiscuit said:
Yeah, the backwards part was always harder for me.

One thing too is knowing what’s coming was really helpful the second time around for me. I could share in greater detail but I‘m unsure if that is frowned upon/illegal. Afaik I didn‘t sign an NDA though
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My impressions as long as you're prepared through reading the guidelines very strictly, preparing through brain cognitive apps for being in that mind state for extended periods of time , and being very mentally prepared and meditating and eating healthy for the week prior to make sure your gut biomes and your brain is in perfect working form for taking the exam along with communicating with the correct person who will administer your Cogscreen seems like the highest strategy for success if you truly do not have/need to medicate to your ADHD. All you have to do is prove through the FAA and be able to perform, To my knowledge they base the exam on a pool of previous concussed pilots and if you fail any of their sections below 15th percentile it's a automatic fail. Did your examiner tell you why you failed the first time around?
 
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Half Fast said:
Bruce is outstanding, but we do have a couple of other equally outstanding docs on this forum. If Bruce is swamped, you might try contacting @lbfjrmd and @WingmanMed .
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Thank you sir. i've read on these forms that Bruce is the epitome of efficiency when it comes to dealing with the FAA when it comes to cases like these, not to discredit any doctors years of expertise but he's been on this forum almost as long as i've been alive... I'll see about reaching out to seeing opinions to these 2 fine practitioners.
 
MMorales, I did reply but it prollywent to your spam bin.
Kim Johnson, Ph.D., not in HOU but in NE DFW is a great bargain and she does NICE work.
 
bbchien said:
MMorales, I did reply but it prollywent to your spam bin.
Kim Johnson, Ph.D., not in HOU but in NE DFW is a great bargain and she does NICE work.
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Thanks Dr Bruce. it didn't even reach my spam strangely enough. I had the master list just sending out emails in my area trying to see if any AME's had expertise in cases like mine. Is it fine if i email the email attached to your Godaddy? Thanks for putting Dr Johnson in the forum for consideration?
 
bbchien said:
MMorales, I did reply but it prollywent to your spam bin.
Kim Johnson, Ph.D., not in HOU but in NE DFW is a great bargain and she does NICE work.
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Nice!!!! Wished I would have known about this 5 yrs ago...would have made the trip
 
Eat well and sleep well the night before. Especially if that is your normal routine.

Dr Bruce can take care of you as good or better than any alternative.
 
When I took the COGScreen test a few years ago, I tried not to make any mistakes in my answers, but I wound up going too slow. Basically, the test is for correct answers + speed (both are important). I retook the test and instead of worrying about getting some answers wrong, I just answered the questions as quickly as I could. The doctor said I did great on the second test.
 
mmorales said:
Thanks Dr Bruce. it didn't even reach my spam strangely enough. I had the master list just sending out emails in my area trying to see if any AME's had expertise in cases like mine. Is it fine if i email the email attached to your Godaddy? Thanks for putting Dr Johnson in the forum for consideration?
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mmorales: turn on "display siglines" in this forum and it'll display a link to my website. That works best and send a message.

B
 
mmorales said:
My impressions as long as you're prepared through reading the guidelines very strictly, preparing through brain cognitive apps for being in that mind state for extended periods of time , and being very mentally prepared and meditating and eating healthy for the week prior to make sure your gut biomes and your brain is in perfect working form for taking the exam along with communicating with the correct person who will administer your Cogscreen seems like the highest strategy for success if you truly do not have/need to medicate to your ADHD. All you have to do is prove through the FAA and be able to perform, To my knowledge they base the exam on a pool of previous concussed pilots and if you fail any of their sections below 15th percentile it's a automatic fail. Did your examiner tell you why you failed the first time around?
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Yep. But my examiner made it sound like it was a combination of things rather than one specific thing. A big part of it was that some of my results were amazing, while others were... less amazing (bad). According to my examiner, this variation in the results makes the FAA uncomfortable because they have no idea what it means.

The FAA has a great, somewhat irrational fear of the unknown.
*unintelligible grumbling about this slow process*
 
my CogScreen examiner reminded me that I should retain a copy of my results so in the future my family can assess if I am in cognitive decline as I get old! That's real fun to contemplate....
 
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