Admission To Hospital Question

Discussion in 'Medical Topics' started by Frankmarsh5, Oct 9, 2021.

  1. steingar

    steingar Taxi to Parking

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    I don't feel a bit bad about the OP. Yes, it was a bad situation, but he put himself in it. Had he been responsible with the alcohol I doubt any of that would have happened. A victim of sexual assault is a different animal entirely. That can do a big number on someone's state of mind. That said, abusing alcohol or drugs just is. Can't have it in the cockpit, so if it shows up on the FAA's radar its bad news. Can't have someone impaired at the controls of an airplane no matter how they got there.

    The truly sad thing is this is the easiest thing in the world to get around. If you really want to drink that much, do it at home. Don't do it right before you're going to drive or go fly. Take a little responsibility. It really isn't that hard to stay off the FAA's radar. Those that can't mostly need the help. And a recidivism rate of 15% is amazing when talking about alcoholics.

    If I really have to show you studies showing drunk people don't fly well perhaps you need to go back to grade school and catch up a bit. Your freedom ends when you can crash an airplane into me.
     
    Last edited: Oct 27, 2021
  2. BladeSlap

    BladeSlap Ejection Handle Pulled

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    Quote to me where anyone said someone who is drunk should be flying

    It feels like as there are no proper medical studies that back up the faa stance the hims program, the only fall back response on this topic has been “you want people who are drunk to fly”.
    This response is very weak, no one has ever said that, and if someone where to try to fly drunk it would first and foremost be a regulatory violation, and no one would have a issue with that pilot being made to jump through hoops, or just lose their certificate outright.

    So could we stop with that stilly statement if we’re going to have a honest discussion?
     
    Last edited: Oct 27, 2021
  3. GaryM

    GaryM Cleared for Takeoff

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    What’s to discuss? The current FAA position is clear.

    We could pick this up again after you’ve convinced congress to force a change.
     
  4. BladeSlap

    BladeSlap Ejection Handle Pulled

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    Discuss how it’s a screwed up system and figure out how to change it.

    People getting together and talking of such things is how we became our own nation.
     
  5. Salty

    Salty Final Approach

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    I don’t agree with way the Faa treats drunks and especially suspected drunks, but if you’re regularly drinking to .16, you’re a drunk. Not sorry if that offends you.
     
  6. BladeSlap

    BladeSlap Ejection Handle Pulled

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    Why would that offend me?

    Thankfully for most of the medical world, aside from the faa, we go off large evidence based studies, not some bureaucrat or some guy on the internet.

    I am only offended that a agency that represents me and is funded by me and claims to have anything to do with medicine or health isn’t following the modern medical guidelines, guidelines so many much more accomplished real doctors and scientists worked to develop and prove, and continue to evolve and improve
     
    Last edited: Oct 27, 2021
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  7. bbchien

    bbchien Touchdown! Greaser!

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    Before HIMS you just got fired. Everyone. Be careful for what you wish.
     
  8. BladeSlap

    BladeSlap Ejection Handle Pulled

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    So we should accept their current deficiencies in not following modern medicine, because they used to be even more incompetent?
     
  9. Lachlan

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    Flying is not mentioned in The Federalist Papers- it’s not a right. It’s a privilege. Don’t abuse it. We don’t make the rules by violating them until The Man relents and lowers the bar. Far better to accept the guidelines and not drink or do drugs if you want to keep your SI certificate. I thought pilots were supposed to be a little bit smart? Who thinks that getting drunk/high is a good choice? ESPECIALLY after getting an SI (which recommended abstinence) for a DUI? Some pilots are smart. Some “previously certificated as a pilot” types are not.

    So, how many members of Congress have you called or emailed this week about forcing the FAA to “follow modern medicine”?
     
  10. BladeSlap

    BladeSlap Ejection Handle Pulled

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    Well there are few things about not all rights being mentioned and due process

    Again abusing it would be flying drunk, and for the millionth time no one is condoning that.

    And to your last question 4

    Go to a real doctor or scientist, a accomplished doctor or scientist, argue why not following modern evidence based medicine is better than following modern evidence and large scientific study based medicine.
     
  11. PaulS

    PaulS Touchdown! Greaser!

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    Have you ever witnessed a functional alcoholic spiral out of control? I have a few times, it is not a pretty sight and the last place I would want one is piloting the airliner I am about to board. Or flying over my house. Alcoholics need to fix their ****, then work through the morass developed to keep them from hurting people. There are many cases of pilots being arrested before or after a flight sloshed. If a pilot doesn't want to deal with this crap, don't go out and drink. It's that simple.
     
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  12. BladeSlap

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    Agree 100%

    So let a real doctor practicing real medicine with their real hands on the patient make that call.

    Basically just make our entire medical system like basic med, but provide the doctor a “day in the life” of a pilot and let real doctors and the best of modern medicine work it’s wonders.

    I’d trust that far more as a pilot, pax, or guy with home by a airport, compared to the broken system we have now where some mid level management bureaucrat type, not practicing any credible form of medicine, at the faa makes these important calls
     
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  13. Palmpilot

    Palmpilot Touchdown! Greaser! PoA Supporter

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    I had a cousin who was pilot for a major airline for many years. He would always dry out the required number of hours before he went on duty. After he reached the age limit, he died not long after. No longer having a reason to dry out, he basically drank himself to death.
     
  14. Lindberg

    Lindberg En-Route

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    Nothing that hadn't been invented by the 1780s, and even many things that had, is mentioned in the Federalist Papers.
     
  15. ThatOtherGuy

    ThatOtherGuy Pre-Flight

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    You're delusional and speaking about something which you clearly have no experience in. Your best course of action would be to stop talking, start listening, and apply some true critical thinking. It'll get you much further than spouting off a troll-like answer to any logical statement presented to you. You might learn something.

    The docs at the FAA aren't in the best position to know the "patient", but that's not their problem. Their problem is to look at the facts, apply the criteria laid out in the FARs and make a determination. Do they get it perfect all the time? Hell no. Do they stop A LOT of situations from getting someone hurt? Yes. If someone who's come on the radar for their alcohol use curbs their problem drinking does their life get better? Hell yes.

    You think someone with an alcohol problem and brains enough to get a pilot certificate is walking into their PCP and saying, "Hey doc, I'm finishing off about 30 beers every 3 days and on average I do this 3 days a week"? Especially considering they know it'll be reportable on a medical? Here's the answer every PCP and cop on a DUI stop gets, "I have a couple drinks with dinner here and there and everything's good." Then the liver enzymes come out abnormal or the breathalyzer "isn't calibrated".

    It's the same answer the AMEs get and it would be WAY worse if they weren't specifically told to look out for red flags related to alcohol and substance abuse.

    You think "modern medicine" has the answer to "work wonders" when it comes to substance abuse? Then why the hell do we have people dying from alcohol and substance abuse at a greater prevalence than we've ever seen? If they've got all the answers why don't those $25k rehab centers just get everyone sober and fix them? It's because they don't have the answers and your "real doctors" don't have the answers. There isn't a single cure and it's a complicated problem that can't be solved unless the patient has a vested interest in solving it.

    Here's some info from your "real doctors" (National Institute on Alcohol Abuse and Alcoholism) on what "wonders" modern medicine is working for substance abuse. Pay attention that this has NOTHING to do with the FARs or the FAA.

    Alcohol Facts and Statistics | National Institute on Alcohol Abuse and Alcoholism (NIAAA) (nih.gov)

    "Low risk drinking": Women, no more thank 3 drinks on any single day, and no more than 7 drinks per week. Men, no more than 4 drinks on any single day, and no more than 14 drinks per week. Notice it's impossible for the average person to hit a .15 BAC (tolerance) under this criteria.

    "Binge drinking": pattern of drinking that brings blood alcohol concentration to .08. Typically after a woman consumes 4 drinks or a man consumes 5 drinks in a 2 hour time frame. This is very close ir well below the level opined by everyone in this thread. This level probably wouldn't get most to a .15 BAC.

    "Heavy drinking": SAMHSA defines heavy drinking as binge drinking on each of 5 or more days in the past 30 days. This is WAY below the level you'd need to routinely function at a BAC of .15 or greater.

    High-Intensity drinking as an emerging trend: Compared with people who did not binge drink, people who drank alcohol at twice the gender-specific binge drinking thresholds were 70 times more likely to have an alcohol-related emergency department (ED) visit, and those who consumed alcohol at 3 times the gender-specific binge thresholds were 93 times more likely to have an alcohol-related ED visit. Ending up in the ER because of alcohol is not "normal".

    An estimated 95,000 people (approximately 68,000 men and 27,000 women) die from alcohol-related causes annually, making alcohol the third-leading preventable cause of death in the United States. The first is tobacco, and the second is poor diet and physical inactivity. Compare this to the deaths related to the current situation, and the measures the government in specific states have instituted. Then tell me about infringement of rights and privileges.

    Alcohol consumption is associated with increased risk of drowning and injuries from violence, falls, and motor vehicle crashes. When you drink at problem levels, BAD stuff happens.

    Prevalence of Alcoholism in the United States (verywellmind.com)
    Men: 23% report binge drinking five times a month. 12% report binge drinking three times per month. If these stats are a representative sample that means 37M men and 20M women are problem drinkers.

    College students: 36.9% reported binge drinking in the past month and 9.6% disclosed heavy drinking. All of these percentages are significantly higher for the same age group among non-college students. It's not youthful partying, we've turned college into an alcoholic factory.

    Alcohol Relapse Rates: Abstinence Statistics, How to Avoid & Deal with a Relapse (therecoveryvillage.com)

    Relapse in first year of alcohol sobriety 30%. 2nd year 21.4%. 3-5 years 9.6%, >5 years 7.2% There's a reason why monitoring period are as long as they are. No well understood and treated disease has the recidivism and fatality rates.

    I didn't make this stuff up, and it's not like I had to search hard for stats to prove my point. NONE of this is from the FAA. MUCH of this came from your tax dollars funding it. If you think it's BS then you probably have a bunch more letters to write.

    TLDR: You're whining about stuff which you have no real understanding of and you're adversarial towards the few that do understand and are actively invested in trying to provide real help to those that need it. I'm done with this thread. Grow up.



     
    Last edited: Oct 28, 2021
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  16. Lachlan

    Lachlan En-Route

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    But they were written at a time when the Constitution was brand new, and the ‘Papers most certainly addressed the future of the United States under a brand new form of government, and individual rights, states’ rights, etc. ;)
     
  17. Daleandee

    Daleandee Pattern Altitude

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    There was another poster that I asked, "What took you so long?" He misinterpreted my point. I now ask you the same question. My point is that your post is excellent but you will find that some people are just not willing to be educated. Some argue against proven facts and the best evidence regardless of how clear and concise it is. So I do wonder why so much time is wasted trying to educate the unwilling. It's obviously a rhetorical question.

    Is the present system perfect? No system is perfect as we live in a very imperfect world. But there is no denying the fact that the FAA is making great progress at keeping pilots with addictions out of the sky until they can be brought into compliance with a strict standard that is necessary for the safety of the flying public and the folks who live on the ground that they could endanger.

    So ... if folks want to meet a higher standard and be a pilot, then there are expectations that must be met. I'm not saying I'm totally happy with the overreach we sometimes find with the FAA but they have a job to do and the record shows they are getting pretty good results.
     
    Last edited: Oct 28, 2021
  18. BladeSlap

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    You have more faith in a department of transportation workers opinions on health compared to modern evidence based medicine?
     
  19. Lachlan

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    Tell us more about this “modern evidence based medicine” that the FAA should be using to filter out the alcoholics and drug addicts. Does it work for mental health conditions, heart problems, kidney stones, sleep apnea and diabetes, too? What, exactly, does your catchphrase mean?
     
  20. BladeSlap

    BladeSlap Ejection Handle Pulled

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    Yes it does

    https://en.m.wikipedia.org/wiki/Evidence-based_medicine

    Crazy to trust some random department of transportation workers opinion of a person they never met, compared to a real doctor who has hands on the pilot.

    I’m just not sure how one can logically argue that
     
  21. Lachlan

    Lachlan En-Route

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    Let me save you some more wasted time…. I work in healthcare, my wife does, many family members do, too. I know that terminology well. I want you to tell us SPECIFICALLY what you think the FAA should do that they are or are not doing now regarding alcohol. You have not done that. I don’t think you can do it.
     
  22. BladeSlap

    BladeSlap Ejection Handle Pulled

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    I already did, multiple times, I said let the doctor who has hands on the pilot make the call like basic med, but give the doctor a “day in the life” of what a pilot actually does, what’s required of them, and let the doctor make the call on his medical license.

    Ask your health care friends what doctors think of other providers who don’t believe in evidence medicine, or if they would trust a diagnosis from a doctor who couldn’t even pick their patient out of a line up, vs a doctor who actually examined the patient.
     
  23. Tools

    Tools Line Up and Wait

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    1. Quit FORCING religious 12 step treatment.

    2. Allow options, just like you have for ALL OTHER special issuance conditions.

    3. Pull their head out of the sand and realize their “success” IS NOT DUE TO THEIR INEFFECTIVE methods. It’s due to a BUNCH of pilots in their program that don’t need to be.

    4. They adopt 49 CFR 40 (or vice versa, what ev), then disavow these methods and protections in HIMS.

    5. How about if you’re going to use alcohol biomarkers to enforce HIMS requirements, and let’s face it, that’s 99 percent of the program, use FDA approved ones. They exist. They don’t use them.

    Keep in mind the biomarkers they use have more false negatives than false positives... where’s the “safety” in that?

    6. How about requiring HIMS AMEs to become experts in biomarker testing if they’re going to use that to regulate a pilots career? I’ve heard numerous HIMS AMEs say “well, I’m no expert in testing...”. What if your oncologist said, well I don’t know much about cancer... WOW. Oh, this would include one of the six ORIGINAL HIMS AMEs. Told me that personally.


    Here’s a few simple practical examples. Could go deep and theoretical really fast. But let’s just ask for some simple and reasonable things to ask of a system that REQUIRES treatment. Treatment is a medical thing, not administrative. Let’s just consider allowing an airman to manage this medical condition having access to treatment options newer than 1935 thinking.

    Hell, in the 70s they adopted 30s practice, threw a bunch of people in there ABLE to skew their success due to not having the condition, said WOW, look how amazing this is, and call it a gold standard.

    AND THEN turn around and do it again with PETH testing. They say it’s 100 percent. “No known false positives”. I suppose they believe in James Bond truth serum too... Geesh...
     
  24. Tools

    Tools Line Up and Wait

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    HEHE, I have a recording of a doc working for the FAA, doing an investigation, who plainly said EVALUATIONS done by doctors who have never even seen the patient are just fine... ya, no problem there.
     
  25. Lindberg

    Lindberg En-Route

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    How about someone tell us SPECIFICALLY the FAA isn't doing that it should be. For example, the OP isn't obligated to report his BAC to the FAA. Do you believe he should be?
     
  26. Lachlan

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    Evidence based practice is certainly the current model for most areas of healthcare. The FAA is a regulatory agency who gets to make their own regulations, or administrative laws. Let’s look at a HIMS evaluation and CogScreen, for examples of evidence based practice. These take hours and hours of one on one contact time to determine a very clear clinical picture of the individual patient. HIMS programs are tailored to meet the needs of the specific patient. That *IS* modern EBP. In the old days these pilots would be denied and never able to follow a pathway to certification, or, if certified, terminated with no hope of ever getting back in the airplane. It’s ok to be dissatisfied with your FAA and want things to be different, but you need to choose your words and descriptions better than what you can parrot off of Meta and /Reddit.
     
  27. Lachlan

    Lachlan En-Route

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    Nope.
     
  28. GaryM

    GaryM Cleared for Takeoff

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    A completely unrelated anecdote I feel compelled to insert here: Early in my career (late 80's, maybe early 90's) I was working at a life sciences company when the edict came down from corporate that mandatory drug testing would begin. HR sent two representatives around to explain the program. They read from note cards and explained that this thing called HPLC-MS, whatever that was, was an infallible method; 100% accurate, no false positives, no false negatives, we had nothing to fear! The system was perfect.

    In the session I attended, they were speaking to the Analytical Sciences department. A room full of mostly Ph.D's who had developed a lot of the methods and in some cases had played a role in inventing the instruments themselves. Responses from the room were many, immediate, often brutal, and frankly hysterical. HR never knew what hit them. It was THREE YEARS before we heard another word about mandatory drug testing for employees, and then it was greatly scaled back and much better thought out.
     
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  29. Tools

    Tools Line Up and Wait

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    High Performance liquid chromatography followed by mass spectrometry.

    Peth has been using LCMSMS. Liquid chromatography and tandam mass spectrometry.

    it’s simply the method to determine if something is in a sample. LIGHT YEARS ahead of the more fundamental question, how is the chemical you’re looking for formed? Is consumption of alcohol the only way?

    See? The FAA isn’t mucking around in the area of uncertainty. They are screwing up BASIC COMMON SENSE, and wrecking careers and lives doing it.

    A former major airline HIMS co chairman just shot himself after taking an early retirement. Been in HIMS for years... The guy admitted repeated suicidal tendencies, but he was in hims, and the company doc said he was fine, so he must be fine. Personally I thought it was patently obvious he was suicidal, yet his ENTIRE PROFESSIONAL TEAM (hims AME, psychologist, psychiatrist, peer monitor and chief pilot) missed it... or perhaps were they not really looking?

    This entire program is pitiful. It does NOTHING to protect the public, it does woefully little to help individuals (maybe ten percent HONESTLY express “gratitude” to it). Plainly speaking it hurts more than it helps.
     
  30. RussS

    RussS Pre-takeoff checklist

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    But it’s not that easy.

    I think the argument that I see made a lot on this thread and many others is that there are potentially MANY non-alcoholics forced into the program because of way the current system works. If a cancer study showed a cure rate of 85% but a bunch of people in the study never had cancer…it would be a skewed number, yes? That is the argument I think people don’t see….or care to see. No one wants alcoholic pilots running free in the skies. That was never the argument as far as I’ve read. Maybe I interpret it incorrectly?
     
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  31. Tools

    Tools Line Up and Wait

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    YAY! I am speaking English . I was beginning to wonder... ever see Shelter Island?!!
     
  32. BladeSlap

    BladeSlap Ejection Handle Pulled

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    that

    The high cure rate with cancer when you start with a bunch of people who don’t have cancer argument is spot on
     
  33. jbarrass

    jbarrass Cleared for Takeoff PoA Supporter

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    This is the root problem. But it's worse. They will gratuitously overrule a doctor that has actually examined the patient.

    The Docs in OKC are not materially different than docs that give medical marihuana cards if you fill out an on-line form. An examination is ethically required for a diagnoses even if OK by bureaucratic fiat.
     
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