Another “Can I Pass Medical With This Litany of Issues?” Post

Discussion in 'Medical Topics' started by HopefulPilot, Aug 24, 2021.

  1. HopefulPilot

    HopefulPilot Filing Flight Plan

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    Hello, I am a software engineer in my early thirties living in south Florida seeking any information and assistance that could help me acquire my pilot's license. This topic has already been discussed many times on this forum and others, and I have probably read them all, but I wanted to get some opinions on my own predicament. There seems to be quite the knowledge base here, and I would greatly appreciate any input.

    Like many others, I have wanted to fly my entire life and will soon be in a financial position to do so. I would strongly prefer to get my PPL. I want to someday have my own C-182 and be able to fly across the country on a whim without worrying too much about cargo capacity or weather conditions (within reason).

    I understand this requires a third class medical certificate, and that I should speak to an AME who can evaluate my case without actually "pulling the trigger". I am aware that my case will probably require the assistance of an expert, and that I should choose my AME wisely.

    First, I do not intend to lie to or mislead the FAA about anything. Absolutely zero chance. I like to account for every possible risk factor when making decisions, and I hate gimmicks.

    Secondly, I am aware of and have looked into the LSA license. Worst case scenario, this is the route I will take, with the expectation that some heavier aircraft will fall into this class once the FAA finishes whatever they are doing at the end of 2023.

    Third, I am aware of the battery of tests I will be required to take. I found an awesome write-up around here somewhere with a list of the tests. I plan on studying and practicing any way I can, along with increasing my exercise regimen to get in tip-top mental condition.

    I apologize for the long post. I have recently acquired my entire medical history, and even called afterwards to verify that nothing could be missing. I have tried to organize my background the best that I can:

    2000-2001, 10-12 years old (ADHD)
    My mother took me to see my pediatrician, because I wasn't turning in assignments during middle school. The pediatrician said I had ADHD and tried to medicate me, but I refused the medication at the time. I knew that I didn't need it, and that I was just lazy about turning in assignments. Since I did well on exams, my teachers always let me progress to the next grade despite typically failing their classes. I went to the same provider from birth to adulthood, and I have all of my medical records. It is not clear to me if I was ever actually tested for ADHD, if I was, no record of it apparently exists.

    2002-2007, 13-17 years old (DL Suspension from Speeding, Battery Conviction)
    While in high school, I began to feel that my academic performance mattered, and as a result, I obtained pretty good grades - mostly A's and B's and sometimes in classes like AP physics. I was never medicated or seen by a doctor regarding mental health issues during this time period. However, my home life was rough, and I ended up on the streets when I was 16/17. I bought myself a used car for $750 bucks and lived in it. I ended up getting mixed up with some bad people, and I made some really bad choices. I was careless, rebellious, and racked up half a dozen criminal charges in a six month period of time. I ultimately ended up pleading guilty to a felony battery when I was 17 in a plea deal (2006). Additionally, and in the same time period, I got several speeding tickets and my license was suspended for six months. Since this short phase of my life, by any objective measure, I have been an upstanding and productive citizen who contributes to society as much as I can.

    2009-2011, 19-20 years old (Anxiety, Depression)
    I began waiting tables at a restaurant in order to pay for part-time classes at a community college. Approaching tables made me pretty anxious for a while at first, and during a routine physical I mentioned this to my doctor who prescribed me Zoloft to deal with the anxiety. I took it for maybe a couple of weeks and stopped. At a later appointment in this time period, he prescribed it to me again, but I don't believe I even picked it up from the pharmacy. In my medical file, the doctor noted "anxiety, nervousness, and depression". To be clear, I am not and have never been depressed. By 2012, it was made clear in my medical file that I no longer suffer anxiety of any kind. This is the only time in my medical history I see the term depression and anxiety is never discussed again.

    2012-2021, 21-32 years old (ADHD, Adderall)
    After studying business at a community college for a few years, I transferred to a university and began studying finance and MIS. After a semester or two, I mentioned to my doctor that I sometimes find myself spacing out during class, and that I was diagnosed with ADHD as a child (I was seeking medication). He put me on Concerta, which I eventually stopped taking, but later on we switched to Adderall, which I have continued to take to this day. I have continued to take it, because my career is pretty intellectually demanding and I wanted to wait until I was in a good place to stop taking the medication (withdrawal involves pretty severe sluggishness). I don't think I need the medication though; I am not even sure I have ADHD. I have always figured that even if the benefits of taking the medication are marginal, I might as well. I have a reasonably high IQ. There are remarks like "no cognitive deficits", "good eye contact", and "good attention span" all over my medical file, and during periods of time where I was doing well in school. The only real deficit in this area I may have, is that sometimes it seems like I have trouble processing sound. I was given an OWL test when I was a child and scored pretty low, like around 70 (100 is average). My actual hearing is fine though, and this has never really inhibited me from doing anything, just something I have noticed.

    So is it doable? Any thoughts? AME suggestions? Again, sorry for the long post, and thanks for any advice!
     
  2. AggieMike88

    AggieMike88 Touchdown! Greaser!

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  3. Daleandee

    Daleandee Pattern Altitude

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    I'm not a doctor and won't try to play one but I would recommend that you pursue a Light Sport Certificate as it appears, from what I've seen in other threads of this type, that if you can get through this it will be both costly and lengthy.

    You say light sport is a "worst case scenario" but I disagree. If you end up with a denial you will be looking at balloons, gliders, & ultralights. Even that ain't so bad for those that really want to fly but light sport, for me, has been an absolute blast!
     
  4. PeterNSteinmetz

    PeterNSteinmetz En-Route PoA Supporter

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    Of course the senior HIMS AMEs mentioned above by AggieMike are the ones you will need to contact and do a consultation with.

    My sense also from threads here is that this may well be issuable, depending on current evaluation and testing, but expect needing the full work up costing $5-10k and 6-18 months of work on it.

    Perhaps see my medical information page at http://faamed.info, if you have not already done so, for some ideas on how to start your training in the meantime.
     
  5. HopefulPilot

    HopefulPilot Filing Flight Plan

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    Well my plan is to pursue the medical certificate only if the odds of acquiring one are reasonably high. Also, my wife would like to pursue her PPL as well at some point. So we will have some options either way hopefully.
     
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  6. HopefulPilot

    HopefulPilot Filing Flight Plan

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    I appreciate the recommendations. I will probably have to wait until December, but I am willing to spend any amount of money, and I will travel anywhere in the country to see the right people. I bookmarked your write up.
     
  7. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    Between now and December, you can still arrange and participate in consultations with the right Senior AMEs. Start organizing your team and begin educating yourself on the process.

    Then when you’re ready to start, you can hit the ground running.
     
  8. HopefulPilot

    HopefulPilot Filing Flight Plan

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    Sounds good. Do you know how the SSRI process works? I am having trouble wrapping my head around it. There was a 14 month period of time, where on month 1, I was prescribed an SSRI but discontinued it on my own immediately, and then did not see my doctor again until month 13th, where he put me back on it for the same "condition", and then on month 14 there was a follow up where I said it seemed to be working, but then discontinued it on my own forever. The next appointment after that I clarified that I did not think I need it and that I wasn't really experiencing anxiety. This was about 10 years ago.
     
  9. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    Sorry, I do not have specific details. Just some general knowledge leaned here and in another forum Dr. Bruce used to moderate.

    With the history provided above, you need to find the right HIMS AME for you and then follow the guidance provided.
     
  10. Rushie

    Rushie En-Route

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    The others gave good advice and you know not to apply unless you know the outcome is most likely you’ll be issued.

    All I can offer is if it comes down to plan B, if your wife gets her PPL and you don’t, you can still buy the 182 and fly it as long as she is willing to be PIC and goes with you. She would have to be really into it though. It won’t work if she is only lukewarm or just doing it for your sake. I suppose you could also have your own sport pilot plane for solo, if you can afford two planes simultaneously. But it would be awkward, I think it’s well worth the expense to try to get the class 3. Although I think the biggest concern is you are continuing to take Adderall. This might be an uphill battle but I can’t say, other than you need a really good AME.
     
  11. PeterNSteinmetz

    PeterNSteinmetz En-Route PoA Supporter

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    From the history here and above, you may be able to go on pathway 1, but I suspect you will be in for the full “P&P”, forensic Psychiatric evaluation and neuro Psychological testing and evaluation.

    Start by consulting with a senior HIMS AME. You will also need to have all pertinent medical records sent directly to them. Coordinating all that can take months, so perhaps start the consult now.
     
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  12. benyflyguy

    benyflyguy En-Route PoA Supporter

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  13. Daleandee

    Daleandee Pattern Altitude

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    Yep ... like I noted in my post above, bring plenty of money and have a bunch of time to wait. Patience will also be needed in abundance. In the meantime ... fly light sport! ;)
     
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  14. HopefulPilot

    HopefulPilot Filing Flight Plan

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    Exactly what I was thinking. Wife has been interested in learning to fly for quite a while, she's constantly looking up used airplanes-it's authentic.
     
  15. HopefulPilot

    HopefulPilot Filing Flight Plan

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    We make enough money that we can pretty much do what we want, and this is a worthy cause in my view. Honestly my biggest concern about flying light sport is the potential for significant depreciation of the aircraft when/if the FAA removes the current weight limit in 2023. Who will want these smaller aircraft if nobody is manufacturing them anymore and parts are scarce? I am pretty new here, and I hadn't heard of a light sport aircraft until two days ago, so I am pretty open-minded. Actually I would really like to be wrong about this. Are there any LSA you could point me towards? The large number of manufacturers and concepts out there, along with things like the failure of the C-162 have kind deterred me from looking into it further.
     
  16. PeterNSteinmetz

    PeterNSteinmetz En-Route PoA Supporter

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    My understanding from a person on that committee is - not going to happen anytime soon. The issue is the total kinetic energy in heavier aircraft being a danger to those on the ground.

    Never mind that that is apparently a very small risk given that is not what drives insurance premiums. This is the FAA after all.

    So I would not let that be a determining factor.
     
  17. WDD

    WDD Pattern Altitude

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    Whatever happens with the PPL/3rd class, got to say very impressive with how you turned things around from living in a car as a teenager to community college, etc.
     
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  18. HopefulPilot

    HopefulPilot Filing Flight Plan

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    A consultation with a senior HIMS AME is definitely in my near future.

    In the mean time (passed couple of days), I have been scouring the internet reading posts by @bbchien and a few other experts on various forums. I am still collecting everything. But what I gather so far, is that if I was prescribed the SSRI on two different occasions with a 90+ day separation, that this would be considered de facto a "recurrent illness", making pathway 1 a no-go. I need to try and get a list of every prescription over the past 10 years or so to verify if this is the case. But if it is, does that mean my only route would be the "SSRI pathway", which means starting back on the SSRI under the evaluation of a willing HIMS AME, and that after six months if my HIMS AME says that my "condition" is stable, I could potentially receive a special issuance 3rd class medical certificate (no psychosis, suicidal ideation, etc.)?

    Also it would be worse if I had stopped taking the SSRI without the direction of the prescribing doctor, right? Or if that happened in between the two prescriptions, could I use that to demonstrate that it was not a "recurrent disease" but an irresponsible young adult suffering a "one-off disease" (guessing not)?

    Also, I seem to recall Dr. Chien mention some place about the possibility of a "successful life test", which involves demonstrating ten years of no medication and no issues. Could that potentially help me in the event I am stuck going the recurrent disease route? Or is it that recurrent disease has been found to reoccur over long periods of time on average (I read this someplace but didn't save it)?
     
  19. Palmpilot

    Palmpilot Touchdown! Greaser! PoA Supporter

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    I wonder if they have any data on how many sport pilots have hit people on the ground.
     
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  20. HopefulPilot

    HopefulPilot Filing Flight Plan

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    Thanks, I appreciate that. It was a journey for sure.
     
    Last edited: Aug 25, 2021
  21. PeterNSteinmetz

    PeterNSteinmetz En-Route PoA Supporter

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    Probably would have to scrape the NTSB database like the author of the prior paper did. Unfortunately he longer had the results of his prior scrape.
     
  22. PeterNSteinmetz

    PeterNSteinmetz En-Route PoA Supporter

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    Yes, if it looks like recurrent illness than you will be on pathway 2 in all likelihood for an SI. Determining if that is true will be the job of the forensic psychiatrist.

    This will likely be regarded by the FAA aeromedical people as a sign of lack of insight and untreated illness. You will have to convince the forensic psychiatrist otherwise.

    That means 10 years, no meds and no illness and no signs of it. Documented.

    I think it might be best to stop trying to parse this too deeply as much will depend on how exactly the evidence is interpreted by the forensic psychiatrist. The variations in your possible outcomes now are well within the noise of these type of evaluations.

    Go consult with the senior HIMS AME and know that in the meantime there is likely a decent chance that with enough money and time you can probably get an SI.

    Then I would stop reading and worrying about it and get out and start your flight training in one manner or another. Without a medical you can’t solo a non-LSA. You can start your training for LSAs or gliders without a 3rd class and apply that training to a regular private later when you get your medical. Get out and have some fun!
     
  23. HopefulPilot

    HopefulPilot Filing Flight Plan

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    What would be the consequences of the FAA regarding my actions (stopping the medication on my own) as a lack of insight and untreated illness? Could that support the argument that the multiple prescriptions (if 90+ days apart) were to treat a "on-off" instead of a "recurrent" condition?

    Also do you handle this stuff in some capacity professionally? Just wondering. Thanks!
     
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  24. Daleandee

    Daleandee Pattern Altitude

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    A number of certified planes like Champs, Cubs, Luscombes, etc. have been around since before light sport and are compliant for light sport pilots to fly. If money really is not a hinderance you can buy a wonderful Bristell that can even be used for IFR once you have the rating. A possible downside for you is that LSA have limited seating (2 place) and payload on some models can be a bit limited.

    The Vans RV12 is a light sport plane and I don't see Vans ever being in a position to not support these planes. Still I do see your concern and there is some validity to it. But my thought was to get a light sport rating and fly while you battle your way up the hill to a PPL. Your light sport training will count towards your PPL and you'd be flying in the meantime.

    Either way I pray you have a great deal of success with whichever road you choose.
     
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  25. PeterNSteinmetz

    PeterNSteinmetz En-Route PoA Supporter

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    It just means that the forensic psychiatrist is going to have to opine on all of this. You and I cannot really predict here how that is going to turn out with any degree of accuracy. Once you consult with the AME and have the forensic psych exam, you will know more.

    I understand the anxiety about getting a medical, but I seriously do suggest that in the meantime, just get out and train. Spend your time studying the Pilot’s Handbook of Aeronautical Knowledge or Kershner’s book or study a video program. You’ll be making progress toward your certificate and likely have more fun and be happier.

    I am a research neurologist with a strong interest in aeromedical issues but am not an AME and just fly as a hobby.
     
  26. HopefulPilot

    HopefulPilot Filing Flight Plan

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    Yeah, I hear you. I understand that I'm not qualified to come to any settled conclusions on my own, that this stuff is extremely nuanced, and that it would take me many years of education and research to fully understand the complexity and scope of the problem, but that's easier said than done. :cool:

    I have a hard time blindly placing my destiny in the hands of another, no matter how competent they are, so I am probably going to keep putting in work until I accomplish this. I will definitely look into those books you mentioned though. Thanks. I thought about trying out flight simulators as well. Is this something you recommend?

    Cool
     
  27. PeterNSteinmetz

    PeterNSteinmetz En-Route PoA Supporter

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    I think that with persistence and effort you will be successful - good job.

    For primary flight training I do not recommend flight simulators as they don’t teach the feel of the plane and can lead to an over-focus on the instruments. They are fun and probably provide some familiarity with the process if you have not been in small planes. There was actually a recent thread that discussed this at length - Microsoft Flight Simmer takes a real flight lesson
    https://r.tapatalk.com/shareLink/to...t-lesson.131202/&share_type=t&link_source=app

    The Airplane Flying Handbook and the Pilot’s Handbook of Aeronautical Knowledge can be downloaded for free from the FAA website. Perhaps a bit dry. The Gold Seal online course has a free trial IIRC. There are lots of free resources to get started with. Have fun with them!

    And if you can find a local glider club, they usually welcome new members with open arms and will give you some introductory flights. http://www.ssa.org. Also if you tell people here where you live, either on this or a different account if you want to be more anonymous, many local members will offer you a local flight.
     
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  28. Half Fast

    Half Fast Final Approach

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    Just a minor caveat: the sport pilot training will only count toward PPL IF

    1) you receive it from a full CFI (not a sport CFI) ​

    OR

    2) you actually take the Sport checkride and receive your Sport Pilot certificate.​

    The rule is written weirdly (typical FAA). If you take a bunch of training from a Sport CFI and then switch over to PPL without getting the SP ticket, the previous training won't count. If you go that way, it's worth paying for the checkride and getting the SP certificate so that you don't flush all that training.

    BTW - you can do your PPL training in a light sport. I flew under SP rules for a couple of years before getting my PPL and I just flew the same LSA all the way through.
     
  29. Daleandee

    Daleandee Pattern Altitude

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    :yeahthat:

    Thanks for the clarification ...
     
  30. murphey

    murphey Touchdown! Greaser! PoA Supporter

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    That's why you contact an experienced AME who specializes in these issues and who knows the ins & outs of the FAA Medical services. Do not try to do this on your own - you have neither the FAA knowledge & connections nor the medical knowledge acquired over 20-30-40 years of working with the FAA. As noted in the legal profession, a lawyer representing him/herself has a fool for a client.
     
  31. HopefulPilot

    HopefulPilot Filing Flight Plan

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    I am sure you have good intentions, but that's a gross misrepresentation of what I said. I have no intention of doing this on my own. I don't even know what that means in this context. Are you proposing that I can reach out to the FAA myself, be my own HIMS AME, run my own diagnostics, and write my own report?

    I just want to be informed. I understand that different AMEs have different philosophies and approaches to solving these problems. I have heard that you should be very selective when choosing your AME. So, I just want to learn as much as I can before choosing which route to take.

    Once I reach out to an AME for a consultation, I will put my trust in that person completely. If my AME says to do X, then I shut up and do X, and I do it quickly.
     
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  32. murphey

    murphey Touchdown! Greaser! PoA Supporter

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    I read your comment:
    "I have a hard time blindly placing my destiny in the hands of another, no matter how competent they are, so I am probably going to keep putting in work until I accomplish this."

    as doing it yourself.
     
  33. HopefulPilot

    HopefulPilot Filing Flight Plan

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    That’s fair. I probably should have chosen my words more carefully.
     
  34. WDD

    WDD Pattern Altitude

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    I would still get a couple of opinions / different AMEs. Treat the FAA like the IRS
     
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  35. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    Welcome to the internet. (friendly poke in ribs)
     
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  36. Vincent Becker

    Vincent Becker Filing Flight Plan

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    Just another guy on the internet, but do LSA training with a full CFI and get sport certified while you figure out the medical. Hours count towards PPL if you figure out medical. If you don’t, you’re still flying. And that’s the goal.

    Have had a lot of fun going that route myself and it will sincerely decrease your anxiety about the medical. If you want to fly, don’t find an excuse to not. LSA is there for you to pursue.


    Gesendet von iPhone mit Tapatalk
     
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  37. HopefulPilot

    HopefulPilot Filing Flight Plan

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    Yeah, I am starting to realize you guys are right about that. I mean if I can use the hours towards PPL anyway there is no cost? The flight design LSAs are pretty attractive! I am a little worried about wind. I am trying to understand the factors that affect cross winds and turbulence tolerance. Something like weight/wing size?
     
  38. HopefulPilot

    HopefulPilot Filing Flight Plan

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    Thanks that was a fun rabbit hole to go down. The Bristell looks amazing for sure! When I said money is not a hindrance I meant in the context of acquiring a PPL haha. 100k is probably the most I would want to spend on a plane right now. What do you think about the flight design LSAs? I really liked the Camps, Cubs, etc. that you mentioned but my wife and I want to be able to sit side by side.
     
  39. WDD

    WDD Pattern Altitude

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    Buy a used RV 12. Hard to go wrong with such a popular and successful design.
     
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  40. HopefulPilot

    HopefulPilot Filing Flight Plan

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    Yeah I was looking at those too. What attracted me to the flight design models was that the wing was over the cabin, so I figured the sun would be less invasive... maybe not? Also I was a little worried about vetting the planes since many of them were kits put together.