another fainting thread

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Hi all, long time member, first time medical poster:

Recently, I had a fainting incident. I was coming down with my son's recent stomach bug, chose to ignore it and went out with friends. While out, I started to feel very nauseous and dizzy, and excused myself to go out and get some air. Apparently I never made it, as I began to pass out, banged into a door (opening up a cut on my forehead), at which point my friend rushed over and helped me to a chair, where I did pass out for all of 3 seconds.

I came to, feeling much better already, but someone had already called 911 and the cavalry arrived soon after much to my total embarrassment. (I did end up needing stitches for the cut--all else was fine).

Sure enough, that night I was up all night puking. Already better the next day, and was in top physical condition after that. I am in my 40's excellent health, shape, weight, everything. I had even just had a physical 2 weeks prior.

My understanding is that I get one fainting freebie. How should I word this when the time comes?
 
Bruce will no doubt provide the details, but remember that it's the "unexplained" part which gets the FAA's attention. If there's a good explanation for it, and the underlying cause isn't one which would upset the FAA (e.g. stomach flu plus exertion rather than epilepsy or such), it should not be a problem.
 
I HOPE you went to your family doctor and got all this documented. If you did, and he writes a nice letter containing essentially what you posted, you get off once. I have seen this get through with testimonial letters on LETTERHEADS by adults who accompanied you and whomever you live with who might have observed you puking all night. It really helps is one of them is an Rn or a doc, however.

However, if it's undocumented, OMG. It's a world of documentation. Treadmill, EEG, Holter, CV eval letter by cardiologist......
 
Here is more info:

The EMT who attended to the 911 call took my BP and so forth. All fine. I went to an urgent care place to get my stitches where they also did an EKG, which was also fine.

About 5 days later I went to my regular doc who took the stitches out, listened to my story, and was not even slightly concerned. As I said, I had just seen him for a physical, BP check, and blood work, all of which was fantastic. Only issue is "prehypertension" and on Diovan 80 mg for about 3 years, well controlled, no other issues.

My medical doesn't come up till August. Should I just have a letter in hand ready to go from my doc stating that this is basically a big yawn (like Ron said--stomach virus and exertion, etc)?
 
Get him to write the letter. Now. If it has all the elements in your first post.....Take it with you to the AME and it SHOULD be a yawn.
 
OP here.

Follow up--I went in for my renewal today with my primary care doctor's note in hand, and got deferred anyway. The AME made a call to the regional guy who said they were going to need EKG, echocardiogram, and halter monitor test, and that I would be receiving notice of that in the mail.

I'm aggravated that I have to go through all this. I'm in terrific shape, in my 40's, 6', 185 lbs (after losing 15 lbs this year), bp excellent, pulse 58, and I'm a marathon runner!

Is there anything else at this point I should be aware of? I will jump through the FAA's hoops and do what I have to. My AME actually expressed surprise that I told him about the fainting, and my answer was that it was all a matter of record (visit to urgent care, follow up with primary doc, and insurance submissions), so what choice did I have, even had I been inclined to not say anything.

Finally, a question: I hold a Class II medical which expires Aug 31 (which I was trying to renew). While this is going on, am I legal to exercise the privileges of a Class III after this month? Or does the deferral put me up the proverbial creek?
 
Dang. That brings up a question. If one is deferred for a medical, is one legal to fly on one's current medical at all, or is one required to consider oneself unfit for flight as one now definitively knows that one cannot pass a medical on that date?

(Sorry for all the "ones", but I want it clear that I'm not trying to pick on the OP's situation, but asking a general question.)
 
Unregistered said:
Finally, a question: I hold a Class II medical which expires Aug 31 (which I was trying to renew). While this is going on, am I legal to exercise the privileges of a Class III after this month? Or does the deferral put me up the proverbial creek?
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Answer from FAA Eastern Region Flight Surgeon's office:

If one is deferred for a new medical problem (i.e., one not previously reported and dealt with on an 8500-8), then one is grounded until the newly reported condition is dealt with via regular or special issuance. If one is deferred for a condition or event already dealt with by previous reporting and issuance, then one may continue to fly on that unexpired previous medical certificate.

Sorry.
 
is 850-8 a special issuance form? or is that the medical application form?
 
Wanna send me a copy of the letter the Family doc wrote? I'll bet it was insufficient. Most family docs have forgotten how to write in simple, declarative sentences. If it is sufficient, you went to the wrong AME. Sigh.

So start with the testing, get 'er done. If the AME is activist and can call the results in for approval, you might get this all done in a month.

So now you are committed to doing the studies that I outlined, too. I think it's pretty clear you're grounded by the AME's failure to issue, which is pan- class of certificate.

SOMETIMES when you roll your own, you lose. Sadly, I DON'T hold out on the internet, and were it not for that policy I might have posted more strongly.

Sigh.
 
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Thanks--I won't bother sending you the letter because as you point out, it was either obviously insufficient or wasn't considered adequately anyway. What's the point?

I did roll the dice and here I am. I will wait for the official letter spelling out exactly what I need and I will get it taken care of asap. I was told by the AME that I then mail in the results to the FAA and that they will issue the SI with any additional directions that may be needed.

I know from reading the boards that I should send it all in certified, return receipt requested. Dr. Bruce, when I get the initial letter from the FAA, I might PM you if I have any questions.

Thanks.
 
It's pretty safe to get the treadmill and the holter while you're waiting. They're in EVERY syncope evaluation..... :(
 
OP here--

I thought I'd post an update--I've got my medical! From initial deferral to this point has been approximately 1 month, which I think is pretty good. I thought I'd post my story since I don't think it's typical.

On Aug. 23 I got deferred by my AME, after he spoke with the Deputy RFS, who told him what tests I would have to get (EKG, Echo, Holter).

Couple days later I decided not to wait around for any FAA letter or anything. I called the Regional AMD, identified myself, and asked to confirm those were the tests I needed. She remembered the AME calling, and confirmed. She also said she could just keep everything right there in the regional office.

I spoke to my primary doc, and got referral to cardiologist and scrip for tests.

On Aug. 30, I saw cardio doc, who happened to be a pilot himself! He did a nice, thorough exam, and ordered those tests, plus a stress test (he said the FAA would want to see it).

I managed (through my own "affable persistence") to schedule all tests for that week. By the end of the week, I completed them. (holter was quite uncomfortable and I rocked the treadmill test!)

Waited one complete week for all results to be evaluated and reported by doc. In the meantime, I did more running around gathering up all records of the syncope from urgent care and primary doc and having them all faxed to cardio guy.

Cardio office calls and reports "minor abnormalities" with echo, nothing urgent, and gives me appt for over a week and half away because that's all they have and it's not considered urgent. Person on phone won't elaborate on what minor abnormalities mean. I call the next morning, say Listen, I'm training for a marathon, I need to know if I should be modifying my exercise, and lo and behold, I get an appt for first thing the following morning.

I see the doc, he explains the abnormalities (some minor thickening of something), no medication, no modifying anything is necessary, just that he'd like me come in to see him in a year. As far as he's concerned I'm cleared to train, to run, and to fly. I give him the contact info for the AMD and he says he'll have the office send everything in.

I call back a couple days later to see if it was done, and they tell me, yes, he faxed everything in (I hadn't even given him the fax number).

I call my contact at the AMD (I'm on a first name basis with her now). It is now late Friday afternoon, Sept. 17, and I actually get her on the phone. She says, Oh, good thing you called, it was on the wrong person's desk. She will take it and give it to the Deputy RFS to look at.

The following Monday afternoon, I call her again and she says, he didn't see it yet, he should the next morning. I say, great, I'll call back Tuesday. I go in fact call back midday on Tuesday and she says, that doc is actually out on training, let me give it to the RFS. I say, thanks, can I call back later today, and she says, sure how about around 4:30.

I call back around 4:30 and she says, hold on, let me transfer you to another phone, and I then find myself on the line with the RFS herself. She is not familiar with my case, and now has the file in front of her. She asks me to go through the whole episode, telling her exactly what happened along the way. She asks a bunch of questions, teases out a lot of details. Then she looks through all the paperwork, files, and records that are in front of her. She is satisfied and says, I'm gonna certify you for a year. Just have a letter from your primary doc when you renew saying all is OK. She puts me back on the line with the other woman who tells me it'll go out in the mail.

On Thursday, I call her again, asking Did it go out in the mail? She answers, I'll put it out in today's mail.

As of this moment, I have not actually officially received it yet, but I know it's been processed because it now appears on my FAA database listing, with the updated SI and new date information. I'm hoping it is in Monday's mail.

I thought it was very interesting that 1) I never had to deal with OKC at all, and 2) I dealt directly with the RFS.

I'm assuming it was my combination of persistence, being proactive, and yet always polite and friendly that let me solve this problem in only one month.

Can't wait to fly!!!!
 
Wow, that's a great example of polite persistence winning out. And, getting in touch w/ the RFS directly w/out going thru OKC was definately a bonus a I imagine had it gone to OKC it might have been 6 weeks before you even heard the first round of "we need more ......"
Congratulations!
 
Unregistered said:
I'm assuming it was my combination of persistence, being proactive, and yet always polite and friendly that let me solve this problem in only one month.

Can't wait to fly!!!!
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Bingo, plus being willing to go out and find what they required and procure that for them. Congrats!
 
Dr. Bruce, is it at all common for an airman to talk directly with the RFS? I was pretty taken aback.
 
bbchien said:
Nope. It's distinctly uncommon.
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But it sure made it easier for me when getting my initial SI last year. Call, confirm exactly what they want and make sure they get it. 8 days from mailing paper to receiving medical and SI. NW Region rocks.
 
OP here.

I thought I'd resurrect this thread.

I went in today on about the 1 year anniversary of my getting deferred to renew my medical.

According to the SI letter I got from the RFS a year ago, I had my primary doc write a letter to my AME providing a list of required information. Taking no chances, I mailed a copy of this letter with a copy of the SI letter to my AME a week before my appointment, so that he could look at it at his leisure and make sure that nothing was missing and there were no surprises.

Today's exam was a big yawn. I am good for another year.
 
Thanks for resurecting this thread. I read and learn, hopefully I won't need this information for years and years. I do have one 75+ yr old tow pilot that does through the SI process every year. It keeps him flying power and forces him to see his heart doc every year for a check up. About 10 yrs ago he had his chest cracked for bypass. Never had a heart attack.
 
Unregistered said:
OP here--



Cardio office calls and reports "minor abnormalities" with echo, nothing urgent, and gives me appt for over a week and half away because that's all they have and it's not considered urgent.

I see the doc, he explains the abnormalities (some minor thickening of something), no medication, no modifying anything is necessary, just that he'd like me come in to see him in a year. As far as he's concerned I'm cleared to train, to run, and to fly. I give him the contact info for the AMD and he says he'll have the office send everything in.
Click to expand...
Most likely there was some mild thickening of the left ventricular wall (muscle). This is very common in highly trained athletes. If the wall thickness is beyond a certain limit it can be difficult to differentiate an athletic heart from hypertrophic cardiomyopathy (abnormal heart muscle). The simplest test is to have the athlete stop training and become a couch potato for a couple of months and repeat the test. The wall thickness will decrease in the athlete's heart but not for hypertrophic cardiomyopathy. Fortunately this was not necessary in your case.
 
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