Another medication and grounding question

[Unregistered]

Dr Bruce:

I am almost thru the second two years of a six year SI for glaucoma, and my optho has noticed more cupping in the right eye, and wants to change one of my medications from timolol to Xalatan. I am on a 6 week trial of Xalatan now. The following paragragh is from the SI letter from Silberman:

"You must promptly report any adverse changes in your medical condition to the AMCD at the above address. You are cautioned to abide by Title 14 of the CFR's, Section 61.53, relating to operations during the medical deficiency. Because of your glaucoma, opertion of aircraft is prohibited at any time new symptoms or adverse changes occur or if you experience side effects from, or require a change in medication."

While my optho doens't consider this to be an adverse symptom, she is being cautious and is changing my medication.

The letter says nothing of how long to self ground, or basically what to do. I fear this means I am grounded, and must do the whole SI dance again.

Help?

 

[Unregistered]

ooops, forgot Barb and our other resident AME docs. Sorry. :-(

I'd certainly appreciat advice from you all.

 

[bbchien]

I think they are pretty clear that they mean losses in your visual fields. Ask your optho to remeasure your Visual fields, and if they are fine, there has not been a change in your condition, only a change in how your condition is managed.

However, I would get a letter from you opthalmologist stating that there really has not been a change in your visual fields, that your are no stably on "this and such medication" and send it it. You'll get another abide by title 14 letter and you will have successfully reported it.

What they want to hear is that your are stable on a new regimen and have FULL VISUAL FIELDS still.

 

[gprellwitz]

Well, not one of the docs, but it's pretty clear that you're grounded.

Because of your glaucoma, opertion of aircraft is prohibited at any time [you] require a change in medication

The only argument you might have is that it didn't "require" a change in medication, and it's an argument you're almost sure to lose.

The question is, and it's a good one, is for how long? In other words, as you state, do you have to go through the whole SI dance again.

Edit: Well, it appears that Dr. Bruce and I disagree on this a little. He knows (a lot) more. Mine is the more conservative approach. It's your ticket on the line. I'd play it safe. Report it precisely as he suggests, but don't fly until you get the new title 14 letter.

 

[bbchien]

Well, not one of the docs, but it's pretty clear that you're grounded. The only argument you might have is that it didn't "require" a change in medication, and it's an argument you're almost sure to lose.

The question is, and it's a good one, is for how long? In other words, as you state, do you have to go through the whole SI dance again.

It would be safer if he self grounded due to the wording. However, were you in my office, I would simply take the letter, the electronic visual fiels, and the statement, and call them in to FAA.... and a telephonic authorization would be had.