BasicMed Class 3 SI - Medical Conditions

Discussion in 'Medical Topics' started by Chris Ward, Jul 10, 2018.

  1. Chris Ward

    Chris Ward Filing Flight Plan

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    First off, Hello! I'm new here so be gentle :)

    Since I was a kid I wanted to either be a pilot or be a train engineer. Neither happened, parents bought be a computer in the 80's and I became a computer guy.

    Fast forward to now being 45, I have type II diabetes controls by diet and oral medication (Last A1C was 6.2 in January) my regular doctor keeps an eye on it and my blood pressure which I'm on medication for that but last checked it was 105/68 which is on a regular basis at Publix. I do check my Blood Sugar just not like 4-5 times a day normally only if I feel it or after I eat something new that I don't know how my body will react. I've never had a low blood sugar normally it's about 100 after fasting and stays under 200. I'm 6'1" about 280lbs

    That all said I'm worried I won't get cleared to fly by the FAA and would like to do as much research up front and have as much paperwork done before I even see an AME and attempt this.

    I don't want to waste my time or the CFI's time or any money if it's just not in the cards for me.

    While I know this is not a place to get medical advice I'm looking more for maybe someone that was in my shoes and went through this and can tell me what kinds of tests and paperwork I can expect and timelines it will take if I can be cleared. So far I've been told to expect to wait up to 6 months.

    Oh and yes I have contacted Dr. Bruce through his website to see how he can help as well.
     
  2. Chris Ward

    Chris Ward Filing Flight Plan

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    Also forgot to mention if you want to remain anonymous I understand but would appreciate if you could still PM me. No I'm not with the FAA on a witch hunt looking for violators :)
     
  3. gdwindowpane

    gdwindowpane Pre-Flight

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    Dr. Bruce will certainly be your best resource. I can tell you that I have type II diabetes, high blood pressure and OSA, all controlled and I received my class 3 a few months ago. I have since gone BasicMed as there is much less reporting and physicals every 4 years. I did have to change my diabetes medication as the one I was currently taking was on the FAA do not allow list. Check your current meds against the list. When I switched I had to wait I believe 60 days (maybe 30) and get a statement from my PCP stating that diabetes still controlled and no side affects. Same thing with blood pressure, you'll probably need a statement from your PCP saying that everything is controlled, etc. Once again Dr. Bruce is the man and will tell you exactly what the statements need to say. No mention of you having OSA. I do know that if the AME determines that you are at risk of OSA based on BMI factors (neck size, weight, etc.) he can defer until you get a sleep study done. I was already diagnosed and was on a CPAP machine. So I had to get the FAA 12 months of data showing 6 hours/night sleep, airmen statement and statement from PCP.

    I think it is certainly doable. Might just take a while. I think mine took 9-10 months. However my information was "lost" within the FAA for quite a period of time but that's another story.

    Good luck and listen to Dr. Bruce. Not sure where you're located but if you are any where close to Illinois it might behoove you to hire Dr. Bruce as your AME.

    Chris
     
  4. Chris Ward

    Chris Ward Filing Flight Plan

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    That's for the response, I am in the Tampa, FL area. I have not be diagnosed with OSA and my PCP has never mentioned getting a sleep study done.
     
  5. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    That you have a good history of control of Type 2 Diabetes, especially that your A1C is documented under 6.5, you quite likely can qualify for CACI issuance, also known as "Conditions AME Can Issue". See this worksheet for additional info: https://www.faa.gov/about/office_or...es/aam/ame/guide/media/C-CACIPre-Diabetes.pdf

    So you will need to bring the AME a copy of the latest lab results (within past 90 days), and a status letter from your treating physician saying
    • that you have DM2,
    • are being treated by him with meds (name, dosage, frequency) and diet/exercise,
    • tolerate the meds well with no adverse side effects
    • Your last A1C was under 6.5% and your fasting blood sugar is less than 126 mg/dl
    • he examined you and found no diabetes related issues associated with
      • cardiac
      • peripheral nerves
      • ophthalmology (eyes)
      • nephrology (kidneys)

    The second item you mentioned you are concerned with is hypertension. But your numbers for that are okay. The CACI worksheet for that is https://www.faa.gov/about/office_or...es/aam/ame/guide/media/C-CACIHypertension.pdf

    Timeline wise, the right AME should be willing to do this as an "in office" issuance. But the key is doing a bit of homework to find the right AME.

    Therefore use the advice we give to lots of folks to visit with the AME as a consultation before a live exam happens. See https://tinyurl.com/ame-consult for a post on PoA on how to go about that.


    Based on what you shared, I think you have a really good chance of obtaining your medical.
     
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  6. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    BTW, the CACI program was designed as a means to prevent flooding FAA Medical with applications for Special Issuances when the airmen exhibit good control.

    If your condition was beyond CACI, but still within reason, then the Special Issuance would be submitted.

    Last we heard from Dr. Bruce, SI's are taking around 12 weeks to be reviewed and decided upon.

    So if you can keep your numbers within the CACI range, that is a very good thing.
     
  7. Chris Ward

    Chris Ward Filing Flight Plan

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    Wow thanks, Mike, I've probably watched 40hrs or Youtube training videos and have read hundreds of websites on all of these and was starting to bum myself out with the feeling that it might not be in the cards for me. I really like your answers and finding an AME that would give an "in office" issuance I never dreamed possible I will definitely be looking into this.

    Thanks for lifting my spirits up I'm so ready to get my learning on :)
     
  8. Chris Ward

    Chris Ward Filing Flight Plan

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    AggieMike88 just so I'm clear the two CACI forms those would be completed by the AME not my PCP and would just need documentation from my PCP to answers those questions on those forms which from looking at them I pass all those questions. My Last A1C was Jan so I'll need to get that done again.

    What all does the AME do, is there anything I need to have my PCP do first or do I need to get a vision test done?
     
  9. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    Correct.... the AME does those CACI forms, adds some additional details to his part of the FAA Form 8500-8.

    Your doctor will just write a letter on his letterhead including the things listed. And remind your doc to leave the medical thesaurus on the shelf and use language that a 5th grader can understand. And if you need a template to share with your doc, I can share mine.

    Speaking of FAA forms, if your doc isn't comfortable doing the eye exam, go see a local eye doc for a diabetic eye exam and have them fill out the FAA Form 8500-7, Record of Eye Evaluation.


    What the AME does is review your medical history and compare that to the standards put forth by the FAA.
    • He will have you pee in a cup to detect if any blood sugars are being excreted by your kidneys (a sign of pre- and existing diabetes)
      • But since you are a "known", you will have the documentation for how well in control you are.
    • He will check your blood pressure.
    • He will check your height/weight and figure out your BMI
      • If your BMI is a certain number or higher, he will discuss Obstructive Sleep Apnea with you.
    • He will conduct a vision exam, including looking at the chart down the hallway, small letters at normal reading distance, and color vision
      • If he uses the Ishihara dot plates, make sure this is done in natural sunlight, not bad fluorescent office lighting. The plates are geared for sunlight and bad office lights will work against you.
    • He will conduct a physical examination.
    • He will review any documentation and records you bring in that helps to explain items in your medical history.
    • He will make appropriate notations about his findings on his portion of the 8500-8 form
    • He will determine if you meet the standards to be issued in office, and if you do, print out your medical certificate before you leave.
      • or if something prevents that, defer your case to Oklahoma City for further review.
    • If your situation and medical history contains a major or significant item that disqualifies you from operating an airplane, he might deny you.

    The last bit of the second to last point is something you really want to avoid. And the last point you really, really want to avoid. Which is why we advocate the consultation visit as mentioned above.
     
  10. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    And on the paperwork you gather to bring with you, Put in the upper right hand corner of each and every page

    • Legal Name, surname first
    • Date of Birth.
    • And after you are issued your FAA numbers (such as pilot's license), add that too.

    Once the papers are at FAA central, they are scanned into their document system. With the identifying info on each page, it makes it simpler for them to keep everything in the right files.
     
  11. Chris Ward

    Chris Ward Filing Flight Plan

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    Awesome information Mike Thank You.

    For the part of doing a consultation visit with an AME, what am I'm looking for there and what questions might I ask. It sounds like I would be feeling him/her out on if they feel they would issue an "in office" class 3 or if they would differ.
     
  12. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    From our conversation, I think you said you needed more recent blood lab work. So might as well go ahead and do the "routine physical" thing with your primary doc and get him to write the status letter and provide copies of the lab results.

    Fill out the online MedXpress form, save it to your hard drive as a .pdf file, and print it out. But as directed in the ame-consult post, cut off the confirmation number that prints at the bottom of the form. Put that in your wallet.

    Then schedule the consultation visit with the AME. Make sure the office minion knows this is a consultation for third class medical and not a "live exam" for a third class medical. If the minion says "doctor don't play that", then you got your answer that particular AME isn't the guy you want.

    Once you're at your consultation visit, do not hand over the confirmation number. Do hand over copies of the 8500-8 form, your labs, and doctor letter. But don't surrender the confirmation number until the AME says all is good and you can be issued before you leave.
     
  13. Chris Ward

    Chris Ward Filing Flight Plan

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    So this "consultation" should I be expecting to pay if he/she says there are problems? But if he/she you look good then I hand over my number and throw cash at him/her for their time? "consultation" to me I was assuming free, but I think I follow you too far. Basically, don't give up my number unless they are giving me the green light so that they can't submit a deny or defer to the FAA.

    And yes my last A1C was from Jan 2018 so I'll need another that's not over 90 days old so yea I can have the PCP do as much as I can that way my insurance pays for that anyways.
     
  14. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    And I'll leave this here....

    Definition of a Good AME:
    • Is a pilot himself
    • Isn't an AME just because it sounds cool to have the additional accreditation on his shingle.
    • Is a Senior AME (with a closet full of BTDT T-shirts) who will be a true advocate for his airmen.
    • Has the OKC Offices on speed dial
    • Knows the all of the Senior examiners (the 5 or 6 top reviewing doctors) by first name.
    • Prefers to take charge and issue the more challenging certificates "in office" rather than defer and let someone else "deal with it".
    • Is not afraid to use said speed dial to reach out to said senior examiner to discuss your case and possibly obtain permission to complete the said "in office" issuance.
    • If you have to be deferred, will remain on the case and follow up with you and OKC until you do receive your medical certificate.
     
  15. Chris Ward

    Chris Ward Filing Flight Plan

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    Next time you are in the Tampa Area I owe you a lunch/dinner. Thanks for your help.
     
  16. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    Yes. Do pay for the doctors time.

    Even if the consultation result is, "Well, you're close, but I cannot issue due to x and y and z",
    • then find out what you need to go get,
    • what it needs to say (in plain language),
    • verify that if you bring those items he will issue,
    • thank the doc for his time,
    • pay the bill, and
    • get busy getting those items.

    If the consultation result is, "You're good to go, we can do this now if you want"
    • Then surrender the confirmation number so he can "open the file"
    • Let him enter the things he needs to enter to successfully issue your certificate
    • pay the bill, and
    • try not to grin too much as you happy dance your way to the parking lot.
     
  17. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    Happy to do this.

    And I will definitely take you up on your offer. Especially if I do the Sun-n-Fun event in Lakeland next year.
     
  18. flyingron

    flyingron Touchdown! Greaser!

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    I have an AME who isn't a pilot. In fact, I believe he can't even hold a medical himself. He's still pretty good.
     
  19. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    Since you're entering things into the online MedXpress, something else to park in your brain....

    If you make a mistake after saving, or discover you left something out, you are not allowed to make changes once you've "locked in your answers". This is by design to follow some FAA rule. You can only have one form active at a time per individual email.

    But all is not lost.

    Create another email account on a free service like Yahoo, or GMail. Re do the MedXpress with that new email address.

    Any MedXpress that is not opened by an AME with the confirmation will vanish after 60 days. And because it was not opened, there is no jeopardy or "coming back to haunt" you.
     
  20. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    You've said that before on the Red Board....

    But you also know that list is something Bruce has often said and I was just one of the folks that wrote it down. And Bruce made a sticky post about it on the Red Board :thumbsup::thumbsup::thumbsup:
     
  21. LoneAspen

    LoneAspen Line Up and Wait

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    I can't speak for anything diabetes related, but I have two conditions of my own I had to jump through some hoops for - glaucoma in one eye, and OSA/CPAP. I saw the appropriate specialists for those things, and engaged Dr Bruce as my AME, made sure he had all the necessary paperwork and reports, flew to Illinois for the exam in person, and walked out with my third class medical.

    To me, it was worth the additional time and money to let Dr Bruce handle it, fly to him for the exam, and walk out with the piece of paper. Compared to how much AMU I'll spend for training and plane rentals, the extra cost of doing this to get my third class medical was a drop in the bucket.
     
  22. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    @Chris Ward ... what @LoneAspen describes is why we hold Dr. Bruce in such high respect.

    Plus he is one of the few that use the practice of "review the case first" before opening the MedXpress files. So if he finds the landmine, he can advise how to disarm it, if it can be disarmed.

    To many of the other AME's in the land rather open the MedXpress file, tell you to cover your eyes, start walking, and good luck not blowing your leg off.
     
  23. Rushie

    Rushie Cleared for Takeoff

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    Yes and very good analogy. OP, it sounds like you've done your homework but in case you missed it, these major land mines might be if you were given an ADHD med as a kid - this particular one is very common - if you were diagnosed or treated for any other psychological disorder (except marriage counseling), if you have ever had a DUI or any other drug or alcohol violation. These are the most common issues from the past that trip people up; you can read all their threads on this forum. If DM2 is your only issue you are in good shape.
     
  24. Chris Ward

    Chris Ward Filing Flight Plan

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    Thanks, everyone, as a kid I had asthma but that's it other than broken bones. Never had any regular medication until last year with the DM2 and High Blood pressure both under control with diet and meds now. This could also motivate me to shut my pie hole and get on a treadmill too haha.

    No consoling or ADHD meds or anything although after my divorce I probably could of used it.
     
  25. AggieMike88

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    Desire to fly "saved" my life.

    8 years ago, when the "want to fly" bug bit me, I went to a primary doc after not doing any physicals for more than 10 years or longer. I was already diagnosed with OSA and Dr. Bruce had already advised me of what I needed from the doc so I could get that SI.

    What I wasn't aware of is that all of my previous bad nutrition and lack of exercise habits had put me flat squat at the tail end of pre-diabetes and moving toward full blown like a runaway freight train. I think my blood work for that physical rang the A1C bell somewhere in the mid to high 9's.

    So I was put on oral meds, made right lifestyle changes, and went to my first AME exam with muuuuch lower A1C (6.8 I think). Back then, CACI didn't exist, so I had to do the SI route. But fortunately, Dr. Bruce's guidance and getting the sugars under control made that a non-event.


    But if I hadn't had the desire to fly, I might have never found out until DM2 did some serious damage to my systems.

    And I've seen the end result happen to a guy who used to work for my dad. He was a 30's-year old 6'3" guy who was very overweight and never paid attention to what he ate or need for exercise. Over the next 8 years, he first lost some toes, then had a cardiac requiring surgery, developed stage 2 kidney disease, had another cardiac event requiring major surgery, then lost his left leg above the knee due to another toe getting gangrenous, developed some eye issues, then had a final cardiac event that he didn't come back from. Left behind a young wife and 2 young kids. All because of a "it's all good and I'm fine, I don't need to change" attitude.


    So, yeah... good health before good flying helps to ensure there is more flying to be done.

    Plus, every 6 lbs you lose means another gallon of AvGas can be in the fuel tank when you're at max take off weight. And each gallon is more flight time.

    Shedding the weight and keeping it off will benefit you in many ways. So you had better be reading this post while you're clocking off your 22nd minute on the treadmill.
     
  26. rk911

    rk911 Pre-takeoff checklist

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    regarding your oral meds...FAA allows a max of 3 and they're divided up like a Chinese restaurant menu, columns A, B, C, etc. you can have 1 med from each group. check the list. good luck.
     
  27. Half Fast

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    Chris, if all this becomes too much of a PITA, don’t forget that you can earn a Sport Pilot certificate without a Class 3 medical. All you need is a driver’s license. I’m having a great time flying as a Sport Pilot.
     
  28. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    Fortunately, I don't think Chris' situation will be a PITA.

    Compared to some of the folk who wander into this sub-forum with alcohol or substance or DUI's, or SSRI, or depression or ADD/ADHD issues, his situation is pretty easy.
     
  29. Palmpilot

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    I paid Doctor Chien for a consultation which involved reviewing my medical record by email, and resulted in a "do not apply" recommendation. It was WELL worth the money, because it enabled me to enjoy two years of fun, flying light sport aircraft without fear of deferral (which would have had an iffy outcome). And when BasicMed went into effect, I was eligible for that as well.
     
  30. bbchien

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    Check your email: this is easier than you think. :)
     
  31. Chris Ward

    Chris Ward Filing Flight Plan

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    I thought I read somewhere on a Sport License when I considered you were limited to like 1 or 2 passengers which would be kind of a bummer. The Alt. restriction I didn't care about but the passenger one did. I'd probably at some point go for IFR rating as well just because it would allow me to fly more and also be able to handle more situations if the weather changed unexpectedly. Definitely not interested in for hire or commercial or anything. Twin or Jet engines would be cool but I don't think that would be a reality.
     
  32. Chris Ward

    Chris Ward Filing Flight Plan

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    Since I already had my regular blood work and PCP visit schedules August 13th that's my timeline to get as much upfront figuring out before I see my PCP and have documents for her to fill out before I schedule my AME. Also going to schedule an eye exam around then as well so that I have that all documented for the AME.
     
  33. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    Remember, 8500-7 to document the eye exam.
     
  34. Chris Ward

    Chris Ward Filing Flight Plan

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    Thanks so far I have the following to get filled out.

    FAA Form 8500-7
    C-CACI Hypertension
    C-CACI Pre-Diabetes
    FAA Form 8700-2
    Diabetes or Hyperglycemia on Oral Medications Status Report
     
  35. bbchien

    bbchien Touchdown! Greaser!

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    8700-2 you can only use aftter ypu get a third class. But per our email make SURE you get sleep apnea addressed BEFORE you go. You can’t just ignore that which is “wishful thinking”. You’re a large guy and the AME will screen you....
     
  36. Chris Ward

    Chris Ward Filing Flight Plan

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    Yup plan to talk to the PCP about sleep apnea to see what she says I need to do.