Blood Pressure

Terry

Terry

Line Up and Wait
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Terry
Hi all,

Feeling bad today and went and saw my doctor.

She put me on Hydrochlorothiazide @ 25mg and Lisinopril @ 10mg. Take both tablets once a day.

Also she has a MRI and CI scheduled for next Wednesday. (Mainly to rule out other things and make sure it is just high blood pressure. )

What do I need to do about notifying the FAA? Am I still able to fly or do I have to quit flying until I hear from the FAA?

Thanks,

Terry :frown2:
 
From a common-sense standpoint, you shouldn't act as PIC (which is not the same thing as not flying) until you've got yourself stabilized on your medications - this can take a few months. My wife got put on a similar regimen as you after HCTZ alone wasn't sufficient, and until they got the dosage right she was not her usual self.

Now, once you're stable, my opinion is that ethically you need to go through the process of renewing your medical certificate, which will include reporting all of this to the FAA, before you act as PIC again. I expect Dr. Bruce or one of the other AMEs will chime in and tell you what things you will want to have ready and done to take to your AME, or you can get in touch with EAA or AOPA for assistance too.

And I can't stress it enough, being medically prevented from acting as PIC is NOT the same thing as stopping flying. Just be sure to take a CFI or other pilot along to act as PIC, if you are in the "waiting for OKC" mode.
 
Terry said:
Hi all,

Feeling bad today and went and saw my doctor.

She put me on Hydrochlorothiazide @ 25mg and Lisinopril @ 10mg. Take both tablets once a day.

Also she has a MRI and CI scheduled for next Wednesday. (Mainly to rule out other things and make sure it is just high blood pressure. )

What do I need to do about notifying the FAA? Am I still able to fly or do I have to quit flying until I hear from the FAA?

Thanks,

Terry :frown2:
Click to expand...

You notify them on your next medical questionnaire.

Be patient enough to wait a week or so to let the Lisinopril do its job.. it takes a few days.. but other than that you do not need to ground yourself......
UNLESS you are having symptoms that would make you unsafe:
dizziness, vertigo, visual changes, significant headaches, etc..

Make sure you know how the hydrochlorothiazde (HCTZ) affects you before you start planning long trips (can make you have to pee A LOT, so you might need to plan ahead with regards to bladder endurance versus when you take your meds. Or get one of those nifty jugs for in flight use.

No added salt. Avoid salty foods like pickles (whole/spears), Olives, canned meats and soups, potato chips and the like.. If your doctor did not give you a list of things to stop eating or at least limit quantities of, check out the American Heart Association website.

Depending on your overall health, once you get cleared by your MD, some exercise and reasonable weight loss may reduce or eliminate the need for BP meds, but that needs to be monitored closely with active involvement of your doc. You very well may be on bp meds for life, but there is a reasonable chance you will not. Diet, exercise and medical surveillance MAY be the outcome.


If you are otherwise healthy and nothing else "shows up" you have very little to worry about. You may need a letter from your doc stating you are on x-y-z meds with good control of BP, no incapacitating side effects, blah blah (This is where Dr Bruce and other AME's get down to the details)





Hypertension (HTN) is the "silent killer" because it is pretty quiet about doing its dirty work and causing its problems (heart, kidney, eye, brain). Can cause things like an enlarged heart.. worsening of kidney function including the spilling of proteins (something that would show on your AME medical exam in the urine test).

I would have expected your practitioner to have drawn some blood, done an EKG and a chest Xray to evaluate the heart size and kidney function

I am curious just what they are doing a CT and MRI of (what body part).. If its not the head, I'd be very curious to know what they are looking for. Sounds like she is looking for signs of an old or not so old stroke (which can cause HTN as well as be caused by it).

Disclaimer: I'm a nurse, paramedic and pilot. If an AME tells you something different, chances are they are right.

Dave
 
You may find this helpful:

http://www.leftseat.com/medcat1.htm

Interesting to note what it says: "The FAA has not published an official list of approved drugs."

The LAST thing you want to do is let the FAA know -- they can know in due time. Make sure YOU are feeling OK and get smart on the medicines to insure that you wouldn't fly - PIC or otherwise - if there was a conflicting health issue ---- chances are that you probably feel better WITH the medication than without! NOW --- when it comes time to get your medical -- call the doctor well ahead of time (30 days at least) and find out exactly what s/he is going to want and then gather all of your paperwork. Right now, start keeping a blood pressure record and take it with you; also make sure your doctor monitors your blood pressure. BOTTOM LINE - you want to walk into your medical so that there can be absolutely no question, no doubt, that your blood pressure is under control. Let the FAA get 'hold of your record and take a look at it and your blood pressure will surely go up! You wil be GROUNDED for 3-6 months and they could care less while they make you provide all sort of records and documentation . . . This is clearly a situation where you need to take control of your own destiny long before the FAA even needs to know a thing about it.
 
I'm still going to say that once you know you have a medical condition that requires additional scrutiny from the FAA, you cannot ethically continue to act as PIC until you've completed that scrutiny.

What might happen if you have an incident or accident (even if unrelated to your condition) and have to go through the usual investigative process? Do you really want to sit there and say "Yes, I was taking these medications, and I figured that the FAA could wait until my current medical ran out before letting an AME certify me for flight and notifying the FAA."?

We get a lot of latitude to self-certify ourselves in between AME visits. Getting diagnosed with a condition we know the FAA looks at closely and self-certifying that it's "ok" is abusing that trust, in my opinion.

Doing it "my" way means that you may not be able to act as PIC for a period of time, but once you're through the process you'll be good to go, both with a clear conscience and an expectation of continued exercise of the privileges. If the FAA feels that you deliberately withheld information, or used horrible judgment in self-certifying, then you could lose your PIC privileges by way of a suspension or revocation.
 
Last edited:
TMetzinger said:
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Doing it "my" way means that you may not be able to act as PIC for a period of time, but once you're through the process you'll be good to go, both with a clear conscience and an expectation of continued exercise of the privileges.
Click to expand...

Given the case at hand, a controlled blood pressure, absence of symptoms and a physician prepared to state that in writing meets my interpretation of "your" way.

How long that be may vary. It may be a week or it may be months, depending on what meds are required to obtain dependable control.

As someone else mentioned, logging your own blood pressure is a good way to document things (particularly if you take it first thing in the morning before you get up out of bed)


When I had my LASIK, I did heavy research not only into the procedure but into what the FAA required. End result? self grounding for 2 weeks, until after the second follow up, a letter in hand from the surgeon stating no persistent side effects, and a visual acuity that no longer required glasses. I submitted all this on my next medical visit to an AME, over a year later. He was unfamiliar with the requirements for LASIK and held my ticket for a day until he could make a phone call, then I was good to go - was a shall-issue situation.

I hope that nothing I've stated in a "reassuring" manner is interpreted to be "cavalier" instead.
 
I just went through this about 6 months ago. I am a student and didn't know any better than to just walk into the AME's office and say here I am. Come to find out I had high BP so no certificate. A month of taking Lisnopril and HCT got my BP down like it should be. A blood test, EKG, and note from my PCP to the AME and I was in good shape. I went to a senior AME and he reexamined me, called OKC told them what we where trying to do. OKC looked up my original results and said the if I had all the paperwork and tests that where needed and passed the rest of the physical the senior AME could give me my certificate.
Long story short if you stabilize and get the tests and documentation you need BP shouldn't be a major issue.
 
I will say that, assuming HBP is your only problem, your prognosis for continuing to fly is quite good. I have controlled HBP using two medications. I'm on my 3rd medical and no problems or delays.

Having said that, my blood pressure was controlled before I even started flying (no connection), I listed the meds on my application and I had the letter from by physician in hand before the exam. I think I had to have an EKG within some period of time after issuing the first medical, but I'm not sure about that.

I hope that's all you have to deal with and the other tests come out clean.

John
 
Hi All,

Took first dosage yesterday at 6 p.m. and at 10 pm BP was 112/65.

Took BP this morning, Friday at 5:45 am, and BP was 120/80.

Later on today the Doctor called me back and said ALL the blood work was great and I did not need to take the MRI unless I just wanted to. (My answer was no thanks.) The CT or I thought she said CI was for a tingling in my right arm. I carry a very heavy tool pouch with a shoulder strap, 54 pounds, and I changed to a lighter tool box a couple of days ago and the tingling has dramatically decreased. Will give it the weekend and then decide. She was thinking it may be a pinched nerve.

I am recording my blood pressure and will see the doctor in 30 days.

Thanks for all your help and advice.

I am not flying until I am sure ALL is okay or I have a CFI with me. I take long cross countries several times a year and would rather play TOTALLY by the rules and make sure all is okay and in order before going up again.

I have had a hard time keeping my IR current and may let it go "non current." I don't fly much IFR anyway and I am at the age where I need to slow down and enjoy the ride. (62) Anyway, even the astronauts only fly VFR. :D

Terry
 
All you will need is (but you need EACH item):
(1) Letter from your treating doc that your BP is under good control. This takes 2-3 weeks, and 3 nonsequential days' BP checks in your record.
(2) Letter states no side effects, mentions all meds and doses.
(3) Reasonable looking EKG
(4) Letter states that you have no overt coronary disease.

ANY AME can issue if you have these. This is AMEing 101.
 
Hi All,

The blood pressure came under control immediately after taking my medication.

Found blood pressure medications on the AOPA web site and they are "approved."

All is well.

Thanks everyone for your help.

Terry
 
Terry said:
Hi All,

The blood pressure came under control immediately after taking my medication.

Found blood pressure medications on the AOPA web site and they are "approved."

All is well.

Thanks everyone for your help.

Terry
Click to expand...
Do you have the items in my prior post?
 
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