Documentation for Pituitary Tumor

whiskey4

Filing Flight Plan
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May 17, 2023
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whiskey4
I'm 44 and decided that this is a good time to learn how to fly since I've wanted to be a pilot since I was a kid. Done lots of reading, and it seems that getting the medical part out of the way is a good first step. Makes sense.

Where I'm stuck is figuring out the documentation needed for a pituitary tumor (prolactinoma) I was diagnosed with in 2017. Long story short - Testosterone was super low (50's, range 300-1080), had blood tests that showed super high prolactin (1900's, range 2-15), had an MRI, pituitary macroadenoma, went to a neurosurgeon, he said just treat with cabergoline, had a visual field test (normal), and saw an Endocronologist a few times. My testosterone was 50's range, and that seemed to be out of her expertise, so I went to a urologist. The urologist has manged my prolactin, testosterone, and all that since early 2018. MRI in 2021 showed the prolactinoma was continuing to decrease and everything's hunky dory on my blood work.

The FAA's guidance PDF (new account, can't link) on brain tumors has a special callout saying, "If tumor type is Acoustic neuroma or Pituitary Tumor - see the corresponding section." But that corresponding section is nowhere to be found. The acousitc neuroma has its own PDF, but no amount of Googling and searching the FAA's website brings up the pituitary tumor guide. And there's very few anecdotes here and elsewhere of people dealing with these things, but those folks seemed to have had surgery. I reached out to the regional flight surgeon's office and I'm told that "the specific information you are looking for is not yet available online", and no further explanation. What in the world? Is it classified? Some technical glitch? I'd really like to show up to the AME with all the documentation I need, but... Any educated guesses (or anyone that flew over a Holiday Inn Express even) on how this will go?
 
We have helped a few pilots with history of and/or current pituitary adenoma. The length and breadth of the plan is not something simply given in a forum post. You should engage with an AME experienced in complicated cases or use one of the consulting services like AMAS, Pilot Medical Solutions or Wingman Med.
 
I take care of a fellow for whom we had to obtain that SI. It is indeed a long list, but isn’t insurmountable.
 
I take care of a fellow for whom we had to obtain that SI. It is indeed a long list, but isn’t insurmountable.

Any idea why the requirements are such a closely guarded secret? They're rather detailed for "regular" brain tumors but not these. It seems so strange.
 
Any idea why the requirements are such a closely guarded secret? They're rather detailed for "regular" brain tumors but not these. It seems so strange.
It just takes a long time to type out in a phone. Am on vacay….

Current (<90 days prior to application):
Mri brain
Humphrey visual fields
FAA 8500-7 (Ophthal not Optom)
Endocrine OV and current lab (ACTH, TSH, prolactin
Entire endo record
…is pretty much minimum…..
 
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Any idea why the requirements are such a closely guarded secret? They're rather detailed for "regular" brain tumors but not these. It seems so strange.

It isn't a closely guarded secret. And there is no such thing as a "regular" brain tumor. But the AME Guide that the FAA puts out is for the most commonly encountered conditions. Anything not explicitly spelled out with requirements by the FAA says "submit all pertinent requirements." It takes someone who understands all aspects of the process to know what the pertinent requirements are. Pituitary tumors are not common.

Speaking only for Wingman Med, we will gladly answer questions here that we would be able to answer in our free consultation. We also will gladly link to articles we have already published on our blog or in Flying. But highly detailed plans are reserved for actual clients.
 
WingmanMed said:
Speaking only for Wingman Med, we will gladly answer questions here that we would be able to answer in our free consultation. We also will gladly link to articles we have already published on our blog or in Flying. But highly detailed plans are reserved for actual clients.
Also, happy to give generic advice here...but the concept is, "hire expertise, avoid frustration".....and months of delay cycles.

It think the fellows here who have gotten assitance would be happy, to describe how this works. Accurate advice that is going to work, really depends on reading the record and communicating with the endocrinologist.
 
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The email notification didn't have the requirements listed and I just happened to check back. Seems like thousands of dollars just to have a chance at starting flight school, which may or may not work out itself. So I'll probably look in to light sport training, if anything. Thanks for the info.

I can find the US Navy's waiver guide that has pretty good requirements for their aviators with prolactinomas. Still remains strange that the FAA just mentions that they have it but won't actually provide it. Oh well.
 
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