Eosinophilic Esophagitis

[John Doe pilot]

Howdy all,
I am an aspiring career pilot. I have a CFI checkride coming up. I also have a first class medical which I received in 2020. Since then I have developed eosinophilic esophagitis, an allergic reaction characterized by difficulty swallowing. Such is the difficulty swallowing that I have had to receive emergency care due to food impaction in my lower esophagus. I.E. I couldn't swallow a single thing, not even my own saliva, due to a chunk of food being lodged in my lower esophagus. I could still breathe and speak just fine. I was initially prescribed prilosec, then budesonide (a steroid normally given to asthma patients but I was instructed to swallow the doses in a slurry of the medicine mixed with maple syrup to reduce swelling of my esophagus). I have had an upper endoscopy and a biopsy since my ER visits. This condition is caused by an allergic reaction to one of six food groups. I have since eliminated all of these foods from my diet. I plan to re-introduce them one at a time in order to hopefully determine which one is causing the issue. My symptoms are minimal and I feel the condition is managed. I have a GI who is willing to vouch for me if need be. I'm not terribly worried about disclosing my condition as it stands on my next medical, but I am worried that the two ER visits for emergency endoscopies could raise some eyebrows is Oklahoma City. I would appreciate any input on how best to proceed.
Cheers all and thanks,
John Doe

 

[bbchien]

Howdy all,
I am an aspiring career pilot. I have a CFI checkride coming up. I also have a first class medical which I received in 2020. Since then I have developed eosinophilic esophagitis, an allergic reaction characterized by difficulty swallowing. Such is the difficulty swallowing that I have had to receive emergency care due to food impaction in my lower esophagus. I.E. I couldn't swallow a single thing, not even my own saliva, due to a chunk of food being lodged in my lower esophagus. I could still breathe and speak just fine. I was initially prescribed prilosec, then budesonide (a steroid normally given to asthma patients but I was instructed to swallow the doses in a slurry of the medicine mixed with maple syrup to reduce swelling of my esophagus). I have had an upper endoscopy and a biopsy since my ER visits. This condition is caused by an allergic reaction to one of six food groups. I have since eliminated all of these foods from my diet. I plan to re-introduce them one at a time in order to hopefully determine which one is causing the issue. My symptoms are minimal and I feel the condition is managed. I have a GI who is willing to vouch for me if need be. I'm not terribly worried about disclosing my condition as it stands on my next medical, but I am worried that the two ER visits for emergency endoscopies could raise some eyebrows is Oklahoma City. I would appreciate any input on how best to proceed.
Cheers all and thanks,
John Doe

John Doe, a good AME would have to see the entire record. Sometimes this can be issued in the office, but sometimes not.....

 

[John Doe Pilot]

John Doe, a good AME would have to see the entire record. Sometimes this can be issued in the office, but sometimes not.....

Would this fall into the realm of a SODA? A SI? Or god forbid a denial?

 

[dbahn]

I'm sure Bruce will have a better spin on this, but it isn't applicable to a SODA (the condition isn't "static" if you can change it with diet), and a denial is unlikely at this stage, so I think you're dealing with either an outright approval or an SI. If you go to page nine of this document you might get some idea of precedent with this diagnosis, but there are a lot a variables that need to be known before predicting a possible outcome in your specific case.

 

[bbchien]

Thank you Dave, I was looking for that very cite.
What counts here is

“If the condition requires treatment, and
the “time-stability since obstruction…..”

but if he’s had obstruction it’s a special issue rather than a clear issuance” for sure…..

Again to John Doe, “it depends on the record….”

 

[John Doe Pilot]

I won't have a medical for another couple years most likely. And I believe I'm on track to have this totally solved by then. What should I have my doctors include in my records to increase my chances of easy success on my next medical?

 

[bbchien]

It depends on the record, John Doe.......

 

[dbahn]

You have to remember that "the record" could include anything that has ever been documented about your past health, and virtually anything in that record can leak out into what goes to the FAA. That's not to say that they can data mine your record, but when they want specific information they may ask you for your medical record documentation. See this link. Basically, the record is available to them unless you refuse to authorize its release, in which case they may just refuse to issue (or revoke) your certificate.

If they ask for a physician statement and you have a good working relationship with the physician, you may be able to help word the document in a favorable way. I think if that's the case you want to eliminate uncertainty and to the extent possible, present the information in a positive manner, addressing the specific FAA requests and avoiding unnecessary additional information.

 

[John Doe Pilot]

Lets say i show up to my next medical with all my records in hand. Can you offer any guidance on the verbiage contained in the records that would allow my AME to issue me a medical? Or would the hospitalizations cause it to get kicked up to the next level (a hellish prospect given what I've heard about the local office handling such things)

 

[AggieMike88]

Lets say i show up to my next medical with all my records in hand. Can you offer any guidance on the verbiage contained in the records that would allow my AME to issue me a medical? Or would the hospitalizations cause it to get kicked up to the next level (a hellish prospect given what I've heard about the local office handling such things)

Visit Doc Bruce’s how to start page and engage his services privately. Http://www.aeromedicaldoc.com/how-to-start.html

He lists a reasonable retainer to review your documents and is willing to act as “project leader” to get your application in order possibly of success is way higher than if you went somewhere else.