Frustrated

Discussion in 'Medical Topics' started by Kenny Lee, Dec 5, 2018 at 7:46 AM.

  1. Kenny Lee

    Kenny Lee Filing Flight Plan

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    Reluctant to toss all this out here in a forum, but, here goes.

    I'm 61 y/o and am 10 hours into getting my PPL. I consider myself relatively healthy although I am Type 2 diabetic, I smoke, & my exercise consists of walking to the truck from the office or house. I did have a Melanoma removed off my left thigh about a year ago. I take cholesterol meds to keep it in check. I control diabetes with meds, and I'm not on insulin. I take Blood Pressure medication for preventive reasons. My blood pressure has always been great.

    Today is 12-5-18. I submitted an application to MedXpress on 10-8-18. I made an appointment soon after with my AME. 2 weeks later I think. The AME seemed really knowledgeable, cordial, helpful and things went as I expected. He told me mine would have to be a special issuance through FAA but he felt I would get my medical. Just that it would take time. He gave me some forms to have filled out by my Oncologist (Vanderbilt hospital in Nashvville), by my Primary Care Clinic, and my eye doctor. I've never had a problem with my eyes, but evidently Melanoma can move into the eyes, and my oncologist recommended I get annual eye exams. So I head home and start trying to get these forms filled out. I knew Doctors don't get paid for filling out forms, so I knew it would be a pain. Took a month. After getting the required forms, I called to set up an appointment with my AME. Took 2 weeks to get in.11-7-18. It's a 2 hour drive by the way. (one way). Visit was short and sweet and he started the process and told me not to expect to hear anything back until after the first of the year. He did warn me he expected them to require a MRI brain scan because of the Melanoma. They want to make sure I don't have cancer in the brain. Below is what my Oncologist explained to me at the time of the surgery:

    The Melanoma was on my left thigh. Right before the surgery they inject some sort of die or fluid to "map" my lymphoid system. They chose two lymphoids in the groin area to remove during the surgery. If the lymphoids were clear it was a 99.9% chance the cancer hasn't migrated to other parts of my body. If they weren't clear, they'd need to do more tests. They came back 100% clear and she assured me I'm cancer free.

    I received a letter from FAA yesterday 12-4 that was dated 11-27. They give me 60 days to reply or they will either refer my case for legal enforcement action or deny my application. Well 7 days has gone by since they wrote the letter. So, I suppose I need to hurry.

    They are insisting on a brain scan. My oncologist didn't see the need for one, why would they? Do I argue or give them what they ask for?

    They are also insisting on a stress test due to my coronary artery disease. HUH? Not sure how they decide I have coronary artery disease?

    I'm not even sure if the FAA has had a chance to review the papers and reports my AME sent them 11-7. I think my first step is to contact my AME again, as they copied him on this letter. If they are trying to get me to give up on this medical, they don't know me very well. I won't quit. But, it sure is frustrating.
     
  2. PaulS

    PaulS Final Approach

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    Sounds like you didn't know this when you applied for your medical, but you are a classic case of someone who should go in for a consult before submitting to the actual FAA medical exam. This would have allowed you to get all this stuff done before the exam and possibly have your medical sooner. You are dealing with a big bureaucracy, it's nothing personal, don't get paranoid, just give them what they need to approve you. We have a couple great AMEs on the forum who hopefully will comment, but you should contact your AME immediately, sounds like the guy knows what he is doing.
     
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  3. Kenny Phillips

    Kenny Phillips Line Up and Wait

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    You can't argue with the FAA, no sense trying. I'm your age, never smoked, walk a bit, no issues other than typical aches and pains, no meds, and I consider myself relatively healthy. I guess it depends on what you relate it to.
     
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  4. lbfjrmd

    lbfjrmd Pre-takeoff checklist

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    You are actually in a good position! Provide that which the FAA is requesting. You are not wasting time trying to divine the machinations of the FAA. I am a fan of pre exam consults with the AME usually only for drug, alcohol and mental health cases. Sounds to me you have a good AME!
     
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  5. PaulS

    PaulS Final Approach

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    This is one of the great AMEs to whom I was referring.
     
    Last edited: Dec 6, 2018 at 6:24 AM
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  6. Kenny Lee

    Kenny Lee Filing Flight Plan

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    thanks for the feedback guys!. I think/thought I'd work through this. It sure can be frustrating though.
     
  7. WannFly

    WannFly En-Route

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    Do what FAA says and save your frustration for important things in life like... how do I stop ballooning and such
     
  8. Aviator305

    Aviator305 Filing Flight Plan

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    I am going to say this even though I am afraid that it will come off as abrasive or mean or unsolicited advice, and I will go ahead and do so because it drives me a bit up the wall when patients’ self-assessment of their health is way out of alignment with reality. Diabetes by itself puts you in the same risk category as someone that has already had a heart attack right off the bat (reference Framingham risk score). On top of that, you choose to smoke. You have high cholesterol. Your blood pressure situation as you describe it is not clear, but prescribing blood pressure medications for preventive reasons is not common practice, so I suspect that you have hypertension that is under control with medication (if you need medications to keep you blood pressure normal, you still have hypertension). At any rate, you are the classic case of a person who should be scrutinized more carefully as you have every single risk factor for a heart attack. You may feel good, but you are not what I would describe as a healthy 61 year old. I have seen 61 year-olds that have great looking coronaries, and I have seen 45 year olds that are a hot mess full of plaques - usually diabetics. A lot of what you describe can be managed to some degree with meds, but there is no substitute for lifestyle changes, and for the love of everything please stop smoking. -a flying doctor that cares

    PS Getting a stress test is not a crazy thing to do at all given your risk factors. You seem to be taken care of by people that care.
     
    Last edited: Dec 5, 2018 at 6:48 PM
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  9. bbchien

    bbchien Touchdown! Greaser!

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    You cannot argue with the crown.

    You melanoma was either Clarke level 6 or had penetrated you beyond 0.75 mm below the “basement “ membrane. FAA has their own experts who disagree with yours. So you can have a fit or jyst comply.

    Your choice: there is no other. Dr. Lou an I differ in how we “operate” insofar as responses from the agency are taking soo very long that my approach has been to get all of which we know to be necessaty BEFORE the flight physical. Then it’s only ONE round of waiting.

    CAD and stress: There must have been a comment in the notes to give you the dx of probable CAD. You sure have the risk factors ( and need to STOP Smokimg). You should have ithe treadmill done anyway! Know that for a 61 year old they expect you to go 9 minutes and get your heart rate up to 144 at the peak (“but i found THIS on the internet...”). Any other number you may cite from the internet is the “mandatory denial” cutoff and you don’t want to be there....(!)

    Oh well what’s done is done. Get the MRI. Do the treadmill. Fly.
     
    Last edited: Dec 5, 2018 at 11:51 PM
  10. vman

    vman Pre-takeoff checklist

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    i took that treadmill test recently for the first time, haven't done much cardio in ages & 59, it was ugly,

    wife did it awhile ago & couldn't finish,

    i'd sort out the medical before continuing lessons
     
  11. Kenny Lee

    Kenny Lee Filing Flight Plan

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    You’re wrong about that part. I can do both. I threw a fit, but it only lasted a few hours. Now I am in the process of complying. Really no other choice, if I intend to fly.
     
  12. Rushie

    Rushie Pattern Altitude

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    Many of us, including myself, threw fits at first when discovering that the FAA has no interest in the preponderance of one's own trusted doctors' conclusions, and instead exists in totalitarian rectitude, unilaterally holding anyone who wants to fly hostage to its whims. It goes against our understanding of this country's unique concept of unfettered liberty. Then we remember that it is only a concept after all, and not perfectly realized, only partly so, but still, in the U.S. better than ever before in the history of man. ("You think this is bad, just try to fly in Europe, or China, blah blah blah"). At least now we have BasicMed, a rare step back indeed, toward a nostalgic time when anyone could climb into a machine and kill themselves.
     
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  13. gdwindowpane

    gdwindowpane Pre-takeoff checklist

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    Any OSA issues? That will add some reports/time to the equation.
     
  14. Kenny Lee

    Kenny Lee Filing Flight Plan

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    Nope. I am in good shape there
     
  15. murphey

    murphey Final Approach

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    My doctor asked if I'd ever taken the stress test. I reminded him I teach college computer science - every day is a stress test.