Heart Attack - What's Next?

I am not familiar with many (if any) "private physicians" who are able to reliably determine whether a pilot has a medical deficiency that would interfere with the safe performance of sport piloting duties.
The doc doesn't make the decision, the pilot does and is held resposible for it. Again, but only the salient points:
"If I suspect I have a significant medical condition...

Response by the Federal Air Surgeon

Long-standing FAA regulation, 61.53, prohibits all pilots... from exercising privileges during periods of medical deficiency.

You should consult your private physician to determine whether you have a medical deficiency that would interfere with the safe performance of sport piloting duties.​
The mere suspicion of a medical deficiency is enough to hang a pilot unless, after consulting with a doctor, there either is 1) no "medical deficiency" or 2) a minor one that doesn't interfere with sport flying. How minor? "Can you still drive a car safely?" comes to my mind. I wouldn't try it with my leg in a plaster cast.

dtuuri
 
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Your phrase, "a minor one that doesn't interfere with sport flying" is not what the FAA stated. The FAA stated that the exercise of flight privileges is prohibited when medical deficiency would interfere with safe performance of sport pilot duties.

Regarding your example, sure, a person with a plaster cast on his leg can't fly a plane safely. OK. Its easy to be certain about some conditions, I already stated that.

Here is the rub, and I don't see how consulting a personal physician will help - a substantial proportion of adults have one or more chronic conditions. Can a diabetic (insulin dependent or non-insulin dependent) safely drive a car (your criterion)? Many do. Can a person with peripheral neuropathy safely drive a car? Many do. Can a person with monocular vision safety drive a car? Many do. Can a person with chronic bronchitis safety drive a car? Many do. Can those persons safely perform sport pilot duties? Does your personal doctor actually know?

What are the criteria to decide whether an illness prevents a pilot from flying in a safe manner? Is your personal doctor trained to apply those criteria? I bet not, since mostly, such criteria do not exist.
 
What are the criteria to decide whether an illness prevents a pilot from flying in a safe manner?
I'm pretty sure it's a driver's license. Wasn't that the whole point of it?

Is your personal doctor trained to apply those criteria? I bet not, since mostly, such criteria do not exist.
I should hope so, since nearly everybody drives a car.

Here's the "rub" as I see it: We can't predict how the Flight Surgeon will treat our individual cases, so we never know whether or not our medical deficiency would prevent us from flying under an SI if we applied. Rather than take the risk, the FAA has given sport pilots a safe harbor by punting the decision to the individual pilot. But prudence dictates any suspected medical condition be blessed by a doctor in the setting of sport piloting to comply with 61.53(b).

dtuuri
 
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Hoping so does not make it so. Unless he or she is quite extraordinary, your personal doctor is not qualified to provide consultation about the effects of any of the conditions I named in my posts above on a sport pilot's ability to fly in a safe manner. I believe this because, for most chronic conditions (and many acute conditions), no data exist to support decisions either way.

Also, in what way is the blessing of a doctor obtained? How does the pilot even know what kind of doctor to ask? What if the doctor doesn't know the answer? Does the pilot have to keep looking for doctors until one is found who does know? Does the blessing have to be put in writing?
 
Hoping so does not make it so. Unless he or she is quite extraordinary, your personal doctor is not qualified to provide consultation about the effects of any of the conditions I named in my posts above on a sport pilot's ability to fly in a safe manner. I believe this because, for most chronic conditions (and many acute conditions), no data exist to support decisions either way.

Also, in what way is the blessing of a doctor obtained? How does the pilot even know what kind of doctor to ask? What if the doctor doesn't know the answer? Does the pilot have to keep looking for doctors until one is found who does know? Does the blessing have to be put in writing?
The rules place responsibility on the pilot, right? Pilot's aren't able to define a medical deficiency, so they need to consult a doctor before they decide what to do. If a doctor refers to a specialist--go there. Why is this a problem? If your medical record reflects that you operated an aircraft against your doctor's advice you are illegal and all that goes with it.

Personally, I like the freedom to make these decisions after weighing the evidence, don't you? Certain medications might be considered safe for sport pilots, but not allowed for others, something many doctors would agree with, I'm sure.

dtuuri
 
"Why is this a problem?"

Because if the doctor is honest, he/she will have to say "I don't know" in response to most medical deficiencies and their effect on the ability to fly in a safe manner.

Not sure why you think doctors would agree on these questions. Doctors have no training to make such assessments.

Yes, I very much like the freedom. All I'm saying is that it is not dependent on the blessing of a doctor.
 
News Flash- We are all slowly dying. Your doctor has no real ability (short of a few diseases) to predict your possible incapacitation or imminent death. Even with a class three medical a lot can change in 2 years. I would guess most doctors have no understanding of what it takes to be able to fly or not.

Conveniently the FAA has said a valid drivers license is enough so if you really want your doctor's approval (they recommend you do get that but as stated it is "should" not "must") it would seem to me simply asking them if you are OK to drive should be enough. Then the rest is up to self certification. Do you think you can safely fly the plane today. If yes then have at it.

Why make it harder than it is?
 
Thanks for the responses.

Light Sport is not going to work. You guys can continue arguing about it all you like, but it's useless for me. Won't get into that discussion at all.

The couple of germane pointers were very much appreciated. I am gathering things I have now and setting up appointments for follow up tests at the 90 day point. I have found the doc I'll be working with and was very pleased with my initial interaction.

I'll post here when all is done 3-4 months down the line.

-Saro
 
That's good to hear. My heart issue is different than yours but I get by just fine. I hope you can report the same after a couple of years. Best wishes for good health and a successful return to flying.
 
Thanks for the responses.

Light Sport is not going to work. You guys can continue arguing about it all you like, but it's useless for me. Won't get into that discussion at all.

The couple of germane pointers were very much appreciated. I am gathering things I have now and setting up appointments for follow up tests at the 90 day point. I have found the doc I'll be working with and was very pleased with my initial interaction.

I'll post here when all is done 3-4 months down the line.

-Saro
I hope you mean you've "interacted" with an excellent cardio doctor and he is running the tests necessary to ascertain the total condition of your heart. This would include but not be limited to , a stress test, catherization to look at your heart with dye in it, echocardiogram, etc. I've been thru all this and was fortunate to have an excellent specialist from hopkins watch over me. First things first.
 
Just wanted to close this loop.

I got my SI a few weeks back. It was a bit of an annoyance to do - and it ruined my plans to attend Airventure but my situation is heading in the right direction.

Was nice to be PIC again. Now I gotta finish the panel upgrade on my VariEze...

Thanks to all who contributed thoughtful responses.

-Saro
 
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Glad you got out the other side, but hoping even more that you've dealt with the underlying cardiovascular issues. If not you can gleefully look forward to more of the same. Good luck.
 
Health is more important than flying. But glad you got both right now. Keep up with the healthy living.

A few years ago a friend of mine ignored warning signs.

Dead at 31.
 
Thanks for the responses.

Light Sport is not going to work. You guys can continue arguing about it all you like, but it's useless for me. Won't get into that discussion at all.

The couple of germane pointers were very much appreciated. I am gathering things I have now and setting up appointments for follow up tests at the 90 day point. I have found the doc I'll be working with and was very pleased with my initial interaction.

I'll post here when all is done 3-4 months down the line.

-Saro

Yea.. that turned into one giant turd salad there didn't it.

So here's some non-binding medical non-advice. Its worth what you paid for it.

You've been told your cardiac enzymes were elevated. Most likely, somewhere, a blood vessel is blocked. There may be several, but one of them is to the point it caused you a problem or symptoms.

You should be seeing a cardiologist. If you aren't, you need to be. You will likely undergo a cardiac catheterization to look for a culprit artery that caused the problem.

You will likely undergo an echocardiogram to evaluate the heart's pumping function and valve function. A key number here to know is the Ejection Fraction, or EF. Its a percentage. >50% is great/Normal. <35% not good and <20% is pretty damn bad.

There are other tests that may or may not be done, but these first two will guide the decision-making for the others.

Depending on those findings, your cardiologist may recommend anything from medical management to stents to bypass surgery. Things that impact the decision is the number and size of blocked vessels, and how the pumping function of the heart is affected. The heart will "remodel" itself over the next 6 or so weeks to account for the infarcted tissue (a scar forms).

Where you are when this 6 week period is over will give you a better idea of your flying prospects for the future. Things such as what your EF is after natural remodeling or stenting or surgery, the presence or absence of symptoms will be important factors. If your cardiologist has recommended you wear a wearable defibrillator, or have one implanted, you should consider that the time to hang up your spurs.

One bit of medical advice. If you DO have a stenting procedure done and your cardiologist places you on an antiplatelet med like plavix or eliquis, you need to take it as prescribed, come hell or high water, for at least 6 months and do not stop taking it for any reason without the cardiologists knowledge and consent. If you are having side effects, talk with the doc, dont just unilaterally quit taking it. I've seen folks with in-stent restenosis after recent angioplasty who missed two doses in a row. When evaluating your hierarchy of needs for the first 6-12 months, your priorities are 1) Plavix/Eliquis and then 2) Food/Clothing/Shelter.
 
If you have read the link posted earlier I don't see how you can say that. Here it is verbatim, FWIW (my emphasis):

Sport Pilot Medical Certification Questions and Answers

If I suspect I have a significant medical condition, but have never had an FAA medical certificate denied, suspended, or revoked, can I exercise sport pilot privileges using my current and valid driver's license, if otherwise qualified?

Response by the Federal Air Surgeon
Long-standing FAA regulation, 61.53, prohibits all pilots--those who are required to hold airman medical certificates and those who are not--from exercising privileges during periods of medical deficiency. The FAA revised 61.53 to include under this prohibition sport pilots who use a current and valid U.S. driver's license as medical qualification. The prohibition is also added under 61.23 (c) (2) (iv) and 61.303 (b) (2) (4) for sport pilot operations.

You should consult your private physician to determine whether you have a medical deficiency that would interfere with the safe performance of sport piloting duties. Certain medical information that may be helpful for pilots can be found in our Pilot Safety Brochures.​
The standard the FAA would expect is pretty clear to me: Pilot's aren't qualified to self-diagnose suspicious medical conditions which might affect safe sport piloting duties. That may not be what some want to hear though.

dtuuri
That doesn't say what you think it says. Clearly, if you were responsible for the FAQ, you would have written, "No, Long-standing FAA regulation . . . " Other answers in the FAQ are written that directly, but this one isn't for a reason. Because the lawyer who wrote it knows that wouldn't be accurate. Suspecting you have a significant medical condition is not the same as knowing you have a medical deficiency that would interfere with safety of flight. Just a trivial example to prove the point, color blindness is disqualifying for a Third Class without jumping through some hoops. But you can still fly sport knowing you're color blind. Now, what's legal and what's a good idea may diverge in the woods, but that's a different issue.
 
That doesn't say what you think it says. ... Suspecting you have a significant medical condition is not the same as knowing you have a medical deficiency that would interfere with safety of flight.
Didn't I say that? That's why the FAA says you should consult your doctor when you suspect you might have such a condition--to find out for sure.

Just a trivial example to prove the point, color blindness is disqualifying for a Third Class without jumping through some hoops. But you can still fly sport knowing you're color blind.
I'd say it differently, "You can still fly sport if your doctor says your color blindness isn't a medical deficiency that would interfere with the safe performance of sport piloting duties."

dtuuri
 
Didn't I say that? That's why the FAA says you should consult your doctor when you suspect you might have such a condition--to find out for sure.


I'd say it differently, "You can still fly sport if your doctor says your color blindness isn't a medical deficiency that would interfere with the safe performance of sport piloting duties."

dtuuri

According to the regulation, what matters is whether you, the pilot, "know or have reason to know of any medical condition" that would make you unable to operate in a safe manner. You can't simply avoid going to the doctor in the face of serious symptoms and then claim you didn't "know" you had a medical condition (because of the "reason to know" language). And what your doctor tells you obviously forms an important part of what you "know or have reason to know."

But it isn't a requirement to get the sign-off from your doctor to fly light sport. (The quoted FAA statement merely says that you "should" consult your doctor when you suspect a significant medical condition.) And it also isn't necessarily sufficient to get a sign-off from your doctor. (If you have uncontrolled epilepsy, and you find a doctor willing to tell you that you can safely fly an airplane, don't expect that to serve as a get-out-of-jail-free card with the FAA.)

As I see it, the sport pilot medical deficiency rules are all about common sense. If based upon what you know, there is a good chance that it is unsafe for you to fly, you can't fly. And if you have reason to suspect there is a problem, investigate to figure out if there actually is one or not.
 
Didn't I say that? That's why the FAA says you should consult your doctor when you suspect you might have such a condition--to find out for sure.


I'd say it differently, "You can still fly sport if your doctor says your color blindness isn't a medical deficiency that would interfere with the safe performance of sport piloting duties."

dtuuri
You are missing the point entirely. You can fly light sport with color blindness because it doesn't interfere with the safe performance of your piloting duties. It doesn't matter what a doctor thinks. That's the point of self certification. If you have a question about whether a particular medical condition would interfere with safe piloting, a doctor would be a logical person to ask. But there's no obligation to get his sign off on every condition you have. That's called a medical certificate.
 
You are missing the point entirely. You can fly light sport with color blindness because it doesn't interfere with the safe performance of your piloting duties.
I'd still say it differently, "You can fly light sport with color blindness because it doesn't interfere with the safe performance of your driving duties."
:)

dtuuri
 
so I wanted to bring this up as I had this talk with my Dr yesterday. 2 years ago, i had a heart attack and some stents, a defib was implanted at the time as a backup, fast forward to now, my BP is contolled 114/70 resting rate of 64 and topping out at 140 at peak on treadmill....i take meds to keep condition from worsening, I ask my Dr yesterday did he need to pull my DL because of my health, he said well no, ive told you to live a normal life all along, I then asked if I were fit to fly and his response was "I dont know and I cant answer that" I drive everyday about 100 miles roundtrip and drive 4 or more hours monthly. Do I question my ability to drive? No I dont because no one has told me different.......so do i seek further Drs advice or finish my sport pilot? asking from a legal standpoint if something ever happened.
 
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Not being a smart*#*^ but by definition isn’t anyone who goes basic med or LSA (because they think they can’t swing a class 3) in violation of the regulation. If you have a condition that would disqualify a pilot from a class 3 and that pilot goes to basic med/LSA, isn’t that pilot required to self ground for the same condition that forced him into basic med/LSA in the first place?
 
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Well I just read the entire conversation, this has already been answered. But I still think class 3 should go away. If you can fly a Bristell or a VL3 you can probably make it in a 172…..
 
If you have a condition that would disqualify a pilot from a class 3 and that pilot goes to basic med/LSA, isn’t that pilot required to self ground for the same condition that forced him into basic med/LSA in the first place?

No. The aircraft you can fly are limited and have a minimal safety impact to the public. With a 3rd class, you can fly anything non commercially. At basicmed, you're limited to 6000', about the same as a heavy SUV (Escalade or Yukon Denali). For sport, you're limited to 1320 lbs. That difference warrants a lower standard.

There ARE things that you should look out for related to 61.53, but that is not the same as the standards for a 3rd class.
 
I don't think anyone here is advocating that. There's no way to read the Flight Surgeon's mind, so there's no way a pilot can know whether a given case qualifies for a SI until they apply. On the other hand, since the Flight Surgeon is out of the loop for sport pilots, the medical decision is left to the pilot's personal physician for sport aircraft--according to the FAA (see RMJ62's link). In my case, my cardiologist "cleared me" to resume flying, but that doesn't negate the need for the Flight Surgeon's approval if I want to fly anything other than SP.

dtuuri
That's not quite true, Dave. And you know that personally, dated July 16, 2020.
Bruce
 
That's not quite true, Dave. And you know that personally, dated July 16, 2020.
Bruce
Necro post. You're replying to a (almost) 7 year old post. I'm not interested in re-reading the thread, but the date you published w/r to me is the date of my SI for those curious as to its significance. I certainly was not using Sport Pilot to "hide" anything from the FAA (I wanted to go Basic Med), so I hope you aren't implying that—if you are, take it off line, please. You quoted my opinion that my cardiologist's "clearance" to fly, in and of itself, carried no weight. The Federal Air Surgeon needed to agree, which was my point. I don't see where I stated anything untrue.
 
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I don’t have airmen apply for denial. So in some instances it IS possible to know what the FAS is thinking......
 
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