Important Medical Issues

pozitivehope

Filing Flight Plan
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Mar 17, 2014
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PozPilot
Hello everyone,

My name is Josh and I am currently in the process of obtaining my private pilots license. My goal is eventually to go all the way for ATP because becoming a pilot has been a life long dream of mine. I have a couple of medical issues however that are going to be an obstacle to get over and I wanted to get some professional opinions on how much of an issue each one will be.

1. First off - I am HIV Positive and was diagnosed after my ex girlfriend cheated on me. I have since started on treatment (Complera) and am under the impression that I will automatically be deferred by the AME and have to complete a series of steps to obtain a special issuance medical. I have been undetectable since the beginning of my diagnosis, have responded fantastic to treatment, have great white blood cell/liver counts, and have no adverse side effects from my treatment. I understand I will have to submit all my lab results and get new ones taken as well as completing a COG Screen test to prove that it doesn't effect me mentally ext.

- When I was first diagnosed with HIV it was a very tough moment at my life. I had gotten diagnosed with anxiety and depression however despite being prescribed the medicine, it never really worked for me, so I stopped taking it. I have since then (2 years ago) accepted my diagnosis, am a big time HIV Advocate and public speaker now, and have an extremely positive outlook on life, I was confusing a couple bad days with depression. I have spoken with the FAA and they said they can't tell me what I would have to submit until I actually go for the medical but going to a world renowned psychologist as well as my primary care doctor to "Undue" the diagnosis and state I am not experiencing either one, then that wouldn't hurt. Would this really help at all? I am not a depressed person but hope they can see that an HIV diagnosis at first can be very hard for someone, since then it has gotten much easier and I live life to the fullest.

2. My second issue is I have had ongoing issues with staph infection in my left leg. I had necrotizing fasciitis in Feb of 2010 and survived with all limbs in tact. A year later in 2011 I had a reoccurrence of staph due to stress from a relationship and had a surgeon that got a little scissor happy and ended up getting a second surgery. Well that second surgery screwed up my whole lymph system in my left leg and since 2011 have had multiple recurrences (not of ned fasc or MRSA however of reoccurring cellulitis). I usually was in the hospital a couple of days with antibiotics and it would clear right up, released. I haven't had a major flare up in almost 2 years thats why I am wanting to go for pilot now, because my leg doesn't seem to be presenting me any more problems. Will these issues I have had with my leg become an issue ?

- The last issue is the fact that due to the chronic swelling that caused extreme pain since all this happened, after many failed attempts through other routes to help my pain, he put me on narcotic medication (oxycontin) for the last 7 months or so. I obviously completely understand that being a pilot I will not be able to be on this medication and for very good understandable reasons. This last 7 months I went out on disability for a little bit (I have been a workaholic since I was 16, now I am 24) to give my leg time to really rest and guarantee i wouldn't have another flare up. It has worked fantastically and I have not had one flare up. I have already detoxed off the medicine and am currently in a 3 month waiting period before I can actually go and apply for the medical. My issue is the question that pertains to substance dependence/abuse. I was never abusing it, never experienced withdrawal, I did have to increase my doses a couple of times but not because of tolerance but due to pain increasing, and I had no negative side effects from the medicine either at work or in my personal life. It never affected me negatively and I was only using it to help the pain in my leg and so my leg could get better once and for all. I have since been off the medication and my doctor switched me to an FAA Approved medicine Naprosyn and it has worked well in maintaining my pain in my leg. Since I didn't have any of the symptoms of substance dependence or abuse as defined by the FAA, I would mark no for that question correct? I have copies of all my medical records from the past 4 years, so I don't want them to look at it and say well he was on oxycontin, I can understand the concern but I am no longer on it and won't be for when I go for the medical. I am maintaining my leg pain with naprosyn just fine now.

As you can see I have a couple of issues and hurdles to jump over. Mainly the ongoing cellulitis however the fact I haven't had a flare up in almost two years should work in my favor. I have consulted with several AME's and they said the cellulitis should not be an issue, what say you on all of this? I know I have a lot of hoops to jump through but this is my life long dream and HIV is not going to stop me. I want to show the world that no matter what condition someone has, they can reach their goals and dreams in life. I know aviation is all about safety and that is my upmost priority. I have started flight lessons and currently have 10 dual hours logged, I will be paying for some extra lessons due to the fact of the deferral however I don't have a choice in the matter. I understand that my HIV medicine Complera is FAA approved so the main thing will just be getting the cog screen, my numbers are superb. The leg issue is the main thing that will present me obstacles but how big of a deal do you think it will be? No flare ups within 2 years and haven't have nec fasc in over 4 years. I am currently doing very well on preventative antibiotics (Cefadroxil 1 G 1 x daily and Bactrim 800 x2 daily).

I appreciate your opinions and listening to this very long post, I know its a lot but I really just want to get some solid answers from everyone. Best of luck

Have a great day
Joshua
 
Also I don't know if it would help to get something from my doctor to show that my lymph system is still working how it should be and has since improved? From what the AME told me I need letters from both my primary care doctor and infectious disease specialist giving a brief history of the condition, a current status report, and future prognosis. Does this sound about right? Not sure if my doctor can do some kind of ultra sound or test on my leg to see that my leg is doing better or if it all goes based off of looking at it visually (no tenderness, pain, redness, heat, ext…) Hopefully even if it isn't necessary he can get that for me so the FAA can see I am going to be just fine. Whenever I fly with my instructor I have no problem handling the rudder peddles or completing any of the airmen functions. Thanks for the advice everyone
 
Dr. Bruce, aeromedicaldoc.com, is the person you want to talk to.

That plus 1,000

You're lucky about surviving the necrotising fasciitis. I had a bout in 2008 and they had given me 24 hours to live. Had an emergency surgery which took care of the issue, but it was a two week hospital stay. Please consult with Dr Bruce Chien. He is the guy to talk to with tough issues. Best wishes.
 
Josh, welcome to POA. Next thing I want to say is WOW! You sure have been through a lot at the Young age of 24. I can't tell you what is DQ or not with regard to your various Dx. It certainly does not sound like your use of oxy, was chemical dependence but rather medically supervised for pain management on a temporary basis.

I echo the recommendations to see Dr. Bruce especially is you want to get your ATP. There are others on this board who have fought past great obstacles to get their ticket, I'm sure they can give you some general advice.
 
Josh, Im sure Doc Bruce will take good care of you. I wish you good luck with all you do, your life trials to date sure are tough.
 
Josh, Dr. Bruce will tell you the straight up truth about your situation and if there is a way to make it work he will know it. Best of luck to you.
 
There's nowhere to go but Dr. Bruce on these issues. Posting in a forum such as this is a waste of time other than the referral to him. Good luck.
 
There's nowhere to go but Dr. Bruce on these issues. Posting in a forum such as this is a waste of time other than the referral to him. Good luck.

Agree with that. Armchair "docs" can give misleading advice. Go to the expert.
 
I appreciate all the help everyone however how would I go about going with him for my AME since he is in Illinois and I'm in California. Is it something I could ask him over the phone or pay a fee for him to review my records after I have everything ready to go ? Much appreciated. And thank you for the kind words, I know I have a big journey ahead of me , a long and difficult one, however , I am determined. I know it'll have to be a special issuance license which I am fine with, becoming an ATP and finding employment will be extremely difficult but I'm willing to take the gamble. These medical a are major steps to overcome first tho but I have two really good docs who are willing to write me letters stating how much I have improved. Some studies show that 70% of necrotizing fasciitis cases are fatal, I went into septic shock while in the hospital, it was terrible. Hospitalized prob close to 15 times for reocurring cellulitis and then some outpatient clinic stuff after :/ So ya I have been through a lot but it's all brought me to this point, everything happens for a reason, and I use my story and experiences to help others. And ya as far as the oxy it was for temporary medical use so I don't want to Mark yes because even my doctor says I was not dependent, I did use it daily, but because I was following my doctors instructions. Nothing I did was out of abuse and the use of it doesn't meet any of the substance dependence definitions put out by the faa so I guess my main two concerns will be my leg and the HIV. Hopefully Dr. Bruce will see this post if not I'll try giving him a ring
 
I appreciate all the help everyone however how would I go about going with him for my AME since he is in Illinois and I'm in California.

Hopefully Dr. Bruce will see this post if not I'll try giving him a ring

Dr. Bruce is no longer on POA, you can contact him directly. As for options, there are different things listed on his website; you can fly out there ($300 to secure a 1st class Med is cheap); OR he might refer you to a trusted doc in CA.
 
Yes, he does do consultation over the phone or by email. If he does do the actual exam, as pointed out, you'll have to go see him. 90% of what you will need will be tests that will be administered by someone who is NOT an AME. The key is to know WHAT tests to get done and how to submit them to the FAA in a way that is not going to be kicked back for further information or worse. If whatever AME you are using has NEVER handled an HIV+ applicant before, they should be highly suspect. As noted in the link to the FAA brief on the subject, there is extensive testing on just your HIV issues alone, let alone the complex issues that your other health problems involve.
 
Dr. Bruce is no longer on POA, you can contact him directly. As for options, there are different things listed on his website; you can fly out there ($300 to secure a 1st class Med is cheap); OR he might refer you to a trusted doc in CA.

And be willing to pay for a consultation.
 
I appreciate all the help everyone however how would I go about going with him for my AME since he is in Illinois and I'm in California. Is it something I could ask him over the phone or pay a fee for him to review my records after I have everything ready to go ? Much appreciated. And thank you for the kind words, I know I have a big journey ahead of me , a long and difficult one, however , I am determined. I know it'll have to be a special issuance license which I am fine with, becoming an ATP and finding employment will be extremely difficult but I'm willing to take the gamble. These medical a are major steps to overcome first tho but I have two really good docs who are willing to write me letters stating how much I have improved. Some studies show that 70% of necrotizing fasciitis cases are fatal, I went into septic shock while in the hospital, it was terrible. Hospitalized prob close to 15 times for reocurring cellulitis and then some outpatient clinic stuff after :/ So ya I have been through a lot but it's all brought me to this point, everything happens for a reason, and I use my story and experiences to help others. And ya as far as the oxy it was for temporary medical use so I don't want to Mark yes because even my doctor says I was not dependent, I did use it daily, but because I was following my doctors instructions. Nothing I did was out of abuse and the use of it doesn't meet any of the substance dependence definitions put out by the faa so I guess my main two concerns will be my leg and the HIV. Hopefully Dr. Bruce will see this post if not I'll try giving him a ring

I flew out there in October to get my first class after I screwed up my third class a couple years ago. I paid a small fee for him to deal with the paperwork remotely and then I paid his very reasonable fee for the medical itself. I was out and back in 1 day (I live in Phoenix) and it was 100% worth it. Your medical is your CAREER. Without it you have no career in the cockpit.
 
Hello everyone,

I just spoke with Dr. Bruce Chein and he gave me some excellent advice. I'll be flying out to Illinois to go for my medical in 3 months once the 90 days has been completed off the pain meds and I have gotten all correct medical ppw.

Thanks a bunch

-Josh
 
You're well on your way to a flying career now Josh. Good choice.
 
Hello everyone,

I just spoke with Dr. Bruce Chein and he gave me some excellent advice. I'll be flying out to Illinois to go for my medical in 3 months once the 90 days has been completed off the pain meds and I have gotten all correct medical ppw.

Thanks a bunch

-Josh
The smart thing to do. Hope it all goes well. Sounds very promising.
 
If Dr. Bruce didn't feel you were certifiable, he would have told you that straight up. The fact that he apparently recommended you come to Peoria in three months is very encouraging, as he doesn't have folks come there unless he's certain you can be certified. And no, there's absolutely no problem with using an AME remote to your location. A number of us on this board have made cross country trips to Peoria to see Dr. Bruce, and continue to use him as our AME of record. Best of luck to you...
 
Good luck! I had necrotising fasciitis and sepsis twice from a routine surgery that went bad. Keep up the good fight.
 
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