medical and bad prescription reaction...

Discussion in 'Medical Topics' started by FJJ, Jun 24, 2022.

  1. FJJ

    FJJ Guest

    I have a complex FAA medical question, sorry for the length.

    I'm a 50 y/o retired-at-35 software entrepreneur, and I've recently become interested in getting a pilots license. I'm married with a wife and two kids. Mostly on vacation all the time, do lots of active sports like skiing and mountain biking and wakesurfing. I think flying would be fun. However, I have a complex past mental health event that I don't understand what to do with regarding the class three medical.

    Medical is important to me, because my research says 80% of private pilot fatalities are VFR into IMC by VFR only pilots...I'm a very safety conscious risk minimizer, so I will avoid this huge and easily avoidable set of pilot error issues... which means either getting IFR training or flying local-only on blue sky summer days, which seems a bit limiting.

    ---

    And here is the tricky medical event...

    When my son was born, I had a rough patch (my father was a mentally ill alcoholic who I stopped talking to at 15, so the father-son thing kinda threw me for a loop).

    When I saw a doctor to try to get out of my funk, I made the mistake of seeing an ADHD specialist (all the rage) who hit the nail with a hammer and prescribed me ritalin. I ended up experiencing a rare but known side effect (which the doctor warned me about) where I had an escalating mania event. My wife could see it, and called the doctor and he said to take me to the ER "for safety, because he could do crazy things, spend all his money who knows", so I voluntarily stayed in the hospital for several days (not taking anything) while the drug filtered out of my system. I've never done illegal drugs, but it felt like I was high for a week, which actually was fun, but kinda scary after the fact.

    The issue I have is, some doctors believe presenting with mania (even if drug induced by ritalin) is evidence of bipolar. And they mentioned this alot as I was going through this event because when doctors see mania, they say bipolar. However, some research I've found does not support a link between this manic side effect of stimulants like ritalin (which apparently are not far from cocaine) and bipolar diagnosis.

    I don't have, and have never had any of the dysfunction that is typical of bipolar. Am I 100% neurotypical? Probably not. More like mild-depression with family-PTSD and compulsion to obsessively over achieve.

    I learned to program computers when I was 10, parted ways with my father when I was 15, started my first "hobby" software company when I was in high school, earned a computer engineering degree, worked for several tech startups, started a tech startup, sold it profitably. Rode a motorcycle for years without incident.. What I love to do most is dive really deep and learn things. Ohh, and I don't drink either (<2 drinks a month).

    So what in the world do I do about the FAA medical?

    I fear if I explain my ritalin event, I'll get deferral denial. And I fear if I don't explain all this I'm withholding. Am I just screwed by this doctor who wrote me a bad prescription?
     
  2. OneCharlieTango

    OneCharlieTango Line Up and Wait

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    As long as you don’t intend to fly over 18,000’, 250 knots, 6 seats, 6000#, or in Canada or Mexico, BasicMed is for you.
     
  3. GeorgeC

    GeorgeC Administrator Management Council Member PoA Supporter

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    You'll need at least a third class before you can go BasicMed. I am not a doctor, but the ADHD diagnosis (by way of the rx) and the hospitalization need to be disclosed and may result in deferral, and you may have to go the HIMS route if you desire a medical certificate. It will cost you time and money, but it sounds like you have both of those things. Good luck! There's also sport pilot; an LSA with a chute may help mitigate some risk.

    @bbchien @lbfjrmd
     
    Last edited: Jun 25, 2022
  4. lbfjrmd

    lbfjrmd Line Up and Wait

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    my comments:

    i’m glad your Ritalin reaction was quickly noticed and taken care of. Side effects occur with these drugs known as sympathomimetics.

    Yes, disclose all to your AME and the FAA.
    The only way you will learn what you are up against is by applying for a FAA medical. It will be deferred to the FAA but that will not be an automatic denial. The FAA will require information, but much if not all will hinge on your psychiatric and possibly a neuropsychological evaluation.

    concerning the basic medical: I believe you have to have had a FAA class medical in the past, but others on this form knows the basic medical ins and outs more than I do.

    this is indeed a complicated medical, but since apparently no drugs and or alcohol are involved and you have not nor are currently taking any SSRIs the HIMS route may not be recommended by the FAA.
     
    Last edited: Jun 25, 2022
  5. OneCharlieTango

    OneCharlieTango Line Up and Wait

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    George, you're right. I'd forgotten, but you have to have had an FAA medical after July 14, 2006.
     
  6. SimilarDude

    SimilarDude Guest

    Hey mate, so am in a similar situation myself. I experienced symptoms similar to mania simply due to the use of drugs and alcohol in the past and had a bipolar diagnosis slapped on me. However. For the last 3 years I have been on no medications (I was taken off of them by my medical provider) and since then my life has continuously and progressively gotten better. Once the drug and alcohol usage stopped, any symptoms that presented similarly to bipolar ceased, and I've lived a very normal and emotionally balanced life since then.

    I recommend joining the AOPA, they have medical experts who can help you along with this process. I'd also recommend finding a HIMS AME in your area, request a consult (do this BEFORE you attempt to go for a medical) and they can get you set up with what you need beforehand (referrals to an FAA recognized psychiatrist, a clinical psychologist for a cogscreen, tell you exactly what documentation to get before applying and getting deferred) that way you're on track to have everything the FAA can request from you promptly upon getting deferred (because you will 150% get deferred).

    Although I do agree with the FAA's emphasis on safety, many people with some form of mental health issues (especially substance abuse/dependence) end up being misdiagnosed with bipolar. Mental health diagnoses are unfortunately an (extremely) imperfect science, and misdiagnosises are far too common. I am actually in school en route to earning licensure as a licensed clinical social worker (who themselves are able to and licensed to diagnose MH disorders), and I plan to try to address these issues in the aviation field (very much a David going against Goliath idea but someone needs to do it).

    I hope this helps friend, and that you're able to keep pursuing your dream!

    JUST DONT GIVE UP ON IT.
     
  7. flyingron

    flyingron Touchdown! Greaser! PoA Supporter

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    How else are they going to get their kickbacks from the COGSCREEN developer.
     
  8. FJJ

    FJJ Guest

    Thanks for the replies.

    I see this OneCharlieTango posting his BasicMed answer in several threads, but as I've read -- one has to pass a normal FAA third class medical *once* to be qualified for BasicMed. So this is not an answer to these types of questions.

    Since my main interest is in scenic recreation and < 3hr cross country in LSA backcountry planes (and/or glider soaring), my current thinking is it's not worth the risk of failing third class medical and being denied even a light-sport license. So I suppose I can look at the glass half full and be glad the light sport license was created.

    It makes me a little sad, as I think I would be a really good IFR pilot. I learned all about aerodynamics as a kid when I started my R/C airplane and helicopter career. The few times I've taken the yoke in a GA aircraft, I've felt *more* comfortable maintaining attitude through instruments than 'feel' or external orientation; and my brother-in-law is an ATC, so I know and trust how the 'system works'.

    Perhaps in the future there will be a path to BasicMed without third class medical.. I can't currently find reviews of the safety of LS-only pilots who never held 3rd class medical - possibly because there are so few LS-only pilots. I suspect over time their accident causes will be well aligned with private-pilot 3rd-class-medical holders, and not caused by medical issues, and that could yield a path to BasicMed without third class medical.

    Also, perhaps IFR is not as important to risk mitigation as I originally concluded. When I look at LSA crashes (mostly by current or former GA pilots), it's not VFR-to-IMC but runway-loss-of-control that seems to present the greatest risk.

    And in the GA pilot-error accidents I've reviewed so far, after the judgement mistake to fly in marginal weather puts the pilot in the bad situation, in my subjective naive view, most of the bad outcome spirals seem to stem more from an inability to prioritize safety first, and to trust and fly by instruments rather than an inability to use the entire IFR procedure set.

    I still need to do some more research before I can conclude whether I can make LSA safe-enough-for-me and my family.

    Thanks for the thoughts and replies!
     
  9. 4CornerFlyer

    4CornerFlyer Line Up and Wait

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    You may fly right now under Sport Pilot rules, as long as you hold an active US driver's license. You can continue to do so if you get a deferral on an FAA Medical exam, but not if that eventually becomes a denial.

    The Sport Pilot does limit you to VFR operations and certain aircraft but it is better than nothing. You are not eligible for Basic Med until you have been issued an FAA medical 3rd class or greater at least once. If the history is as you describe, it sounds like you will eventually get the 3rd class, but expect testing and consultations at your own expense, and a delay of about a year. Do that once and you can fly Basic Med the rest of your life, including IFR.

    Not to disagree with the benefits of an instrument rating, but you can do a lot of flying VFR. If you use good judgement, it is safe. Flexibility is the key in regard to the weather.

    Jon
     
  10. kath

    kath Administrator Management Council Member PoA Technical Administrator

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    You sound like a risk-aware, sound-minded, thorough, and thoughtful sort of person. The kind of who takes safety seriously. (Such people make good pilots.)

    I would predict that if you go the LSA/SportPilot route, that you will love it. They are real planes; it is real flying. Gliders, too -- some would argue that's even "realer" flying. You'll learn a ton. And if your goal is to enjoy scenic beauty, you won't be out there on marginal-VFR-turning-IFR days anyway. Enjoy. Go for it!
     
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  11. Palmpilot

    Palmpilot Touchdown! Greaser! PoA Supporter

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    61.303(b)(2) says that the person must "Have been found eligible for the issuance of at least a third-class airman medical certificate at the time of his or her most recent application (if the person has applied for a medical certificate)." Until a determination is actually made that the person is eligible for the medical certificate, I don't see how a deferral meets that requirement.

    What I did was hire Dr. Chien to look at my record. As a result, I learned that applying for renewal of my medical certificate would have been too much of a gamble. As a result, I was able to exercise sport-pilot privileges (and BasicMed after those rules went into effect).

    BasicMed is the one that doesn't say you have to have been found eligible; it just says you can't have been denied. It's a similar concept but slightly different wording, so people get confused between the two.
     
    Last edited: Jun 26, 2022
  12. lbfjrmd

    lbfjrmd Line Up and Wait

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    you can always have your CFI give IFR instructions. You can also take the written test for FAA IFR. Then have your CFI give you a check ride. even though you won’t be certified by the FAA to fly in IFR conditions you may find yourself in those conditions regardless of planning. and it will be fun and make you a better pilot!

    I still think would prevail in your pursuit of a third class medical. We’ll see what Dr. Chen has to say about applying. Good luck
     
    Last edited: Jun 25, 2022
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  13. Lindberg

    Lindberg Final Approach

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    This. If you just want the IR to be a safer pilot and you don't care to fly IFR, just get all the training.
     
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  14. bbchien

    bbchien Touchdown! Greaser!

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    The key here is can you substantiate the assertion that this was a ritalin reaction? (records!)
    and
    How many years continusoly to the present can you substantiate "successful life test" and good function

    This will require the HIMS psychiatry eval and the HIMS neuropsychology eval.
     
  15. FJJ

    FJJ Guest

    I can see the option to roll the dice on the third class medical right up front before i start. Worst case i never get into the sport or just go the gliding route.

    I can see the option to do Light Sport Pilot and forgo the medical forever.

    I can *not* see why i would ever pursue light sport training, enjoy it, and then risk losing it to a medical denial. Thats the same kind of thinking as people taking off in marginal weather and *hoping* for a good outcome.

    I dont hope for good outcomes. I design them. If i decide to go the light sport license, there is zero chance i would even apply for medical - at least not unless they change the rules so you don't lose light sport.
     
  16. FJJ

    FJJ Guest

    On the idea to get IFR training only.. certainly i could take the written training and test..

    However, it is unclear to me whether a CFI would / can do IFR flight training as the rules say you are only allowed to do IFR training either with a pilots license or under a concurrent PP+IFR training program.

    Certainly i could get an extra amount of IMC/foggles training.
     
  17. Palmpilot

    Palmpilot Touchdown! Greaser! PoA Supporter

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    The reg says you need at least a private pilot certificate or a concurrent PP+IFR training program to APPLY for an instrument rating. You apply for the rating AFTER you receive the training. It does not say you need that to receive the training.

    § 61.65 Instrument rating requirements.
    (a) General. A person who applies for an instrument rating must:
    (1) Hold at least a current private pilot certificate, or be concurrently applying for a private pilot certificate, with an airplane, helicopter, or powered-lift rating appropriate to the instrument rating sought;​
     
  18. Daleandee

    Daleandee En-Route

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    Most sport planes will not have the equipment to fly IFR. Having said that as a sport pilot I have had some very minimal IFR training. My plane is not properly equipped for IFR but I do have some options if I'm careless enough to get into a mess. My plan is to stay well clear of objectionable weather conditions.
     
  19. Jeff Oslick

    Jeff Oslick En-Route

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    Since $$ don't seem to be an issue with OP, it would appear they could go ahead and do all the testing without the FAA's involvement, to see where they are at. Then, with all those records, have a senior AME review to determine the likelihood of getting past the aeromedical gatekeepers. Might have to do the evaluations a second time for the FAA, but maybe not with proper planning and consultation with an AME.
     
  20. FJJ

    FJJ Guest

    I appreciate the optimistic ideas, but explaining all of this im pretty resigned not to roll the dice on medical. It just seems too unlikely.

    I would have to overcome an acute mental distress that caused me to seek doctor help (questionable), having an alcoholic mentally ill father (questionable), a doctor with an ADHD diagnosis (prohibited) which turned to ritalin (probibited) and a ritalin induced mania (probibited) causing a 5? day stay in a mental hospital (prohibited), which while invalidating the adhd diagnosis has most doctors concluding im bipolar (prohibited). The only medication i've had a positive experience with and take sometimes is Wellbutrin (prohibited), and i have tried and dont get benefit from allowed SSRIs.

    So in the end, i doubt the FAA would pass my medical.. and that would end my chances of learning this wonderful sport.

    -----

    However, this thread had a happy ending, because it convinced me i really dont need IFR rating or a PP/Class3 to get most of what i want to out of flying and train to maintain a good safety margin.

    I have lots of experience with respect for safety and safety procedures through motorcycles, scuba, backcountry skiing, power boating, firearms, etc.. and it's that safety judgement that seems to be most important in being as safe as possible.

    I think the biggest compromises of light sport i will notice are the 10,000 ft ceiling (the airports i am near most of the year are high altitude, Truckee CA and Heber UT), and the inability to fly widely available GA rental/club aircraft. However, my flying dream looks more like flying a RENS S21 into nature or to a friend's rural properties... Or maybe gliders.

    Thank you all afain for the well considered and helpful opinions. And for an ear to listen.
     
  21. Matthew

    Matthew Touchdown! Greaser!

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    If you jump into the glider world, it's like a whole different life than power flying. Some people get seriously hooked, and it might even be more technically challenging than flying powered if you really work at getting the most out of whatever the weather conditions can give you. Try it out. There are positives and negatives to club and commercial operations. If you end up getting a self-launched glider you don't even need a ground crew or towplane/pilot.

    https://www.ssa.org/where-to-fly-map/
     
  22. Half Fast

    Half Fast Final Approach

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    The altitude limit for Sport Pilots is 10kft OR 2000ft above ground level. So if a mountain is 11,000 ft high, you can go up to 13,000 ft to clear it.

    SP will be a fine option for you and I’m sure you will enjoy it. Rentals are hard to find, so plan on buying an airplane. LSA aircraft run the financial gamut from sub 30k to 200k, so you can surely find something suitable.
     
  23. FJJ

    FJJ Guest

    Both Tahoe/Reno and SLC seem like amazing places to glide. utah near me seems to have a pretty active glider comunity, and Nephi Utah is one of the few US airstrips with a winch launch.

    Ive been up in GA planes, but never in a glider. I plan to go for a ride in the next few weeks over Tahoe!

    Thanks for the encouragement.
     
  24. unsafervguy

    unsafervguy Pattern Altitude

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    How many times does it have to be said, you cannot go basic med without having held an faa medical. People please learn the rules before committing on this subject.
     
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  25. Half Fast

    Half Fast Final Approach

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    BTW, you can also fly motor gliders with a glider ticket (takes an extra endorsement, I believe). I think you can even do IFR in a motor glider without a medical. Just another option for you to consider.

    https://en.m.wikipedia.org/wiki/Motor_glider
     
  26. 4CornerFlyer

    4CornerFlyer Line Up and Wait

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    I don't believe you were getting advice here to "roll the dice" on an FAA medical. To echo the message we want you to hear, consider Sport Pilot first if that meets your needs. If it doesn't, then consult with an experienced and pilot-friendly aviation medical examiner, such as the two who have posted on this threat. Only if they tell you that you should be approved for a Class III after whatever testing they recommend would you submit an application to the FAA. A consult does not disqualify you from Sport PiIot.
    Jon
     
  27. FJJ

    FJJ Guest

    Thanks for that clarification, Jon.

    Do you think an AME consult can reliably predict the FAA likely deferral decision?

    Or is a consult to see if i could produce enough evidence that there is no disqualifying condition, so the AME would be able to approve directly without deferral? (Aka showing no bipolar and ceasing wellbutrin)

    One thing that could accelerate this is whether i feel committed to purchase soon after SP licensing.

    If I buy an LSA, im pretty unlikely to want to risk losing the right to fly it because the AME defers and the FAA doesnt approve.

    However, if i want to rent/share more to know how committed to the sport i am, and i practically cant rent LSA, then being contingent on as medical review might be favorable to not being able to get access to a plane.

    It's curious how much pre-flight-planning there seems to be before i start lessons. I'm really glad this forum is here, as it would have been much more complex to handle this topic if i had just charged in and ended up staring at the medical questionarre.
     
  28. Half Fast

    Half Fast Final Approach

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    My advice, FWIW:

    - Get your SP ticket. All your training will count toward a PP certificate later on if you decide to go that route.
    - Buy a used LSA that you can later resell for the purchase price if you choose.
    - Fly as a SP for a while, at least a year. If that proves satisfactory, just enjoy! Add a glider ticket if you’d like.
    - Only if you’re not satisfied with SP, go do a consult with a top-shelf AME (Chien and Fowler are highly recommended) and learn what would be required to get a medical and what your chances would be.
    - Only if the costs and odds for a medical are acceptable pursue a 3rd class and then a PP ticket. If they’re not, stick with SP.
    - If you get the medical and the PPL, sell the LSA and buy whatever plane you’d like. Let the medical expire and go Basic Med.

    This gets you flying as soon as practical and keeps your options open down the road.
     
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  29. FJJ

    FJJ Guest

    My main interest in IFR training is to enable 3-4hr cross-country flights without the risk of the "decision danger spiral" around "is it VFR enough? still VFR enough? divert to dodge IMC. oops, im in IMC."

    I'm not a pilot, but from my research, flying a glider in IMC sounds like a very very bad idea, IFR training or not. This is because most gliders lack an attitude indicator, because they lack a sufficient power source for a the spinning gyro. Which means a glider in IMC will quickly end up in an unpredictable attitude, probably in a spiral dive.

    My understanding is that glider IFR is normally used to request access to class-A airspace, and is issued as a "zone" not an IFR heading, because an unpowered glider can't maintain an IFR heading and altitude.
     
  30. FJJ

    FJJ Guest

    You forgot one..

    - if you don't get the medical, sell the LSA and cry. :)
     
  31. idahoflier

    idahoflier Cleared for Takeoff

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    Lot of good advice, Half Fast nailed it all succinctly above. The only thing I would add that I haven't seen mentioned is that if you want instrument training, you can do that in ANY aircraft, it doesn't have to be in a LSA. You just can't log any of the training as PIC if the aircraft doesn't fit the Sport Pilot criteria...

    FWIW I think you have a a very reasonable approach. If I was in your situation I would go Sport Pilot and not look back...

    Good Luck and Blue Skies!
     
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  32. Palmpilot

    Palmpilot Touchdown! Greaser! PoA Supporter

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    In some ways, I had more fun in the two years I was confined to light-sport airplanes than I did before or since.
     
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  33. FJJ

    FJJ Guest

    This is diverging pretty far from medical approval, but this issue of attitude indicators in gliders is really fascinating.

    There are modern attitude indicators, like the Garmin G5 series, which have small enough power requirements to be practical in a glider, as they have solid-state laser-gyros, not spinning gyros.

    However, oddly, *glider contest* rules typically prevent competition gliders from having attitude indicators, to prevent pilots from entering clouds for an advantage. (they don't know whether you entered a cloud or not, so they prevent you from having an attitude indicator, so going into a cloud is sufficiently dangerous you won't do it - not that it's not dangerous enough already. That's twisted.)

    https://aviation.stackexchange.com/...ies, for contest,and gain an unfair advantage.

    So I see why you're saying one can have a motor glider outfitted with an AI and the necessary IFR equipment, and while meeting the glider IFR pilot requirements, fly a motor glider in IMC under IFR heading coordination.. even up to 17,000, all without a third class medical. Seems a bit of a curious edge case, but could provide some margin of safety for certain cross country glider operations. Neat.
     
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  34. Albany Tom

    Albany Tom Pattern Altitude

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    I have an IT background as well, and flew RC before full size, so I can relate a bit to what you're saying. The thought you've put into this is solid. I'd suggest getting some light sport part 61 instruction next. I think in general technical people do well with instrument flight..but that's exactly why I wanted to do LSA first. I wanted to learn to fly by sight and feel, and not the gauges, because I knew I had a natural tendency to be too geeky/technical, and because I knew from RC flying how important it is to just get a feel for flying. So I went in LSA and learned to fly in an aircraft that more or less only had airspeed and altimeter, and I learned so much from that. Couldn't have asked for a better introduction.

    So I'd say, get up there and fly. Get the light sport, and sort out what you want to do next after that. I don't think you have enough info to plan 3 decisions ahead on this one. But most of all, do it for fun, and with the caution you have. I know more than one person who spent a career flying big things over oceans, and now wouldn't trade time in a Champ or Cub for any other aircraft.
     
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  35. Capt. Geoffrey Thorpe

    Capt. Geoffrey Thorpe Touchdown! Greaser! PoA Supporter

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    That's what works for me. There are times that I elect to not take a trip due to weather, but, oh, well.
    Do you want to fly for fun or transportation?

    Light Sport Aircraft are light and sporty... Low speeds and low wing loadings results in a bit more of a wild ride when things are gusty.
     
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  36. PaulS

    PaulS Touchdown! Greaser!

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    Ok OP, we started with a Ritalin event, which seems to me, if you do and pass the required steps will get you a medical. Then after the docs comment we find a repeated history of mental health consults with at least one med (Wellbutrin) taken for a period of time. It would really help to have all the potential issues up front rather than bit and piece at a time. Have you taken other drugs for mental issues? What else is going on, heart issues, dui, criminal issues? For the type of flying you describe, light sport or ultralight would be fine. But please make good decisions if you pursue flying.
     
  37. lbfjrmd

    lbfjrmd Line Up and Wait

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    We can help ... with the truth, the whole truth and nothing but the truth!
     
  38. kell490

    kell490 Pre-takeoff checklist

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    kell490
    I want to own a power plane and a glider at least be able to rent a glider looking at the lowest cost training route is to get a PPL then a glider endorsement. If you get a Light Sport certificate and you want to get an endorsement for gliders you could only fly a glider that meets light sport rules from what I have been reading. It's possible many gliders do meet light sport I haven't looked into that. it's not a show stopper just means you have to start from 0 to get a glider PPL if you have the money to spend maybe it's not really an issue anyway.
     
  39. SoCal 182 Driver

    SoCal 182 Driver Line Up and Wait

    Joined:
    Sep 11, 2019
    Messages:
    617

    Display name:
    SoCal 182 Driver
    Hire Dr. Fowler or Dr. Chien and have them walk you through the process, step-by-step. They're your best chance of successfully dealing with this issue and getting a medical certificate.
     
  40. Palmpilot

    Palmpilot Touchdown! Greaser! PoA Supporter

    Joined:
    Apr 1, 2007
    Messages:
    20,382
    Location:
    PUDBY

    Display name:
    Richard Palm
    Another relevant point is that you do not need a medical certificate to become a private-pilot with a glider rating. See 14 CFR 61.23(b)(1)(ii) and 61.23(b)(3):

    (b) Operations not requiring a medical certificate. A person is not required to hold a medical certificate -

    (1) When exercising the privileges of a student pilot certificate while seeking -

    (i) A sport pilot certificate with glider or balloon privileges; or

    (ii) A pilot certificate with a glider category rating or balloon class rating;

    (2) When exercising the privileges of a sport pilot certificate with privileges in a glider or balloon;

    (3) When exercising the privileges of a pilot certificate with a glider category rating or balloon class rating in a glider or a balloon, as appropriate;​