Medical Question

[Sgt. Pilot]

About 2 1/2 years ago, I had a spontaneous pneumothorax. Just sitting around in my living room on a Saturday morning and BANG.

I spent 4 days in the hospital with a chest tube during which time I had a CT scan that revealed it was resolved, but also that I had a couple of "blebs" on the opposite lung. I asked my surgeon what this meant as far as flying, and he told me that it was disqualifying as far as the FAA was concerned. He said I would need to have the blebs surgically repaired in order to get my medical back. I asked if he would do it and he told me the rule of thumb with these was that he would only do the surgery if my livelihood depended on it or if I had another SP.

I really want to get back in the air, but obviously don't want to have surgery if I really don't need it. I am 43 years old, in excellent physical condition, exercise regularly and have never had any indication of another SP.

Is there a chance I would qualify for a Class III medical without surgery to correct my left lung?

Thanks for any info you can provide.

 

[KennyFlys]

Msgt, welcome to the board! Doc Bruce should be able to help you with some basic answers and then a follow up from any questions he may ask. Something he may recommend is see an AME but do not fill out FAA Form 8500. Make it a consultation only to review your situation with the same AME who may ultimately issue a certificate.

Bruce is a pretty busy guy but before the weekend is over, he should be around to give an answer to ya. He goes to great lengths to help other members on the board with medical questions and a possible resolution. I wanted to give a quick response just so you knew you were not being ignored.

Again, welcome to the board. I'll look forward to your participation!

 

[bbchien]

About 2 1/2 years ago, I had a spontaneous pneumothorax. Just sitting around in my living room on a Saturday morning and BANG......I really want to get back in the air, but obviously don't want to have surgery if I really don't need it. I am 43 years old, in excellent physical condition, exercise regularly and have never had any indication of another SP.

Is there a chance I would qualify for a Class III medical without surgery to correct my left lung?

Thanks for any info you can provide.

Msgt, the presence of a spontaneous pneumothorax takes the decisionmaking out of the AME's hands. The questions FAA will want addressed, are:

(1) Are there other blebs (Chest CT scan)
(2) Do you have an alpha 1 antitrypsin deficiency (it's a blood test, positive is assoc. with many future ruptures, not fun).
(3) Your pulmonary functions have to be at least 70+% of normal (Forced Exp. Volume in one second as a fraction of Total forced vital capacity over ten seconds).

Usually, if you get a central FAA issuance, it will say, you are to self ground if another is to occur.

Some of these, if bad enough, cannot be dealt with by surgery and too much lung would have to be resected.

The REASON you have surgery for this condition is not to cut out the rest of the blebs. It's to sclerose the outer lung surface to the inner chest surface (a "sclerosis") so that even if you get a bleb rupturing, the whole lung cannot come down.

Lastly, you need to get all the above items evaluated, along with a statement from a MEDICAL PULMONOLOGIST as to your condition, and have an AME who does Office based Special Issuances (authorized telephonically) evaluate your folder BEFORE you even touch a form 8500-8. A denial precludes sport pilot!

 

[Sgt. Pilot]

Thanks for the replies!

My personal physician stopped doing FAA exams a couple years back, so I'll have to start from scratch with this issue I guess.

1, I do have a couple of blebs on my left lung ( Per the CT scan I had while in the hospital for my SP

2, As far as an alpha 1 antitrypsin deficiency, I have no idea (will have to get that checked obviously)

3, I have had a PFT every year for the last 15 years or so (job related) and have always come out at 100-110% of expected. Should I get copies of these to bring to the AME?

 

[bbchien]

Thanks for the replies!

My personal physician stopped doing FAA exams a couple years back, so I'll have to start from scratch with this issue I guess.

1, I do have a couple of blebs on my left lung ( Per the CT scan I had while in the hospital for my SP

2, As far as an alpha 1 antitrypsin deficiency, I have no idea (will have to get that checked obviously)

3, I have had a PFT every year for the last 15 years or so (job related) and have always come out at 100-110% of expected. Should I get copies of these to bring to the AME?

The key is to get a pulmonologist to give his estimate of the probability of a recurrence. That depends on - the other lung, the size of the blebs on the left lung, the number, and the Alpha 1 antitrypsin.

If the probability is low, you can get issued. But if it's high, I would talk to the pulmonary guy about sclerosis. This is NOT the same as a thoracic surgeon, even though they do this procedure as well. It's done through a 'scope, the incision and recovery are small, and once a side is done the probability of symptoms if it recurrs on the left is pretty darn small.

PS- what kind of job ("job related pft's"). Sometimes the kind of exposure/job can be connected to the disease.

 

[Sgt. Pilot]

The key is to get a pulmonologist to give his estimate of the probability of a recurrence. That depends on - the other lung, the size of the blebs on the left lung, the number, and the Alpha 1 antitrypsin.

If the probability is low, you can get issued. But if it's high, I would talk to the pulmonary guy about sclerosis. This is NOT the same as a thoracic surgeon, even though they do this procedure as well. It's done through a 'scope, the incision and recovery are small, and once a side is done the probability of symptoms if it recurrs on the left is pretty darn small.

PS- what kind of job ("job related pft's"). Sometimes the kind of exposure/job can be connected to the disease.

My job requires confined space entry, specifically into military aircraft fuel tanks. The main contaminate is JP-8 jet fuel, and there is also some exposure to MEK and polysulfide sealants.
I must say that I feel very well protected as I wear a full face air supplied respirator (3M7800) and a tri-layer Gortex cover-all for 90% of my work, along with engineering controls that are designed to limit exposure.