Medical with FMD

[Unregistered]

My last Medical expired 4 years ago and been doing the Sport Pilot since. I want to get my 3rd Class Medical back but I am not 100% sure I will get approved due to a health episode in 2006. Back then I had a renal infarct caused by FibroMuscular Dysplasia that took 1/3 of my Kidney out but still retain better than 97% Kidney renal functions.

I am 52 in good shape, BP is 120/80 or less, lift weights and am fairly muscular in complexion at 218 lbs and 6’ 0’’. I run 5K races each Saturday when it is not too hot. My yearly physicals are routine and my cholesterol is under 140 with 10mg of Simvastatin/day.

I was treated at the Mayo Clinic and told to have a CT scan in 10 years to see what, if any changes, took place in my system. There is no treatment or therapy other than having a healty lifestyle with low BP, low weight, and low cholesterol. I feel great, lead a regular life, and only remember I have FMD when the thought of going to get a 3rd class comes to my mind. I have plenty of energy and hit the gym 4 times a week for 1.5 hours.

Is FMD a reason for a 3Rd class denial regardless of symptoms or will my entire health be evaluated for risk? I am unable to find anything on the web about this subject. Should I stay away from the 3rd class or purse one and get on with it and fly bigger airplanes. Thoughts are appreciated.

 

[AggieMike88]

If you have been lurking or participating for a while, you've heard us mention Dr. Bruce Chien many times. He's the right guy in the right place for question like this.

If your situation permits cerfitication, he will provide the right guidance of what is needed as far as documentation and how to go about obtaining it.

If an special issuance (SI) is required for your condition, it can be worth travelling to his office in Peoria to get the examination done and walk out with your medical certificate. Bruce is one of the few AME's who take the additional steps to obtain permission to issue in office, while other AME's will stuff you into deferral hell.

If he doesn't respond this evening or next, reach out to him via email: bbchien@comcast.net

 

[Unregistered]

If you have been lurking or participating for a while, you've heard us mention Dr. Bruce Chien many times. He's the right guy in the right place for question like this.

If your situation permits cerfitication, he will provide the right guidance of what is needed as far as documentation and how to go about obtaining it.

If an special issuance (SI) is required for your condition, it can be worth travelling to his office in Peoria to get the examination done and walk out with your medical certificate. Bruce is one of the few AME's who take the additional steps to obtain permission to issue in office, while other AME's will stuff you into deferral hell.

If he doesn't respond this evening or next, reach out to him via email: bbchien@comcast.net

Ditto the comment

 

[bbchien]

FMD can affect many organs. the question being asked at your certification: what organs, and how much disease; what is the record of progression vs. stability.

This one needs your rheumatologist and nephrologist to comment, and then FAA will send it out to an outside expert while you hang in jeopardy of denial.

There's no slick answer to this one.

 

[Unregistered]

Sounds reasonable. I was never referred to a Rheumatologist during my episode or after it. I only worked with a Neprhologyst and a Vascular Physician at the Mayo Clinic. Both Drs cleared me to continue sports and lift weights with no restrictions. I did have had a follow up CT Scan a year after that showed no changes to my renal arthery and was told to do it again in 10 years for comparison. My Family Dr cleared me for arhro surg on my knee so that I could continue my running regiment 2 years ago. All tests, including EKG was normal for the pre-op. If anything my BP and pulse were “low” for a man my age due to my physical activity.

I will set up an appt with my old nephrologyst, get a lipid profile while at a it and give him a heads up. If the overall assessment includes a report from my Dr. and the ME then I think my chances are very good. I do not have any pain or have physical limitations, I bench press 225 and run regularly. The rest I guess is in the Feds hands.

Appreciate the advice.

 

[Unregistered]

One question in my mind is this…

What happens to my ability to exercise the Sport Pilot privileges after I set foot on the AME door? Today I fly under Sport Pilot and never been denied a medical.

I am assuming the visit to the AME will not result in me walking out with the medical as I did in the past unless the AME is familiar with FMD and determines that I look fit to fly and that my history since the 2006 episode is clean.

Will the AME deny it on the spot? or do I have to wait until word comes back from the Fed? The entire process is not clear to me.

I really want to go through this and get word. It will be good for me and those with FMD. The sad thing is FMD is not that uncommon, it is always poorly diagnosed (I took 3 days and a trip to Mayo Clinic to get the proper Dx). Good news is more MDs are becoming more familiar with it and beginning to learn more about it as it afflicts 3 or 4 % of the population. FMD is not a fatal disease so most folks don’t know it until they pass an autopsy is performed and shows the person had FMD in some form, unrelated to cause.

Thanks

 

[azure]

So don't fill out MedExpress and if you do, DON'T give your AME the confirmation code. The event that locks you out of Sport Pilot is doing the formal flight physical. Once your AME puts your code into the system the whole exam is for real, there's no chance of doing a trial run, let's see if I can pass this thing. Then you either get issued, deferred, or denied (and deferred means eventually only the other two possibilities). Until you're as certain as you reasonably can be that you have all the info the FAA needs to issue you (even if you'll have to wait 6 months ), don't be giving him that info.

If he's any kind of AME you want to deal with, he will let you come into the office for an off the record consultation. No FAA, just you and the doctor reviewing your case to determine if you meet the FAA's standards. If he doesn't let you do this or if his office staff won't put you in line to be seen without the confirmation code, you need a different AME.

 

[AggieMike88]

If he's any kind of AME you want to deal with, he will let you come into the office for an off the record consultation. No FAA, just you and the doctor reviewing your case to determine if you meet the FAA's standards. If he doesn't let you do this or if his office staff won't put you on the appointment list to be seen without the confirmation code, you need a different AME.

Egggs-actly!

This is one of the many reasons I pointed the OP to Dr. Bruce. He already does this and is a proponent of "let's see if issuance is possible before we go official". But he is one of the very few.


PS. FMD = Fibromyalgia Disorder.... correct?

 

[AggieMike88]

FMD can affect many organs. the question being asked at your certification: what organs, and how much disease; what is the record of progression vs. stability.

This one needs your rheumatologist and nephrologist to comment, and then FAA will send it out to an outside expert while you hang in jeopardy of denial.

There's no slick answer to this one.

Since this needs to go to an outside expert, does this mean that the higher quality of the submission (aka right items and right words in the right status letters) would reduce the jeopardy of denial?

 

[azure]

Egggs-actly!

This is one of the many reasons I pointed the OP to Dr. Bruce. He already does this and is a proponent of "let's see if issuance is possible before we go official". But he is one of the very few.

It probably depends on what part of the country you're in. In my area, there are two (at least) within easy driving distance. There may even be more that I don't know about.

And you may have to ask. The AME I go to doesn't advertise that he does consults, and his office ALWAYS asks you for the confirmation code if you go in for a FAA-related appointment. But the first time I wanted a consult, I called in advance to make sure he allows this, and when the receptionist asked me for the code, I explained politely that I was there for a consult and not an official exam. From that point on, they were cool about it.

PS. FMD = Fibromyalgia Disorder.... correct?

Fibromuscular Dysplasia, from the OP.

 

[bbchien]

Since this needs to go to an outside expert, does this mean that the higher quality of the submission (aka right items and right words in the right status letters) would reduce the jeopardy of denial?

That means there is no way to pre-qualify it. There isn't a nice way to certify this one without going "at risk".

You have to apply, submit, and defer and wait.

 

[Unregistered]

First of all, thanks to everyone for the advice and support.

I checked the AOPA website and it has some numbers that help me decide to just go ahead and pursue the Medical sometime later this year. The numbers paint a picture where denials are not as common as I was thinking they are.

Since FMD is not listed as a disqualifying condition I see that as a plus. When combined with the low numbers of denials and the fact that FMD is not a killer/debilitating disease I am lead to think I have a good chance.

For the time being I need to collect all of my medical record data into a single file and need to be ready to provide names and data as needed when the time comes.

I moved from WI to NE Philly and will look to establish a relationship with an AME as my family physician to take care of for my yearly exams. I can then use his services as an AME when I am ready to start the process. My old Family Doc in WI was an AME and it worked pretty well in the past. No conflicts there.

If I get denied then I will just move on and get a sailboat. Flying was fun in WI because I had a farm with a runway and kept my plane at home. Combined that with auto gas and being an EXP bird and my flying was rotten cheap and fun.
Losing my flying privileges will not be as big a loss so I will just move on. The biggest issue would be the defeat of not qualifying. I don’t like it when someone tells me that I can’t achieve things.

Again, many thanks to all and will post my results in a few weeks.

 

[AggieMike88]

will look to establish a relationship with an AME as my family physician to take care of for my yearly exams. I can then use his services as an AME when I am ready to start the process.

Others can add more detail and supporting data. But there is something to be said about keeping the family/primary doc separate from the AME. At least that's my preference.

For the time being I need to collect all of my medical record data into a single file and need to be ready to provide names and data as needed when the time comes.

I'll continue to recommend that you contract with Dr. Brice directly during this phase. And then go to Peoria for the exam and to make him the AME of record.

Makes it much easier to have him work for you if his help and expertise is needed once the packet has been submitted to the FAA. Or you get a letter from the FAA that is beyond your capacity to handle quickly.