medication reporting ??

[Unregistered]

I'm a 73 year old who just passed his 3rd class medical. I went for a physical prior to the medical to insure I didn't have any unknown issues.

The chap who gave me the physical wants to start medicating me. Your blood pressure is marginal you need some pills. Your cholesterol is edging up and you need some pills. Your prostrate is enlarged and you have to pee during the night, you need some pills. You have reflux at times you need some pills.

If I start on all these medications what documentation will I need to insure that two years hence I don't stall on my next 3rd class?

Thanks much

Old fart

 

[Unregistered+1]

Dr Bruce,
My family doc recently added Niaspan to my meds to lower my triglicerides, they've been over 210 for two years now.

I checked the AOPA meds page as approved meds. Do I need to report this now to my AME or FAA or wait until my next Class II renewal in a few months. I've had no problems to report taking this medication.

Thanks

 

[AggieMike88]

Many of the items listed can be managed with moderate weight loss, if you are overweight to start with that is.

Dr. Bruce will provide the final word on what to do, but in the mean time, you can always take your doc

a printed copy of the AME guide: http://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/guide.pdf
a printed copy of the FAA medication database: http://www.aopa.org/members/databases/medical/druglist.cfm
​

and say that if it isn't permitted by the FAA, he needs to prescribe a treatment/medication that is.

Finally, the biggest thing to take away is to do what is needed to maintain good health. Dr. Bruce's mantra of "Good health now, fly later" is worth committing to heart.

 

[bbchien]

Well, along the lines of general advice- I watched Rose Kennedy preside with her hemiparesis from a wheel chair many years ago. Figured I didn't want that.

(1) So if you want the next ten years to be useful, start controlling the BP now, and I don't mean 150/90 I mean 130/80. Your risk of MI or stroke is really quite high. First time certification with medicated High BP is simple. Letter from the treating doc; Fasting glucose (you HAVE had it checked, haven't you?), Serum creatinine, and serum K+ if you have a diuretic part to your BP meds, and fasting lipid profile (which I gather your doc has). Recurrent requirements: letter from doc each 2 years.

(2) The cholesterol I can't second guess unless I have the fasting profile. There are some profiles in which an HMG-CoA inihibitor are useful. SOME.

(3) Avodart for benign prostatism is FAA acceptable and it's nice to sleep all night.

(4) Chronic reflux in the esophagus is a risk for cancer. You want Over-The-Counter Prilosec, if anything at all. A 2x4 under the head of the bed also works.

BUT all that being said, if you lose weight I gather from this list you have gotten big, it's pretty obvious), losing it will make all on the list better- BUT I GOTTA TELL YA, so few are successful in their 70s- the average weight gain this decade is 25 pounds, that I think the doc is on target. If you hold off you'll be trying to lose weight right into the stroke.

 

[Gary F]

Well, along the lines of general advice- I watched Rose Kennedy preside with her hemiparesis from a wheel chair many years ago. Figured I didn't want that.

(1) So if you want the next ten years to be useful, start controlling the BP now, and I don't mean 150/90 I mean 130/80. Your risk of MI or stroke is really quite high. First time certification with medicated High BP is simple. Letter from the treating doc; Fasting glucose (you HAVE had it checked, haven't you?), Serum creatinine, and serum K+ if you have a diuretic part to your BP meds, and fasting lipid profile (which I gather your doc has). Recurrent requirements: letter from doc each 2 years.

(2) The cholesterol I can't second guess unless I have the fasting profile. There are some profiles in which an HMG-CoA inihibitor are useful. SOME.


BUT all that being said, if you lose weight I gather from this list you have gotten big, it's pretty obvious), losing it will make all on the list better- BUT I GOTTA TELL YA, so few are successful in their 70s- the average weight gain this decade is 25 pounds, that I think the doc is on target. If you hold off you'll be trying to lose weight right into the stroke.

In general I agree with Dr. Bruce's recommendations, however, I suspect that I have a lower threshold for prescribing statins (HMG-CoA inihibitors). I think that statins should be used more often than the current guidelines (new guidelines are being developed) recommend for primary prevention. Coronary artery and peripheral vascular disease are common in this country. A fair number of people discover that they have coronary artery disease by dropping dead or having an acute coronary syndrome. The standard lipid panel which includes total cholesterol, LDL, HDL and triglycerides does not accurately predict who is at risk. Several statins have been out for decades, are very safe and two are now very inexpensive which was not the case when the old guidelines were published. I also think that most men over 40 and women over 50 should have periodic coronary calcium scoring for risk stratification but this can really cause problems for pilots as many would need to be worked up for previously undiagnosed coronary artery disease. An alternative would be to use statins at a lower risk threshold than currently recommended.