Questions from a lurker

F

flightmedic

Pre-takeoff checklist
Joined
Feb 5, 2011
Messages
270
Location
Ormond Beach, FL
Display Name
Display name:
flightmedic
I have been lurking for several months because I hope to begin training for my private pilots liscense next year. I am trying to educate myself so I have a good understanding of what I will be getting into when I do begin. My questions are what are the differences in the medical classifications, can a history of high blood pressure preclude a medical clearance even if the blood pressure is well controlled by medication, and when do I need to get that physical?
 
I'm sure someone can answer your other questions directly, but regarding the physical: I was told to get my medical certificate before taking my first flight, otherwise I was just wasting my money, since you can't get a Private Pilot's License without it, which made sense to me. Technically I believe you only need the medical certificate prior to solo flight, however.

All certified pilots, with the exception of those with a sport pilot certificate (or when in command of balloons or gliders), are required to maintain a medical certification commensurate with the privileges they intend to exercise as pilot-in-command of an aircraft. http://en.wikipedia.org/wiki/Pilot_...States#Medical_certification_and_requirements

You can find an FAA approved medical examiner here: http://www.faa.gov/pilots/amelocator/
 
Last edited:
Challenged said:
I was told to get my medical certificate before taking my first flight, otherwise I was just wasting my money, since you can't get a Private Pilot's License without it, which made sense to me.
Click to expand...
Nothing personal, but that's really bad advice.

It's basically throwing the dumb SOB to the wolves and if he/she makes it out the other side, THEN we will make the effort to teach him/her to fly...

You need to find out if you are going to pass before you even start to fill out any FAA forms at the AME's office. If there is any doubt schedule for a consultation first.

Why? If you walk in and fail you are locked out of the sport pilot option forever. But if you don't fill out any forms and don't fail you potentially could pursue the sport pilot certificate (Assuming you and your family doctor agree that you are safe to act as pilot in command.)

Now, back to the original question.

You need a third class medical to solo in anything that requires a private pilot certificate (except gliders and maybe balloons).

Higher levels allow you to pursue various commercial operations.

Sport pilot requires a valid driver's license. And, an agreement from the family doctor if there are any possible issues is strongly recommended. If you and your doctor agree that you aren't safe to act as pilot in command of a Piper Cub, well, I hope your wife drove you to the doctor's office…

For the medical, and at least some BP medications don't seem to be a job stopper - find out about you specific medication first. However, past use of medication for depression or ADD, a history of DUI, or anything remotely in those categories and you may be screwed as far as a FAA medical is concerned.

Know BEFORE you go.
 
Blood pressure controlled by (approved) meds is not a disqualifying condition.

You need a medical prior to soloing (a powered aircraft). But it would be good to get it right away just to assure you have it. However, don't go until you are SURE you will pass; denial will preclude flying on a driver's license medical as a Sport Pilot.
 
Capt. Geoffrey Thorpe said:
Nothing personal, but that's really bad advice.
Click to expand...

I guess it just depends on each person's health status, which I didn't take into consideration here. I'm still fairly young and in decent enough shape, so I really didn't even question the fact that I would pass my medical when I went. It was as easy as I had guessed for me personally to get my medical, took about an hour; the doctor was even really fun to talk to, as he loved aviation.
 
Capt. Geoffrey Thorpe said:
Nothing personal, but that's really bad advice.

It's basically throwing the dumb SOB to the wolves and if he/she makes it out the other side, THEN we will make the effort to teach him/her to fly...
You need to find out if you are going to pass before you even start to fill out any FAA forms at the AME's office. If there is any doubt schedule for a consultation first.
Click to expand...
That is why I send the students a copy of the FAA 8500-8 and ask them to please fill it out and discuss it with me before going to the AME. I try and explain to them that the FAA is a large bureaucracy and everything needs to be precisely in order. If they're not comfortable talking to me about it then I recommend someone like Dr Bruce.
 
Thanks for the info. I am so green at this that I appreciate all the help. It will be a year before I start any training so all the info here is helping to point me down the right road.

And, Capt. Thorp, I am (mostly) sure you weren't calling me a "dumb SOB." But if you were, you wouldn't be the first and I don't take offense.:wink2:
 
jesse said:
That is why I send the students a copy of the FAA 8500-8 and ask them to please fill it out and discuss it with me before going to the AME. I try and explain to them that the FAA is a large bureaucracy and everything needs to be precisely in order.
Click to expand...

Had my first CFI done that, I would either have found another CFI or just abandoned the whole idea. CFI has no need to know my medical history. Not a shot at you, Jesse, just a statement.

If they're not comfortable talking to me about it then I recommend someone like Dr Bruce.
Click to expand...

Excellent suggestion - consulting with an AME before filling out the paperwork is a good idea. Joining AOPA and consulting their medical resources is another suggestion.
 
wsuffa said:
Had my first CFI done that, I would either have found another CFI or just abandoned the whole idea. CFI has no need to know my medical history. Not a shot at you, Jesse, just a statement.



Excellent suggestion - consulting with an AME before filling out the paperwork is a good idea. Joining AOPA and consulting their medical resources is another suggestion.
Click to expand...
Your choice. I don't tell them they have to. Most would rather discuss it with me then walk into an office and discuss it blindly with a complete stranger. I can save them a hell of a lot of headache and money.

I don't ask them to show me the form. I simply advise them that if they had to answer "yes" on any item, or if they are taking any prescriptions, or if there was a single thing on there that concerned them whatsoever. From there I either tell them that I can help them through it if they tell me what it is or I can tell them who can help them. I have yet to have a person be concerned about discussing it with me. I'm not the FAA, I'm not the insurance company, and they're already trusting me with their life.

I am walking several through the process of obtaining what they need. Had they just stumbled into the local AME they'd be in way worse shape.
 
Last edited:
wsuffa said:
Had my first CFI done that, I would either have found another CFI or just abandoned the whole idea. CFI has no need to know my medical history. Not a shot at you, Jesse, just a statement.
Click to expand...

It all depends on how it's presented to them. In his post, Jesse seems to present it as an option that could help them move forward with the process.

Jesse- your avatar hat matches the colour of your foot.
 
jesse said:
Your choice. I don't tell them they have to. Most would rather discuss it with me then walk into an office and discuss it blindly with a complete stranger. I can save them a hell of a lot of headache and money.

I don't ask them to show me the form. I simply advise them that if they had to answer "yes" on any item, or if they are taking any prescriptions, or if there was a single thing on there that concerned them whatsoever. From there I either tell them that I can help them through it if they tell me what it is or I can tell them who can help them. I have yet to have a person be concerned about discussing it with me. I'm not the FAA, I'm not the insurance company, and they're already trusting me with their life.

I am walking several through the process of obtaining what they need. Had they just stumbled into the local AME they'd be in way worse shape.
Click to expand...

Sounds like a good idea to me.
 
The only prohibited meds are reserpine, guanethidine and alpha methyldopa, all in the $4.00 category at Wally world. The reason is that these meds work in the brain. Clonidine is permitted but only arfter a 30 day wait and a current status letter.

For first time certification with BP meds, you will need:
(1) A recent EKG that looks reasonable. Recent means within six monthsIf you have Right bundle branch block on it there are a lot of hurdles, including a full Bruce protocol treadmill test (Google "bruce protocol").
(2) A letter from your doc saying, BP well controlled no side effects reported, and no apparent coronary disease.
(3) Fasting lipid profile, Fasting glucose, and serum creatinine. If you diuretic includes a diuretic in part ("/HCT") you also need a serum potassium.

The recurrent requirements are just the letter (#2 above) every two years. Any AME can issue if they have 1-3.
 
Thank you all for all the information, Especially Dr Bruce. This site has proved very useful and I am sure over the next year I will gain valuable information towards my eventual private pilots license. Thanks again.
 
FlightMedic: Another option, if available to you, would be to start out pursuing a Sport Pilot's License to see how you like it. No medical required. If the SP would be okay for your future use (i.e. no more than one passenger) you might decide to stay with it. Most people can get a medical certificate if they are reasonably healthy and have a good AME like Dr. Bruce. But, a lot of times you have to jump through a lot of hoops, like getting an EKG, Holton monitor, cardio echo, etc., etc., etc. You wind up with the certificate, but what a hassle. A lot of people I have talked to (and some here) have indicated they are thinking about the SP in the near future, especially as they are getting older. Not a bad option, all things considered. Just a little limiting on aircraft, but hey, I would just as soon fly an old Champ or Cub anyway.
 
Ghery said:
"Right bundle block". I've heard the term. What does it mean?
Click to expand...

It's a disturbance in the electrical system of the heart. Cells in the heart conduct electrical impulses. The cardiac muscle does so relatively slowly. There are actual
Conduction pathways that do so relatively faster than the muscle.

Slow or fast, the times in question are measured in milliseconds.

A right bundle branch block interrupts the fast pathway to the right ventricle. So, the impulse reaches the right ventricle (RV) by traveling down the left bundle ( or it's two branches) then slowly through the muscle.

The result is a delay in contraction by the RV. One possible (but not only) cause of this conduction disturbance is myocardial infarction ( heart attack, death of portions if heart tissue).

Otherwise healthy people may have a right bundle branch block and it does not appear to cause any harm or symptoms in those persons.

I would expect this finding to warrant evaluation by a cardiologist for coronary artery disease and that specialist can determine if it's the result of another problem or not.

Doc Chien can speak with regards to the aeromedical implications.
 
Last edited:
Ghery said:
"Right bundle block". I've heard the term. What does it mean?
Click to expand...
It is an electrical abnormality of the heart diagnosed by ECG and is usually no big deal in otherwise healthy individuals although it can be a manifestation of heart disease. In a study of 122,000 apparently healthy Air Force personnel and applicants the incidence of RBBB was 1.8 per thousand. In another study of 394 of those patients only 30 had evidence of heart disease. They followed 372 of those guys for about 10 years and only 3 died as the result of cardiac problems. Dr Bruce mentioned that a treadmill stress test would be required and a cardiologist may want to get an echocardiogram to exclude certain other heart problems. The two tests can be combined as a stress echo. If someone has no history of heart disease, feels well, and has good exercise tolerance then it would be unlikely that RBBB was caused by another heart problem.
http://en.wikipedia.org/wiki/Right_bundle_branch_block
 
Last edited:
In the Framingham study of 6,000 men from 1947 through 1978, Right Bundle branch block was not associated with premature death. In the MRFIT trial that followed there was some indication that RtBBB persons DID have a higher prevalance of Coronary Artery Disease. It is only recently that the FAA's external Academic cardiologists have been recommending screening new Complete Rt. bundle branch block pilots for CAD, thus treadmill.

There is another process in which an "incomplete Right bundle branch block is found; if you have an EKG showing this, SAVE it, because when it becomes a complete Rt. BBBlock, THAT CONDITION does NOT REQUIRE CAD screening , e.g, the treadmill run.
 
If an apparently healthy person with RBBB is sent to a cardiologist (it happens) he or she will likely get an echo in addition to the stress test, so attempt to convince the primary physician to just order the treadmill to meet the FAA requirements. Specialists are held to a higher standard of care so they tend to order more tests which can complicate the issue.
 
Sigh. The first world war, and arguably the second, would have been lost to those standards.
 
Sac Arrow said:
Sigh. The first world war, and arguably the second, would have been lost to those standards.
Click to expand...

The 18-25 year olds who were the primary combatants likely would have has no problem at all.

Not to mention, many of the current disqualifying conditions were not manageable back then. You either died or were moribund.
 
Compared to 1900-1919, we are lucky to live to the age of bundle branch deterioration. Recall the London Cholera epidemic of 1853 only a FEW YEARS BEFORE, the death of Tchiakovsky in 1893.

......the times they are-a-changin....
 
Last edited:
There are some less common causes of RBBB which require specific medical treatment including atrial septal defect, Ebstein's anomaly and Brugada syndrome. Brugada syndrome is associated with lethal heart rhythm problems but is accompanied by other ECG abnormalities that should be obvious. Ebstein's anomaly is a congenital heart problem and I doubt that somebody would live to adulthood undiagnosed except for an abnormal ECG. Atrial septal defects may not be discovered until adulthood and are usually apparent on an echocardiogram. Other causes include hypertension, diseases of the heart muscle, rheumatic heart disease, and others. So although it can occur in healthy individuals it can also be the result of heart disease. Hopefully the evaluation will show it is a benign problem.
 
Old Thread: Hello . There have been no replies in this thread for 365 days.
Content in this thread may no longer be relevant.
Perhaps it would be better to start a new thread instead.
Back
Top