questions from airman

Discussion in 'Medical Topics' started by lbfjrmd, May 27, 2019.

  1. lbfjrmd

    lbfjrmd Line Up and Wait

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    Senior AME/ATC AME
    I get these 2 or 3 times a week. I answer for free ... for a while:

    1 of 23

    DWI arrest



    to me
    [​IMG]
    Good evening,

    My name is x and on April 5, I got arrested for a DWI in x. I've been in contact with Dr. x about my case, but I wanted a second opinion on some of the stuff he's shared with me. If you have some time, I would love to chat with you and see what your thoughts would be. I'm not questioning his expertise by any means, but like any diagnosis, it sometimes helps to have a second opinion, or even just clarification/confirmation of what's already been communicated. I appreciate your time and consideration.

    Thank you,
    x

    [​IMG]
    Louis Fowler <lbfjrmd@gmail.com>
    10:03 AM (1 hour ago)


    to x
    [​IMG]
    For now, kindly outline Dr. x's suggestions and pose me your questions.
    • [​IMG]
    • Louis Blanding Fowler Jr., M.D.
    • Family Practice / MDVIP
    • Senior Aviation Medical Examiner
    • Consulting Medical Director Services
    • FAA / HIMS / ATC
    • [​IMG]
    • Addictions Treatment ( Suboxone - Vivitrol )
    • Medical Aesthetics / Facials / Massage
    • 431 E. Government St.
    • Pensacola, Fl 32502
    • 850-433-9391
    [​IMG]

    x
    10:22 AM (1 hour ago)


    to me
    [​IMG]
    To make a fairly long story short, I had a PI back in college in 2010 and a DL suspension resulted from that. Regs say "actions arising from the operation of a motor vehicle," which wasn't the case for the first incident. I've been told that I need to do private random drug and alcohol screening and attend meetings prior to visiting a HIMS psychiatrist. I have no issue with any of that (except the enormous cost!) as I've stopped drinking entirely following this DWI. Further, I'm told that my medical is already invalidated, although I haven't received any notice from the FAA at this time. I'd like to continue to fly if it's legal to do so, but if it isn't, then I'll respect that and discontinue flying. I have a third class medical and a PPL. Thank you again for your time.
    [​IMG]

    Louis Fowler <lbfjrmd@gmail.com>
    10:42 AM (45 minutes ago)


    to x
    [​IMG]
    for clarity what is a PI?

    A HIMS-AME cannot assign to case as being HIMS. The FAA makes that determination upon application.

    Yes, technically you no longer have a valid medical. In fact this should have been reported to the FAA immediately, though most pilots do not. It does not influence your case going forward.

    My approach is to gather facts and submit application to FAA ASAP and then tailor program to their requirements. I have taken cases that I was fairly sure were 2 B HIMS, only to hear from the FAA to do x and y but not z.
    [​IMG]

    x
    10:45 AM (41 minutes ago)


    to me
    [​IMG]
    Public intoxication. It has nothing to do with driving at all. I did self-report after consulting with Dr. x, but as I said, I’ve gotten no word back yet. Again, I’m not opposed to jumping through the FAA hoops, but they are expensive!
    [​IMG]

    Louis Fowler <lbfjrmd@gmail.com>
    10:59 AM (27 minutes ago)


    to x
    [​IMG]
    I myself had similar issues 22 years ago. To keep my license to practice medicine i experienced expense ($80K) and 1 year away from the practice of medicine. You wont come close to that. But you will have hoops (the FAA will choose them for you) and expenses.
    [​IMG]

    x
    11:21 AM (6 minutes ago)


    to me
    [​IMG]
    Thanks for the input; good to know that even a senior AME can keep on trucking with a “history”. So I guess my last question is this: am I officially illegal to fly at this point?
    [​IMG]

    Louis Fowler <lbfjrmd@gmail.com>
    11:25 AM (1 minute ago)


    to x
    [​IMG]
    no
    [​IMG]
     
  2. Velocity173

    Velocity173 Touchdown! Greaser! PoA Supporter

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    Just like on POA, I’m sure this will only get worse. Word is out that there’s a pilot shortage. Anyone who’s ever dreamed of flying for a living is now jumping through the FAA hoops to straighten out their medical history.

    It amazes me how many people who have had alcohol/ drug issues in the past and are looking at becoming pilots. Sometimes I think I’m the only pilot around who hasn’t smoked dope, got a DUI or has been diagnosed with ADHD. :D
     
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  3. SkyDog58

    SkyDog58 Touchdown! Greaser!

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    Haven’t been caught or diagnosed yet, huh?
     
  4. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    The original "I don't know it all" of aviation.
    @lbfjrmd ... thank you for sharing “real AME stories” such as this. I hope you will make future ones a regular contribution as you have the time. I think they would help all of us gain both a better understanding of the system/requirements and an appreciation of the work our really good AME’s do to help us airmen.


    PS.... FAA medicals plus a relaxing massage? Interesting
     
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  5. flyingron

    flyingron Touchdown! Greaser! PoA Supporter

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    MDVIP eh? My neighbor has the franchise for that here.
     
  6. midlifeflyer

    midlifeflyer Touchdown! Greaser!

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    I get similar ones as an attorney. Some think I can yell and threaten and make it go away. I explain they have a medical issue and don't want it to become a legal issue, and send them to people like you.

    Other times, the contact me early and sometimes (not too often) I can help if they have an attorney for the case.
     
  7. Velocity173

    Velocity173 Touchdown! Greaser! PoA Supporter

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    Nope, I’m too smart for them. ;)

    To me, the whole drug and alcohol thing is about priorities. If one values a career in aviation, then they’ll make smart decisions in order to pursue that career. Whether it be military flight physicals or FAA, there are enough basic medical problems that could put my job in jeopardy. I don’t need to make it even worse by abusing drugs / alcohol. Seen too many people in the military destroy their careers and see patient drug / alcohol abuse on almost a daily basis in my current job. Not worth the risk.
     
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  8. flyingron

    flyingron Touchdown! Greaser! PoA Supporter

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  9. bbchien

    bbchien Touchdown! Greaser!

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    ...and so it goes in the Brian patch in which Dr.Lou and I labor.....you have TWO episodes of publically recorded alcohol behavior and the question is not of Abuse (two establishes that) but of whether or not by strict FAA criteria you actually have untreated dependency. It matters not that a vehicle was not involved with the public intoxication.

    That will require the only person qualified to make that call: the HIMS psychiatrist. I suggested that you take that seriously and do something a truly dependent person usually will not not do- voluntarily prove medium term abstinence, esp so that if and when you see the HIMS psych, if he ways, "it's just abuse” you will be issuable by the FAA and the application will not go to waste.

    However, if you don't want do any of that- Both the HIMS psychiatrist, & FAA will make the judgement that you likely have dependency and deny you and then send you to the HIMS AME who will tell you the same thing. You see one of the criteria is "continued use in the face of repeat events and in the face of negative consequences". And by your refusal to voluntarily show you have stopped (document it) you probably will be judeged dependent. Unlike abuse, which is quickly (after 4 mos’ proven sobriety) special issuable dependence will take you 2 years B4 you can possibly fly.

    "ANYTHING BUT QUIT".
    “But I am fine”
    Sigh.

    I'm afraid you can't be helped much here.....
    AS we say in this profession, "We recommend sobriety".

    We all work from the same book.
    Face the music if able.
     
    Last edited: May 27, 2019
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  10. Dean V

    Dean V Pre-takeoff checklist

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    A drivers license suspension for a PI? What state?
     
  11. Juliet Hotel

    Juliet Hotel En-Route

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    I believe some states will suspend your drivers license if you're under 21 and convicted of PI.
     
  12. Dean V

    Dean V Pre-takeoff checklist

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    That is not unusual for under age consumption or possession conviction. Not PI.
     
  13. Juliet Hotel

    Juliet Hotel En-Route

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    Kind of hard to get to intoxication without first possessing and consuming.
     
  14. bbchien

    bbchien Touchdown! Greaser!

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    So many airmen think tis' about DL suspension. It's about more than that. The FAA, upon DUI will require all your documentation and that will include the PI (Box 18w). Then you have two publically evaluable alcohol incidents. Just because a non-DL related Pub. Intox (or it might have been a plead down, doesn't matter) doesn't get reported on it's own, doesn't mean "it doesn't count". So arguing about it is dancing on the head of a pin.

    It will show up on the Criminal background search, and then see 67.107, 67.207, 67.307 for the definition of abuse. It is at the second evaluable incident. The OP now has two and the first one even if it did not involve a motor vehicle, counts.

    Since "continued use in the face of adverse consequences" gives him alcohol dependence, the only way to forestall that is to show that use has ceased. "Substantiate your claim" means, private urine random test program, which meets FAA stds, at time of application, sober for 4 months...That is not a guarantee against the FAA diagnosis of alcohol dependence, there are things like:

    Tolerance
    LIfestyle centered on the use of alcohol
    Blackouts
    Drinking to prevent a withdrawal syndrome

    ...but by not addressing the obvious criteria in the prior paragraph, pretty much seals an airman's fate.....


    Bruce
     
  15. bnt83

    bnt83 Final Approach

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    There needs to be a flowchart for these people's questions, similar to the Can I Log it?
     
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  16. Matthew

    Matthew Touchdown! Greaser!

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    The proper question should be: “How do I report this?” not “Do I need to report this?”
     
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  17. lbfjrmd

    lbfjrmd Line Up and Wait

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    ... with the truth, the whole truth and nothing but the truth!'
     
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