some medical questions

[makeupaname]

I'm looking at getting my first medical in over 30 years (didn't fly for some time and then it was ultralights and light-sport until now). Now I may be buying a plane that's over the LSA limits so I need at least one medical before going basicmed. I should be fine but I have a couple of concerns and questions.

I have hypertension, well controlled with irbesartan 150mg/day. As I understand that's OK and the AME can issue, but what do I have to get from my primary doctor to give to the AME? Also Plaquenil for rheumatoid arthritis, also should be no issue?

"All doctor visits within the past 3 years"?... does anybody really keep track of those? In my case it's just a routine yearly physical, 6 month visits with my rheumatologist, and 3 month followup with my primary doctor to monitor my blood pressure (no problems). Do I really need dates on the form, or is, for example, "rheumatologist routine visit every 6 months" sufficient?

I do see the eye doctor twice a year to check for possible side effects from the Plaquenil (never have been any). Is that a "routine" eye doctor visit that doesn't have to be reported?

I had an ocular migraine (probably that's what it was) about 10 years ago. Went to the local clinic where they checked me out and let me go with what basically amounted to "don't worry about it, call us if it happens again", which it never did. Is that something I have to report ("disturbance in vision"?) and if I do have to, will it cause requests for more info (which I don't have) or delay? I don't even remember what doctor it was.

 

[AggieMike88]

First off, welcome to our forums and back into the air.

Next, until you know with 100% certainty that you will receive your medical, DO NOT go for a live exam. Keep any encounters with the Aviation Medical Examiner on a consultative tone. See http://tinyurl.com/ame-consult for additional information on consultations.

I'm looking at getting my first medical in over 30 years (didn't fly for some time and then it was ultralights and light-sport until now). Now I may be buying a plane that's over the LSA limits so I need at least one medical before going basicmed. I should be fine but I have a couple of concerns and questions.

I have hypertension, well controlled with irbesartan 150mg/day. As I understand that's OK and the AME can issue, but what do I have to get from my primary doctor to give to the AME?

See the following items to learn about what the FAA is going to want to know about hypertension

1. AME Guide: https://www.faa.gov/about/office_or...m/ame/guide/app_process/exam_tech/item55/amd/
2. Hypertension FAQ: https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/Hypertension FAQs.pdf
3. Hypertension Disposition Table: https://www.faa.gov/about/office_or...pp_process/exam_tech/item36/amd/hypertension/
4. CACI - Hypertension Worksheet: https://www.faa.gov/about/office_or...es/aam/ame/guide/media/C-CACIHypertension.pdf

One of the items you will need is a status letter from the treating doctor providing in very plain language

• He is treating you for hypertension
• Your latest set of blood pressure readings
• What medications/dosage/frequency you are taking. And are you doing well on them with any (or no) side effects
• He is or is not following you for any other cardiac related items.

Also Plaquenil for rheumatoid arthritis, also should be no issue?

For Arthritis, the FAA has this:

1. AME Guide: https://www.faa.gov/about/office_or...e/app_process/exam_tech/item43/amd/arthritis/
2. CACI - Arthritis Worksheet: https://www.faa.gov/about/office_or...fices/aam/ame/guide/media/C-CACIArthritis.pdf

Like Hypertension, you will need a status letter from your treating doctor detailing the extent of your arthritis, treatment, medications, etc, and that you are stable with the current treatment.

"All doctor visits within the past 3 years"?... does anybody really keep track of those? In my case it's just a routine yearly physical, 6 month visits with my rheumatologist, and 3 month followup with my primary doctor to monitor my blood pressure (no problems). Do I really need dates on the form, or is, for example, "rheumatologist routine visit every 6 months" sufficient?

I do see the eye doctor twice a year to check for possible side effects from the Plaquenil (never have been any). Is that a "routine" eye doctor visit that doesn't have to be reported?

Best to list all visits and dates. If the repeat visit is to the same doctor for the same activity, you are allowed to summarize.

For the eye doctor, it will need to be listed amongst your doctor visits since it is related to the reporting of the arthritis and the medication you are taking. The CACI authorization for the arthritis will require your eye doctor to complete a FAA form 8500-7, Report of Eye Evaluation. This form can be found via Google search. Bring this completed form with you to the AME.


You need to proactively report everything, especially when there is a chance they will find it in your history and start dinging you for not reporting.

But be sure to report it right. Otherwise, you open cans of worms when there were no worms to be worried about.

I had an ocular migraine (probably that's what it was) about 10 years ago. Went to the local clinic where they checked me out and let me go with what basically amounted to "don't worry about it, call us if it happens again", which it never did. Is that something I have to report ("disturbance in vision"?) and if I do have to, will it cause requests for more info (which I don't have) or delay? I don't even remember what doctor it was.

Question 18 on the FAA 8500-8 form specifically states, "Have you ever in your life..." So even though you had the ocular migraine 10 years ago and perhaps none since (that you knew of), you will have to check yes on this. And you should provide some appropriate documentation to make the FAA dogs realize this is old news and not jump up and start barking on this.

Using the PoA search function found a post from Dr. Bruce Chien about migraines accompanied by an ocular event. Cutting and pasting what he said...

"The visual event can only occur once per month, cannot be in the central visual field etc. A negative MRI is required..."

And I found a link to the AME Guide on Headaches: https://www.faa.gov/about/office_or...me/guide/app_process/exam_tech/item46/amd/ha/​

Will an MRI be needed to keep the FAA happy? I don't know. Maybe @bbchien will stop by to comment. If you go to the consultation like I mentioned earlier, hopefully that doctor can provide the proper advice.

________________________________

Hopefully this answers some of your questions.

 

[lbfjrmd]

Dr. aggiemike88 sumed it up nicely. All issues should pass muster after the FAA have reviewed your application and records/statements from all doctors!

 

[AggieMike88]

I got promoted! Guess that overnight stay at the Holiday Inn Express worked as advertised.

 

[lbfjrmd]

indeed!

 

[bbchien]

Placquenil: FAA 8500-7 by your ophthalmologist. AME statement that here is no deformity and good ROM and gait. Heck the necessary statement- no retinal deposits due to placquenil MAY BE IN YOUR RECORD already.
Hypertension: Letter from the Rx ing doc: "I am satisfied with Airman makeupaname's BP contro and have no immediate plans to make changes". Issue in the office.

Ocular migraine: AME essay. 5 years with no Ocular migraine is "old history" to the FAA.