Special Issuance.

Discussion in 'Medical Topics' started by Rotorminkey, Sep 12, 2017.

  1. Rotorminkey

    Rotorminkey Guest

    I received my special issuance for both type II diabetes and Obstructive sleep apnea december of 16 good for two years. Both require documentation of compliance with diabetic care and use of CPAP. Diabetes is no problem I take my meds and check my sugar daily. But after months of cpap adjustments finding no optimal setting that would eliminate events, the sleep people shrugged their shoulders and I stopped using it. I was only prescribed cpap for my large neck but not necessarily obstructive events. My primary has just signed off my Basic Med. Does that signing off supersede the conditions of the Special issuance? Starting up lessons again so need have that figured out before hand.
     
  2. AggieMike88

    AggieMike88 Touchdown! Greaser! PoA Supporter

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    For Class 3 re-issuance....

    Compliance for Diabetes is a letter from your treating physician
    1. stating what your latest A1C result was from blood lab work
    2. he has examined you for diabetic complications for neuro, cardio, nephro, and vision and there are no complications
    3. what medications you are on (name, size of dose, frequency of dose) and that you do not suffer from adverse side effects.

    Compliance for CPAP is a letter from your treating physician
    1. stating that he has reviewed 1 year's worth of data from your that shows actual time used. Target goal should show use for at least 75% of sleep periods and an average minimum of 6 hours use per sleep period.
    2. that you appeared before him well rested, alert, and no signs of abnormal fatigue.
    https://www.faa.gov/about/office_or...me/guide/special_iss/all_classes/sleep_apnea/

    This is unfortunate and sorta sounds like you were poorly served by your sleep doctor. And you did go see a board certified sleep doctor, correct?

    Mine got it right the first time. And I can really tell the difference in quality of restorative sleep when I am on the blower versus when I'm not.


    As far as your "supersede" question, I'll defer to folks who know more about that than I, such as Dr. Bruce Chien aka @bbchien on this board.
     
  3. WannFly

    WannFly Pattern Altitude PoA Supporter

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    BasicMed requires that you have a medical (with or without SI), nothing else. but wait for Doc Bruce or someone from FAA to confirm
     
  4. AggieMike88

    AggieMike88 Touchdown! Greaser! PoA Supporter

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  5. Stewartb

    Stewartb En-Route

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    Neither sleep disorders or diabetes are disqualifying for Basic Med. You could have gone for Basic med without any SI, but since you have them? If you use your third class for flying you'll need to comply with the SI letter's requirements. If you elect to go Basic Med immediately you can do so and disregard the conditional third class medical.
     
  6. rotorminkey

    rotorminkey Guest

    Your help has been invaluable. I sleep with a nurse who says I don't snore. But the AME didn't like my neck size and ordered testing. The sleep lab (certified) said that although I didn't snore, my saturation dropped to a low of 94 the night I spent at the sleep lab. When they adjusted the CPAP it had no impact on my "events" and when obstructive events were decreased, my "central" events increased. Never been a nappy guy and once I wake up after my seven to nine hours I'm refreshed and ready to go. I promise all of you that as a nurse myself I would not fly if I felt this issue impacted me at all or my ability to fly.
     
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  7. Matthew

    Matthew Touchdown! Greaser!

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    A couple years ago FAA made a few changes to its OSA policy. They tried to encourage pilots to get tested instead of avoiding it. One of the consequences if that change is the AME can tell the pilot to get a sleep apnea screening if the pilot fits the profile. The profile of the typical OSA person is a BMI > something and a neck >= 17".

    The SI for OSA is simple to renew, but with Basic Med even that isn't necessary.
     
  8. Matthew

    Matthew Touchdown! Greaser!

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    Your sleep people couldn't make the CPAP work for you?

    I don't know your numbers or event types, but if your machine has full recording capability you can use that 2 ways: 1) print reports to renew your class 3 SI (if you don't go Basic Med), and 2) check out the ApneaBoard.com forum. Plenty if smart people that can look at those recordings and give you good feedback on what's going on so you have something to take to your sleep people.
     
  9. Rushie

    Rushie Line Up and Wait

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    Maybe you need to find a different sleep lab. Since when has forcing air into your airway fixed centrally caused apnea? Maybe they liked selling you the machine for no good reason.
     
  10. Matthew

    Matthew Touchdown! Greaser!

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    I think there are xPAP machines that can be used to treat central apneas. But --- I thought that FAA doesn't like to issue medicals for CSA because it's caused by a problem with the central nervous system vs OSA which is a mechanical obstruction of the airway.

    I don't know the OPs actual diagnosis, he said "OSA" and apparently has some level of centrals. Possibly the centrals do not reach the level of a CSA diagnosis and are in the normal/acceptable range and the OSA numbers are out of the normal range.

    edit:

    https://www.sleepassociation.org/adaptive-servo-ventilation/
     
  11. Rushie

    Rushie Line Up and Wait

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    Yeah as I typed that I wondered if maybe there was but I hadn't come across it back when I was looking into it (when I had a sleep study, no obstructive at all, doctor concluded rare something else similar to central).