SSRIs and deferral timeline **Issued**

RussS

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rshermer
I figured I would post a summary of my timeline for anyone who is going through a similar situation as me. I applied for second class medical in December of 2019. Here is my story;

12-10-19 - FAA physical at my local AME. I thought this would be a breeze because I was a healthy 39 year old, no medical issues (so I thought). I did NO research prior to my MedXpress and that was mistake #1. I was on Sertraline and Buspar for a situational anxiety I had a couple of years earlier. I never went off the meds as I had no side effects or anything and didn't even think about it affecting my medical. Needless to say, I was deferred and the wait begins. My local AME told me just go off of the meds and in 60 days we can issue. He gave no other indication of what might be needed.

12-10-19 - Called my PCP and discontinued both meds.

1-2-20 - Called OKC for an update: "under review"

1-4-20 - Found POA and read others stories and was advised to contact Dr Chien, which I did.

1-11-20 - Dr Chien had agreed to take my case, HIPPA forms were signed, my medical records were requested from my PCP to be sent to Dr B.

1-15-20 - Called OKC: "deferral in the mail"

1-23-20 - Received FAA Deferral which requested a complete clinical history including medication as related to my anxiety diagnosis

1-29-20 - I was advised that the FAA will want a psychiatric evaluation from at minimum a board certified psychiatrist, and that may or may not even be enough for them. ***This is where an HIMS AME's knowledge is worth every penny*** I hadn't been told by the FAA that they needed anything like what I was being told, and it would have likely been months of back and forths before it was even requested. I took Dr B's warning about a regular psychiatrist possibly not being enough and decided to go right for the HIMS psychiatrist. This would cost more, but the FAA relies heavily on their word, so I knew whatever came of it would be accepted from the FAA. Going directly the HIMS route likely saved me months as well.

2-6-20 - Had my psych exam performed. Nothing crazy with the exam...general history, some memory recall, drug and alcohol questions, and some blood and urine taken.

2-26-20 - Had to visit my PCP to have am "on record" date of discontinuation of meds added to my medical history, a letter written explaining I was examined and fine off of medication.

2-27-20 - Here's where things turn. I receive a call from my HIMS psych. One of the blood tests they run is for alcohol biomarkers. Carbohydrate Deficient Transferrin (CDT). Yeah, I had never heard of it before either. I was a moderate drinker on the norm. Never any home, work, legal issues ever, so alcohol consumption wasn't even on my radar of things to worry about. Well, coming out of the holidays and plenty of birthday parties at my house....I guess I drank A LOT in the 8 weeks prior to the exam. My CDT was sky high. The psych said nothing else in your exam points to any kind of problem....but this test...the FAA isn't going to know what to think about it.

2-28-20 (ish) - Dr. B basically says were hosed...Anxiety doesn't look like an issue, but this CDT level definitely is. The FAA will label you with abuse and you will have to go through the HIMS process.

3-5-20 - Psych report still no done, file an extension with the FAA for my response to the initial deferral letter.

3-20-20 - Dr B has the psych report, faxed in my response to deferral letter along with letter from my PCP about the discontinued meds and the HIMS psych report....the psych would not send to me as a matter of policy between him and the FAA. (they dont want people altering their results before the FAA sees them). He confirms that he believes it will be a Special Issuance and monitoring because of the high CDT. I now must go to Chicago and have another second class medical done by him to make him my AME of record.

3-26-20 - Fly to Chicago for medical exam (passed), talk about the upcoming requests that will be coming. Trying to stay ahead of FAA requests to cut down on delays. Urine ETG checked in office (negative) and talked about starting alcohol monitoring right away...again, stay ahead of the FAA. Also requested my full medical record from the FAA. (this would include my psych eval report).

3-28-20 - Began "14 in 12" random urine ETGs

4-21-20 - Received demand letter from FAA requesting clinical history, and current status of headaches that they saw in my medical record. Back to my PCP to get another letter stating there are no headaches anymore and no medication is being taken. Headaches were caused by rebound. Another thing I didn't know. I started taking Excedrin Migraine years earlier for headaches...my body got use to it, and I would get headaches when I DIDNT take it...almost like a withdrawal. Anyway, I had weaned myself off of Excedrin about a year ago, so it was no longer an issue.

4-30-20 - Got the letter from my PCP and submitted to Dr B to be faxed to the FAA

6-7-20 - Received my full medical record from the FAA

6-19-20 - Received demand letter asking for a personal statement from me on my past, present, and future relationship with alcohol.

6-24-20 - Submitted personal statement. Dr B also had me take another CDT test so we could send that in along with the negative urine ETG's to date.

7-23-20 - Advised that my file was being discussed and the FAA was worried about alcohol dependence. Again, having a good HIMS AME in your corner is paramount. (Thank you Dr B!) They were reminded that a HIMS psych said there was no indication of that.

7-27-20 - about 1 minute ago....I printed my medical certificate....It is an SI and we don't even know ALL of the requirements yet.....but I can fly.

I can't even tell you how much of an emotional roller coaster this has been. Without the help of this site, and of course the best HIMS AME there is (maybe I'm biased), I have no clue where I would be. As for the alcohol stuff... You've heard it before,I have no alcohol problem..accept I drank too much. I quit at the end of February when I got that CDT result...that scared me a bit. Flying is a much bigger priority to me than the beers I would drink. Once again thank you to everyone on here. If anyone has other questions about my process, I'll be happy to answer them. I am an open book. Finally, the best single piece of advise I can give to anyone facing a special issuance. Get a GOOD HIMS AME.....I dont care if you have to travel....and LISTEN TO THEM.
 
Congratulations. My own SI wasn't so arduous, but I know what it feels like to have it back.
 
Welcome to the air, Russ. :)

(Flying, is wayy more important than Beer. And 4 months from 3/26/20 to certificate is about what it takes if you can get it right.).
 
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Dr Chien, thank you for your effort on this. Every new pilot flying is a win for aviation.
 
Welcome to the air, Russ. :)

(Flying, is wayy more important than Beer. And 4 months from 3/26/20 to certificate is about what it takes if you can get it right.).

Sooo many thanks to you! Couldn’t agree more, flying is wayyyy more important. “If you can get it right” is where so many get it wrong.

It won’t be this year...but one day I’m going to FLY into Bollingbrook to see my AME. Seems trivial to some I guess, but that’s a big deal to me.
 
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