Stroke and basic med.

Brad Z said:
What it really requires is for the airman to understand the peculiarities of operating under BasicMed. It's not like the 3rd class medical, where if the doc issues the medical, you're good to go.
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You're not really "good to go" with an FAA medical either since we are still required by 61.53 to evaluate our fitness for each flight. Different "peculiarities" but peculiarities all the same.
 
midlifeflyer said:
You're not really "good to go" with an FAA medical either since we are still required by 61.53 to evaluate our fitness for each flight. Different "peculiarities" but peculiarities all the same.
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Of course not, but if one had a 3rd class medical exam performed immediately before operating an aircraft, one would expect that the exam would demonstrate compliance with 61.53.

Point being, you could have a “perfect” BasicMed exam, and meet the 61.53(b) standard, but still not be permitted to fly under BasicMed because of factors involving your medical history, the status of your last medical, etc.

Either way, it’s not something that instructors spend a lot of time discussing during flight reviews, so unless you educate yourself, it’s easy to overlook some of the details.
 
Fortunately, about the only time the FAA might look at it would be following a crash that was major enough to require in-depth investigation yet minor enough that you survived.
;)
 
Brad Z said:
What it really requires is for the airman to understand the peculiarities of operating under BasicMed. It's not like the 3rd class medical, where if the doc issues the medical, you're good to go.
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That's one of the things the stupid training course is supposed to teach you while you're burning through it looking for the Mayo clinic Easter eggs so you can get the completion certificate.
 
From what I understand....
I do not need a 3rd class medical to fly.
I allowed my 3rd class to expire in 2017, my stroke was 2019.
My Dr. is an AME.
 
Has BasicMed been tested by an inflight medical incapacitation event yet? Wondering when some eager jackwagon will crash and ruin the party for those happily flying under it.
 
schmookeeg said:
Has BasicMed been tested by an inflight medical incapacitation event yet? Wondering when some eager jackwagon will crash and ruin the party for those happily flying under it.
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It would take more than a single event to prove that BasicMed was a bad idea. It would be necessary to show that BasicMed pilots were having medical-incapacitation events at higher rates than those with third-class medical certificates.

The legislation mandated a study of the results. I haven't heard whether any progress has been made on that.
 
schmookeeg said:
Has BasicMed been tested by an inflight medical incapacitation event yet? Wondering when some eager jackwagon will crash and ruin the party for those happily flying under it.
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Not basic med, but the history of other medical-free flying shows you're about as likely to have a sudden incapacitation with a 3rd class as you are without one.
 
Palmpilot said:
It would take more than a single event to prove that BasicMed was a bad idea. It would be necessary to show that BasicMed pilots were having medical-incapacitation events at higher rates than those with third-class medical certificates.

The legislation mandated a study of the results. I haven't heard whether any progress has been made on that.
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https://www.faa.gov/data_research/research/med_humanfacs/oamtechreports/2020s/media/202118.pdf

Conclusion: This study could not detect a significant overall difference in aviation safety outcomes,
such as accident rates or ORs between BasicMed pilots and pilots holding third-class medical
certificates. However, given the study’s limitations, generalizations should not be made that because
significant differences were not detected, no differences exist. The power to test the effect of medical
certification changes might be insufficient due to the number of relatively recent flight exams in the
BasicMed group. The results do provide some evidence that the BasicMed rules do not otherwise select
for a risky group of pilots and that further research of the issue is warranted.​

I believe you'll find that there's a bit of selection bias present in Basic Med, as many elderly pilots with a medical issue or two are more likely to switch to it when renewing a 3rd class would require expensive exams and tests for an SI. I personally fall into that camp.

IF I'm correct about that, the results would indicate that many conditions requiring an SI (often at considerable time and expense) do not have any measurable impact on flight safety after all.
 
Tom-D said:
From what I understand....
I do not need a 3rd class medical to fly.
I allowed my 3rd class to expire in 2017, my stroke was 2019.
My Dr. is an AME.
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To fly under Basic Med, you need to complete these four steps:

What do I need to do to fly under BasicMed?
  1. Comply with the general BasicMed requirements (possess a U.S. driver's license, have held a medical after July 14, 2006).
  2. Get a physical exam with a state-licensed physician, using the Comprehensive Medical Examination Checklist
  3. Complete a BasicMed medical education course;
  4. Go fly!
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https://www.faa.gov/licenses_certificates/airmen_certification/basic_med

The only caution that I would offer is that if you're going to an AME for step 2, he might be tempted to apply FAA criteria to your examination. That's not really appropriate. And some AMEs aren't willing to do Basic Med exams. So you might have a conversation with him first.
 
Capt. Geoffrey Thorpe said:
The conclusion will be that incapacitation events are sufficiently rare that a statistically significant determination can not be made.
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I’d wager if a proper study was done on all medical evaluations it would show little statistical difference in events across any of the levels. Between people hiding issues, and people getting new issues, frankly, known issues aren’t the problem. It’s a shame the process can’t be about assuring an appropriate treatment program for the issue rather than pass/fail.
 
I wonder what the stats are for automobile accidents due to stroke?
 
Half Fast said:
IF I'm correct about that, the results would indicate that many conditions requiring an SI (often at considerable time and expense) do not have any measurable impact on flight safety after all.
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I'd love to know what other requirements would be needed (amount/length/quality of data, support of a congresscritter, etc) to use those findings to eliminate the need for those SIs.
 
If I had a stroke, I hope my physician or any physician would find out what caused it. Finding the cause might prevent a future cardiovascular event.
 
Half Fast said:
I believe you'll find that there's a bit of selection bias present in Basic Med, as many elderly pilots with a medical issue or two are more likely to switch to it when renewing a 3rd class would require expensive exams and tests for an SI. I personally fall into that camp.

IF I'm correct about that, the results would indicate that many conditions requiring an SI (often at considerable time and expense) do not have any measurable impact on flight safety after all.
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That's probably true.

It's also probably true that BasicMed pilots are more likely to be treated for medical problems, because they don't have to worry about the effect of a new diagnosis on their ability to fly legally.
 
Salty said:
I’d wager if a proper study was done on all medical evaluations it would show little statistical difference in events across any of the levels. Between people hiding issues, and people getting new issues, frankly, known issues aren’t the problem. It’s a shame the process can’t be about assuring an appropriate treatment program for the issue rather than pass/fail.
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Isn't the most significant difference between classes how long they're good for? Other than requiring an EKG and slightly better vision, are there other substantive differences in the criteria?
 
Lindberg said:
Isn't the most significant difference between classes how long they're good for? Other than requiring an EKG and slightly better vision, are there other substantive differences in the criteria?
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I believe there’s a difference in the acceptable BP range, but I’m not certain.
 
Lindberg said:
Isn't the most significant difference between classes how long they're good for? Other than requiring an EKG and slightly better vision, are there other substantive differences in the criteria?
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Vision, EKG, but also behind the scenes differences in terms of SI protocols for various conditions. FAA Aeromedical typically takes a more conservative approach to 1st and 2nd class versus 3rd class.
 
Half Fast said:
Is your doctor willing to do a Basic Med exam for you? If so, I think you can stop worrying about it.
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Yes..
The only question now is, will I fly enough to make it worth while.

Thanks
 
Brad Z said:
Of course not, but if one had a 3rd class medical exam performed immediately before operating an aircraft, one would expect that the exam would demonstrate compliance with 61.53.
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Well, then there are the cases where the AME hands the pilot their new medical, and the pilots collapses and dies.

How many airline pilots have been incapacitated in flight, even though they get examined every 6 months.
 
Pinecone said:
Well, then there are the cases where the AME hands the pilot their new medical, and the pilots collapses and dies.

How many airline pilots have been incapacitated in flight, even though they get examined every 6 months.
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Yes.
 
bflynn said:
Tom, legal answer, yes, as long as you have not had any of these conditions associated with the stroke. Plus, your doctor needs to be comfortable signing off on it.

good to see you again.
  • A mental health disorder, limited to an established medical history or clinical diagnosis of—
    • A personality disorder that is severe enough to have repeatedly manifested itself by overt acts;
    • A psychosis, defined as a case in which an individual —
      • Has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis; or
      • May reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis;
    • A bipolar disorder; or
    • A substance dependence within the previous 2 years, as defined in §67.307(a)(4) of 14 Code of Federal Regulations
  • A neurological disorder, limited to an established medical history or clinical diagnosis of any of the following:
    • Epilepsy;
    • Disturbance of consciousness without satisfactory medical explanation of the cause; or
    • A transient loss of control of nervous system functions without satisfactory medical explanation of the cause.
  • A cardiovascular condition, limited to a one-time special issuance for each diagnosis of the following:
    • Myocardial infarction;
    • Coronary heart disease that has required treatment;
    • Cardiac valve replacement; or
    • Heart replacement
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Six months earlier an experienced pilot had a health issue. He was using ag chemicals and was exposed during several hours in his farm operation. He did have an A-Fib issue during the problem, did not feel well and drove 25 miles to home. Next morning still noticed his ability to articulate was not as sharp as he should be so drove his vehicle to the doctor and was told he had a stroke. This was the only indication of any fault, all other physical activities were fine. Previous he has had a couple of A-Fib challenges that were minor up to a heart rate of about 100 which is considered by his heart specialist as minor. After the six month issue he has started a drug called eloquis for reducing blood thinner and have been told it will be unlikely to recur the stroke. All cognitive abilities have been tested and are normal. All physical muscle movements have never been affected, speech abilities are now normal. CFII has flown with him and is comfortable with flying skills. The basic med that has been utilized by his doctor feels comfortable with him but the pilot has not renewed his AOPA basic med form. If the basic med approvals will be concerned by the FAA due to additional time frame restraint then the pilot might want to fly with a LSA instead of his larger ASEL. Will the FAA needs additional time beyond the six months (or 2 years), neurologist COG study and basic med review? Can he fill out the form and get back in the pilot’s seat now?
 
Half Fast said:
There is no such thing as an FAA Basic Med review. Basic Med is not an FAA medical and no medical data is sent to the FAA.
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Probably should not have used the term "review" then. Still need to complete the form and send it in to the doctor and complete his Basic Med. Previous Basic Med has been used. Prefers not being turned down regarding a mild stroke and hoping to be know the likely end result up front.
 
Time question said:
Will the FAA needs additional time beyond the six months (or 2 years), neurologist COG study and basic med review? Can he fill out the form and get back in the pilot’s seat now?
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They will insist on two years. Why? The only thing we really really know about this is, a recurrence is 5x more likely than in the general population, within the first 2 years.
 
Brad Z said:
Yes.
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Everyone, Brad's discussion is dead on point. That is also why I do not think the American Public will accept "remote first officer", e.g 1 pilot crew, even though we can send Artemis to the moon. That is a singular event, can you imagine the opportunities to mess up with >30,000 part 121 fligh operations PER DAY?

I wonder what continuing certificaiton for Remote Pilot part 41 equipment will look like?(!)
 
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bbchien said:
Everyone, Brad's discussion is dead on point. That is also why I do not think the American Public will accept "remote first officer", e.g 1 pilot crew, even though we can send Artemis to the moon. That is a singular event, can you imagine the opportunities to mess up with >30,000 part 121 fligh operations PER DAY?

I wonder what continuing certificaiton for Remote Pilot part 41 equipment will look like?(!)
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You may be right. But I think if some Kardashian flies in some single-pilot or ground-pilot thing, flying First Class, and tweets about how awesome it is, a large fraction of the public will eat it up and clamor for their chance to take unpiloted selfies.
 
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