Third class medical Denial

H

HunterMaddison

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In 2013 at the age of 20 I was in the process of getting my pilots license and went to get a third class medical card. I was denied by the AME since I listed on the form that I had two collapsed lungs (same lung different times) and my info was sent off to the FAA for further review. Long story short I had fallen off of the roof of a building and landed striking my chest on a object roughly a year and a half before I applied for FAA medical. I did not puncture anything or seek medical attention at the time I just had light bruising and soreness but was fine within a few days. When doing some heavy underwater swimming in a pool a few months later I experienced a odd sensation in my chest and days later after visiting the doctor I was told I had a partial pneumothorax and was given oxygen to treat it. the next year the same thing happened again when swimming and holding my breath again and it was treated the same way. The FAA wanted me to have a surgery to glue my lungs to the inside of my chest and at the time I decided not to have it.

Fast forward to 2019 I am trying to get all this sorted out so I can get my private pilots license. The FAA once again denied me but said moving forward they wanted me to have a pulmonary stress test and CAT scan so I did. I then had a consultation and review buy a pulmonologist who gave me a clean bill of health as well as recommended that the FAA grant me a medical certificate since he saw no reason I couldn't fly. All of this information was sent to the FAA and after a long wait they once again denied me and stated that there was no foreseeable outcome for change. The re occurrence pneumococcus were due to blebs that had ruptured in the past but upon review of my CT scan the pulmonologist stated that the blebs had scared over and were not a problem any longer.

In my recent communication with the FAA they have stated that they would reconsider if I was to have a aeromedical surgeon review my medical files and contradict the FAA's findings. I currently am working on getting a appointment set up with a Head pulmonologist of a major hospital but wanted to see if anyone else could help or give any insight.

The FAA also has not given me a definitive reason as to why they're denying me so I have sent in a letter requesting their findings and I'm waiting for that currently. I am not opposed to having the surgery, but don't see any reason for a perfectly healthy 26 year old to have a surgery to glue both of his lungs into his chest if he does not need it. In the last two years I have also flown in both pressurized and non-pressurized planes as well as scuba dove with no issues. I understand the FAA's concern four planes falling out of the sky due to medical concerns and the fact that they want proof that I am not going to have a pneumothorax in flight but what do I have to do to prove it to them? The only reason the FAA knows I am at risk is because I fell off of a roof causing a bleeb to rupture. My point being if I didn't fall off the roof they will never known any different between myself or any other individual flying a personal aircraft and being that I have had CT scans, pulmonary function test and other medical exams to prove my airworthiness what else do I have to do?
 
This is way too involved for us regular SGOTI’s the provide useful info. So we page our esteemed senior AME’s to the white courtesy phone.

Pinging Doctor’s Lou and Bruce for their input. @lbfjrmd @bbchien
 
This conversation is mostly going on at pic.aopa.org, the terrible-software AOPA replacement webboard. I would say to "hunter Maddison" that the answer is the same at this board, too. If you don't get the surgery you will have a rough time getting approved....

Aviation standards are harder than community standards.
 
Without the blebs being surgically resected, your spontaneous pneumothoraces will almost certainly recur, on one side or the other (it's a bilateral disease), some day sooner or later. Unpredictably. The concept that those blebs may have "scarred down", or that their presence can always be detected on a CT scan is wrong. Not really in the realm of a pulmonologist...you'll get a more accurate opinion from a thoracic surgeon, which is what I guess the FAA is telling you.

On a positive note...the operation to resect the blebs and abrade the chest cavity lining so that the lung will adhere is generally straightforward and done using minimally invasive VATS. Generally, a pretty quick recovery. Downside is that it will likely be done first one side, then the other at a later date.
 
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