October 1, 2011
By Jonathan Sackier
This column usually addresses ways for you to help yourself. Today, while the same is true, contemporaneously it provides a way for you to benefit your fellow man. The story goes that Prometheus, keen to help mortals, stole fire from Zeus, which rather irritated the big guy. The punishment meted out was for our man to be bound to a rock where a vulture would devour his liver. Those Greek deities were smart; they knew that the liver could regenerate, so poor old Prometheus was condemned to have that gourmand raptor repeat his daily repast. Forever.
In the culinary world the liver is an impressive organ, source of paté, nice with fried onions, and detested by children everywhere. From a physician’s perspective it is a large brown structure lurking under the right and part of the left ribcage, processing our food and medicines, and abused by us in many ways—the most obvious being alcohol. Although many insults are forgiven as the liver recovers and new cells appear, some mistreatments are more subtle than vultures continuously eating the liver in a way that prevents recovery. Many diseases create this scenario, none so stealthy as hepatitis C. The “hepa” part means liver and “itis” signifies inflammation, so hepatitis implies liver swelling, here caused by a sneaky virus conveyed in several ways: from mother to fetus; via blood donation; sexually; sharing a toothbrush or razor with an infected individual; obtaining nonsterile tattoos; or from illicit intravenous drug use, although many patients have no obvious source.
About 15 in 1,000 Americans carry the virus; when first infected about 10 percent develop jaundice—pale stool, dark urine, and a yellow tinge to the skin. Infection then becomes chronic, often without symptoms. If present, the virus needs to be eradicated with regular injections of drugs called pegylated interferon and an oral medication, ribavirin. Untreated, inflammation progresses to cirrhosis, chronic liver scarring, and shrinkage with potentially deadly consequences.
Regardless of the method of infection, when liver destruction has gone too far the only option is to transplant a new organ. Primarily, livers for transplantation come from individuals who have thought about this topic and carry a donor card allowing their organs to be used after death. Alternatively, living donors allow surgeons to remove a segment of their liver to then be implanted into their loved one—a selfless act indeed.
Meet Chris McLaughlin, a British Airways 747-400 pilot. Born in Toronto, Chris learned to fly in Britain, France, and Oakland, California. He ended up driving BAC-One-Elevens, DC–10s, and as captain for five years in the 747. He has flown, he says, “numerous and myriad aircraft, but having 45 minutes in the left seat of the Concorde was fun—she had a nice roll rate, although I might have spilled some champagne in the cabin!” Chris met his wife, Corrine, a purser with British Airways, on a layover in Bermuda in 1991. They married, and by 2005 she had her private ticket.
A clean-living fellow, Chris was involved in a motorcycle crash at 17 years old, requiring transfusion, and this was possibly the source of his future troubles.
“Two years ago I vomited some blood and they ascertained I had hepatitis C. They started the drug regime and while grounded I took time off to travel with my wife,” he says. However, Valentine’s Day 2010 brought an affair of the heart of the undesirable kind—Chris’s heart nearly stopped. He was admitted to a hospital and ended up at Kings College Hospital in London, where he underwent a transplant. Recovery was slow from this major procedure, including having to learn to walk again and falls causing fractured ribs and femur with marked osteoporosis (bone loss). However, by June 2011, with some guidance from AOPA’s Gary Crump, the FAA had granted Chris a special issuance and a third-class medical.
Now determined to raise awareness about organ donation, hepatitis C, and liver transplantation, Chris and Corrine will pilot their Cessna Skyhawk XP from Cape Cod, Massachusetts, to Cape Horn, Argentina, in December 2011. Let’s help them and ourselves in the process.
Hepatitis C is a slow, subtle, and very nasty beast and if the math works out, roughly 7,000 AOPA members unknowingly carry this virus. If you think you or a loved one may be at risk, talk to your doctor, and get tested now. If it’s positive, evaluate treatment options. You carry carbon monoxide detectors—I hope—in your cockpit and that risk is probably much lower than 1.5 percent.
Next, obtain an organ donor card and ask everyone you know to do the same. Every year thousands of people with kidney, heart, lung, and liver problems die because of donated organ shortages—18 a day in the United States alone. If every AOPA member signed on and used their voice as smart, risk-averse individuals, great societal good would be done. For information on becoming an organ donor, visit the website.
Finally, follow Chris and Corrine’s flight and support their efforts. Prometheus’ theft fed the vultures. Let’s help put an end to his suffering.
Learn to Fly,
Pilot Youth and Introductory,
Special Issuance Medical,
Pilot Health and Medical
A Wisconsin pilot with a congenital heart defect is able to solo thanks to the sport pilot regulations.
Diabetes treated with oral medications and under good control can still obtain a special issuance medical under the current guidelines.
Dr. Jonathan Sackier talks about pilot structural failure.
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