April 1, 2012
By Jonathan Sackier
We watch David Letterman’s Late Show and laugh at his top-10 list. Consider “stupid things pilots do to sabotage their medical.” So, like Letterman, let’s count backwards from number 10.
10. In the movie Never Say Never Again, James Bond visits a doctor’s office and a nurse, standing across the room, picks up a specimen bottle and tells 007, “Mr. Bond, I need a urine sample, if you could fill this beaker for me?” In a laconic manner, he responds, “From here?” At your aviation medical examiner’s office your urine will be dipstick tested for sugar, blood, and protein; if present, approval may be deferred until the matter is resolved. Occasionally, however, the test provides a false positive or the cause is readily fixable. To avoid this potential problem, one month before your physical buy some dipsticks and test your own urine. If positive, see your regular doctor, sort it out, and self-ground yourself until you have resolution. You can then report it at your next AME visit and avoid a lot of aggravation.
9. Good vision is so obviously a critical faculty that our friends at the FAA ask that an eye chart be part of the test—and memorizing the letters from year to year is only fooling yourself. See an eye doctor one month before your physical and if you need corrective lenses, get them, and let your AME know. You can have your eye doctor complete an FAA eye evaluation form.
8. While not exhaustive, the physical will include a hearing test. Once you are of a certain age, consider an annual hearing test—or perhaps check out the Internet, because there are online tools for self-evaluation.
7. Feeling the pressure yet? It is sensible on so many fronts to get frequent blood-pressure checks—your family doctor can do this, and if abnormal please take action. Hypertension is a common killer. Further investigation may be necessary and treatment prescribed. Report this at your next AME visit.
6. Breathing regularly is a good thing, right? With weight gain, obstructive sleep apnea—often associated with snoring—impairs your ability to do so. The FAA knows this and, in the 2012 FAR/AIM 8-1-1 e(4), states that snoring, daytime drowsiness, obesity, or a collar size 17 inches or greater merit a sleep study. So if this sounds like you, deal with it before your AME does.
5. Many pilots view their medical with disdain, even hiding problems that might lead to loss of flight privileges. Common wisdom states one-quarter of adults will suffer from mental illness, and an astute AME will detect what you already know—and with a few probing questions, uncover depression. This will again lead to red ink, avoidable by seeing an appropriate physician when symptoms first appear and starting therapy.
4. If you smoke, stop. No smart person should smoke and, as pilots are smart, I hope none of you do. However, a smoking history might inspire several investigations that could lead to being grounded. If you are at risk of lung, heart, or vascular problems, see your regular doctor for a checkup. However, if your AME does find something abnormal, be grateful it was discovered. One pilot told me her AME found evidence of disease in her neck arteries that led to surgery. The alternative could have been permanent grounding—as in six feet underground.
3. Gut problems may affect certification; it is alimentary. If your belly is misbehaving, get it sorted out. Do not be one of the tens of thousands who contract colon cancer every year, an avoidable problem by having a screening colonoscopy. Report this at your next AME visit and keep flying well. Many other illnesses, therapies, and operations need not be disqualifying, but if you fail to disclose them and are later found out, there may be consequences.
2. FAR 91.17 prohibits the use of “any drug that affects the person’s faculties in any way contrary to safety.” Between physicals you may have been prescribed medications by another doctor without checking to see what the FAA thinks. AOPA has an online tool to help you out. The association strives to ensure thoroughness, but certainly tell the prescribing doctor you are a pilot and, if there is an issue, obtain an alternative, “allowable” therapy.
1. Many problems detected at the visit to your AME are easily resolved with a test or two. However, if you schedule your medical the last day of the month it is due, there is no wiggle room. Book an appointment earlier in the month—your AME will definitely appreciate this and if there is an issue, you may be thankful.
There are many other potential pitfalls that might impede your certification, which is why AOPA developed the medical services plan; if you’re not already a member—I am—consider enrolling. There will be some exciting news about future enhancements to this program—maybe it will be on Letterman!
Email the author at firstname.lastname@example.org.
Aviation Medical Examiner,
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