Pilot Protection Services Medical Mailbag - September Q&A

September 11, 2013

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Jonathan Sackier
Jonathan Sackier

  • Surgeon, Clinical Professor 
  • 30 years of healthcare experience 
  • Author of the “Fly Well” column in AOPA PILOT 
  • Flying since 15 years old, owns a Columbia 400 

As you might imagine, Dr. Silberman and I receive lots of emails and letters with questions related to articles, talks and general health news as it relates to aviators. Here is a smattering of some topics with brief responses to give you a sense of the scope of subjects your fellow pilots want to know about. Please feel free to write to us and we shall do our best to answer in future editions of the Pilot Protection Services Medical Mailbag.

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QUESTION: "The FAR AIM specifies oxygen use for pilots and passengers above certain altitudes, why do you advocate more liberal use? And isn't oxygen really difficult to obtain, requiring a doctor's prescription?" 

ANSWER: Oxygen is critical for every cell in the human body and pilots can monitor how much their blood is carrying with a simple device called a pulse oxymeter that slips onto a finger and provides a reading of how well saturated with oxygen the blood is. Knowing what your baseline level looks like on the ground is sensible and should be close to 100% if you are healthy. However with increasing age, tobacco use or lung, heart, kidney and blood disease, resting levels can be lower. As one ascends through the atmosphere oxygen molecules are further apart so each breath pulls fewer into your lungs, making it harder to keep the blood well saturated. Therefore every cell in you body is being relatively starved of life's essential gas. The harm of using supplemental oxygen for GA flights? Irrelevant compared to the risks of being low on this gas - damage to cells and organs, diminished decision-making ability, reduced vision and headache. With planning you can always ensure there is oxygen aboard, the cost is minimal and as an aviator you are entitled to buy oxygen without a prescription. So breathe deep and suck it up!

QUESTION: "AOPA has provided a lot of information about various screening tests, either through a partnership with LifeLine or in articles referencing Heart Scans or Bone Density testing. What should I do?" 

ANSWER: As an organization representing hundreds of thousands of pilots, we are cognizant that 97% of our members are male and the average is over 50. Men are not the best at looking after themselves and once we hit the fifth decade diseases start to become an issue. Our goal is to make everyone aware of what is out there and how screening tests are equivalent to preventative maintenance on our aircraft. But just as you would not pay to have your radar serviced if you do not have one aboard your plane, not every test is right for every person; take the information we provide and discuss this with your personal physician to see if it is relevant to you.

QUESTION: "I am 74 and in pretty good shape but am concerned about my upcoming AME visit - I have heard that the docs may well disqualify me because I am of that age. Have I got anything to worry about?" 

ANSWER: Simply put, age is NOT a disqualifying condition. Of course, as we get older various diseases that might impact your fitness to fly might start to appear. Therefore it makes sense to prepare for your medical - have your regular doctor check blood pressure a month or two before your AME visit and if elevated you can be investigated and treated and just report this with suitable supporting materials when your physical comes around. There are many other steps you can take to ensure you do not miss one day of flying -- have your eyes and ears checked and sorted so that you pass the AME exam. Less hassle for you and your AME!

QUESTION: "I have just learned that I have cataracts and need surgery. Is this the end of my flying days?" 

ANSWER: Not at all. If you and your doctor concur that an operation is the right thing to do, you must be grounded until your vision meets the standards for the class of medical you hold with either implants or contact lenses providing correction, you take the relevant records and the vision reporting form 8500-7 to your AME. FAA will want some details and you must be complication-free, but yes, you can certainly fly again. 

More details on these, and other topics can be found in the pages of AOPA Pilot magazine, on the website and in our regular communiques. Fly well!

Jonathan Sackier