The dreaded flight physical
I was born in England, but have lived in the USA for more than 20 years and know some Americans remain befuddled by the British “class system.” Over the duck pond there was royalty, the aristocracy, and to all intents and purposes, the rest of us, the “great unwashed.”
On these shores we also have class systems—prom kings, homecoming queens, and the class system enacted by the FAA when granting medical certification. Once again, I am a lower-class citizen, but justly proud I have my third class medical certificate. It means I can exercise the privileges of a pilot in the best airspace system in the world.
Most pilots view their upcoming aviation medical examiner appointment with trepidation, an unpleasant but necessary task. Despite being well prepared and familiar with the FAA medical application form (many utilize online tools provided by AOPA such as TurboMedical), few of us anticipate the visit with joy!
Prior to flight, diligent pilots check weather sources, details about departure, arrival and alternate airports, route of flight, airworthiness of the airplane, and finally, their own health. Did you sleep well? Is there any stress in your life? (Who can possibly say no to that?) Any medications that you use regularly? We should all use checklist components found in acronyms such as the popular “IM SAFE.” However, once every year or two or five there is an opportunity to have someone else check you out—for your own good.
Take the story of Candy Smith for instance. She spoke with me after an AOPA Live session at the November 2009 Summit in Tampa, Fla., when AOPA Director of Medical Certification Gary Crump and I talked to Dr. Fred Tilton, the FAA federal air surgeon.
Candy is one of those people who have the highest regard for the FAA medical system. Why? Because it saved her life. When I talked with Candy she said that she felt joyous to be alive and wants to one day personally thank Dr. Tilton for the standards the FAA imposes upon pilots. “During a routine third class medical examination, my very diligent AME found almost total blockage of my carotid arteries, 95 percent on one side and 98 percent on the other,” she said. By applying his stethoscope to her neck he heard bruits, the telltale sounds of turbulent flow that are indicative of blockages. The doctor then ordered an imaging study that showed just how serious the impedance to flow was.
Candy had had no symptoms at all, and hadn’t seen her family physician for a checkup in a long time. Had the blockages not been found, Candy was facing the risk of a potentially incapacitating or fatal stroke, one of the major killers in the United States. “I needed two operations, three weeks apart, which literally saved my life,” she said. The operations, called endarterectomies, involve carefully cleaning out the obstructions to blood flow inside the vessels that run through the neck into the brain. Candy’s AME needs to be commended for his diligence and care: Yes, Candy had to undergo surgery and was not flying for a while, but the alternative was far more tragic.
It was a long road for Candy to regain her FAA physical and she said she wishes she had sought the help of AOPA; she relied instead on the help of a local adviser in her home state of Florida. Given that at the end of that path was her way back into the sky, she describes it as “a wonderful road.” She is now flying with a special issuance and is hopeful of a regular issuance this spring, and she is planning on seeking the help of AOPA this time around. She now describes herself as being in better shape than when she was aged 30, and is now hopeful of earning her instrument and commercial tickets.
Very often a bureaucracy can move slowly, especially if you are at the sharp pointy end, but the bureaucracy exists for a reason: to protect the general public from pilots whose health may preclude them from flying safely, and to protect pilots from themselves. Of course, there are things that could be done better, but the FAA is working hard to be responsive to a rapidly changing medical landscape. Ten years ago diseases that had a poor long-term prognosis are now treatable, and that means there will be pilots with such conditions who want to get back in the left seat.
For example, the FAA has recently medically qualified the fifth heart transplant recipient. Five isn’t a lot, but just a few short years ago no one with a heart transplant was being considered for medical certification. The federal aviation regulations require that pilots “self certify” each time they choose to fly, but within the constraints of the medical certification rules, or standards. The FAA medical examination is just one regulatory tool to help ensure we stay safe. In the future there may be better ways to do it, but for now we all have to work within this system, the best one in the world.
There are several ways to avoid aggravation with your next FAA medical. If you will be reporting a new condition or medication, have good documentation so the FAA will know just what is going on, complete AOPA’s TurboMedical as a pre-medical planning tool, check your medications against the database of meds that the FAA allows (or not), and go to your appointment with an attitude like that of Candy, that this could be a lifesaver. However, first and foremost, look after yourself. You participation in the AOPA Medical Services Program is one step, and there are many others that we shall address here in future issues and in AOPA Pilot magazine.
And as for “class,” having come from the country that gave the word one definition, I can state categorically that we have a class system in the USA—the classiest and best general aviation community in the world!
March 9, 2010