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A few months ago I had a chance to listen to a presentation by a staff attorney from the Enforcement Division of the FAA’s Washington office, Amanda Bruchs. She talked quite a bit about the issues of falsification of the application for medical certification that most of us fill out periodically. I’m talking about FAA Form 8500-8, that miracle of fine print and little boxes into which you pour your life history. Indeed, down in the lower left hand corner of page two we are informed that “Whosoev...
Every time I get a new edition of Federal Aviation Regulations/ Aeronautical Information Manual (FAR/AIM) I’m amazed that it’s grown as fast as my three-year-old grandson! Pilots operate under an increasingly complex matrix of regulations and aviation medicine is no exception. So I thought it was high time to take a look at some of the legal issues and procedures affecting medical certification. This month we’ll touch on the application and certification process. We’ll also cover the options...
Mackinac Island sits in the Straights between Lakes Huron and Michigan. It is a magical, special place. Unfortunately for the pilot it is also a realm of mist, fog and low-hanging clouds with convection currents at each end of the approach and squirrely cross winds pouring over the forest-lined runway. Deb and I were departing from KMCD last September into a 300-foot ceiling. The clag was confined to the island and it was CAVU across the straights in Cheboygan, so we had a good Plan B, if...
“If you want keep her on the runway it helps to see the centerline.” Supporting this truism, the FAA has a maze of regulations to make sure that the intrepid pilot can locate the runway environment. So let’s look at a few common questions airmen ask about their eyeballs. “First of all, just how good does my eyesight have to be?” It depends. For a Third Class Medical Certificate which is all you need unless you’re flying for compensation, you have to see at least 20/40 in both eyes for both di...
In July we talked about migraines. Last month, strokes. Now, brain tumors. I know this is starting to look like “The Grim Reaper Report” but these things are more common than you’d think and sure can affect your flying! As a matter of fact, if you were to do a brain scan (MRI) on every healthy adult that walked in the FBO, you’d find one brain tumor in every 2,000 exams. So these things are by no means rare. How do you know if you have one? Symptoms can vary, but headache is common. The trouble...
My father-in-law Harry was one of the greatest guys you’d ever hope to meet. He always had a ready laugh, a twinkle in his eye. He was a wonderful father to my wife and a kind and supportive grandpa to our kids. And, of course, he loved flying with us! How heartbreaking it was to see him decline mentally as a series of strokes progressively reduced his ability to function in his last years. Unfortunately stroke or cerebrovascular accident (CVA) is a common health issue, and it’s not con...
If someone’s ever buried a hatchet in your head, you know what a migraine headache feels like. At least that’s what patients have told me. They can be devastating, incapacitating events. Unfortunately they are common. Over 30 million Americans experience at least one episode every year. That is estimated to account for over $13 billion in lost productivity annually. They can begin in either childhood or adulthood although it’s unusual for them to start after age 50. To make matters worse, certa...
In a seminar a few years ago, an FAA psychiatrist was describing the “typical” profile of a pilot. “He is independent, wears a big watch and used to be an Eagle Scout.” Over the years, I’ve found that this description holds true, especially for Part 121/135 pilots who fly for a living. They usually are a bunch of admirably straight arrows. They can be depended upon to keep their ducks in a line. However, as the ill-fated Germanwings Flight 9525 of March 24th demonstrated, there are occasiona...
It has been a while since we’ve talked about diabetes (January, 2011). Back last fall the FAA revised their rules on certification including acceptable medications and medication combinations. To back up a bit, you might remember that diabetes mellitus is a disorder of glucose metabolism. That’s doc talk for problems with your blood sugar. Your pancreas is an organ that looks a little bit like a fillet of sole. It’s between you liver and spleen in your abdomen. It secretes insulin. Insul...
Undoubtedly many of you have been following the Clash of the Titans — the FAA vs. AOPA — over the issue of Obstructive Sleep Apnea (OSA). It all started back in late 2013 when Dr. Fred Tilton, the then Federal Air Surgeon announced that the FAA was going to adopt a new obstructive sleep apnea policy. He pointed out that OSA is “almost universal” in obese individuals with a Body Mass Index (BMI) over 40 and a neck circumference of 17 inches or more. Therefore he proposed that Aviation Medical...
Vertigo is common. When you were a kid I bet there was a time or two when you spun around and around until the whole world was topsy-turvy or you tossed your cookies! A variant of that happens in flight. When you’re in the clag and abruptly bend down, let’s say to pick up a pencil, suddenly it seems as if either you or the plane is in a spin. Hold still, don’t do anything funny with the stick and it goes away. Accelerate rapidly and the aircraft seems to be pitching up. Slow down quickly and i...
Back in last June, we talked about new training options for learning about hypoxia and your own specific response to low blood oxygen. As an alternative to an extended cross-country flight to an altitude chamber, the FAA has introduced the so-called portable reduced oxygen training enclosure or PROTE. This can be transported to an FBO near you and provide a great real life experience of hypoxia under carefully controlled conditions. Responding to the article, one of our faithful readers pointed...
I’m beginning to think that not every pilot in the Midwest reads my column! Or if they do, they’re not taking Ol’ Doc’s admonitions to heart. In September the National Transportation Safety Board released a report, Drug Use Trends in Aviation: Assessing the Risk of Pilot Impairment NTSB SS 14/01. Disturbingly, they reported a sharp upward trend in the use of potentially impairing drugs by pilots who died in crashes. When a pilot does a digger the FAA’s Civil Aerospace Medical Institute...
The Minnesota-Michigan game! The Battle for the Little Brown Jug is one of the great college football rivalries and we were flying to Ann Arbor to see it! The hand-off from Rochester to Minneapolis Center was uneventful. We settled into cruise configuration with the expectation of two hours of instrument monitoring until we hit Detroit airspace. Unfortunately the day we launched was last September 26th. You may recall that on that sunny morning, an ATC contract employee decided to burn down...
You are always tired. You can’t remember a darn thing. You can’t concentrate. You always feel cold. Therefore you have, • Lack of sleep • Job and/or marital stress • A hideous life-threatening disease • Low thyroid Trick question! The answer is any or all of the above. Please be reassured, however that Option C rarely is the case. In contrast, low thyroid or hypothyroidism is a fairly common cause of all those complaints. Problem is, choices A and B are even more common causes of feeling lik...
Most airmen can get through their flying careers without ever getting hooked up to one of those funny machines that spew out lots of wiggly lines. Those of us in the medicinal trade call it an electrocardiogram or EKG or ECG. Why the “K” instead of a “C”? The first practical electrocardiogram was introduced by a Dutch gentleman named Dr. Einthoven who spelled it with a C. However his bratwurst ingesting brethren in Germany popularized the procedure and called it an elektrokardiogramm. So to h...
If you read the Aeromedical Forum of October 2010 you would know that smoking is bad for you. Of course unless you live under a rock, you already knew that. Fortunately, the marvels of medical science have come up with a variety of therapies to help folks quit. Nicotine patches, bupropion (Wellbutrin, Zyban) and Varenicline (Chantix) are commonly prescribed medications to aid in cigarette withdrawal. Hypnosis and/or talk-therapy may be helpful too. However, the sad fact of the matter is that...
OK, let’s get one thing straight. Marijuana use is incompatible with flight safety. If you’re stoned, find yourself a bag of munchies and watch some Big Bang Theory reruns. Don’t even think of getting near anything with an operable airfoil! That being said, the reality of general aviation is that not all pilots are Eagle Scouts. Marijuana is the most commonly used illicit (in some states) drug. In a recent survey, more than 16 million Americans admitted to using marijuana in the previous month...
James D Lakin, PhD, MD, FACP CFI, CFII, MEI Airline Transport Pilot FAA Senior Aviation Medical Examiner Late winter in Minnesota can be a bleak time. How much more bleak it is learning that you have a cancer. Malignancies are increasingly common especially with advancing age, although they can occur at any time of life. Also, they are bewilderingly varied and complex. Each tumor is unique. Each one carries a unique prognosis and a unique approach to therapy. So if you think something is not...
James D Lakin, PhD, MD, FACP CFI, CFII, MEI Airline Transport Pilot FAA Senior Aviation Medical Examiner It's winter in Minnesota and tis the season to be sneezing! The common cold as its name implies, is one of the most frequent causes of disability for otherwise healthy folks. For those of you with children around the house, you know why they call them snotty-nosed kids. Young children usually have at least six colds a year. Mercifully as they get older and their immune systems get more...
James D Lakin, PhD, MD, FACP CFI, CFII, MEI Airline Transport Pilot FAA Senior Aviation Medical Examiner We’ve all seen the aviation movies where the B 707 is over the mid-Pacific and a passenger needs an emergency heart transplant. Up pops a recovering alcoholic thoracic surgeon who just happens to be carrying a spare organ. He deftly does the deed with a butter knife and a bottle of brandy for anesthesia. They then fly happily off into the sunset. Well perhaps I got the plot line a bit t...