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Articles written by james d. lakin


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  • COVID-19 Vaccines: Get 'em Before They're Hot!

    James D. Lakin PhD MD FACP CFI|Feb 1, 2021

    t is my sincere hope that the day is near when I will not be devoting this column exclusively to Corona Virus Disease 2019 (COVID-19). However, more Americans are dead from COVID-19 than died in the entirety of World War II. Pilots are in a unique exposure position. So it’s critical that we understand our options in dealing with this pandemic. As I write we are seeing a surge from the post-Thanksgiving, Christmas and New Year’s gatherings. A new, more highly infectious strain of the virus is spreading across the country. It’s going to get w...

  • Seat Belts and Shoulder Harnesses: Use 'em!

    James D. Lakin PhD MD FACP CFI, CFII MEI Airline Transport Pilot FAA Senior Medical Examiner|Oct 1, 2020

    The NHTSA isn't the only federal agency that has fun crashing things! Our own FAA's Civil Aerospace Medical Institute (CAMI) in Oklahoma City has blasted a number of perfectly good airplanes to smithereens in the interest of aviation safety. One thing they have found is that both seatbelts and shoulder harnesses are pretty darn good things to have around-around you the pilot! None of us plan on having an accident or an incident. Yet we all know that in spite of our best planning and precautions...

  • Aeromedical Forum

    James D. Lakin PhD MD FACP, CFI CFII MEI Airline Transport Pilot FAA Senior Medical Examiner|Jul 1, 2020

    This spring I received a note from an airman wondering about his odds of getting off a Special Issuance. Five years previously he had a heart artery calcium scan which showed heavy calcification in one of his coronaries-arteries that supply the heart muscle with blood. He reported this to the FAA. They promptly requested additional studies including a stress test and imaging studies. These looked OK, according to the airman. However, they placed him on a Special Issuance requiring these tests... Full story

  • Aeromedical Forum

    James D. Lakin PhD MD FACP, CFI,CFII,MEI, Airline Transport Pilot, FAA Senior Medical Examiner|May 1, 2020

    A couple of months ago we talked about the then looming pandemic. Well here it is and it looks like it's going to be around for a while. The good news is that Minnesota has done an effective job of slowing the rate of viral transmission of SARS Cov 2 (Serious Acute Respiratory Syndrome Coronavirus 2) and reducing the rate of development of clinical Covid 19 (Coronavirus 2019) illness. The bad news is that the duration of the epidemic may be prolonged, albeit at a lower intensity. So assuming that you're not going to spend the next two years... Full story

  • Aeromedical Forum

    James D. Lakin PhD MD FACP, CFI,CFII,MEI,Airline Transport Pilot, FAA Senior Aviation Medical Examiner|May 1, 2020

    As I sit in my office at Airlake, a King Air is revving up its engines. Good Lord it's loud and I have the benefit of 30 yards separation and a wall between me and it. Pity the lineman that's out there waving his batons. Ever since Wilbur and Orrville ran their Flyer down the sand at Kitty Hawk the business of powered flight has posed a threat to the hearing of pilots. So how to retain what hearing you have after an adolescence of rock concerts? First of all, let's talk about sound. You may... Full story

  • Aeromedical Forum

    James D. Lakin PhD MD FACP, CFI,CFII,MEI, Airline Transport Pilot, FAA Sen. Medical Examiner|Apr 1, 2020

    How many months are we into winter? How many pounds have we put on? Since you can only get so much exercise from throwing around snow, it's hard to avoid the "Late Winter Couch Potato Syndrome"! Lack of physical fitness and overweight are bad enough for the Average Joe. It sets you up for anything from lower back pain to hypertension to heart attacks. For a pilot, deconditioning can lead to problems in stamina, alertness and the ability to respond to the emotional and physical stressors... Full story

  • Aeromedical Forum

    James D. Lakin PhD MD FACP, CFI,CFII,MEI,Airline Trans Pilot,FAA Sen. Aviation Medical Examiner|Mar 1, 2020

    One thing about the aviation community, we get around. We are exposed to many different terrains, population, cultures and, unfortunately infections. If you’re flying under Part 121 or 135 you often cover a lot of territory and come into contact with a lot of people and a lot of viruses. Many General Aviation operations also fall into that category. Given all that, a lot of pilots have been wondering about the Coronavirus epidemic that started in China in January. It is spreading. The possibility of coming in contact with it is not as remote a... Full story

  • Aeromedical Forum

    James D. Lakin PhD MD FACP, CFI, CFII, MEI, Airline Transport Pilot, FAA Sen. aviation Medical Examiner|Feb 1, 2020

    What better flying weather than a crisp clear February day in Minnesota. You’d think you were flying a helicopter with the short takeoff runs. The air is smooth and the visibility unlimited in bright sunshine. The reflection from the snow is dazzling. I sure hope you didn’t forget those sunglasses! Sunglasses are a very important and often underappreciated piece of a pilot’s equipment. They are critical to optimize visual performance in the cockpit. If you have a good pair, they will reduce eye fatigue, reduce the negative effects of harsh... Full story

  • Aeromedical Forum

    James D. Lakin PhD MD FACP, CFI,CFII,MEI, Airline Transport pilot, FAA Senior Aviation Medical Examiner|Jan 1, 2020

    It's winter flying season! Some of the best conditions imaginable can be had on a clear crisp winter morning in Minnesota. You ease the throttle forward and suddenly your C172 feels like a P52 Mustang as it takes off in nothing flat. Same with the climb as you plow through that calm solid air. So what could go wrong on a day like this? Unfortunately, weather that's good for aerodynamics isn't necessarily good for pilots. Of course, I'm talking about cold injury, something I try to touch on... Full story

  • Aeromedical Forum

    James D. Lakin PhD MD FACP, CFI, CFII, MEI, Airline Transport Pilot, FAA Sen. Med. Examiner|Dec 1, 2019

    Aviation training doesn’t come cheap. So, when the FAA offers it for free, you might want to take a hard look. Of course, there’s a catch. Training is done in Oklahoma City, the headquarters of the Civil Aerospace Medical Institute (CAMI) which does take a few gallons of avgas to reach. However, this time of year, odds are it’s a good deal warmer and sunnier than here at home. Now that I’ve almost talked you into it, what training is available? The two big programs are CAMI’s Physiological Training Course and Basic Survival Skills for Gener... Full story

  • Aeromedical Forum

    James D. Lakin PhD MD FACP, CFI, CFII, MEI, airline Transfer pilot, FAA Sen. Med. Examiner|Nov 1, 2019

    The weather is cooling down and you probably are cranking up the cockpit heater more often now. That’s fine. It’s hard to keep her straight and level when your teeth are chattering. But with the comfort of cockpit heat comes the possible discomfort of doing yourself in. Do I have your attention? Most general aviation aircraft use a time honored heating system where intake air is passed over the exhaust manifold of the engine. If you’ve ever bumped against a tailpipe you know that it’s red hot and has plenty of heat to spare. Using that heat to... Full story

  • Aeromedical Forum

    James D. Lakin PhD MD FACP, CFI, CFII, MEI, Airline Transport Pilot, FAA Sen Medical Advisor|Oct 1, 2019

    A couple of months back an older gentleman came in for a flight physical. He’d flown a number of years ago and wanted to “get back in the game” now that all the kids were through college and on their own. His health record looked good. He seemed a reasonable candidate for hopping back into the cockpit. Then we tested his vision. Much to our mutual surprise he was blind as a bat! Well, not really blind but he was having trouble seeing 20/100. In case you’ve forgotten what the funny numbers... Full story

  • Aeromedical Forum

    James D. Lakin, PhD,MD,FACP,CFI,CFII,MEI|Jun 1, 2019

    One thing that endlessly confuses airmen (and occasionally AMEs) is the processing of Special Issuances. First of all what, you might ask, is a Special Issuance (SI)? An SI is granted by the FAA to a pilot who has a medical condition that otherwise would disqualify him from obtaining a medical certificate. The list of disqualifying conditions is a very long one. Basically anything that might suddenly or insidiously impair your ability to physically or mentally carry out the duties of pilot in co... Full story

  • Aeromedical Forum

    James D. Lakin, PhD,MD,FACP,CFI,CFII,MEI|May 1, 2019

    The days are getting longer. The temperatures edging upward along with the cumulus build ups. It will soon be summer flying time! But before you start buzzing off to all those great pancake breakfast fly-ins you should be adding one more item to your I'M SAFE checklist-sun safety. All that time out on the tarmac and around the FBO adds up. If you're flying open cockpit, that can drastically increase UV ray exposure. UV or ultraviolet rays are high frequency light waves invisible to the human eye... Full story

  • Medications on the Mind: Flying (or not) with Drugs:111

    James D. Lakin, PhD MD FACP CFI CFII MEI Airline Transport Pilot FAA Sen Med Examiner|Feb 1, 2019

    Over the last two months we’ve been talking about the many problems that can pop up when using medicines while flying. Side effects to watch for in the labeling of over-the-counter medications include light-headedness, drowsiness, dizziness and visual disturbance. Allergy, cold and sinus medicines are some of the most common culprits. Be very careful if you are thinking about taking any of those. Prescription medications usually don’t come with a list of side effects so it’s important to ask y... Full story

  • Medications on the Mind: Flying (or Not) with Drugs: II

    James D. Lakin, PhD MD FACP CFI CFII MEI Airline Trans Pilot FAA Sen Aviation Med Examiner|Jan 1, 2019

    Last month we covered things to think about before taking a medication and hopping into the cockpit. Medications can cause a world of trouble for a pilot including idiosyncratic reactions and side-effects as well as failure to control the underlying condition for which you’re taking the drug. Light-headedness, drowsiness, dizziness and visual disturbance are the tops of the pops for side-effects that can cause a flight into the glass mountain. So what are some of the drugs to for-sure stay a... Full story

  • Can Arthritis Ground You?

    James D. Lakin, PhD,MD,FACP,CFI|Aug 1, 2018

    As we get a little older its par for the course to get a little stiff and have a few aches and pains. If you fall into that silver-hair category, try sitting in a GA cockpit for five hours and then spring onto the tarmac. Make sure there’s somebody there to catch you! Sometimes however, those aching joints can get out of hand. Swelling, redness, pain, warmth and loss of function in a joint mean you’ve got arthritis. Arthritis happens frequently and comes in many forms. The most common type is... Full story

  • Aeromedical Forum

    James D. Lakin, PhD,MD,FACP,CFI,CFII,MEI|Jul 1, 2018

    It’s been a long time since we’ve talked about the medical issues of high altitude flying. Since then General Aviation pilots have been spending more and more time at higher altitudes. The ubiquity of turbocharged single-engine GA craft has made it easy to crank an unpressurized cabin up to the flight levels and get that big tailwind. Before you do that though, make sure you have the right equipment for supplemental oxygen delivery and know how to use it! Your risks of oxygen starvation or hyp... Full story

  • Aeromedical Forum

    James D. Lakin, PhD, MD, FACP, CFI,CFII, MEI....|Jan 1, 2018

    If you've looked out the window recently, you've probably noticed its winter in Minnesota. Thus, it's time to talk about how you can easily loose bits and pieces of your anatomy on the tarmac if you are not respectful of the cold. Not all of us have the luxury of a heated hangar. When we're flying cross-country in winter, it usually means doing some pre-flights on a windy, frigid stretch of concrete. That's an ideal set-up for freezing some part of you-Frostbite! The mildest form of Frost Bite... Full story

  • Flying with Glaucoma: A CACI Condition

    James D. Lakin, Phd,MD, FACP, CFI, CFII, MEI,|Dec 1, 2017

    I don't know about you but that kind of call from ATC always gives me the willies. Someone is buzzing around out there. They don't have enough sense to turn on their transponder, if they have one, and I'm not picking them up with my peripheral vision. It makes you realize how difficult "See and Avoid" really is. Imagine how much more so that would be if hunks of your peripheral vision were gone. That's what happens in early glaucoma. That's why the FAA is really concerned if you have it.... Full story

  • Flying with High Blood Pressure: A CACI Condition

    James D. Lakin, PhD,MD,FACP,CFI,CFII,MEI|Nov 1, 2017

    Back in March of 2013, the FAA started defining “Conditions AMEs Can Issue (CACI).” They realized that many uncomplicated illnesses that had required a decision by the FAA in Oklahoma City could be monitored by a local Aviation Medical Examiner (AME). It’s been nearly five years since the FAA started granting this discretion to AMEs and it seems to have worked out well. There has been no increase in accidents attributed to this delegation of oversight and life has become a lot easier for pilot... Full story

  • Sudden Pilot Incapacitation: Yikes!

    James D. Lakin, PhD, MD, FACP, CFI, CFII, MEI|Oct 1, 2017

    March 29 this year, a Boeing 737-300 (AA 1353) was on short final heading into KABQ down in Albuquerque when the First Officer suddenly slumped forward, unconscious. Fortunately, the Captain noticed, summoned paramedics, and landed the plane safely. Attempts to revive the First Officer were unsuccessful, the presumed cause of death being a heart attack. Fortunately, life-threatening incapacitation of pilots in a commercial setting is rare. Even more rare is the flight's safety being... Full story

  • The FAA's New Approach to Sleep Apnea

    James D. Lakin, PhD, MD, FACP, CFI, CFII, MEI|Jul 1, 2017

    It's been almost five years since we talked about sleep apnea (September, 2011) and the FAA's approach to this problem has been updated. Obstructive sleep apnea (OSA) is very common. .It affects anywhere from 9% to 28% of adults. It happens when the upper airway becomes obstructed during sleep causing disruption of normal sleep patterns. It is usually caused by overweight. Fat tissue in the neck can block the airway, causing an interruption of air flow. It seems to occur more commonly in men... Full story

  • Melanoma:The dark spot that can do you in!

    James D. Lakin|Jun 1, 2017

    Our cousin had a dark black spot on her lower leg for a couple of years. Her local doc told her not to worry. It got bigger. She let it slide for a few months as she and her husband were moving up here to The Cities. I got her in to a dermatologist who biopsied it and confirmed what we both were thinking and dreading-malignant melanoma. It had spread throughout her body. She was dead six months later. Unfortunately, this tragic story is a common one. The incidence of this form of skin cancer... Full story

  • Aeromedical Forum

    James D. Lakin|Apr 1, 2017

    Last month we took a look at some of the provisions of BasicMed, a new way to legally fly without a Third Class Medical Certificate. We talked about the restrictions on aircraft type and operation as well as the basic procedures a pilot will have to follow if she/he elects to go this route to establish medical qualification. Bottom line-if you are a healthy person under the age of forty, it's probably easier and more cost effective to stick with the traditional Third Class Medical. If, however,... Full story

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