Had my medical today...had problems and need advice.(warning...long)

[Doug]

***For those who don't want to read the whole thing...I have a heart murmur, and I THINK white coat induced Hypertension(only bottom number was over limit, and I was nervous as anything)...what should I do, he said I need to see a cardiologist, I need advice***

Here is a long rambling of my experience getting my medical.

We'll right from the start things went bad. I got there, and had to pee in a cup...not just any cup, but in a paper mickey mouse cup that was in the bathroom. I bring that out, and the doctor keeps saying "where are my glasses", even though I was wearing them(WTF!!!), I guess he was just trying to be funny. Then he came out with a box of various power reading glasses. Kind of a strange guy, and office, but whatever, I just wanted my medical. It was a very old house, out in a part of town I have never been to.

I am sitting there and waiting around...I fill out all of the paper work, take it up to the receptionist, and she asks how I am going to pay, and gives me two options..."check or cash". I had neither, so I asked if they took credit card...she said no. [Im sorry but I haven't been to a doctors office in a long time that didn't take a card of some sort.] So the receptionist says, "lets see what he says". I figured I could send them a check, or swing by with the cash, or something. Anyhow I wait and wait, and then the doc comes out. She tells him that I had no money, and he asked if I had a bank card, and that I should go to the local convenience store and get the cash. So he says while I do that, he will take the next patient. At this point I have been at the office for an hour. I don't exactly have time to crap around...my wife is out of town on business, so all household responsibilities are on me, I have a lot to do, and haven't had dinner yet. I head out to my car, and in the back of my head am feeling like just driving away, not coming back, and finding another doc. I felt that would be rude, so I got the cash and came back. Sit around for another 1/2 hour, and then the doc comes out.

I go in, and the guy is asking all sorts of questions, and talking really fast. He has me running through the test, and says stuff like "you have major astigmatism, you should get that checked out", then on some other test I screwed up, "can't you follow directions!", he just had me so frickin frazzled. I understand this may have been a "haze the student pilot" moment for him, but it was totally inappropriate, as my medical was at stake.

He asks me to pull my shirt up, and checks all the vitals, then pronounces "you have a raging heart murmur"...I start getting a bit nervous. Granted I have known I had a heart murmur since childhood, and have had it checked many times, but no one ever referred to it as "raging".

Then the fun starts. I get not only the "cup the balls and cough" test, I also get to turn around and spread my cheeks...yeah I guess I got "that guy".

So by this point my heart is racing like crazy...he takes my pulse, of course it's high. He takes my BP, and the top number was within limits, but the bottom number was I believe 94. It didn't suprise me at all, I was so high strung at this point. Also I ate chili and a bunch of tortilla chips..very salty before the exam, so I doubt that helped.

He does a couple more tests, and then prints out copies of the AME guide that I need to get resolved, and says I need to see a cardiologist. Apparently he sends in his paperwork, and then I need to contact the FAA with the appropriate info.

I guess now the quest begins...I need to see my fam doctor, which is not a biggie, since the office is in the same building as I work. I should be able to get a referral tomorrow, and be into a cardiologist pretty quickly(hopefully I can get some strings pulled). Given that, who knows if I will get cleared.

The AME I went to today said I am looking at 8-10 weeks till the FAA would clear me, if everything goes well with the cardiologist.

So now I am at a point where I guess I should hold off on lessons until I get this straightened out. The part that sucks is my wife got me a hefty sum of a gift certificate to the flight school, which is of course non-refundable, but I guess the balance I could use as my fairwell to flying time if I can never get passed on the medical. I guess it is good advice to get your medical BEFORE you start lessons.

 

[Gulfstream 200]

dude relax.

No wonder your BP was high, mine was after trying to read this story!!

First off, you can take all the lessons you want, certainly enough to use your gift...you simply need the medical before you solo.

Next, see a different MD. Your guy sounded like a complete freak. There really is no reason not to be able to get a 3rd class medical if you can walk and breath.....Im really not kidding here.

Whats your BP normally? 94 is a bit high yes....but you can bet your a$$ there are pro pilots flying with higher #s than that. And YES, most pilots BPs are higher at the Docs office, heck, your livlihood depends on these stupid #s and your body knows it...and most Docs know this also...

I would see the cardiologist anyways, see what he says. But really, you are most likely getting yourself worked up over NOTHING...

PS - ask around a bit before seeing an FAA Doc next time...

 

[Doug]

Thanks for the advice.

Thing is, can I tell him not to send in the FAA paperwork, and then go somewhere else. I just feel like it's too late now, and my head is spinning. I really feel like if I went somewhere else they would have passed me, but I got "the freak who checks your anus".

I am generally in good health, and have never had a physician tell me otherwise, including recent blood pressure readings. As far as the heart murmur they keep an eye on it, but everyone has said it is very minor, and many people have them.

So can I tell them not to send in the medical and go somewhere else?

 

[jimpilot]

AOPA has great medical advise on their web site for members. You can also call in for advise.

I have a current class one and take BP med. No problem, all you have to do is bring in a letter each year from your GP saying you're taking such and such medication, two readings from the last year and a statement of no adverse effects. The first time you have to have him do a few other tests (basic stuff from a blood test, no stress test or anything like that required).

Again check the AOPA site and talk with them for full advise, but don't sweat the BP, it is no big deal. And if it is high, much better than ignoring it.

 

[qmaster3]

i've never had the nut, or cheek check for an FAA exam

 

[GogglesPisano]

Nor a pee cup. My medical lasts about 3 minutes. I've been going to the same Doc for 13 years.

Find someone less nosy!

 

[JB74]

I would certainly join AOPA. Like jimpilot said, their website has a bunch of stuff on arrhythmias and murmurs (along with a whole bunch of other medical issues).

So can I tell them not to send in the medical and go somewhere else?

I am 99% sure that is out of the question.

And I too have never come across Dr. Coldfinger, and I certainly have never had my sac rolled around during a medical.

Good Luck.

 

[cfi on the fly]

You may want to check out the limits for the Blood Presssure Test. I believe its 155/95...if your bottom number was 94, you passed buddy. I have white coat hypertension too. I actually went to a doctor before my medical and had this diagnosed and written down on paper. When I showed up at the AME, sure enough it was high and he was just about to start the red ink, when I pulled out that note. He took my blood pressure a couple more times and it started to go down. Its really wierd, just by putting that cuff on my arm, blood pressure goes through the roof. I went out and bought a blood pressure tester and now practice calming myself twice a day and its working. Its really mind over matter. Anyhow, check out those numbers again, probably nothing you can do now that the paper work is started, but you never know.

 

[Doug]

Now that I think about it, I believe it was 195 on the nose. I wanted to ask him to take it again, but I was not getting any calmer, and figured it was useless.

Also, I am a member of AOPA.

Lastly, if I go to the cardiologist and my BP shows normal, is that enough for the FAA...I really don't want to go on BP meds, if I don't truly have high BP

 

[cfi on the fly]

If it was 195 over something, that is pretty high...but doctors are not going to do anything rash. If you suspect white coat hyper., then they will definately take several readings over the course of days to determine this. I have no idea what all the paper work with the FAA will entail, even if the doctors say everthing is ok.


Were you planning on career in aviation or was this just to get a license and have some fun? Hope it all works out.

 

[falcon20driver]

It's to late now, but you should have checked out the new sport pilot certificate, I know a J3 Cub is in this catagory and you don't need a medical to get a sport pilot certificate, your driver license can be used as a medical.

 

[Flyin Tony]

For my 2nd class she had to take my BP like 3 times and im only 18

 

[Lead Sled]

So can I tell them not to send in the medical and go somewhere else?

Doug,
No, the AME is obligated to send in the paperwork and you're going to have to jump through a few hoops to get a medical certificate. If I were in your position, I would contact the folks at AOPA, if you're a member, or www.leftseat.com for one of their consultations. Be assured that you're not alone - there are a lot of guys who psyike themselves out when it comes time to take a flight physical.

Along these same lines, there were some very good articles in some of the business aviation magazines a few years back that made the point that it's probably not wise to hold a medical certificate any higher than what you actually need. In other words, if you only need a 2nd class don't go after a 1st. If you are a private pilot and you're not planning on getting any advanced ratings you probably shouldn't be going for a 1st or 2nd class.

The reason is simple. If you apply for a higher rating than you need and for whatever reason you are disqualified you can not simply amend the application to a lower class or ask the AME not to submit the paperwork then go "doctor shopping". A medical won't be issued and you've ended up opening a whole can of worms for yourself with the FAA unnecessarily. It's happened to more than one pilot, including one of my close friends.

I'm not saying that you guys who are planning on an airline career shouldn't get that initial 1st class medical and EKG, you do need to know if there's anything disqualifying. What I'm saying is that as long as you only need a 2nd or 3rd class certificate you're not doing yourself any favors by holding the higher class physical.

'Sled

 

[Doug]

Sorry, I am getting things all messed up now

The upper number was normal, it was my lower number that came up high...it was actually 95, not 195...oops.

Also, this is purely for recreation, I do not plan to do this professionally.

 

[Doug]

The more I think about this, I am getting a little pissed off. The heart murmur, fine, it's there, it's been there since child hood. Would another AME even made an issue, I don't know. But the BP thing is what irks me. Especially since it was within faa limits on the upper, and 95 on the bottom(right on the dot for the FAA failure). You would have thought the guy would have checked it twice. He was using the cuff that does not contain a digital readout...you would think he would want to double check at the very least.

I just feel like now I have this "mark" with the FAA for the rest of my life, simply because I chose an AME that makes things difficult. From what it seems like this one stupid physical is going to nag me for the rest of my life. In some ways I just want to say screw it and hang up my headset, or whatever a pilot does when they retire.

Guess I am moving on from the shock phase into the anger phase...lol

 

[9GClub]

Consistency between docs seems to be an issue.... I've applied for (and received with no problem) a 3rd-class twice..... had to drop the pants for the first one but not the second. Dunno about the cheek dexterity inspection though man, that's weird. I usually handle the yoke with my knee when I'm eating the $100 hamburger, not my rear end.

BP was noteworthy too on the most recent one (130/90 maybe?), but I think that was just "white coat syndrome" as others have suggested. It is sort of a pain, though, when you're 18 (or 21 like me) and evidently dealing with BP issues.

 

[cfi on the fly]

Yeah, picking the right AME is a big deal. Whenever I move, I always find out the scoop on doctors in the area first. As for the class of medical issue...I don't think it really matters what class you are going for. On paper, there is no real difference between qualifying for a third as opposed to a first, except for the vision requirements. The real difference might be the doctors thoroughness, if he knows you are a captain flying 300 people around and you need this 1st class, he might go a little deeper into things, even though the requirements are the same for a 3rd class.

 

[JetBlast2000]

Sorry, I am getting things all messed up now

Also, this is purely for recreation, I do not plan to do this professionally.

Sounds like your stressing out a bit too much. In your situation it does not matter too much what’s on your record. Go through the steps, take care of the paperwork and keep flying. If your doing this for fun, it will sort itself out. If that was your BP for a medical, I wonder what it will be on a check ride… Fly safe

JB2k

 

[Vector4fun]

Doug,

Chill out..

This will take a bit to sort out, but should be OK. You've got two issues. One the murmur. The FAA will probably require a few tests and a Cardiologist's evaluation before ruling on this. I'm no heart expert, but if it's truly something hamless, a cardiologist should be able to verify that. AOPA or the other group can provide you and the cardiologist with info on what the FAA will want to see to pass on the murmur. If it's nothing potentially progressive, then you may only have to sort it out this one time and be done with it.

Issue #2, your BP. I believe the BP limits are on a sliding scale. The younger you are, the lower the limits, so the 95 may well be disqualifying for your age. Nevertheless, if your regular Doc can document 3-4 normal blood pressure readings in a row, then you should be able to send that to the FAA as proof your BP is OK. As the others have said, White Coat disease is pretty common.

If your description of the exam was accurate, then never, repeat, never go see this Doc again. A good Doc will spend a little time with you, chat with you and calm you down so as to give you every chance to pass the BP check.

The form letters you'll receive from the FAA regarding this medical stuff will seem pretty stern and severe. Don't let that get to you either. I've had to jump through dozens of hoops to keep my medical because of several common problems. But I've also talked to the folks at Aeromedical in person several times, and they do understand. What they need is documentation to cross every T and dot every I so as to cover their butts should you sieze up and crash into a school or some such. (Not that that would ever happen of course.) It's just a paperwork exercise for the most part, unless you really do have a serious medical condition.

 

[qmaster3]

OK

The nut check I can understand MAYBE. The BP would be the least of my concerns.

Has anyone else had to pull down the pants, bend over and grab the ankles??????????
If this is not required then I would be asking some questions. Probably calling the FAA, state medical board, etc.

 

[6'0 AGL]

maybe he thought you were trying to "stick it" to him with the money thing...

 

[Doug]

So let me try to get this straight...I can get a couple readings for the BP from my regular doc, and then send that to the FAA, as far as the murmur, I need to go to a cardiologist?

I also was thinking about calling the AME today and asking if I can stop by to take another BP test before he sends off the paperwork.

The whole exam was a mess in my opinion, and I wish it could just be torn up and I could try again. I do feel the murmur is a valid reason to hold the medical, although I have always been told it is minor, and on the same level that many people have in the world and never experience a problem. I think the AME blew it way out of proportion. On the BP, I think that was just pure BS, as the dude had me so freakin worked up...of course my BP is going to be high...but the fact that it was RIGHT on the acceptable/unnacceptable line tells me right there that it would be fine in a calmer situation, and I could most likely pass even if I took another test in his office...

Why wouldn't he offer to have me take it again...the FAA says you can take it I think 3 times over the 2 weeks before the examiner sends it out.

I'm sure that the FAA has no tolerence for this, but I have a good mind to contact them and dispute the results.

Lastly, how do I go about sending this information to the FAA. The guy gave me an address on oklahoma, but provided 0 explanation of what to do.

Thanks for everyones help...

 

[Doug]

Another thing...isn't it required to test my hearing...this guy didn't do any hearing tests. But a funny thing happened. He checked inside my ears and declared that my eardrums were beautiful perfect specimens. Then proceeded to ask what I clean my ears with...of course I said Q-Tips. He says "stop, don't do anything, just let them be, the wax is there for a reason". Well if for 25 going on 26 years of using q-tips, I still have perfect eardrums, I think I will keep doing what I am doing, thank you very much, and I don't exactly want wax pouring out of my ears.

So my question is this...if he did not perform a hearing test(if it's required), is that excuse enough for me to try and get the FAA to throw the whole thing out?

Demonstrate hearing of an average conversational voice in a quiet room, using both ears at 6 feet, with the back turned to the examiner or pass one of the audiometric tests below.

So if he wants to be mr hard a$$ AME, then maybe I can be mr hard a$$ patient and note that he is lying to the FAA if he says he administered a hearing test.

 

[cfi on the fly]

Alot of times the hearing test is done without you knowing that it was done. If he had you turned around and he was at least that far from you talking about anything, and you responded...hearing test over.

 

[bobbysamd]

FAA Physicals

I've had my share of fair AMEs and one SOB. That SOB, in Prescott, Arizona, whose day job was opthalmology, nearly yanked my medical on the eve of me going to FSDO with my logbooks to be signed off for the ATP written. That SOB forced me to take a different vision waiver. I found a great optometrist in Prescott who completed paperwork for me to get back my original waiver. I also found a much better AME in Phoenix who was a colleague's stepfather.

Unfortunately, you'll have to sweat out Oklahoma City issuing your medical. Next time, ask around about AMEs. When I considered resuming flying three years ago, I posted a request on the board. I got connected with an AME who reissued my First with fewer hassles than I experienced when I had my last one eight years before.

Good luck with your flying.

 

[dalegribble]

Sorry to hear about your problem. My best advice is if you are an AOPA member, call their medical department and they will not only listen and help but they will let you know within five minutes what your chances are. I had a student while I was instructing that had a murmur from childhood (he was a healthy eighteen when he started flying).....bottom line getting his medical cert was a hassle and took a few months, but he got it and is now eligible for a first class medical, so although it may take a bit, you should get it. The other thing is since this guy ticked you off and he was definitly a jerk, report his a** to the FAA pronto! When you call the aeromedical branch in OKC they too might be able to give you advice.

One appeal over the local AME you may have, is to the regional FAA medical office. I don't know if AOPA will have that info but the local FSDO will, depending on where you live some FSDO's are filled with VERY nice people who want to help (others are not though). I wish you the best in your trials to get you medical certificate.

 

[Vector4fun]

Doug,

Call AOPA. They like to brag that their services are great, let them earn some of that dues money. They can tell you how to proceed. I can't really help because I usually deal with another office. (Controller's medicals) After I get everything sorted out with the controller's medical office, they just forward it down the hall to another office that handles pilots medicals and they OK it.

Last I knew, the prostate check was optional. (My Doc justs asks whether I want one or not.) Wouldn't worry about it unless you're over 40 or so. And I've always gotten the hernia check. But hey, one time the Doc actually found one!

 

[Doug]

Ok, I am in the process of getting setup with a cardiologist.

So what steps should I be taking. I plan on getting a couple BP readings today from my doc to compare to what my BP readings were at the AME.

Then I guess go to a cardiologist and see about the murmur.

What should my steps be after that? Do I call the FAA, or do I send the info in via mail? I am very green with this, so I feel really lost.

Should I call the AME and tell him I want the medical report held for the two weeks, or just let him send it in today like he said he was going to?

 

[Doug]

AOPA was very helpful...I have an idea of what I need to do now.

 

[Northern Lights]

As far as the hearing test goes...

Usually as the Doc is finishing the paperwork he asks if I have any hearing problems. Of course one time I was so glad to have made it through, I was daydreaming and said "what?"

My pulse is usually high, and BP towards the upper limit. I find that if they take it later in the exam, I have relaxed a little. Also, I do better if they take it while I have my shirt on. I feel more relaxed that way.

Good luck.