High blood pressure, but whats really going on?

[siucavflight]

So go to see the AME, first time seeing this guy. Never had blood pressure as an issue, so not sweating the medical too much, last medical 6 months ago blood pressure is 125 over 70. Today he takes it and says that I am 165 over 110, takes it six different times trying to get a reading below 155 over 95 cant do it. Me freaked out runs to my normal physician, get a full check out, and of course now I am stressed so I am really worried about what the reading will be. He takes it five different times, highest reading he gets is 130 over 80, and cant figure out what is going on. He calls the AME who will have no part of what my doc is trying to tell him and insist that he was right, so my doc calls in one of his collegues and asks him to take my blood pressure using differnt equipment, guy takes it twice same findings both times 130 over 75.

My question is what is my course of action here? The AME will have no part of the other docs telling him he is wrong. What can I do?

 

[xcrjdriver]

Go to aopa.org. If you are not a member, join they may be able to help you.
good luck!

 

[N1VIBS]

Did the Ame use the same blood pressure cuff (I think thats what they call it) all 6 times? I had a problem aabout 2 years ago. My blood pressure had always been good. Went for my 1str class physical renewal and my blood pressure had gone up to about 170/100. I had beem to this AME for years and he knew something wasn't right. Tried another "cuff" and everything was normal.. Turns out the cuff gauge was broke.

 

[siucavflight]

No, I asked him if he could try a different machine, and he said no, he knows his equipment and knows it is working right.

 

[N1VIBS]

Sounds like one arrogant S.O.B. AME. Don't know it would work exactly (1AME says you have high blood pressure, another says you don't) but I think I would try another AME and see what happens. Good luck.

 

[SPilot]

Shouldnt there be a "static inspection" on the pressure gauge that the AME is using?

 

[whatitdoing?]

If the blood pressure device is one of those electronic ones, they are very very unrealiable. I only go to AMEs who use the old hand pump ones. The electronic ones need to be calibrated regularly and if they don't, they aren't accurate. Also, if these BP machines come close to anything else that's electronic or anything that emits energy, they'll give incorrect readings. By the way, who's the doc and where? Seem to be a real jerk.

 

[cmsick8]

Do us all a favor and rate this guy @ www.amereview.com. We have all worked too hard to lose medicals over an arrogant doc.

 

[siucavflight]

Do us all a favor and rate this guy @ www.amereview.com. We have all worked too hard to lose medicals over an arrogant doc.

Thank you, I put up a review for him. I am going back to him tomorrow, as long as he feels my blood pressure is back to normal he will not pull my certificate, I have been to my real doctor every day since and my blood pressure has been fine, and he has noted where it is every time that I have gone.

 

[Metro752]

Sue the AME for malpractice. Mmmmmmmmmmmmmmmm money. My bro, a doc, suggested this, after i emailed him your plight!

 

[siucavflight]

Sue the AME for malpractice. Mmmmmmmmmmmmmmmm money. My bro, a doc, suggested this, after i emailed him your plight!

I am not really thinking along those lines, I just want to get my medical and not have to worry about this, if it turns out that this was intentionally done (which I doubt) I would consider some other type of compensation, but for now I just want to keep flying.

 

[Metro752]

Intentional or not, if you lose your ticket, and or your job, and you have documented evidence from two other doctors that he is incorrect, you have every right to make sure he compensates you for any hassle and loss of income you have.

 

[atlcrashpad]

I believe AME's are protected under Federal Law. Call AOPA or ALPA.

 

[Say Again Over]

Sounds like a bad reading,why not go to Walgreens and buy the automatic type and check yourself.

 

[Applemac]

A few questions...

- Did the AME place the cuff over the sleeve of a long sleeve shirt?
- Did you "have a few" the previous night?
- Were you on any medication?

There is a phenomenon known as white coat hypertension where anxiety leads to elevated BP readings when you go into a doctor's office.

However, to record a patient as being "hypertensive" in a medical chart requires three individual high BP readings on three separate office visits. So it sounds like this AME not only was not a good AME (not rechecking with different equipment, etc) but was a piss poor doctor to boot.

Did he end up turning down your request for a medical and reporting the findings to the FAA, or what was the outcome specifically?

I'd get your union (if you're a professional pilot), AOPA (if you're not), and potentially a lawyer involved.

 

[siucavflight]

Applemac,
He gave me two weeks before he would turn in the paper work, so for the last two weeks I went on a fruit, veggies, and water diet. Went back yesterday and the same results, I knew it was going to happen, I could feel myself tensing up while sitting in the room waiting for him. Now he has given me a pretty strong dose of Tenoretic and asked me to come back next Friday, if it is down he will grant me the first class, so he is trying his best to help me out, he understands that this is my life and he does not want to screw it up, and he mentioned the white coat thing as well. And no the night before I did not have anything to drink, I was on the usual three day before a medical healthy food binge.

 

[Applemac]

Applemac,
He gave me two weeks before he would turn in the paper work, so for the last two weeks I went on a fruit, veggies, and water diet.

Good idea, however make sure you be careful what sort of veggies you eat. Dark green vegetables like spinach and broccoli are good, high carb content veggies like corn, not so much.

Cut white bread, white rice, dessert, potatoes, beef, and pork out of your diet entirely.

Add fish (not fried) 3 times a week. Supplement with fish oil tablets.

 

[michael707767]

and he mentioned the white coat thing as well. And no the night before I did not have anything to drink, I was on the usual three day before a medical healthy food binge.

follow all the normal advice on diet, etc.

As for the "white coat" syndrome, I had the same problem. Never had a problem with blood pressure at my regular doctor, but at my FAA exams I was always right at the limit. My regular doctor suggesed I buy a blood pressure machine for home, and regularly take readings. I did that and over time I have gotten the confidence that I don't have a problem and I can relax more when I go to the FAA doc.

 

[BoilerUP]

Call your local FAA Regional Office ASAP, and tell them everything you've told us here. Also provide all medical records if requested!

I had an *********************************** AME when I went to get my very first medical who denied me because I had a "hypoglycemic-like episode" from not eating right and doing football 2-a-days when in high school. I HAD NOT BEEN DIAGNOSED WITH HYPOGLYCEMIA, and didn't know any better to not report it. I started tearing up, telling him I had passed a USAF FC1 with flying colors & thinking my dream was toast, and this guy had the gall to tell my mother he didn't think somebody with "my emotional disposition" should be defending our country.

A short phonecall to the head flight suregon guy in the FAA office in Atlanta (actually got to talk to him!) set my AME straight. I was told I could return to him or go to somebody else.

 

[BoilerUP]

http://www.faa.gov/licenses_certificates/medical_certification/rfs/

Regional Flight Surgeon listing. Call the person representing you right away!

 

[siucavflight]

http://www.faa.gov/licenses_certificates/medical_certification/rfs/

Regional Flight Surgeon listing. Call the person representing you right away!

I did, talked to a very very nice lady at the great lakes region, thanks for the info. She said that they have had quite a few problems with this doc, and that if he winds up deferring it that my first call should be to her, I will let you know the outcome next friday.

 

[need2fly]

Normally I don't like to see names posted here....But...I am also in the Great Lakes region and I don't want to accidentally go to this guy. So, could you please post his name or address.

Thanks,
N2F

 

[Say Again Over]

Six beers before ya go next time should take the anxiety away, just a thought. :beer:

 

[michael707767]

Six beers before ya go next time should take the anxiety away, just a thought. :beer:

I know an who will send you to the resturaunt next door to have a couple of glasses of wine if you test too high on the BP.

 

[Below Mins]

As for the "white coat" syndrome, I had the same problem. Never had a problem with blood pressure at my regular doctor, but at my FAA exams I was always right at the limit. My regular doctor suggesed I buy a blood pressure machine for home, and regularly take readings. I did that and over time I have gotten the confidence that I don't have a problem and I can relax more when I go to the FAA doc.

I had "white coat" too. My first BP reading was usually on the high side but would come down to normal after a few minutes. I decided not to purchase a home BP monitor because the only readings that count are at the doctor's office. I got over it by having my regular doctor's nurse check it every few days over a two to three week period. Eventually I got over my fear of the cuff and now have normal readings on the first check. I still have it checked every month or two just to keep an eye on it. I can now walk into my AME's office more confident knowing that I do not have a problem.

 

[myq2u]

SIUCAV…

I think you are making a huge mistake going back to this doctor! He is NOT your friend regardless of what you think. You should go to ANY other doctor and ask to be put on BP medication and then follow the steps I described below in order to get the FAA approval (I think you read my post describing the process). It is a very simple process but you must have an AME you can trust, this guy is a joke!!!

DO NOT EVER GO TO AN AME UNLESS EVERYTHING IS OK! (always, always, always have a "real" doctor to go to for problems)

Stay AWAY from your doctor!!!

From my previous post where you asked about Tenoretic (Atenolol)

No Problem, it’s a Beta blocker and it is on the list – look here http://www.leftseat.com/hypertension.htm
Or read below…

As far as “how long it takes to get approved?” NO TIME AT ALL! There is NO time frame for approval, it’s really a very simple process (if you don’t like forms and have a very busy schedule use Leftseat.com [~$500] but you can do it yourself).

I am really amazed at how many pilots still think getting BP medication is a big deal with the FAA. It is NOT!!! They are very proactive now and they want pilots to be on BP meds if they cannot control it otherwise! Remember, if you wait too long your heart muscle WILL get enlarged (if it does - it's still not the end of the world but more paper work) and that shows on the EKG, do not wait - be proactive!

First find a doctor (a physician assistant - PA will work too) who will check your BP over a span of 2-3 days, get the BP medication he/she thinks is best for you AND which is on the list (take the list with you to the doc).
Wait about 1-2 weeks after taking the meds so your BP stabilizes and then check your BP at the office again. If the BP is ok and within limits, all you need is your BP readings spread out over several days (a simple excell spreadsheet will work) , a statement from your treating doctor saying you are under his/her care and taking medication ABC, what dosage you are taking (XXmg a day), and that your BP is now normal and under control. (If your medication includes a diuretic, you will also need a pee test checking for potassium levels and if the levels are ok, it needs to be stated in the letter from your doc.)

Now you will take the letter and your BP readings to your AME, and hand it to him/her. He/she will submit it to the FAA with your medical AND you will be issued a regular 1st class right then - just as always. If you are due for an EKG (turning 35 or once a yar after 40) you will get an EKG too, but it's not required otherwise.

About 2-4 weeks later you will receive a letter from OKC saying your 1st class medical is valid and that a year from now you need to submit another statement from your BP treating doc to your AME that you’re still ok and that potassium levels are fine (if taking diuretic). You’ll do it once a year and you are supposed to bring the FAA letter to the doc (even though they usually make a copy of it and then you don't need to bring it) and each time you'll bring the OK letter from your treating doctor.

From that point on you will not be receiving any additional correspondence from the FAA.
Really, it's a piece of cake!

From www.LeftSeat.com

The following medications is a partial list of FAA approved drugs. These medications are acceptable to the FAA on a case by case basis:

Alpha Blockers / Inhibitors

• Cardura (Doxazosin)
• Catapres (Clonidine)
• Dibenzyline (Phenoxybenzamine)
• Hytrin (Terazosin)
• Micardis (Telmisartan)
• Minipress, Minizide (Prazosin)

Beta Blockers

• Blocadren, Timolide (Timolol)
• Cartrol (Carteolol)
• Cibenzyline (Phenoxybenzamine)
• Coreg (Carvedilol)
• Corgard, Corzide (Nadolol)
• Inderal, Inderide, Innopran (Propranolol)
• Kerlone (Betaxolol)
• Levatol (Penbutolol)
• Lopressor, Toprol (Metoprolol)
• Normodyne, Trandate (Labetalol)
• Sectral (Acebutolol)
• Tenormin, Tenoretic (Atenolol)
• Visken (Pindolol)
• Zebeta, Ziac (Bisoprolol)

Calcium Channel Blockers

• Adalat, Procardia (Nifedipine)
• Cardizem, Dilacor, Tiazac (Diltiazem)
• Cardene (Nicardipine)
• Calan, Covera, Isoptin, Veralan, Tarka (Verapamil)
• DynaCirc (Isradipine)
• Norvasc, Lotrel (Amlodipine)
• Plendil, Lexxel (Felodipine)
• Posicor (Mibefradil)
• Sular (Nisoldipine)

Angiotensin Converting Enzyme (ACE) Inhibitors

• Aceon (Perindopril Erbumine)
• Accupril (Quinapril)
• Altace (Ramipril)
• Capoten, Capozide (Captopril)
• Lotensin (Benazepril)
• Mavik (Trandolapril)
• Monopril (Fosinopril)
• Prinivil, Prinzide, Zestril, Zestoretic (Lisinopril)
• Univasc, Unitrec (Moexipril)
• Vasotec, Vaseretic (Enalapril)

Angiotensin II Receptor Antagonists

• Atacand (Candesartan)
• Avapro, Avalide (Irbesartan)
• Benicar (Olmesartan Medoxomil)
• Benicar HCT (Olmesartan Medoxomil + Hydrochlorothiazide)
• Cozaar, Hyzaar (Losartan)
• Diovan (Valsartan)
• Micardis (Telmisartan)

.....

 

[siucavflight]

SIUCAV…

I think you are making a huge mistake going back to this doctor! He is NOT your friend regardless of what you think. You should go to ANY other doctor and ask to be put on BP medication and then follow the steps I described below in order to get the FAA approval (I think you read my post describing the process). It is a very simple process but you must have an AME you can trust, this guy is a joke!!!

DO NOT EVER GO TO AN AME UNLESS EVERYTHING IS OK! (always, always, always have a "real" doctor to go to for problems)

I agree with you, I would not go back to him except for the fact that he has not denied me yet and I began the paperwork with him. I see him Thursday now and will see what happened. And yes I have a family doctor that I go to and have been to him three times in the last three months, the only problem is that he says that I do not need to be on high blood pressure medication because the last three visits the highest he could get my BP was 125/75.
Thank you very much for taking the time to research this for me.

 

[myq2u]

Ok so he has not denied you yet? So what's that mean? Just tell him you are switching to a different AME and do not want to use his services anymore?

Have you invested in a BP cuff yet? They are inexpenisve and pretty reliable (walgreens?). Maybe find a PA who can check your BP several times of the day and bring that reading to your nazidoc?

 

[siucavflight]

Ok so he has not denied you yet? So what's that mean? Just tell him you are switching to a different AME and do not want to use his services anymore?

Have you invested in a BP cuff yet? They are inexpenisve and pretty reliable (walgreens?). Maybe find a PA who can check your BP several times of the day and bring that reading to your nazidoc?

He will not allow me to see any other AME, he said that since he has started me he has to be the one to finish me. Yes I have a cuff, and I am seeing my doc every day and going to bring her certified note of my BP to him.

 

[myq2u]

Wow, what a jerk! Please post his name as soon as your medical issue is resolved, others need to be warned! Good luck to you!