Knee/AME problem....

de727ups

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I hurt my knee playing a stupid youth group game a couple months ago...it never really healed right and was causing some minor problems...so I went to the doctor. Got an MRI and it turns out I tore three ligaments and need to wear a brace for six weeks to let one of them heal and get the scope surgery for the other two. I've been working no problem, can drive fine, and can walk on the treadmill for an hour with no pain at all. It's the high impact stuff that causes me pain. I saw the PA today and she told me I need to wear the brace which will keep me from bending my leg more than 90 degrees. Fine....I think I could take it off a few times to work but I didn't mention that to her. It just so happens that there is an AME/knee doctor in the office and she mentioned my case to him. He wants to ground me based on my reaction time being slow because of my knee. He hasn't even talked to me but gave the message to the PA who left a message on my phone. We're not even talking about flying with the brace on but talking about my reaction time being less because of the injury. Keep in mind, I've been leading a very normal life with no problems since I hurt the knee and completely think my reaction time is fine. Heck....I fly an almost center line thrust jet for pete sakes and can kick rudder for a crosswind just fine. I flew the week after I hurt the knee when it was still actually swollen a lot into windy, gusty, BFI with no problem.

I haven't spoken to this guy personally, and don't want to get into a pissing match with him....since he's an AME and all. If he'd recommend it, I'd be willing to come visit him so he can see I'm fine, but if he's so cocked to ground me without even seeing me or asking me to come in....I'm sorta thinking I should avoid him.

I'm pissed enough that he'd just ground me sight unseen that I'm pretty sure I want to find another knee doctor to do the surgery...since this guy was one of two doctors at the office.

And now for my real question. Can an AME, who isn't even your regular flight surgeon, just ground you like that? I mean I know the FSDO guys can do an emergency revocation on your license but can an AME do the same on your medical? Heck....the guy hasn't even seen me.

Sorry for the length of this post but I'm partly just venting.....
 

flx757

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I believe the most he could do, particularly sight unseen like that, is send a report to the Regional Flight Surgeon's Office, who in turn would likely send you a letter to the effect that they need additional information to determine your eligibility for medical certification. In that case, perhaps your regular AME could send a report stating that you meet the certification requirements. The Regional Flight Surgeon's office seems to always cite FAR 61.53 with regards to physical condition, treatment, etc.; then kind of puts the burden on you to prove your eligibility to hold a medical.
But again, it's my belief that any official action regarding your eligibility to hold or exercise the privilege of you medical certificate has to come from either the Regional Flight Surgeon's Office or the FAA Aeromedical Division in OKC.

Personally, I can't believe this AME would take it upon himself to report this to the Regional Office without direct first-hand knowledge of the situation.
 

bobbysamd

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AME

You have every right to be pissed. In which capacity was the AME approached? Did the PA approach the AME while he was wearing his orthopedist hat or his AME hat? I thought at first about patient confidentiality and release of medical records, but that may not apply if the PA and this "doctor" are in the same office.

I don't see how he can ground you without examining you personally. Have you even met this man? Aside from it sounding like 1984 I think he's basing his threat at least in part on hearsay. He hasn't even examined you to measure your range-of-motion or reaction time with your knee.

Maybe the best defense is a good offense. Consider seeing your regular AME to update your medical. Obviously, you'll bring up your knee injury. If your AME clears you, you should be fine. In the meantime, look for another knee surgeon. Most people don't recommend using an AME as a treating physician. AMEs aren't really looking out for your best interests. They are industrial physicians, the FAA's doctors, and really are looking out for the FAA. Moreover, you need to find another doctor or medical office, which will keep its yap shut about your aviation medical matters.

I know of a decent web site on aviation medical matters, www.leftseat.com. Try it. Calling AOPA would be even better. Best of luck to you.
 
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de727ups

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Thanks for the replies

The PA works in the same office as the AME so she had to consult him on the MRI's. It just happened to be that the guy was an AME....pretty lucky for me, huh....and I filled out the medical forms that asked my vocation. I've never met or spoken to the AME/knee doc. All I can figure is he thinks it's best to ground me and has the right to ground me on the basis of the MRI's. Thing is....I'm fine and could easily pass a first class physical. I think the doc is being unreasonable and is on a power trip.....not the kind of guy I want doing surgery on me.

I'm going to keep not answering my phone...thank God for caller ID, the PA has called three times in the last 24 hours. I feel bad for her cause she thinks it's a matter of life or death that I know I'm "grounded" because pilots need better than an olympic skiers knee performance to do their job safely...right.

Thanks again for the replies....I'm off to do my tough Seattle to Vancouver trips for a few days.
 

EAP

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Here's the deal....

First off, GET ANOTHER ORTHAPEDIC SURGEON to treat you. Don't go to this obviously spineless PA anymore, using "doctor down" as your surgeon. Get a new doctor. Do some research, ask point blank questions and a lot of 'em - and get THE BEST guy you can. Knee doctors are worth their weight in gold if you want a fast recovery and minimal pain. Don't go to a quack!

When is your next medical? What you don't want to do, is go in for a medical and get it denied. If it may be an issue, just don't get your medical until you are re-habbed. It takes a lot of effort to get your medical back after a denial. Conversely it takes no additional effort to just re-instate your medical to a 1st class after it downgraded to a 2nd or 3rd class, but you now are subsiquently recovered.

I blew my knee out over two years ago skiing at an airline skiing convention. It required ACL reconstruction surgery. It was bad enough I knew I wouldn't be good to fly (Flying the MD-80 at the time, but it didn't matter - I was down). The ACL/PCL is the grandaddy of the surgeries, the others are not nearly as bad with quicker recovery times than mine had.

I started my sick leave immediately and had ACL surgery a week later (March 1st). Recovery was a bitch, but totally doable and I was in class for my 737 transition school (pre-scheduled even from the year prior) on May 8th after getting a new 1st class medical on May 1st. The bastards even picked on my recovering knee with single engine excercises all day long, but it was no sweat.

If you have the sick leave and you can manage it, then I'd almost suggest getting the knee done asap before you get any collateral damage going on inside. This also negates the "flying with a known medical deficiency" disqualifier the FAA may take issue with if it comes down to it.

Good luck. I've been there, you will appreciate the fully functioning knee in the long run!

Ed
 

de727ups

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Knee stuff

Thanks for the reply. I got a fresh medical just before my LASIK surgery last September...hehe. The Lasik went fine and I had a great doc who is also a pilot. I doubt I'm doing any more damage to my knee as there is no pain and nearly normal function, except for playing basketball. The plan is to wear the brace for six weeks after I finish my currently busy schedule. I only work six days during those six weeks. Not sure if I can fly with my brace on and not sure if I should take the brace off for the few hours I fly....YVR-BFI...hotel...BFI-YVR hotel. All the brace is supposed to do is keep me from bending the knee more than 90 degree backwards....I haven't actually seen it yet. After the six weeks with the brace...supposedly the one ligament will have healed and I can make plans for the surgery on the others. The PA said the meniscus surgery is really important but the other one was optional....it would okay if I didn't have it and just wore a smaller brace for basketball....I'm leaning towards having it done since they will be in the knee with the scope, anyway, and the only downside is a longer recovery. This summer, between vacation and sick leave I could probably string together three months off....not sure I want to wait that long, though. Again..I appreciate the reply from someone who's been there.
 

EAP

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..Sounds like you want to get your schedule done before any time off. You are still waiting for your functional knee brace then?

Just to re-state - my ACL reconstruction (total tear) took two full months for me to be flight ready. I thought I could have gone back in about a month and change, but looking back on it, I was wise to listen to my surgeon's advice to let it heal more before I put it through the rigors of hauling my lugage in and out of the cockpit and running around jetway stairs, etc. As it was, I went right back to engine out scenarios in the sim and it was nice to have a stable knee. The meniscus and LCL type surgeries are better recovery wise than an ACL/PCL (what I had). The PA's right though, the meniscus has got to be done to save your cartalidge. I think your surgery will be easier to recover from than mine.

Do you think you are gonna stay with your PA? What about looking around for a highly recommended Ortho Surgeon that's on your medical plan? You'll get the story straight from the horses mouth that way. I'm not a medical industry guy but PA's give me the willy's sometimes.

Best of luck, knee surgery has come a long, long way. Every year they come up with better ways to fix knees and recovery gets shorter. Ten years ago it was major surgery with risks. I have full mobility and even though I have bad knee days occasionally, I don't hold back on sports and activities.
 

de727ups

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More Knee stuff

I'll be getting the brace next week but have a Europe trip right after. If I take the brace with me, I'll just take it off to work. Starting in April, I've got a really easy schedule for six weeks and plan to wear the brace all the time except for the little flying I'll be doing. After six weeks, I'll decide where and when to do the surgery...not sure if they will want another MRI or what. I'm going to find another knee doc in the area. Don't like the way things have played out with a hostile knee doc/AME in the same office as my PA.
 

EAP

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Good luck with the rest of the scenario and I'm sure you'll come out of this thing fine.

Ed
 
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