Medicals - how much should you tell?

[huskerfan]

How much should you tell an examiner about your health? I have a student who is taking a antidepressant, has asthma and has high blood pressure. Will he be denined a third calss on these items?

 

[Salty Dog]

Jeez, maybe you should just shoot him on the ground...save a good airplane.

Sorry, couldn't resisit. Don't know the real answer but I hope he/she doesn't lie.

 

[MetroSheriff]

How much should you tell an examiner about your health? I have a student who is taking a antidepressant, has asthma and has high blood pressure. Will he be denined a third calss on these items?

Perhaps you are joking. In case you are not, I will post some info for your student from the ALPA Aeromedical page.

Medication aside, if he needs antidepressants, he has NObusiness flying an airplane. From what the FAA has to say, your student is done for now, and until such time as he has gotten his medical problems resolved and waitied the appropriate time to return to flying.

Failure to do something about it could leave you open to some liability as an instructor. A lawyer could be more specific. I would not let on to the FAA that you are instructing him with known, undisclosed medical issues. Not really my businees, just a bit of friendly, if not conservative advice.

From ALPA Aeromedical:


Antidepressants and psychoactive medications:

The FAA will not approve any of the medications in this category--including serotonin uptake inhibitors (Celexa, Effexor,Prozac, Paxil, and Zoloft) as well as other psychoactive medications (Lithium, Buspar, Elavil, Sinequan, Amitripityline, etc.). Pilots who undergo treatment with these medications can be cleared to return to flight duty after they have stopped taking the medication and the treatment issues have been resolved. See Depression in the VFS Medical Information Center. These medications are sometimes used for non-psychiatric conditions, but are still not approved for use in flight in this context.

The FAA generally requires the pilot to wait 60-90 days after completing treatment with the medication. You must submit records of your treatment to the FAA for the agency's approval. Formal psychological testing is often required. VFS can assist with this process.



Antihypertensive (blood pressure-reducing) medications:

These include a wide variety of medications such as diuretics, beta-adrenergic blocking agents, ACE inhibitors, calcium channel blockers, labetolol, prazosin, and minoxidil. The FAA does not automatically authorize use of these medications. See Blood Pressure in the VFS Medical Information Center for more specific information on this topic.

The agency requires that you demonstrate normalization of blood pressure and undergo a required evaluation to make sure you have no other disease. Your aviation medical examiner (AME) can grant initial approval for using these medications if you hold a first, second or third class airman medical certificate.

 

[mckpickle]

dude I'd be very careful. Lets say worste case. Hes on the meds, lies about it. Then (not because of the meds) the engine blows apart, crashes into a lawyers convention(you can see where this is going). So his family sues cessna, the maker of his shoes, the old guy who drove the fuel truck once 5 years ago,and you. Why you? Well you KNEW he was taking meds and signed the guy off.

Lots of liability in this one. Is it worth the 20+ hours you'd get flying with him?

 

[JediNein]

Howdy!

If flying is the only thing bringing joy into this person's life, then by all means continue instructing him. If the person does not want flight instructing, but airplane joy rides once a month, then be available for that, too.

Sit down with your student and talk, over coffee or whatever, away from ears. Make it very clear what the FAA's stance is on the antidepressants and the high blood pressure and that the student will not be able to solo until the medical issues are cleared. Unless this person was revived in the emergency room after a suicide attempt, it is best to keep any suicidal tendencies or thoughts FAR AWAY from the AME or CAMI. A person could have attempted suicide at age 12 and the FAA will not certify them medically at age 57 with 45 happy years since then. Ask if any of the medications treating one condition are causing another condition (happens too often). Don't forget to mention, recreational pilot certificates, ultralights, and the possibilities of self-certifying with the upcoming sport pilot certificate.

A call to the regional flight surgeons office usually will give you the most specific information about when and what your student needs to do to be certified, including third class special issuance medicals. Tell them you are a flight instructor calling for a student and need the information to give to him so that he can decide to pursue or not pursue flying.

An old-time instructor once told me, "Flight instruction can be better than therapy."

Fly SAFE!
Jedi Nein

 

[mckpickle]

http://forums.flightinfo.com/showthread.php?s=&threadid=11530

 

[MetroSheriff]

Howdy!

Don't forget to mention, recreational pilot certificates, ultralights, and the possibilities of self-certifying with the upcoming sport pilot certificate.

Don't know about you but I am not real excited about the prospect of some moron jacked up on Prozac or Zoloft crashing into my house and hurting my wife and kids....

Even in an ultra-light or by a"sport pilot" certificated airman.

Self-certifying??? God help us.

Jedi, nothing personal, but we have these rules for a reason. They are not there for you to convince disturbed people there is a way around them just because they like to fly. For an instructor, I think you are dishing out some poor advice.

Howdy!


An old-time instructor once told me, "Flight instruction can be better than therapy."

Fly SAFE!
Jedi Nein

Not entirely sure this applies to the mentally-ill.

 

[Heyduke1]

OK, I don't know where you guys are getting your info about antidepressants and the people who use them. There's a tremendous range of psycological problems (there's a big difference between pyscological and mental illness, btw) that can be addressed by the above list of drugs. Going to college, I've interacted with a LOT of people on antidepressants, and there are some I would absolutely feel safe teaching to fly, and there are some I wouldn't think about letting touch the controls. Being on antidepressants does not mean someone's about to kill themselves or others, although it can. Don't assume someone is nuts because they take Celexa.

I completely agree that behavioral perscription meds (antidepressants, antianxiety, etc) should be disqualifying factors for a medical...but there is no reason that that person should not be able to fly with an instructor (unless the instructor feels uncomfortable with the persons emotional/mental state).

And while I'd be skeptical of letting someone on antidepressants fly a sport class airplane, I really wouldn't too be afraid of a troubled pilot smashing an ultralight into my house. Tell them they can't get a medical until they get better, but don't tell them they can't fly with an instructor. Depression is a temporary chemical imbalance, not some kind of brain defect.

Now the high blood pressure thing scares me, though.

 

[MetroSheriff]

Depression is a temporary chemical imbalance, not some kind of brain defect.

During which, the person has NO business flying an airplane. Never said it was a "brain defect". Couch it in whatever term you like, or is currently PC, but I think you would be hard pressed to not define Manic-Depressiive Disorder or OCD forms of mental illness.

As for crashing the ultra light or any other aircraft for that matter, say what you like. I would imagine that Andrea Yates friends thought of her as having garden variety depression, right up untill she methodically drowned her 5 children in her bathtub.

What do I know though, I am just a dumb pilot, not a head- shrinker. I just don't think folks should be flying if they have a condition that requires them to take medication to be stable, happy, well-adjusted, or whatever.


JMHO.

 

[huskerfan]

Hey guys, thanks for all the advice. I just found out today that my student took antidepressants when I asked him if he'd taken his medical yet. He's only logged 5 hours. I'll definitly have him go and talk to a flight doctor. He seems like he'd be a great pilot. I just know he's gonna be crushed about the medical issue. C'est la vie.
Thanks again

 

[bobbysamd]

Asthma

Your friend can get a First, even with asthma. A lot depends on its severity and its control. The AME will ask for a letter from his primary treating physician and might send his certificate to OKC for issue. After that, it only requires a status letter once a year for the next five years. For all I know, the FAA might have liberalized its requirements and his AME will issue his medical on the spot.

The FAA will approve bronchodialators, inhalers, etc. on a case-by-case basis.

www.leftseat.com is a very informative FAA medical website. A call to AOPA may be better.

Best of luck to your friend.

 

[mckpickle]

i think it is a shame that you all would be critical about me wanting to take a nut case flying. dont you know in this country we go out of our way to coddle every individual at the expense of the general population?

i am so sick of you all that i think this will be my last post..., er,... well, this is better than therapy for me so i will continue. i cant think of anything more depressing than depriving anybody of my astute observations based on my vast flight experience. after all, i have flown the amount of hours a typical profeesional pilot might fly in a year, so listen up!

THIS IS PURE F#(*ING COMEDY

 

[bigD]

What is everyone's beef with JediNein? Although I don't agree with her post either, it seems that many here have a problem with her that goes beyond this particular thread. She's been around here for quite some time and in my opinion, in the past has provided some good information - so what's with the hostility?

 

[Chunk]

That's the funniest thing I've seen all week.

 

[mckpickle]

hey im not bashing the girl its just funny thats all.


And HEY Chunk, what is that movie quote in you signature line. Im trying to remember and its driving me crazy!!!!!!!!!!!!!

 

[shamrock]

what is that movie quote in you signature line. Im trying to remember and its driving me crazy!!!!!!!!!!!!!

Isn't that from Caddyshack when Carl (Bill Murray) is talking about the Dali Lama giving him eternal peace (or something like that) when he dies? I don't remember the exact quote.

 

[JediNein]

Was there a right reason for drugs?

Howdy!

Most of the "older" folks on this board haven't been through the "feel good--can't hurt Johnny's feelings - victim" bull**** that is fed through the K-12 school systems. It seemed to start around 1992 that if Johnny so much as farted during class, he needed Ritalin or Prozac. If he had crooked teeth, the social workers had a choice of putting Johnny in foster care (obvious child abuse) or drugging him so his self-esteem wouldn't be damaged.

A kid can NOT wear a long-sleeved shirt to school if the outside temperature meets some school counselor's standard because once again the kid is hiding abuse and needs therapy. Look in the Grand Junction Colorado Newspapers in 1993 for an expose on how the local school counselors and social workers were getting a serious kickback from the local hospital's mental ward.

If a kid didn't behave himself in class before 1990, his parents were told to cut down on the soda pop and candy. Now, it's drugs. If a person is sad, caused by ex-wives or deaths or any part of a normal grief process, general practitioners prescribe antidepressants instead of those that have studied mental illnesses. Ok, who's a better person to screw around with one's head, someone that stayed at Holiday Inn for the "increase kickbacks" seminar? Or someone that had to study and treat a variety of mental illnesses (shrinks)?

Manic-depression, a completely separate illness, is not usually treated with just "antidepressants." Per the Los Angeles Regional Flight Surgeon, there are some special instances of third class medicals for those folks that can demonstrate the illness is under control, is not on either extreme of mania or depression, long-term history of stability, psychiatric reports, any hospitalizations were in distant past, and so on. CAMI and the regional flight surgeons can provide all of the details.

The antidepressant as a cure-all from knobby knees to acne hurts the people with true depressive illnesses.

So what is this particular flight student's situation? Did his GP think he needed drugs for a few weeks to get over a rough spot? Or is the guy going to be in tomorrow's paper as the next co-pilot to take a one-way flight lesson?

The flight instructor is going to have to use some uncommon sense to ask the right questions anonymously of the various authorities BEFORE this student's record is smeared as undesirable.

Good case: The student with all of their paperwork in order will get to see an AME for a medical (or if already certified, AME clearance). Having all the I's dotted and T's crossed, the AME might be able to issue the medical RIGHT THERE in the office instead of a one year wait through OKC.

Or it might go to the regional surgeon for a few week process, again instead of a one year wait. The student continues flight training and might even get prepped for an instrument rating if the medical is seriously delayed. Once the medical is received, the student solos, and completes the private pilot requirements, checkride, some polish for the instrument rating, and within a short time is a PPSEL-IA.

Not so good case: Student gets all of the information and decides it is not worth the fight and stops flying.
Or student is not qualified and decides to take up skydiving instead.

Worst case: The instructor doesn't give the student the information needed. The student shows up for the medical and the AME defers it. Two years later, a bunch of hoops jumped through, and several thousand dollars later, the student finally gets the medical.

Or, the person that prescribed the medication did so improperly. The student is being treated for a condition that does not exist and now no longer has the hope of ever flying solo or as PIC.

Hope this helps.

Fly SAFE!
Jedi Nein

 

[JCJ]

Reminder - "IGNORE" function

for those who might think that personal insults like the ones posted by "Jedi Inane" aka "Zeek" really don't belong on this board, the board has an "Ignore" function that works really well

 

[bobbysamd]

Me, too

What is everyone's beef with JediNein? Although I don't agree with her post either, it seems that many here have a problem with her that goes beyond this particular thread. She's been around here for quite some time and in my opinion, in the past has provided some good information - so what's with the hostility?

I don't agree with her comments, either, on this subject, or a few of her comments on other subjects. But, she has provided good information and I read all of her posts.

Frankly, I dunno how anxious I would be about taking a student who requires antidepressants. I would be extremely concerned about my liability exposure. However, I've learned from working in personal injury law that quite a few injured people experience depression after their accidents. I recall one who fell down stairs. Her neurologist put her on antidepressants. I remember how down she sounded on the phone when she called. Eventually, she recovered and no longer needed the medication. So, there's oftentimes more than meets the eye in these matters.

I do agree with Jedi about the apparent widespread overuse of antidepressants on kids with behavior problems in school. When I think back, I can think of a bunch of kids with whom I went to school who could have been candidates for the medication. However, to the best of my knowlege they never were dispensed the meds and got through fine. So, how is it, then, that times have changed so much? I recall that either Dylan Klebold or Eric Harris of Columbine was a behavior problem at school. Instead of trying to correct the problem, the kid was given antidepressants. He decided to stop taking them - and we know the rest. Maybe the tragedy could have been avoided if a non-chemical method could have been used to address his problem.

 

[JCJ]

I am a physician, although not an AME - but i do follow the medical issues closely. The hypertension problem is not a big deal. it needs to be controlled, but almost any medication or combination of medications is ok. an initial workup is needed, but provided it is ok the AME can issue the medical certificate. I know about this one firsthand becasue my blood pressure runs a little high - i am on two meds. the rest of my workup is fine and I can keep a 2nd class medical (issued from the AME's office) with no problem.

Asthma under good medical control is not a barrier to certification, and if the required workup is done beforehand and is ok, the AME can issue the certificate if otherwise qualified.

depression is more of a problem. being on any antidepressant medication, even if perscribed for something other than depression is disqualifying for any class of medical (i.e Zyban is often perscribed as an aid to quit smoking, but is an antidepressant so just the use is DQ even if depression is not present) I don't believe the AME can get authorization to issue a medical certificate and therefore must deny or defer to CAMI. my understanding is that the FAA isn't likely to issue a special issuance. The FAA seems to be pretty inflexible about this particular issue.

maybe your student can get off the antidepressants (with the approval of a physician) if he can do OK off antidepressants for three months then he has a real chance of being able to get a medical certificate. As you've already mentioned, he should see an AME who has an interest in working with CAMI, preferably one who is also a pilot.

the AOPA members section has excellent resources for medical certification by the way

my personal advice for the AME visit - tell them exactly what the FAA asks for - note one word less and not one word more. more info than they ask for just confuses things. Also don't confuse the FAA medical certification exam with a physical exam done to preserve your health. My AME is one of my best friends, but I don't use him as my family doc because of the conflict of interest (i.e my doc is to protect my health, the AME represents the FAA to be sure i'm safe to fly)

good luck JCJ