Pilot Protection Services Medical Mailbag- November Q&A

QUESTION: I had an electrocardiogram test done that came back with abnormal results. The doctor then had me do an echocardiogram, which came back normal. The doctor felt that further tests were not needed. Will the FAA be satisfied with this for my third class medical, or will they require more tests? I am 60 years old with a history of hypertension (under control with medications) but no other history of heart issues.

ANSWER: Sir that will entirely depend on the abnormality! An electrocardiogram (ECG or EKG) measures electrical signals that travel around your heart and can indicate issues such as rhythm problems, poor blood supply or enlargement of parts of the heart. In general – and from FAA’s perspective - ECG abnormalities will require a maximal stress test that ascertains if the blood flow is healthy or you are at risk of a heart attack. You need to show the ECG results to the AOPA medical certification people through Pilot Protection Services.

QUESTION: In Dr. Silverman's article, on stress testing, nothing was mentioned about the time reduction, on the standard testing treadmill, from 9 minutes to 7 minutes for age consideration. Is that still in effect?

ANSWER: As above, the stress test is used to measure how the heart responds to stress, for aeromedical purposes that stress involves walking on a treadmill while blood pressure, pulse, breathing and ECG are monitored. And yes, the FAA does take into consideration an airman’s age at the time they are performing a stress test. They do not like to “broadcast” that they will accept a person who is 75 years old only exercising to 6 minutes and thirty seconds, but they will accept that. They really want each airman who has to undergo stress testing to attempt to exercise for as long as they are physically able.

QUESTION: A friend had been taking blood pressure medication for several months before his aviation medical but did not report it on the medical form. He passed the medical; but would now like to report the medication. What would be the procedure?

ANSWER: High Blood pressure no longer requires a special issuance. This condition is considered a CACI (Condition That AME Can Issue). The medical certification of elevated blood pressure is left to the AME. Your friend should get a letter from the treating physician that explains his/her history of high blood pressure and what is being done to treat that. He/she should take that letter into the AME. In general however, this is not a good, one needs to report medical conditions and medications at the time of the medical.

QUESTION: Is the medication Naproxen approved by the FAA? May take it for muscle aches?

ANSWER: This medication is an anti-inflammatory and is allowable. For future reference you could have gone to the AOPA medication database to obtain the answer: Pilots taking non-approved medications is all too common.

QUESTION: I broke my ribs this past year and my medical is coming up soon. What should I expect at the medical related to this? If they are not perfectly healed yet should I wait to have the medical until they make no noise at all? I am functional in all other regards and other than limiting my movement, they present no problem now.

ANSWER: You should provide a letter from your treating physician that states how the broken ribs occurred, what they did to treat you, and how you are currently doing. You are responsible to self-ground until totally mobile once again.

QUESTION: I have a Medical Certification Question about Kidney Failure, Dialysis, and successful Transplant surgery. Have pilots successfully obtained a Class I, II, or III Medical Certificate with the medical conditions above?

ANSWER: Many things cause the kidneys to fail – high blood pressure and diabetes play a role for sure. The FAA does grant medical certification to airmen for all classes of medical after a successful kidney transplant. You cannot provide a packet until you have reached 6 months post transplant. And a quick advertisement here; every year thousands of people die waiting for a kidney so everyone should consider carrying an organ donation card – after death your kidneys, heart, lungs, liver, cornea and more could help so many others.

Jonathan Sackier
Dr. Jonathan Sackier is an expert in aviation medical concerns and helps members with their needs through AOPA Pilot Protection Services.

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