Pilot Protection Services Medical Mailbag- August Q&A

QUESTION: I received a stent in my right coronary artery but did not have a heart attack. After 90 days expires what must I do in order to obtain a limited second class medical in order to continue flying banners and operate my private aircraft with third class privileges?

ANSWER: Delighted that they were able to treat your coronary artery blockage before any damage was done to your heart! There is a mandatory three month wait time after having a stent, unless the stent was placed in the left main coronary artery, in which case the wait is six months.  Afterward, you will need treatment records, a maximum exercise treadmill stress test, blood work, and a thorough report from your cardiologist.  Here is the link to our online information that provides all the details.

QUESTION: An aspiring pilot friend asked me to contact you, he was diagnosed with PTSD, is currently taking Lexapro and wants to start his flight training. He went to his AME and got a deferment. Nothing is mentioned in the AME 2016 guidelines for PTSD. Will he have to go through the same psychological evaluation tests, records from psychiatrists and evaluations as would a student pilot or pilot who had depression?

ANSWER: PTSD or post traumatic stress disorder is more commonly known these days in the wake of war injuries and terrorist attacks and merits serious attention. Lexapro is one of the SSRI drugs (Selective Serotonin Reuptake Inhibitors) that are used to treat depression and it can have profound side effects including disturbed thoughts, impaired vision and gastrointestinal issues. The short answer to your question is “yes,” your friend will need to undergo the same battery of tests.

QUESTION: Quick question. Can one withdraw a medical application?

ANSWER: No, once an application is opened and active, there is no withdrawing it since the Sport Pilot Final Rule went into effect. 

QUESTION: Almost a year ago, I had a CABG performed with 4 bypasses.  My FAA doctor gave me the guidelines provided by AOPA listing all the requirements for getting my medical certificate reinstated.  It was never suspended.  The procedure was elective as I never had a heart attack.  

I did the stress test with great results and obtained a letter from my cardiologist. The questions are:  What do I do with all these records + letter and do I need anything else besides these? 

ANSWER: CABG (“cabbage”) is the commonly accepted acronym for coronary artery bypass grafts whereby blocked arteries supplying blood to the heart are bypassed with either a piece of vein harvested from your leg or an artery re-route from inside the chest wall. This is a treatment for insufficient blood supply causing angina (chest pain) or a heart attach – as you can see this is common and we get lots of questions on this topic.

If your last FAA medical has expired, you will need to apply for a new medical and have an FAA flight physical done by an AME.  For special issuance consideration, you will need a current stress test (no more than 90 days old when it gets to the FAA), current lab work, a status report from your cardiologist, and your hospital records from the bypass surgery that includes the admission history and physical, the pre-op cardiac catheterization (a test that images the areas of blockage), the surgical report, and hospital discharge summary.  The AME cannot issue the medical to you, but will defer your application.  You will then mail your records directly to the FAA Aerospace Medical Certification Division in Oklahoma City.  Here is a link to the details of what is needed and the mailing address to send your records to. 

QUESTION: Is there anyway a pilot can review the data from their last third class medical?  

And the other thing is this:   I hope this does not sound too insane, but do you think there is anyway a pilot could take a "mock" third class physical exam?   In other words, have the doctor do the exact physical exam required by the FAA, except it not be official and not be submitted to the FAA?  This would relieve a lot of anxiety and then you would know what to expect.

ANSWER: There are two ways to keep track of previous medical application information.  One is to print the MedXpress after hitting the submit button to send it to the FAA.  There is a prominent prompt that asks if you want to print a copy.  The other is to complete the application on TurboMedical, then re-input that info into MedXpress.  TurboMedical will save the responses until the member updates the form with new information. If you did not do this one could always ask the AME if they have a copy for you to review. We have covered this many times – ones medical records are very important documents and merit safe and efficient keeping.

As for a mock medical I am afraid that is not possible but one can be prepared and again, this is something we have covered online, in the magazine, during webinars and at live aviation events.

QUESTION: My annual family doctor physical and my AME physical are due at the same time. No known problems exist. Which one should be done first? 

ANSWER: From a health standpoint, it is probably best to see your family physician for a thorough physical exam prior to your FAA flight physical.  If something does show up at the regular exam, you can get it taken care of before your flight physical.  Just be sure to have good documentation from your treating doctor if there is something that warrants additional treatment or follow up that will be reported on the FAA medical application.  That way, your AME has something to refer to in making a decision to issue the medical or defer to the FAA.  A deferral now is a bad thing because the FAA is backed up on processing of deferred applications, so a minimum of 90 days is the expected wait for issuance of your certificate.

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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