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Pilot Protection Services Medical Mailbag- June Q&A

QUESTION: Does implanting a pacemaker require any additional medical clearance to obtain a private pilot's license or to continue with student flying lessons?

ANSWER: Implantation of a cardiac pacemaker is one of the mandatory disqualifying conditions that requires a Special Issuance Authorization.  There are about 300 or so pilots flying with a special issuance for a pacemaker. There are some hoops to jump through, however, as with any special issuance.  Normally, a treadmill stress test, 24 hour ambulatory Holter monitor, an echocardiogram, and current pacemaker performance testing are the basics the FAA will need to see.   You can find out more by reviewing our online information on pacemakers.  Good luck!  

QUESTION: I have started to develop cataracts and I am concerned about my flying and my medical certificate. At some time, I'll probably need surgery to keep my eye sight. How does the FAA approach this problem? 

ANSWER: This is fairly straightforward and simple as far as medical certification challenges are concerned.  At the time of your next scheduled FAA flight physical after your cataract and lens implant, have your eye care doctor complete an FAA Eye Evaluation Form 8500-7 and take that completed form to your AME.  If you meet the vision standards and are otherwise qualified, the AME can issue your medical to you at the time of the examination. 

QUESTION: About seven years ago my wife finally got tired of my snoring so I went for a sleep evaluation. The results showed that I was borderline apneic so I opted for the CPAP machine since Medic Care supplied me with one. Then I found out that to keep my third class medical I had to get a yearly exam from my CPAP doctor and a yearly checkup from my FME.  Since then I have been flying as a Sport Pilot in my small experimental plane. Up to now I have not read anything about CPAP regulation in the new proposed medical requiring just a driver’s license.  Can you update me on this? 

ANSWER: Obstructive Sleep Apnea is a high profile medical condition right now because of the constellation of medical problems that can result from remaining untreated.  Under the current proposed legislative language, sleep apnea is not a condition that would require a one-time special issuance, and pilots would be able to continue to self-assess and exercise privileges without any FAA oversight.  However, if you are on CPAP now and well-controlled, why wait for congress?  You can qualify for a special issuance now and fly a normal category airplane under a 3rd Class Special Issuance.  The FAA will need to see the original sleep evaluation and the results of at least 60 days of compliance data from your CPAP machine showing you are using the machine 75% of nights and averaging about six hours sleep per night. An AME could even issue your medical certificate in the office provided you have all the necessary documentation when you see the medical examiner. 

QUESTION: I had a cardioversion, then a stint, then an ablation, then a clear stress tests (passed), then a pacemaker, over the last two years.  6 months of clean follow-up from my cardiologist. Can I still get a 3rd class medical?

ANSWER: The short answer is “yes,” you can get a medical under a Special Issuance.  You will need your treatment records, a current cardiac evaluation that includes a treadmill stress test, 24 hour Holter monitor, an echocardiogram, and reports of pacemaker monitoring to show that the settings are correct and you are pacing properly. Check out this link for more info. 

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