QUESTION: I hold a commercial fixed-wing license with a multi-IFR and several hundred hours total time. Any advice you can offer is most appreciated. I just turned 60 and am looking for my first flying job. I know, crazy, but true. This would be my third career in aviation, the others behind a desk.Call me overly tenacious, but I can’t let this dream slip away! Apparently there really is a pilot shortage so I’m going to ‘go for it’ yet again. Prior efforts 7 and 14 years ago were met with “you’re a woman, and older, and you might as well give up now.” Hard on the spirit so I became discouraged and changed course.I will probably run into more ageism and unspoken questions about return on investment, losing my medical, cognitive slippage, ability to relate to younger pilots. And on and on and on.My questions for you: 1. Can people be perfectly fit to fly until well into their seventies, and beyond? 2. What are the biggest things I can do to ensure this?3. What are the biggest reasons for losing a medical?4. How can I convince the carriers that this is no more of a liability than a younger pilot switching jobs? 5. How can I convince them that there is enormous value added due to my age and other experience?6. Do you know of any others on a successful, similar path, and if so, anyone I could talk to?

ANSWER: Thanks for writing – and what an interesting story! First, let me say that we need more female pilots! Your questions are interesting. As for age? Absolutely. There are no age-specific contraindications. I know a chap in his 90's who is still flying and more fit than many half his age. And that leads to the second question, how to stay fit? Simple; eat well, exercise, have regular and appropriate check-ups and screenings. As for losing one’s medical? We strongly recommend you see a non-AME first to check everything. Most common reasons? Taking disallowed meds, cardiovascular problems such as hypertension and atrial fibrillation – both treatable and, with suitable documentation do not prevent one from flying – and sleep apnea. How can you convince a potential employer? I think it’s the same for any job: smile, show them you are passionate and serious, and be well prepared. Know what equipment they are flying, routes, missions, and study, study, study! And convincing them that an investment in you is money well spent. Your last question asked about others who have overcome some form of adversity – the story that springs to mind is Chris McLaughlin, whom we featured in the AOPA Pilot magazine story “Stealing Fire” (October 2011, page 34).There is absolutely no reason why more women don’t fly – Patty Wagstaff is one example; an amazing aviator and a great role model. You can be too. And remember, 60 is the new 40!


QUESTION: Two years ago I was diagnosed with trigeminal neuralgia (TN) and was prescribed Gabapentin. After about 5 weeks I was able to get off the medication as the facial pain went away. I was pain free up until about March of this year. This time the facial pain came back with a vengeance and medication could not keep pace with the pain. After spending about three and a half months in and out of hospitals and on and off other medications beside Gabapentin, it was decided that the best option was for surgery. The surgery was called microvascular decompression of the trigeminal nerve and was a success. For a few days after the operation, I had a few minor “facial shocks” while the nerve was healing. Since then I have been pain free with no facial nerve pain and am no longer on any medications. I feel very lucky to be basically fully recovered from TN. I’m a “Rusty Pilot” and wonder if my previous history of TN and the surgery prevent me from getting my 1st Class Medical again.

ANSWER: The trigeminal nerve is one of 12 “cranial nerves”; that is, they emanate from the brain and travel directly to their target areas without passing through the spinal column. The cranial nerves connect the eye, ear, and nose to the brain and four of the 12 connect the tongue, including the trigeminal. As its name suggests, it has three components, one to the area around the eye, one to the lower jaw, and one to the upper jaw. A variety of conditions can cause neuralgia, or “nerve pain.” Sometimes it comes on as part of a disease called “shingles,” a sequel to a prior episode of chickenpox. Alternatively, multiple sclerosis or a tumor in the salivary gland or brain or simply aging can induce it. The symptoms can be quite severe, with a burning, electric shock-like pain with the slightest stimulus – sometimes even the wind can cause it. Treatment usually consists of dealing with any provoking disease or prescribing medicines like Gabapentin that interfere with nerve conduction. On occasion, it turns out a blood vessel in the brain can press on the nerve, causing pain and facial spasms. Dr. Peter Janetta, a Pennsylvania neurosurgeon, popularized a technique to lift the offending blood vessel off the nerve and that is the “microvascular decompression” operation you refer to. One of my dear friends from medical school had this procedure to great effect – it was a life-changer for him and I hope it will be for you also. Since you are off medications and symptom free, we would suggest a good current status report from the treating doctor and the operative report of your decompression surgery is all that is required. Your aviation medical examiner should be able to issue your medical at the time of the exam if you are otherwise qualified.


QUESTION: I recently had my First Class Medical and at the time took my hypertension worksheet, including three blood pressure readings and details from my regular doctor about my prescriptions. I also provided a letter from my urologist explaining my treatment for prostate cancer. I have provided both of these for years as my blood pressure is under control and the cancer is being addressed with active surveillance. My doctor had added an extra BP medication and my AME had to defer for the extra meds, or I guess, crossing the threshold of meds one can take. My application is in Oklahoma City for review and, hopefully, Special Issuance. Is this a problem or just a protocol that the FAA requires for review? I called and was told my application was in the queue. Any ideal how long it might take? They did ask me for a fax number to fax my medical when and if ready. I also briefed my doctor that he might have to write a detailed letter about my visits and meds to the FAA for further explanation.

ANSWER: The FAA allows for an office issuance for hypertension under the CACI program if you are on no more than three blood pressure medications. If you require more than three meds, the FAA will probably grant you a special issuance authorization instead of the CACI if the additional meds get your pressure under the 155/95 certification limit. Unfortunately, deferrals are taking about 90 days-plus before airmen are receiving their certificates, so just be patient and don’t let your blood pressure spike while you’re waiting! For the benefit of other readers, let’s briefly address how your prostate cancer is being managed. Sometimes the best course of action for this disease is surgical removal, sometimes radiotherapy (either by external beams or implanting radioactive seeds in the gland), and sometimes by oral medications. And of course, on occasion, all of the above. However, it is not uncommon to use “watchful waiting” or “active surveillance” – a fancy way of saying we are going to keep an eye on the cancer but not do anything because we don’t think it’s the sort of cancer that is going to cause major issues.For your prostate cancer, you will need a current consultation report from your treating physician that summarizes your cancer history and how it’s being treated. Also, you will need a current PSA. If the status report is favorable and your PSA hasn’t spiked, the AME could issue your medical to you in the office under the CACI program unless you are on more than three blood pressure meds that requires the special issuance. Hope that all makes sense.

Portrait of Gary Crump, AOPA's director of medical certification with a Cessna 182 Skylane at the National Aviation Community Center.
Frederick, MD USA

Gary Crump

Gary is the Director of AOPA’s Pilot Information Center Medical Certification Section and has spent the last 32 years assisting AOPA members. He is also a former Operating Room Technician, Professional Firefighter/Emergency Medical Technician, and has been a pilot since 1973.

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