We often get calls into the PIC from members in despair because of a recent medical diagnosis, treatment plan, or new medication prescription. Happily, in many cases, their fears are unfounded and we can reassure them that the path to a medical certificate, although maybe kinda rocky, is attainable through a special issuance. The FAA has often led the way in establishing medical requirements for conditions that other countries’ regulatory bodies were just not comfortable with.
Organ transplants, for example, are commonplace now, and many of us can remember the first heart transplant done by Dr. Christiaan Barnard in 1967 in South Africa. Although the patient, Louis Washkansky, passed 18 days post-op from pneumonia, ironically brought on by the anti-rejection drugs that suppressed his immune system, the operation was a game changer, and heart, lung, kidney, and other organ transplantation are now commonplace with high long-term survival rates.
The development of immune checkpoint inhibitors is another ground-breaking treatment for certain cancers. Immune checkpoints are part of our immune system that prevent an overly aggressive response to a foreign invader that also targets our healthy cells. The checkpoints kick in when proteins on the surface of immune T-cells recognize and link up with partner proteins on other malevolent cells, such as cancer cells. When the checkpoint and proteins combine, they transmit a “signal” to the T-cells that inhibits the immune system from attacking the cancer.
This innovative treatment therapy allows checkpoint inhibitors to treat many common cancers; breast, bladder, colon, head and neck, Hodgkin’s lymphoma, liver, lung, and renal cell kidney, to name a few. The FAA Office of Aerospace Medicine keeps a close eye on evolving treatment regimens and newly approved medications on the market as well. Generally, any new treatment procedure or medication cleared by the US Food and Drug Administration (FDA) requires at least one year on the market before the FAA will consider it for medical certification purposes. That allows the FAA to review the literature and case studies of the procedure or medication to consider any evidence of side effects or adverse outcomes.
As part of the initiative to publish more specific guidelines on the FAA AMEGuide, alerts are published monthly to announce Guide revisions. This is a good source of information for pilots who are investigating what the FAA will need for many medical diagnoses. The Guide and, of course, a call to the Pilot Information Center medical group will build your knowledge base so when you apply for a medical to report a new condition, having the correct information for the AME to upload into the FAA workflow will provide a faster response, something that everyone wants to see!
