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Medical mistake:

kentb

kentb

Well Known Member
Medical mistake:.

I make a mistake yesterday and filled out my 3rd class medical form to fully.
I indicated that I had a sleep study done and now used a CPAP machine at night.
The Dr. reported 'obstructive apnea'. Meaning that while asleep my tongue block off my airway to some extent and the positive pressure of the CPAP allows me to sleep normally.

The Dr. doing the exam, said that the 'red flag' requires the report to be sent to the FAA and I would need to wait to hear from them.

So now I am grounded!:(

Anyone else that have dealt with the FAA on this issue before want to give me a run down on getting my medical back?

How long will it take?

The Dr. suggested that I could still fly, but with a PPL in the plane as PIC. Not sure what the insurance company would think of that.

The Dr. also suggested that I would be required to do a 'Daytime Wakefulness Study'. My regular Dr. has never heard of such a thing.

Any advise would be apreaciated.

Thanks, Kent
 
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Just to update.

I just got off the phone with the AOPA (medical), and this is the normal process. They indicated 2 to 3 months.:(



Kent
 
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IIRC, you can get "pre-certification" for medical issues so that when you show up at the AME's office, you have FAA approval in hand and the AME doesn't have to "fail" you. Not having a medical (SP and PP Glider), I haven't had the pleasure (?) of this experience, but I look forward to it. Sort of.

TODR
 
OSA

If you have been on the CPAP for several months and have a titration study showing improvement while on the CPAP your AME can call the Regional Flight Surgeon and get approval over the phone. (There a few regions that are hard for the AME to work with but most are very helpful.) The "packet" is still sent to OKC but you get the medical and can keep flying.
 
I had to do the Maintenance of Wakefulness study about a year and a half ago. Physicians, or clinics that do a lot of sleep disorder work are sure to know about it.
 
WHen I originally got my waiver, my AME only dealt with the regional AME supervisor in Chicago. It only took a couple weeks to get the paper processed. It also helped that my AME also uses a CPAP.

My case was a little different, since I no longer needed a CPAP. They weren't sure what they needed to document my case. I guess they don't see many going off the CPAP. Fortunately, I just had a sleep study to support discontinuing the CPAP. I lost over 100 lbs and fortunately my apenea and hypertension went away.
 
ame

after you get the wakefulness study your AME can call his regional AME, or their is a hotline for AME's who can call Ok City and get approval over the phone. It's been done all the time even for more serious problems. If your local Doc doesn't understand the test, etc, see a good 'sleep' doc. From then on you can be prepared ahead of time with the studies and get your 'normal' issuance. see if AME still 'has' your physical and hasn't sent it in. Most AME's will allow 2 weeks to get all the goodies done once the exam is done. He can have you flying right away if he knows what he's doing and hasn't screwed it up. good luck
 
RE OSA

Kent, I don't think it was a mistake to fill out the med form completely. It's a "no-no" to omit significant issues such as OSA.

When I suspected sleep apnea, I grounded myself until I was able to get tested and equipped with the CPAP. After many months, once I was sure that the CPAP was successfully treating the sleep disorder (and with some good guidance from the AOPA) I saw my sleep doc (who did a thorough checkup and wrote a letter that I was compliant and successful w therapy, ticker was great, no longer napped or had daytime sleepiness). I did not need the wakefulness test, as with therapy, I'm more alert than I ever recall being.

Then, I had to go to my regular doc for a blood test, ekg, and general scoping and another letter attesting to the same. (My only complication is white coat hypertension, dang it.)

Letters in hand, off to the AME for a flight physical, and some more paperwork.

So now, I have a restricted FAA med. I need to visit my doc once per year, and show him my APAP compliance report (which I put together myself).

This all might seem like a daunting series of tasks, but it's really not that much of big deal. I'm flying and I feel pretty darned good - - Priceless!

Hoping that your experience will be positive as well.


.
 
As an aside.......

....My Doc is a member of our EAA chapter and flies a Tri-Pacer. At our last meeting, he suggested to NOT sign your medical forms when you go and see him for your physical, if you suspect that you could possibly fail.

The reason was that a coupla older guys were worried that they couldn't fly light sport, so he recommended this. Sign it after you pass.

Regards,
 
For those of us not so afflicted (sleep disorders), why would this be dangerous flying? If the problem occurs when you are sleeping why would this be a problem when you are awake.

This may make sense to the FAA, but it makes no sense to me.

Could you not give the FAA a letter stating you promise not to sleep when flying? :D

What am I not understanding here? I'm trying to understand.
 
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untreated OSA = bad

Geico266 said:
For those of us not so afflicted by sleep disorders, why would this be dangerous flying? If the problem occures when you are speeling why would this be a problem when you are awake.

This may make sense to the FAA, but it makes no sense to me.

Could you not give the FAA a letter stating you promiss not to sleep when flying? :D What am I not understanding here? I'm trying to understand.
Click to expand...

Sleep apnea is basically cessation of respiration while you're asleep; it can be obstructive (usually due to laxity of the soft tissues in the posterior pharynx, such as the thickest part of the tongue) or central (where the brain fails to send the signal to breathe). The most common form, by far, is obstructive sleep apnea.

Sleep apnea commonly leads to daytime fatigue and sleepiness, including "micro-sleeps" where a person falls asleep without warning for several seconds (or longer). This is why the FAA is concerned about it, as these "micro-sleeps" due to fatigue have been implicated in poor pilot performance.

From a medical standpoint, sleep apnea is associated with heart rhythm disturbances (particularly atrial fibrillation), pulmonary hypertension, and systemic hypertension.

To Kent, the OP of this thread: persevere with the process -- it doesn't take as long as you've been told. Work with your local AME and regional Flight Surgeon, as many disqualifying conditions are now dealt with on the regional level rather than in OKC. The main thing is that your AME sends *ALL* of the documentation the regional FS requires on the first try -- the reason the process sometimes takes 2-3 months is that if something's missing, there's a delay in reviewing the submission while requests are sent back and forth.

-- Chris
 
Sleep Apnea is the medical disease "de jour" and has been so for the past few years. I never even heard of it until about 5 years ago,,,,. Now suddenly everyone knows someone who has it! I am sure it has been around forever and a lot of pilots suffered from the ailment and never even knew it. Another reason to find a good pro-active AME and follow his/her directions when filling out your form.
 
OSA

Since you obstruct your airway at night - you don't sleep enough, or don't get a deep enough sleep at night - this makes you tired during the day and can affect your concentration/fatigue during flight

Jason Klovning M.D.

-BTW does anyone know how a guy that's intrested that has an M.D. can get approved to do flight physicals??
 
OSA

I am so glad this topic came up. I've considered going in for a sleep disorder test but have been reluctant because of potential problems with my FAA Medical.

Do any of you guys who have been through the process have 1st or 2nd class medicals? If so, did that complicate matters at all?

Great information guys!
 
Larry Gieger's question

Larry asks...Could you not give the FAA a letter stating you promise not to sleep when flying?

And, it's a reasonable question.

Sleepiness is only one factor in untreated sleep apnea. Mental focus is another.

Once I began CPAP, I was truly amazed at how much better I was at multi-tasking and communicating (written and verbal- - including speeches). My memory has also bounced back nicely, as well as a few other things that I had no idea to expect.

One other thing that probably interests the FAA. My cardio blood chemistry markers, since beginning CPAP, have gone from high normal to less than average risk.

.
 
signing faa form

i think the AME who said don't sign the form until you 'pass' is giving you band advice for sure. Once you fill out the exam, (which are numbered) the AME is supposed to send it in. If you don't complete it, he is STILL supposed to send it in, which will generate letter from FAA, which will likely have you 'denied'. Better to go to friendly AME and have him do a 'regular' physical, and if he then says, if you come back and do FAA exam, you'll be ok or not. Don't start the forms with idea of changing your mind unless you know the doc says he won't send in the forms, which he is supposed to do. FAA doesn't want you to change your mind at the last minute--make it up before you start to fill out forms. IMHO and experience as well.
 
RVFlyer said:
I am so glad this topic came up. I've considered going in for a sleep disorder test but have been reluctant because of potential problems with my FAA Medical.

Do any of you guys who have been through the process have 1st or 2nd class medicals? If so, did that complicate matters at all?

Great information guys!
Click to expand...

No problem with a 1st class for me. Dr. Clay Cowl at Mayo Clinic "walked" mine through the OKC maze with no delays.
 
pierre smith said:
....My Doc is a member of our EAA chapter and flies a Tri-Pacer. At our last meeting, he suggested to NOT sign your medical forms when you go and see him for your physical, if you suspect that you could possibly fail.

The reason was that a coupla older guys were worried that they couldn't fly light sport, so he recommended this. Sign it after you pass.

Regards,
Click to expand...

It is my understanding that once the form is handed to you and you write anything on the form, the flight physical has begun and there is no turning back. Each form is serialized and assigned to a particular individual. I suspect if you refused to sign the form a very red flag would be waving which the FAA would refuse to ignore.

Maybe the doc Pierre is referencing actually said "not to write anything on the form" if you have doubts about passing, in other words, do a "pre-physical" exam.
 
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FYI: if your interested.

I have never had any problem staying awake during the day. In fact I can almost never nap if it is day time.

I went for the sleep study, because my wife could not stand my snoring.:eek:

During the test the hooked me up and then let me fall asleep (it was night time). After a couple of hours of measuring things (some not good, like O2 getting down into the 80's), they woke me and hooked me up the the CPAP.

After I went to sleep they started adjusting the pressure on the CPAP until I was sleeping normal.

They produced a report showing that the CPAP corrected my sleep to normal and I faxed this to my AME.

It seems that now that my sleep is normal, why should I need to prove that my day is normal!:(

Kent
 
kentb said:
I have never had any problem staying awake during the day. In fact I can almost never nap if it is day time.

I went for the sleep study, because my wife could not stand my snoring.:eek:

During the test the hooked me up and then let me fall asleep (it was night time). After a couple of hours of measuring things (some not good, like O2 getting down into the 80's), they woke me and hooked me up the the CPAP.

After I went to sleep they started adjusting the pressure on the CPAP until I was sleeping normal.

They produced a report showing that the CPAP corrected my sleep to normal and I faxed this to my AME.

It seems that now that my sleep is normal, why should I need to prove that my day is normal!:(

Kent
Click to expand...

Well, you are dealing with the FAA! Logic? We don't need no stinking logic!:rolleyes:
 
kentb said:
I have never had any problem staying awake during the day. In fact I can almost never nap if it is day time.

I went for the sleep study, because my wife could not stand my snoring.:eek:

During the test the hooked me up and then let me fall asleep (it was night time). After a couple of hours of measuring things (some not good, like O2 getting down into the 80's), they woke me and hooked me up the the CPAP.

After I went to sleep they started adjusting the pressure on the CPAP until I was sleeping normal.

They produced a report showing that the CPAP corrected my sleep to normal and I faxed this to my AME.

It seems that now that my sleep is normal, why should I need to prove that my day is normal!:(

Kent
Click to expand...

I understand your issue; and I was never sleepy at the wheel (or control yoke) either. But O2 desats as you describe will take a toll. Headaches and "brain fog" are common complaints of untreated OSA. (Eventually, so is diabetes, hypertension, and athrosclerosis.)

Question for you, Kent, if you don't mind. (No worries if it's too personal, just skip.) If you have begun your CPAP (or APAP) therapy, do you notice that you are sharper, more cheerful, focused, alert, and just generally more "with it"?

Good luck with all of this. I know it seems like you have more hoops to hop through, but the xPAP should extend your flying years, your health, and your lifespan. Good deal, is it not?


.
 
Thanks

Okay you guys convinced me to go in for the sleep analysis I've been avoiding. I'll post my results and how any treatment works. I suspect this will be another time VAF comes through for me. Thanks for the kick in the butt.
 
Not problem Captain Sacto....

Captain Sacto said:
Question for you, Kent, if you don't mind. (No worries if it's too personal, just skip.) If you have begun your CPAP (or APAP) therapy, do you notice that you are sharper, more cheerful, focused, alert, and just generally more "with it"?

.
Click to expand...

I have been using CPAP for almost two years. I had some trouble adapting to having it on me for a couple of months. After a couple of re-fittings, I have a setup that although I don't like it, it does work.

I am sharp cheerful, focused and alert person. I am the same now as before being diagnosed with OSA. I guess that my body can get by on less O2 then most. There is a possibility that something not good for me was happening that was not apparent that is now corrected. The major improvement is that my wife can now stand to sleep with me. She claims that the volume of the snoring would keep her up, but it never bothered me.:D

My current situation seems to be the result of my not knowing the FAA stance on the issue. From what everyone is posting, this should have been a non-issue if only I had asked for the Daytime Wakefulness Study and had that ready to hand over with my medical application.

So any that thinks that they may need 'help' with there sleep should get the Sleep study and if then have a problem, just get the DWS also.

Kent
 
Kent:

I am not going to get personal about your weight, but for the good doctors on here, please correct me if I'm wrong. I'm just trying to learn here.

Isn't sleep apnea almost always, ALWAYS associated with obesity? Isn't it true that over 95% of people with OSA are obese?

Isn't is true that 95+ percent of patients who have gastric bypass are diagnosed with sleep apnea beforehand and almost all of them no longer have OSA after significant weight loss?

A member of my immediate family has had gastric bypass. After having sleep apnea for years she no longer has any symptoms. Six months after her surgery she had another sleep study done and they said she no longer has OSA. She doesn't even snore anymore!

Of course I'm not advocating that folks get gastric bypass to get rid of OSA, but isn't weight loss the #1 thing to focus on with sleep apnea?

I guess I'm just saying I don't understand why doctors always want to focus on band-aids (a CPAP machine) when the cure (weight-loss) is obvious.

I have lost 40 pounds over the last year and my wife tells me that I used to be a heavy snorer and I no longer snore! I realize that OSA and snoring are not the same although they are related.
 
Jamie, I can't answer most of your questions, but....

A few years back I went on the Adkins diet and lost over 40 lbs. The high protein diet brought on other medical issues and I decided that I would rather have the weight instead. At 240 lbs, 6 ft and 58 years old, I am definitely over weight (I need to grow another foot taller).:D
My wife reported that I was less noise at night when I lost the weight. Most of my weight is carried around the middle (not a good thing), but some is in my neck area.
I don't think that the OSA would go away if I could loose more weight, because of the age/looseness of the throat / nose tissues.

Kent
 
Jamie said:
Kent:

Isn't sleep apnea almost always, ALWAYS associated with obesity? Isn't it true that over 95% of people with OSA are obese?

Isn't is true that 95+ percent of patients who have gastric bypass are diagnosed with sleep apnea beforehand and almost all of them no longer have OSA after significant weight loss?

Of course I'm not advocating that folks get gastric bypass to get rid of OSA, but isn't weight loss the #1 thing to focus on with sleep apnea?

I guess I'm just saying I don't understand why doctors always want to focus on band-aids (a CPAP machine) when the cure (weight-loss) is obvious.
Click to expand...

There is a strong association of OSA with obesity, yes. However, the long term effect of gastric bypass surgery (which is a procedure that carries a significant mortality risk) on sleep apnea is less than clear.

Also, about 10% of patients with sleep apnea have central apnea, which weight loss does not improve.

I don't know about other doctors here, but as a cardiologist, I spend a significant amount of time urging patients to lose weight, and VERY FEW of them lose weight between visits. (And this is a group of patients that have had heart attacks, heart failure, arrhythmias, etc., remember -- a group that should be pretty motivated!) Most of my patients add pounds over time, in fact.

With regard to your comment about doctors focusing on "band-aids" -- I don't think ANY doctor who makes the diagnosis of sleep apnea in an obese patient would fail to advise them to lose weight. However, until they do (if they do), CPAP will be needed to treat the problem.

-- Chris
 
Sam Buchanan said:
It is my understanding that once the form is handed to you and you write anything on the form, the flight physical has begun and there is no turning back...<snip>
Click to expand...

That checks with something my AME said during my last flight physical, that he's required to report anyone who shows up for a physical and then leaves before completing it. I don't know the rule basis for that statement, but knowing the FAA, it doesn't surprise me.

:confused:

Dave
 
CJK said:
I don't know about other doctors here, but as a cardiologist, I spend a significant amount of time urging patients to lose weight, and VERY FEW of them lose weight between visits. (And this is a group of patients that have had heart attacks, heart failure, arrhythmias, etc., remember -- a group that should be pretty motivated!) Most of my patients add pounds over time, in fact.
Click to expand...
I'm 6' and 170 lbs...and was diagnosed with sleep apnea. That, and a submerged fat test result of 27% even though I work out at a health club, motivated me to begin a gradual weight loss of 10-15 lbs.

Few if any other industrial countries have our rates of obesity. Clearly there is something fundamentally awry with our lifestyle. I find the only way to lose weight is both exercise and diet...and the diet side essentially consists of avoiding the processed, industrial "food" that is everywhere, and sticking to basic food prepared at home. Avoid restaurants and of course fast food joints. Fortunately my wife wants a better diet too.

As for the OSA, I started using a CPAP. I noticed very little difference in my daytime state at first. Now I can tell the difference (for the better) in the first hour of waking when I use it but not after. Like others I went for the test because my wife complained of a loud noise next to her ;).
 
In addition to being an airline pilot, I also founded and part own a couple of sleep disorder centers.

The whole issue of OSA and medicals is frustrating. The good news is that the former FAA administrator put OSA on the list of items that the FAA was going to approve being cleared at the local level. The bad news is that it hasn't been done yet to my knowledge. It is kind of in a grey area limbo right now.

A lot of the hassle factor depends upon the attitude of your local AME. A lot of them are just clearing it themselves and not worrying about contacting OKC other than just submitting the report with their recommendation that no further inquiry is necessary. Old school types are getting OKC involved.

I know airline pilots that have been CPAP users for years who have never had a single inquiry from OKC, yet about a third of our patients who are pilots do end up having to get OKC involved. I haven't heard of anyone who has been denied a medical completely, but several have to take a MWT test after starting CPAP therapy.

OSA is a serious problem for those who suffer it. CPAP and other therapies have literally changed lives for the better. Sleep medicine is advancing rapidly. Hopefully the FAA will advance its thinking as well.

My advice is to get tested and seek out an AME who seems progressive on sleep and liberal on clearing it him/herself.

As far as the comment about OSA patients being obese. A lot of our patients do have weight problems, but you'd be surprised at the number of fit and healthy types who also suffer. We have a nationally ranked marathon runner as a patient.
 
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re Myron's post

Myron writes...you'd be surprised at the number of fit and healthy types who also suffer. We have a nationally ranked marathon runner as a patient

This last statement describes me. Normal weight, distance runner. Probably had OSA (undiagnosed) for 40 years.

Question for you, sir. Do you find much hypertension (especially "white coat" hypertension) among your normally proportioned and "fit" patients?

I'm healthy in every respect (thanks to xPAP) but for some reason, I still get the "Willies" in a Dr's office, and my b.p. responds accordingly. Home readings are well below 120/80, btw.


.
 
RVFlyer said:
Okay you guys convinced me to go in for the sleep analysis I've been avoiding. I'll post my results and how any treatment works. I suspect this will be another time VAF comes through for me. Thanks for the kick in the butt.
Click to expand...

So, what is the status of your testing/results???

I am taking a sleep test tomorrow night:confused: and am sure glad for the information in this thread.
 
FAA medical, restless leg and Mirapex

If you take Mirapex for restless leg syndrome, be aware that Mirapex disqualifies you for an FAA medical. The situation is similar to sleep apnea in that the FAA is very worried about poor sleep from the restless leg as well as the drug's potential side effect of involuntary sleep during the day. The AME got on the phone to the regional FAA people as soon as I told him about the medication and it was a quick slide to an OKC denial, with the burden then on me to change drugs, gather my medical information and appeal. I lost a couple months of flying as a result of my failure to properly prepare for the medical, so I urge anyone on Mirapex to get ahead of the game.

The FAA issued a 1-year medical after I switched to Sinemet and my doc reported to them the condition was well-controlled, with no adverse side effects and no daytime sleepiness. They didn't require a sleep study but I gathered they would have been mighty interested in studying one if it had existed.


Dave Woboril
 
Mike S writes...

I am taking a sleep test tomorrow night and am sure glad for the information in this thread.

Mike, the sleep study will go easier than you might think. They attach some electrodes here and there, and from there, it's not too much different from a night at a hotel.

Sometimes they use the whole night to diagnose, then a later study to determine therapy values. Other places do it all in one night, which is what I had.

If xPAP is in order, it takes a little getting used to, but after a while it's a snap. And the results? You're more alert and alive. The sky might be a little bluer, the songs on the radio could be a little cooler, and the ladies might even be cuter. You'll see.

Good luck.

.
 
Mike's test for OSA

Hey Mike,

I've been using CPAP for over nine years. Following my first test of which most of the night was using the machine, I discovered I was far more awake and alert when I left the lab. It was the first good night's sleep I had in years and didn't realize how much it was affecting me.

Doesn't make the yearly AME visits less inconvenient though. I have the sleep study/MWT done every other year and a comprehensive letter from the sleep doc filling in the odd years. If you have everything well documented and an AME that's easy to work with, you won't have any trouble.

Happy to communciate further by PM.

Regards
 
kentb said:
I make a mistake yesterday and filled out my 3rd class medical form to fully.
I indicated that I had a sleep study done and now used a CPAP machine at night.
The Dr. reported 'obstructive apnea'. Meaning that while asleep my tongue block off my airway to some extent and the positive pressure of the CPAP allows me to sleep normally.

The Dr. doing the exam, said that the 'red flag' requires the report to be sent to the FAA and I would need to wait to hear from them.

So now I am grounded!:(

Anyone else that have dealt with the FAA on this issue before want to give me a run down on getting my medical back?

How long will it take?

The Dr. suggested that I could still fly, but with a PPL in the plane as PIC. Not sure what the insurance company would think of that.

The Dr. also suggested that I would be required to do a 'Daytime Wakefulness Study'. My regular Dr. has never heard of such a thing.

Any advise would be apreaciated.

Thanks, Kent
Click to expand...

Kent,

I feel your pain... Truly! Taking Iron over the counter supplements and duly reporting same for 6 years. Not good enough this time. So far 3 snail mail reports back and forth to OK City, each one avg a month for response. 3 visits to 2 Drs. to get them to write reports on my behalf... Last and I hope final report sent 02/04, checking mail breathlessly every day.

On an on... My advice to everyone is to sign up on AOPA's med program and talk to them before making app, which I obviously did not...

Can you tell I'm frustrated? Many lessons learned here that will not be repeated next time. One thing I learned from EAA after the fact is that AME is supposed to give you 2 weeks to correct anything before sending app to OK city.

Kent, I thinks it's possible we both went for our medicals at the same place?
 
Thanks for the info

Dave, no Mirapex, so that is not a problem.

Tom, and Carl, thanks for the encouragement---everyone I have ever talked to who uses a CPAP has pretty much the same thing to say.

I did call the AOPA med guy, told him what is going on. His response is pretty much in line with what has already been said on this thread----get the test, if they prescribe a CPAP, then use it for a while til I feel normal, then do a wake test, and get a letter from the MD----go to the AME with all in hand, and should be a non issue, other than may take some extra time.

The AOPA guy did suggest a AME up in Chico (extra couple hours drive) who is familiar with this stuff as being better just going back to my regular AME, who might not be that familiar with it.

AOPA guy also mentioned it seems the NTSB is pushing the FAA pretty hard right now about sleep issues, couple of recent high visibility crashes seem to be linked to pilot fatigue/lack of sleep.
 
Whoever had the restless leg syndrome, my cure was to simply cut out soft drinks and take calcium supplements. Works for me, no FAA problems and no restless legs.
 
Jerry, If you got your at Aurora Aviation....

Jerry Cochran said:
Kent,

I feel your pain... Truly! Taking Iron over the counter supplements and duly reporting same for 6 years. Not good enough this time. So far 3 snail mail reports back and forth to OK City, each one avg a month for response. 3 visits to 2 Drs. to get them to write reports on my behalf... Last and I hope final report sent 02/04, checking mail breathlessly every day.

On an on... My advice to everyone is to sign up on AOPA's med program and talk to them before making app, which I obviously did not...

Can you tell I'm frustrated? Many lessons learned here that will not be repeated next time. One thing I learned from EAA after the fact is that AME is supposed to give you 2 weeks to correct anything before sending app to OK city.

Kent, I thinks it's possible we both went for our medicals at the same place?
Click to expand...

Then it is the same Dr.

This year I need to get a FAA form filled our by an AME to keep my medical current. I have heard of a Dr in Silverton that knows about sleep apnea so that where I'll be going in May.

Kent
 
Need a little advice from CPAP users

Well, I finally got an answer back from the sleep test I took almost 2 months ago-----------moderate to severe sleep apnea. :mad::eek:

They want me to start using a BiPAP machine, which is going to be delivered soon.

VAF is my first stop on this particular information quest, I am also going to look into what AOPA can do for me.

For those of you who have "boldly gone where no one has gone before", the question is how do I make sure to get all the necessary ducks lined up so when I go in for my medical, things will go smoothly???

As always, thanks if advance.
 
Mike, it shouldn't be to hard....

Mike S said:
Well, I finally got an answer back from the sleep test I took almost 2 months ago-----------moderate to severe sleep apnea. :mad::eek:

They want me to start using a BiPAP machine, which is going to be delivered soon.

VAF is my first stop on this particular information quest, I am also going to look into what AOPA can do for me.

For those of you who have "boldly gone where no one has gone before", the question is how do I make sure to get all the necessary ducks lined up so when I go in for my medical, things will go smoothly???

As always, thanks if advance.
Click to expand...

My second machine is the BiPAP and it is so much more comfortable the the CPAP. I was dialed in at a setting of 10 (cm?) on the first machine. When I had to get a retake on the sleep test they decided that at times I needed as much as 15. The CPAP only has one setting and I couldn't get to sleep with 15. So I switched over to the BiPAP. Mine seems to just deliver what I need to keep my tongue out of the way.
As to the medical you should take a report from your sleep Dr stating the you have taken and passed the 'day time wakefulness test'. I think also it should include the diagnosis from the sleep test.

Kent
 
Thanks Kent, nice to hear the words of encouragement:)

For those of you out there following this issue, here is a link that was provided by AOPA medical folks.

http://www.aopa.org/members/pic/medical/certification/sleep/apnea_specs.html

Interesting that they say the test should be in a semi recumbent position on a bed in a dark room-------almost as if they are loading the dice against you.:eek:

I know all my flying occurs in a semi recumbent position in a dark room:rolleyes: RIGHT.
 
Passed my annual inspection.

That is it's the first year since my medical condition was called into question by the FAA. It is mostly painless to do this yearly form for the FAA.
I went to my regular Dr. and had three day BP taken as well as testing for potassium. That was for the mild BP problem. I also told him that I was using the CPAP and had no ill effects from it use.
He wrote a four sentence letter to my AME stating the result of the BP/test and stating that I didn't have any adverse effects from my machine and the pill that I take.

The AME took my BP, temp. and weight then signed the FAA form (I can't remember the number). Took all of 5 minutes and $98.00 and I have my medical from next year.

Next year I'll need to get my regular Dr. to make me another letter and then the normal FAA medical exam.

Kent.
 
Nice to hear about a success story. I went in last week for my first medical exam following sleep apnea diagnosis. The AME's assistant had told me that a "wakefulness test" wasn't required. She was wrong. The AME says that it is required but admits it isn't a very useful test.

I am going in for my "wakefulness test" tomorrow. I don't remember being this nervous for any checkride....probably because I had more control over the outcome. If all goes well, the paperwork shoots off to OKC later in the week. I'll let you all know how it goes.
 
Update time

I have been on the BiPap machine for about 2 months now, and have seen a few mornings when I feel really good, awake and energetic. Like what the machine is supposed to do for me.

Most mornings, I feel at least as tired as before the machine----because I cant get to sleep wearing the stupid mask. I am actually getting less hours of sleep, even if it is better quality sleep.

I am scheduled for a "Maintenance of Wakefulness study" (or whatever the correct name is), at the end of the month.

Any of you out there have any hints as how to deal with this???

As always, thanks
 
MWT

First, I sent you PM.

The MWt you have to take is as described earlier:
Dimmed light
Semi recilined
No TV or other stimuli
Every opportunity to fall asleep.
No tapping of feet, wiggling of toes allowed (they watch)

To yourself:
Recite the Gettysburg Address a few times
Call the pattern at your favorite airport. Practice requesting Traffic Advisories, recite IFR clearances etc
Play Inagodadavida in your head a few times ( or other suitably offesive, long rock & roll anthem)

Just about anything you can think of but don't close your eyes except to blink because IT IS stacked against you. Very easy to doze off, even with a great night's sleep prior.

Another aggravation you may run into:
FAA's version of the test is actually easier than an accredited sleep doc's protocol. Show the doc the FAA required protocol and insist that's all you need. It doesn't have to be accredited. It just needs to meet the FAA requirements and that's all that needs to be noted on the letter he writes. Hopefully your doc will cooperate and understand. The accredited version requres twice the amount of time in the darkenened, quiet environment -just what we need.
 
Yes, do something with your mind....

When I take the MWT and laying there quite, I was planning the details of a long xcross country flight. There is a lot to think about. I don't think that I would have had a problem, but I didn't want to take a chance.

Mike as for sleeping at night, I also had a lot of disturbed night at first (6 - 8 months). After my third mask type and adding the water chamber to the machine, it is working well for me.

I am now on the small pillows that fit in each nostril and I keep water in the machine, but set at the lowest setting.

Keep trying and you will adjust after a bit.

Kent
 
MWT

carlrai said:
First, I sent you PM.

FAA's version of the test is actually easier than an accredited sleep doc's protocol. Show the doc the FAA required protocol and insist that's all you need. It doesn't have to be accredited. It just needs to meet the FAA requirements and that's all that needs to be noted on the letter he writes. Hopefully your doc will cooperate and understand. The accredited version requres twice the amount of time in the darkened, quiet environment -just what we need.
Click to expand...

My sleep specialist insisted on testing to the full accredited standard, but he charged the test to Medicare and accepted that as full payment. I was lucky enough that my sleep-room was not fully dark so I could look around. The sleep tecnician did let me go to my car, which was parked in front of the office, and listen to the radio. She peeked out the window a time or two to see if I was sleeping out there. She did not tell me not to wiggle my toes during the test.

When I got the test paperwork together, I took it to my AME and he telephoned it into somebody in the FAA who approved the issuance of a Class III the next day. My old AME was not cooperative and it cost me at least one three-month delay with Oklahoma City.
 
I did it

Short report---I passed.

Long report, this is probably the stupidest thing I have ever had to endure in close to 40 years as a pilot.

Ever heard of Pavlov ???? guy who discovered that dogs will drool if you ring a bell before feeding them for a while, then they learn a bell means food-----and drool at the sound of a bell even if there is no food????

This is called a "conditioned response".

Well, all our lives, and I mean ALL of our lives---everyone of us, is conditioned to go to sleep when put into a bed in a dark room. This is how the test is performed. They put you in a bed, in a dark room, and then you MUST NOT fall asleep:confused: (I do have to admit, at least the head of the bed is raised a bit, not flat)

STUPID!!!:mad:

To pass this test, you must NOT do what you have been conditioned to do all your life.

I discovered that reciting the poem "Jabberwocky", from Alice in Wonderland would occupy my mind, so that is what I did-------recite "Jabberwocky" to myself for 40 minutes at a time.

Four 40 minute sessions of this has left me totally insane.:eek:

Excuse me now, while I go off "whiffling through the tulgey wood".
 
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