In Flight Heart Attack?

I recently experienced a heart attck but not in flight. However, the experience has taught me something that may help my fellow 60+ yr old pilots in the future. My symptoms were classic; chest ache, left arm ache, and lower jaw ache accompanied by shortness of breath. I had seen on TV an add for fast acting aspirin crystals that disolve in you mouth and quickly go into the blood stream and happened to have a newly purchased box of these. They are Bayer Quick Release Crystals in a tiny pouch the size of a stick of gum. I took one and drove to the ER. I know I should not have driven, but I did. By the time I got there (20 min) all pain and symptoms were gone. I went in anyway feeling like a big wimp. A few hours latter I was recovering in the CCU from multiple Bypass surgery. I was told while I had partial blockages there was no permanent cardiac muscle damage luckily. I think the reason I was lucky was the fast acting aspirin that I took. Aspirin can slow the progress of a thrombus growth.
I recommend we all keep one of these little "gum stick" sized packages of aspirin in your airplane all the time. If you feel the symptoms, take it and find a place to land (obviously). Perhaps an MD can comment, but I think this is a good idea.

I am an ER/ICU nurse. I think this is not a bad idea - it probably can't hurt, at least given the described "classic" symptoms. But if the underlying problem is something else, lets say a gut ulcer, with pain mistaken for heart attack pain, it could be a contra-indicated choice.

Giving Aspirin is one thing we do in that brief window of a very busy time from presentation of chest pain (at least once we've identified, usually by ECG (EKG) that it is cardiac), until we get you into the cath lab for an angiogram. It will taste bad, but you could even chew and swallow an ordinary aspirin tablet, although swallowing it with water would be better.

Another thing is oxygen. If you have on-board O2, get that on as well. Heart attack (myocardial infarction or MI) is a lack of O2 supply, so if you can maximise delivery, by sucking in some extra, that will also help. Sometimes, O2 alone is enough to relieve chest pain. So, if you have it, start using it, regardless of altitude. Usual caution: fly the aircraft. No point trying to get out and set up O2 if you're in the pattern or on short final or some other high cockpit workload time, if it results in a loss of control and impact with something hard - the ground below, or another aircraft trying to share the sky with you.

I'm not sure about medical / licence issues (ie would you be allowed to fly if you had known cardiac problems), but if you have had cardiac issues, and have been prescribed a nitrate (sometimes a skin patch, sometimes a tablet dissolved under the tongue, sometimes a spray) and are used to using it (can cause low blood pressure so not a good idea to do it in the cockpit if its your first symptom after being prescribed the med and not being used to it), that would be another thing to think about. BUT, this should have been previously discussed with your doctor. If you have a pax with a nitrate and you've never been prescribed it, DON'T use theirs!! At least unless they are also a pilot, you have dual controls and they can land the aircraft (probably rules out a back-seater in the tandems). But, if they meet those three criteria, then it probably also wouldn't hurt.

Aspirin and O2 and nitrates are probably the only three things you can do in the cockpit that we would do in the ER.

Most important though is to get urgent medical attention. Land as soon as reasonably practical, but make sure help is on the way by advising ATC of the circumstances (including what you have done, like taking aspirin and/or a nitrate) and preferably get them to organise an ambulance to get you to hospital.

DAZ

Great suggestion O2! I would not have thought of that and it sits two inches from my shoulder.

O2 for Stroke

O2 would be a good idea for a stroke too.

Hans

our local heart division of the hospital has a radio add that says if you have any signs of a heart attack to CHEW a regular aspirin (i think it starts getting absorbed under your tongue right away as you chew and to Call 911, not drive yourself. they say the 911 call alerts them and they can start planning for heart stuff, and that the paramedics can administer other things that will help save cells from dying. maybe it is mostly O2, but i don't know for sure.

don't really see a need for the special bayer quick release, i think the chewing gets you the same thing and it is what is recommended by the hospital.

Thanks for sharing your experience and info!

Related, Additional Thoughts

All the above is very good stuff. I offer this as supplemental thinking.

I'm almost 68 and in good health for an old guy, but it can happen to anyone.

I installed my autopilot so that the passenger can operate it (right of center) and my usual passenger, my wife (non-pilot) has been briefed on 121.5 and how to operate the radio. My EFIS is dual screen. I've tried to get her to take the pinch hitter course, but can't make the sale. The AP does not control altitude, only holds it, but she knows how to use trim, go full rich and to control the throttle (FP prop). have a placard for 121.5, too. I don't know for sure, but I think she could be talked down to a large runway if necessary.

I offer these thoughts for those willing to consider the low probability risks.

hevansrv7a said:

...I don't know for sure, but I think she could be talked down to a large runway if necessary.......I offer these thoughts for those willing to consider the low probability risks.

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Had the same thoughts, although a tandem makes things a bit more difficult. The rear seat needs bare minimum equipment; pitch and roll AP disconnects, trim, PPT, and throttle. I'm also installing my faithful old 295. The setup should get a pilot down and give a non-pilot an opportunity. The pilot would prefer more of course. For the non-pilot I'm thinking KIS is better.

Lets not forget to FLY THE PLANE and get on the ground.

Aspirin administered quickly goes a long way to limiting heart muscle damage.
O2 may or may not be of significant benefit depending on altitude.

If you have short acting nitrates with you and are dependent upon them for relief of chest pain you probably should not be exercising the priveleges of a piliot.

Approximately 50% of all true heart attacks (not angina) die before arriving at a hospital. This suggests in half the cases of an airborne heart attack 30-50% of the pilot victims will not live to land the plane.

Heart attacks come in few basic forms: (from a pilot in an airplanes perspective)

Sudden cardiac death>>in this case everything to the pilot is irrelevant and now hopefully your passenger will know what to do.

Heart attack with mild symptoms.

1st thing to do is punch the nearest button and head for an airport, then if it doesn't interfere with your ability to fly go ahead and find your aspirin and O2.

Heart attack with severe symptoms

Get on the ground asap airfield road etc. Your time is limited and the severity of your symptoms will probably get worse and quickly limit your ability to fly.
Once on the ground find and take your aspirin/O2.

In any case, if you can, get on the radio and let someone know where you are, what is happening, and what your intentions are, where you are landing.

IF you land off airport try to land where there will be people who can notify EMS and get an ambulance on the way.

You first priority if you have a heart attack in the air is to fly the plane and get on the ground quickly.

Aspirin is important and helpful but not a miracle cure, more important than aspirin is having your passenger know what to do to give them a fighting chance for survival.

There are approximately 1500 true heart attacks per hour in the United States. Fortunately if you extrapolate this statistically to the number of pilots in the air, with risk factors, (age smoking etc.) at any given time, the probability of having a heart attack in the air is infintessimally small.

If you have any and I mean any reason to believe that you are at risk for a heart related condition, my advice is to go see a cardiologist and get a good cardio eval....one that includes a treadmill stress test or better diagnostic tool!!!

Family history
BP elevated
Blood work elevated
Overweight
Stress
etc., etc.,

Notice I did not say high BP or high Cholesterol. It does not have to be "high" to cause problems!!!

Pilots are almost always afraid to go to the doctor due to the fact that it may impact their medical.....Not the right thing to do!

I would not be here today if I had continued to ignore my situation. My dad died at 52 with a MI, my brother at 32 with a suspected MI. About 20 months ago I had 2 stents implanted in my widowmaker.

My wife forced me to go see a Cardiologist for a workup even though I had never had the first symptom of anything wrong. One week after an abnormal ECG and treadmill stress test, I found myself in the cath lab with two 90% blockages in my LAD.

Lying there on the table as the Dr. was shoving stents in, I thought that I would never see the day that I would be able to legally fly the airplane I was building in my garage.

Well I was wrong, I was able to apply for and receive my Special Issuance Medical in a little over 3 months from the time I let the FAA know about my situation. The process is a pain, the yearly requirements are a pain but getting to fly the plane I built is worth it.

I personally think I am much better off now that I get yearly testing to ensure that the odds are in my favor that I am not going to have a massive MI....

The point is, carry the aspirin, nitro pills, O2 if you want to but the best advice I can give is get to the Cardiologist and get checked out before you have some kind of event!!!

I have no real insight to add other than to the younger guys here it is so important to stay fit... I was 240+lbs and not eating a healthy diet. I have since gotten on a workout program and have gone down to 180lbs and gotten into a healthy lifestyle. I know this won't guarantee I will never have an issue but I know I feel better and have reduced my risks.
I personally started doing P90X and I love it, but anything you can do to get moving and burn some calories (and Fat) is worth it.
It would be neat to get a pilots workout group going

that's right Kirk- so many of my friends parents are very overweight and have all sorts of problems because of it. diabetes, heart problems, joint problems, sleep apnea, etc. I know many of those are not Because of overweight, but it is a large factor.

We Americans already got one financial wakeup- we can't have everything we want, why can't we apply that to the food we eat?

While being overweight does increase one's risk for all of the above, it is not a good indicator of health.

My brother was a specimen of fitness, could outwork anyone I knew. He still had CAD and fell over at 32 with a massive MI. on the flip side, I have seen people live to 90+ that never ate right, never exercised and spent their entire life as a morbid obese person.

Just because you are at a perfect weight and are physically fit, does not mean you are exempt from these diseases.....

Being overweight is a major problem and it is growing. While the mechanism to losing weight is simple, it is still a daunting task. It is easy for people that never have had a weight problem to sit on the sideline and make judgements and tell everyone that is overweight how easy it should be to drop it. After all all you need to do is stop feeding the pie hole right? If it was that easy, America would not be one of the most obese nations in the world.

The important message I would like to make is the mild angina pain type heart attack like I had could be so mild that one can easily ignore it. That is not a good thing to do. Mine was mild but was a chest ache, left arm and lower jaw ache, all mild. Yet still when I went in, it was very serious and I ended up with multiple bypass surgery.

Genetics

Genetics can be a funny thing ...

My mom smoked for 45+ years, drank like a fish, is allergic to everything under (and including) the sun ... and she's 85.

My dad had a bum leg from a car accident in the 40s, never exercised a day in his life, was always "round", a diabetic since he was 40-something, eats at McDonald's every chance he gets ... and he's 90.

I've watched my weight creep up a good 40 lbs above where I should be and losing it isn't any fun. I did a program a few years ago and lost it. But, when life got in the way, I slid back up to where my body is comfortable (why fight nature, right?)

Now, as soon as I lick this cold, I'm hitting it again. My genetics may allow me to abuse myself and get away with it for several more decades ... but dropping some weight is the easiest way to make my plane lighter and improve its performance!

Brantel said:

While being overweight does increase one's risk for all of the above, it is not a good indicator of health.

My brother was a specimen of fitness, could outwork anyone I knew. He still had CAD and fell over at 32 with a massive MI. on the flip side, I have seen people live to 90+ that never ate right, never exercised and spent their entire life as a morbid obese person.

Just because you are at a perfect weight and are physically fit, does not mean you are exempt from these diseases.....

Being overweight is a major problem and it is growing. While the mechanism to losing weight is simple, it is still a daunting task. It is easy for people that never have had a weight problem to sit on the sideline and make judgements and tell everyone that is overweight how easy it should be to drop it. After all all you need to do is stop feeding the pie hole right? If it was that easy, America would not be one of the most obese nations in the world.

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Brian I am in no way talking about you, but I think in general a claim can be made that people that are obese are in poor health. In the United States it is a major problem, and my ideas about it have changed over time to think it is more a result of the types of food available ("fast" food, junk food, to much sugar ) than strictly people overeating.

There certainly is a very strong genetic predisposition to many diseases. I think that is what your brothers death would be attributed to, although his diet (strictly meaning the food he ate ) could have been poor and he still retained a healthy looking physique.

you and the generic population have no control over your genetic makeup. I believe we do have very strong control over our diet, and for the majority of people also their weight. these are some of the major factors of health. there are always exceptions, but i believe these are some of the most important aspects under our control of our health. Of course there is also lifestyle, risky (poor sex decisions, drug/ alcohol abuse ) behavior and social/ family support

Danny7 said:

Brian I am in no way talking about you, but I think in general a claim can be made that people that are obese are in poor health. In the United States it is a major problem, and my ideas about it have changed over time to think it is more a result of the types of food available ("fast" food, junk food, to much sugar ) than strictly people overeating.

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Haha,

No problem Danny, I am fat and I know it. One of those life long struggles.... It is a huge battle to fight! $100 salads are hard to pick over $100 burgers....

Brantel said:

Haha,

No problem Danny, I am fat and I know it. One of those life long struggles.... It is a huge battle to fight! $100 salads are hard to pick over $100 burgers....

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but you are married, right ? I'm not and i know that is a general indicator of a shorter life. there are all sorts of different aspects of health.

Danny7 said:

but you are married, right ? I'm not and i know that is a general indicator of a shorter life. there are all sorts of different aspects of health.

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MARRIAGE is a general indicator of a shorter life??

Wow ... wait'll my wife hears this! "Oh, honey, I have some bad news ..."

I've become a minor expert lately!

With what happened to me end of 2009, let me just say I've become smarter on the heart thing. It is good to read what people are saying here as to working on being in better shape and dieting etc, it surely can't hurt. However, a statistic a doctor recently gave me is this: Most peoples FIRST indication they are having a "heart event" is they are dead! That is correct, aprox 56% of people that die of heart attacks never had a clue or indication it was going to happen. None!

In my case I very recently retired from 24 years as a fighter pilot. I also had a recent Class 1 medical including EKG. I've been closely monitored, poked and prodded for years and my family hertitage is ZERO for heart problems with exceptionally long life spans (Gramps was 94). I am in shape, 49, lean, small wasted and not what you would expect as a heart event kind of guy. Then BANG! I had an electical short, not tissue or artery related.

So yes, doing what we can to mitigate risk is very important, but not necessarily going to be an indicator of the future. On the bright side, as in my case, the heart event happened but because of the shape I was in, I survided the event and it didn't create damage to my heart. And I'm still flying, THANK GOD!

Do what you can to be healthy, but also have your life in order because, well, we are but 'dust in the wind' and life is but a vapor in time. It's been an attitude adjustment for me! A good one!

Salad anyone?

BTW, marriage doesnt make you live longer, it just SEEMS longer...

N8RV said:

MARRIAGE is a general indicator of a shorter life??

Wow ... wait'll my wife hears this! "Oh, honey, I have some bad news ..."

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No, No ! b ein g single is an indicator of on average shorter life span. with a wife you get fed a little better, go to th e doctor more often for things you'd put off if single, etc etc. i hate to say it with divorce being about 50% or worse, but i th in k if you are married you end up bein g happier also.

dan g, looks like my keyboard needs that update to fix the extra space keystrokes.

Here are some suggestions:

1. Don't delay, do what you want now because you never know what will hit you tomorrow. At our EAA chapter, we have 2 or 3 guys who have been diagnosed with diabetes or high blood pressure in the last year or two. Others have been surprised with other medical problems that could cost them their medicals. Several years ago, one of our members was driving a semi out of Salt Lake City and noticed a pain in his chest & decided he had better pay attention to it. 400 miles later, when he got to Boise, he made a routine call to his wife--a nurse--and happened to mention this pain. She yelled at him to get to an ER right away. So he hopped into his 18 wheeler and drove to the hospital. They threw him into surgery & he had something like a 4 way bypass--more than I had ever heard of before. Another guy, flying to a pancake breakfast in his Glasair with his wife in the plane, suddenly lost consciousness. She didn't know how to fly, although she was able to turn it around and fly back to their home airport. About the time they got to the pattern, he woke up and landed the plane. Electrical problem with his heart. No one expected any of these changes in their condition, although the guys with a lot of extra pounds probably knew it could happen, they probably didn't expect it actually would.

2. Set a limit on your weight and don't let it go any higher. If you hit that limit, take the weight off, shooting for a lower target, say 5 lbs less than the limit. If you are not fat, that's the best way to avoid getting fat. It's easier to take off 5 lbs than 50 or 150. It just takes discipline.

3. There's a lot of wisdom in the phrase in the Lord's prayer, "lead us not into temptation". Don't bring home any junk food so you don't have it around. You don't have it, you don't eat it. Look for healthy snacks--snack on bananas, not burgers. Read nutrition labels. 117 calories per day, every day amounts to a pound per month, either up or down. Cut out 117 calories a day and you lose or stop gaining a pound per month. Find a new snack you like and eat that every day & you'll gain a pound per month. Don't go near McDonalds, Burger King, etc. Go for Subway or get a sandwich at a deli. Drink water, not soda--even diet soda, but if that's all you have diet soda can make you hungry. I had a 350 pounder working for me as a forestry technician. Could hardly do his job because it takes a lot of work to haul that kind of weight up a 30 degree slope thru the brush. He had a Pepsi every day, often two. "John, why not Diet Pepsi? One per day is worth over a pound a month." "Oh, I hate that stuff." That was about 15 years ago. Now he is losing weight the hard way because they are chopping off his feet due to diabetes problems. If he had tried the diet soda for a month, he would probably gotten used to it.

4. Take advantage of opportunities for a little exercise. Don't park as close as you can to the store entrance--park across the lot where the spaces are easier to find and you'll probably walk into the store before the guy who drives up and down row after row looking for a space close to the door. Walking briskly rather than a mall walk & you burn more calories. Need a break from working on the RV? Don't go for a snack, go for a walk. The biggest muscles burn the most calories, and walking uses the biggest muscles, so walking is good.

No guarantees in life, all you can do is improve your odds. The foregoing nos. 2-4 is how I have lived and I weigh only 3 lbs more than I did when I got married 43 years ago. When I went for back surgery a couple months ago, 2 people at different times volunteered that I looked like I was in great shape for someone 66 years old. Then a couple months later a new problem came up that could end my flying--a problem unrelated to fitness. The docs are still looking into it. No guarantees! Do it now!

Wow, what timing for this thread.

Today is my first day home from the CCU after suffering a heart attack Saturday while my wife and I were picking up trash along the side of the road. Got my first helicopter ride as a result.

Glad to see that there is at least hope in getting a medical someday.

Yep, most likely as long as your stable, you will be able to get a special issuance medical.

You will be down at least 9 months because you must wait 6 months before you can get the required test that the FAA will require and after you jump thru all those hoops, it will take at least 3 more months to get processed. There is info on the FAA site about what they will require. You must follow that list exactly or it will delay your application. Once approved, you most likely will get a 5 year waiver that will allow your ME to give you your medical once per year as long as you do what they want you to as listed on the waiver on a yearly basis.

Glad you are still with us!!!!

Again, to speed the process...After 6 months from your release from the hospital, get the required test listed on the FAA website (exactly as they require them) and take them with you to your ME and have him send it in with the original request for a special issuance medical. Show the requirements to the people performing the test because the FAA wants you to do stuff a little different than they normally do. If you do not do this, you will be wasting time as all they will do is a few months later turn around and ask for this stuff sending you back to the end of the line. Whenever you do your testing, require the Dr. office to give you all the reports, strips, dictations etc. For the treadmill test, they want the full tracing beginning to end and it must be the original copy as printed by their machine. You will end up with a stack of papers an inch or two thick.

If cost is not an issue, there are services out there that will help you thru the process to speed it along. They might be worth it for folks that need to fly to get paid, but for me it was not.

f1rocket said:

Wow, what timing for this thread.

Today is my first day home from the CCU after suffering a heart attack Saturday while my wife and I were picking up trash along the side of the road. Got my first helicopter ride as a result.

Glad to see that there is at least hope in getting a medical someday.

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Holy Cr#$%

f1rocket said:

Wow, what timing for this thread.

Today is my first day home from the CCU after suffering a heart attack Saturday while my wife and I were picking up trash along the side of the road. Got my first helicopter ride as a result.

Glad to see that there is at least hope in getting a medical someday.

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Wow, Randy, we all hope you are doing all right. You have been an inspiration to a lot of us slooow builders. I hope the process of getting back into the air for you goes smoothly and quickly. We need you flying.

I have your website book marked for reference and use it all the time for the "definitive How-To".

Best of luck

Randy, hang in there!

Randy,

I too have benefited from your EXCELLENT website and it aided me duing many 'now what' episodes! And you are a true craftsman!

I am sorry to hear about your recent heart event but thankful you are back typing about it and not the alternative.....not yet! I have recently gone thru the FAA special issuance process and it was not that tough and my experience was that most cardiologists know 'that FAA' requirements and my package came together quickly. In fact, one week after my waiting period, I had all my tests complete. My waiting period was two months so look and see your requirements specifically. They have changed to less time recently. The key being if you are stable in your current condition.

My paperwork is at OKC/FAA awaiting the cadio board which meets every two months-ish. Once I get the definative word, I'll outline the process and my exact timeline here.

In the meantime get airborne with your friends soonest and often. After all, time spent airborne is not subtracted from your life span!

Tailwinds,

Every night it seems like i tear up looking at my dog, she has bone cancer.

I think there isn't much i can do to help, but it also makes me think i should take my health and each day as a gift.

I'm glad you are still with us Randy, I hope your health improves and am glad you didn't have worse results.

RV Cardio Support Group?

Wow,
I didn't realize there are so many of us who have been through the cardiovascular wringer! It really shouldn't come as a surprise, though, because we RV folks are just a small crosscut of the general population.

I actually started a blog before my mitral valve surgery last April, but after two heart surgeries, I just didn't really want to finish it.

As for my special issuance, my six months waiting period ended last October, and my family doctor recommended a prostate biopsy because my PSA was elevated. So if any of you guys have to wear a urine catheter for an extended period of time, as I did, be aware that there are some urologists (not mine) who admit you can get an elevated PSA reading. My prostate biopsy was completely benign and guess what? Three months later, my PSA test result had dropped from 5.3 to 4.3!

Anyway, my FAA cardio tests were done in January, and my exam by an AME was done on March 3. In February, as an AOPA Medical Services member, I requested AOPA to review my files. They said they didn't see any problems, but with over 300 pages of files eek they said I shouldn't be surprised if the FAA Medical folks come back and ask for more info. Well, yesterday I got the letter...

They want more informaion.

So today I am calling doctor's offices and hospital medical records offices to get the information. I have 30 days from the date of their letter or the whole process has to be re-started...if I want to continue flying.

I could have quit building my RV-7 and started an RV-12 so I could fly LSA, but I really want to fly the RV-7 first.

Maybe we could start an RV Cardio Support Group to share info and encouragement.

Randy, I too have admired your craftsmanship through your web pages. I wish you continued good health and recovery. Hang in there, and take one day at a time.

Don,

It is easy to get an extension on the 30 days. All you need to do is write them a letter requesting an extension. If yours was like mine, the letter came to my house 15 days into the 30 days....send the letter to the same address requesting the info.

One more thing for those that may read this. If you do your test before your waiting period, they won't take em. Also if the test are more than 3 months old when the review board gets around to looking at them, they won't take em.

It is a major circus but it is worth it in the end...

Thanks, Brian.

Right now I don't think the 30 days will be a problem. The letter was dated 3/25 and I got it four days later (yesterday). I am coordinating my response with the AOPA medical folks to make sure I will be sending them what they are asking for.

My first reaction was that they were asking for records which I had already sent them, but after my over-reaction settled down, I could see that one item had not been submitted. They want the results of a test done before my surgery and it wasn't on the FAA list, but hey, if that's what they want, I'll give it to them. The other items should be easy to get, even though I think I have already sent them everything Vanderbilt Hospital has on me.

If anyone has any questions about mitral valve repair surgery and mitral valve replacement surgery, don't hesitate to contact me. I'll be glad to discuss what I know since I have had both surgeries!

Danny7 said:

...Every night it seems like i tear up looking at my dog, she has bone cancer.

I think there isn't much i can do to help, but it also makes me think i should take my health and each day as a gift...

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Danny, we have had several dogs (and cats) while our kids were growing up. One thing I tried to teach our kids when one of our pets died was that they help us in so many ways including how to deal with grief. You are correct that they help us appreciate how precious each day of life is. I hope you are blessed with many good memories of your dog as she reaches that time.

Brantel said:

You will be down at least 9 months because you must wait 6 months before you can get the required test that the FAA will require and after you jump thru all those hoops, it will take at least 3 more months to get processed. There is info on the FAA site about what they will require. You must follow that list exactly or it will delay your application. Once approved, you most likely will get a 5 year waiver that will allow your ME to give you your medical once per year as long as you do what they want you to as listed on the waiver on a yearly basis.

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I have never heard of anyone get a 5 year wavier (special issuance mediacal) for heart desease. I know quite a few people that have had heart attacks or stents (which is what I have) that will require getting a special issuance directly from OK City every year. I talked to the FAA several times and I am told I will need to do the paper work with OK City every year until I die or decide to stop flying (unless I switch to LSA).

Special Issuance and 60 months

Technically, a waiver and a special issuance are not the same. For more information, go to the AOPA medical section on Special Issuances.

As for the 5 year time period, you both may be somewhat correct yet incorrect in your terminology.

"...A special issuance is a two-sided coin. It's great that the regulations offer a mechanism to offset the disqualifying conditions. The downside is that it's a discretionary issuance granted by the Federal Air Surgeon and comes with requirements for periodic interim medical reports and time limitations (usually 12 months) on the duration of the certificate, and it can be withdrawn anytime the FAA sees evidence of an "adverse" change in your condition.

You may hold a certificate that appears to be valid for up to 60 calendar months in accordance with FAR 61.23. In reality, though, the certificate is valid for only as long as the authorization is in force, and that's determined by the type of medical condition and the perceived risk of incapacitation that could result from the condition..."

The bottom line is each person's situation is unique, and the Medical folks in Oklahoma City treat each pilot's situation accordingly.

Thank you All for the kind words

Thank you everyone for the kind words and thoughts. I can tell you it was quite a surprise. I've been fairly active, work out at the gym with my sons, there's no family history, etc. Seems a small clot hit one of the arteries on the backside of my heart, not one of the major supply-side arteries. I did have shoulder surgery 5 weeks ago so maybe that was the source of the clot.

I live out in the country and from the time I had the attack to the time I was on the table at a major heart surgery center in Indianapolis was less than 90 minutes. Truely amazing and I'm sure it had a lot to do with limiting the damage to the heart muscle. Afterwards the cardiologist said there was no damage to the heart and he released me after installing a stent 2 days later without restriction. All is well and getting back to normal.

I too was a little surprised by the number of fellow fliers out there who have had similiar circumstances. It's amazing the support that the forum provides and I am warmed by the kind responses. Thank you all. I doubt you'll ever know just how much it means to me.

The waiver or whatever it is called that I am talking about is the 5 year written authorization that I hold in my hand that allows my ME to issue me a new medical each year as long as I do what is required by the document and there is no change in my condition. The test and paperwork still must be sent to OK City each year. My special issuance medical is only good for 1 year at a time.

This is somewhat of a new thing I am told. The advantage is that your local ME can renew your medical on time and forward your stuff to OK City. Obviously they will then review it and either let you keep your renewed medical or revoke it.

The old way can cause you to be grounded if your package gets held up for some reason and your year expires before it gets renewed again.

plehrke said:

I have never heard of anyone get a 5 year wavier (special issuance mediacal) for heart desease. I know quite a few people that have had heart attacks or stents (which is what I have) that will require getting a special issuance directly from OK City every year. I talked to the FAA several times and I am told I will need to do the paper work with OK City every year until I die or decide to stop flying (unless I switch to LSA).

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Randy and Don, I guess we are all now members of Cardiology Club. My signature has included "RV7 300+ hrs", but I think I should change it to TTSN 64 years, TSMO 4 weeks. They told me after my bypass I would feel better than before and it is true already. Just need to get the sternum completely knitted back and also completely change my eating habits.