Medical mistake:

[kentb]

Originally Posted by Mike S

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

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.

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

[Mike S]

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/medi...nea_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.

I know all my flying occurs in a semi recumbent position in a dark room RIGHT.

[kentb]

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.

[N395V]

Great news Kent.

[RVFlyer]

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.

[Mike S]

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

[carlrai]

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.

[kentb]

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

[Leland]

Originally Posted by carlrai

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.

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.

[Mike S]

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 (I do have to admit, at least the head of the bed is raised a bit, not flat)

STUPID!!!

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.

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