[RV7A Flyer]

http://www.faa.gov/news/updates/?newsId=81444

They just can't stay away from this.

 

[MercFE]

Actually, this sounds like great news.

I went through the OSA SI process while I was still active duty. Had me medically disqualified from flying for about 3 months. One of the biggest contributors to me putting it off so long in the military was the down time required to receive the waiver.

The link you posted shows that pilots will now be able to continue flying, even while starting treatment. Effectively, no grounding what so ever for getting the treatment you need to be a more rested pilot.

No penalty, good reward... Why the negative tone in your post?

 

[grubbat]

Ok for commercial drivers

This is probably a good thing for the commercial pilots but for the 3rd class folks, not necessary. When the 3rd class medical issues came up last year and gaining support in congress, this neck girth and sleep stuff was put on the back burner until the controlling authority could focus on the third class medical "reform" or lack thereof and then revisit the sleep issue later. Looks like later is now.

Nobody wants our commercial pilots to fall asleep at the controls or have impaired judgement due to lack of sleep. But for all the 3rd class folks, who fly when they want at leisure, it just seems another shot at chipping away at the freedoms we enjoy at the risk of some perceived thought of added safety.

If the controlling authority was really serious about improving safety, maybe they should focus on known issues that affect all pilots like ADSB shortcomings and existing facilities that are in need of maintenance and so forth.

 

[RV7A Flyer]

Actually, this sounds like great news.

I went through the OSA SI process while I was still active duty. Had me medically disqualified from flying for about 3 months. One of the biggest contributors to me putting it off so long in the military was the down time required to receive the waiver.

The link you posted shows that pilots will now be able to continue flying, even while starting treatment. Effectively, no grounding what so ever for getting the treatment you need to be a more rested pilot.

No penalty, good reward... Why the negative tone in your post?

Color me skeptical. What exactly is meant by:

The FAA is not changing its medical standards related to OSA; however, it is revising the screening approach to help AMEs find undiagnosed and untreated OSA. The new guidance will improve safety and pilot health by reducing the burdens and disincentives that may have prevented some pilots from seeking an OSA evaluation and treatment...
the new guidance does not rely on BMI and allows a pilot to keep flying during evaluation and treatment. The FAA plans to publish the new guidance in the FAA Guide for Aviation Medical Examiners on March 2, 2015.

I smell the creation of another reason to NOT eliminate the 3rd class medical. "Look at all the pilots who may have sleep apnea that we found! See why we have to keep the 3rd class medical?"

 

[MercFE]

This is the key part of the posting.

the new guidance does not rely on BMI and allows a pilot to keep flying during evaluation and treatment.

As Grubbat was stating, the last round said that AMEs could push the treatment. This round says NOTHING about the AME starting, or even recommending testing. In fact, it says that this is NOT based on the foundation of the previous guidance of BMI.

It also does not state which class this specifically would apply, or not apply, to. So, it could still be in line with the elimination of the Third Class medical.

I'm just saying, don't try to spin this in an anti-FAA sentiment without all of the supporting facts. This release specifically tries to combat some of the hysteria, but it obviously can't answer every specific scenario.

And I've never slept better than after I began treatment for OSA. If any pilot out there has episodes like I did, any attempt by the FAA to get rid of the burden of extended grounding for flyers in an attempt to persuade them to voluntarily seek out treatment is a GOOD thing!

 

[RV7A Flyer]

And it says

OSA screening will only be done by the AME at the time of the physical examination using the American Academy of Sleep Medicine (AASM) guidance provided in the AME Guide.

which does, in fact, include BMI as one of (many) things that they say put a patient "at risk" for sleep apnea.

 

[RV7A Flyer]

This round says NOTHING about the AME starting, or even recommending testing.

Actually, yes it does:

BMI alone will not disqualify a pilot or require an OSA evaluation. The risk for OSA will be determined by an integrated assessment of history, symptoms, and physical/clinical findings. OSA screening will only be done by the AME at the time of the physical examination using the American Academy of Sleep Medicine (AASM) guidance provided in the AME Guide. Pilots who are at risk for OSA will be issued a regular medical certificate and referred for an evaluation which may be done by any physician (including the AME), not just a sleep medicine specialist, following AASM guidelines. If an evaluation is required, a laboratory sleep study or home study will not be required unless the evaluating physician determines it is warranted. The pilot may continue flying during the evaluation period and treatment, if indicated.. The airman will have 90 days (or longer under special circumstances) to accomplish this. The FAA may consider an extension in some cases. Pilots diagnosed with OSA and undergoing treatment may send documentation of effective treatment to the FAA to arrange for a Special Issuancemedical certificate to replace the regular medical certificate....The agency is revising the screening approach to help AMEs find undiagnosed and untreated OSA.

 

[MercFE]

So... You're saying there's no change to the actual procedure already in place for doing the testing. Those guidelines are already in the AME guide. Whether they are followed by your specific AME, or not, is open to debate.

However, the release is not suggesting the implementation of any additional screening requirements. Instead, they are relaxing the burden on pilots... Again, sounds likes a good thing.

 

[RV7A Flyer]

What I don't like is the FAA making my AME assess me for things I *might* be at risk for, and then having me jump through hoops that my primary care physician has never considered an issue. I *might* be at risk for a whole host of things, but being "at risk" doesn't mean it's a problem now. I like good cigars, that makes me "at risk" of getting cancer. Should my AME have to start assessing me for that? I'm over 50, should my AME refer me for a colonoscopy because I'm "at risk" for colon cancer?

Nobody knows my medical history as well as my PCP, and I don't like the idea of the AME taking over for him and forcing me into tests which my doctor doesn't feel are necessary, based on the 30 minutes every two years when he bangs on my knee, listens to my chest, and has me read on eye chart. Oh, he checks my ears, too, but since I'm getting older and fly piston airplanes, I guess I'm "at risk" for hearing loss... . Good thing he hasn't referred me to an audiologist to cover that "risk" (yet) while giving me 3 months more to fly.

This should be the same as every other checkbox on the form...have you ever been diagnosed with sleep apnea? No? End of story.

 

[RV7A Flyer]

So... You're saying there's no change to the actual procedure already in place for doing the testing. Those guidelines are already in the AME guide. Whether they are followed by your specific AME, or not, is open to debate.

However, the release is not suggesting the implementation of any additional screening requirements. Instead, they are relaxing the burden on pilots... Again, sounds likes a good thing.

Yes, it is...

The FAA is not changing its medical standards related to OSA. The agency is revising the screening approach to help AMEs find undiagnosed and untreated OSA.

 

[RV7A Flyer]

Here's my favorite part of the FAA's statement:

The NTSB database lists 34 accidents – 32 of which were fatal – where sleep apnea was mentioned in the pilot’s medical history, although sleep apnea was not listed as “causal” or “contributory” in those accidents.

In other words, even the data doesn't support their action.

 

[MercFE]

Since they're not changing their standards, the standards have already been there. Whether they were enforced or not was, in my opinion as someone that has both gone through the process and avoided it for as long as possible, greatly dependent on how much of the hassle the AME and the pilot wanted to go through.

By keeping the same standard, but loosening the burden during the process, they are effectively revising the screening to entice more pilots to seek out and receive care that they should probably be receiving.

BMI/Weight is NOT the only factor that is looked at, at least not by a good AME. I know many skinny guys that have gone through the OSA process, thereby improving their overall quality of life.

It really is in how you want to spin the news... You can look at it as an hammer to come down on people that just want to be left alone, or a light to help guide those that could benefit significantly from the diagnosis through the process.

Agree to disagree, I guess.

 

[mv031161]

What I don't like is the FAA making my AME assess me for things I *might* be at risk for, and then having me jump through hoops that my primary care physician has never considered an issue. I *might* be at risk for a whole host of things, but being "at risk" doesn't mean it's a problem now. I like good cigars, that makes me "at risk" of getting cancer. Should my AME have to start assessing me for that? I'm over 50, should my AME refer me for a colonoscopy because I'm "at risk" for colon cancer?

Nobody knows my medical history as well as my PCP, and I don't like the idea of the AME taking over for him and forcing me into tests which my doctor doesn't feel are necessary, based on the 30 minutes every two years when he bangs on my knee, listens to my chest, and has me read on eye chart. Oh, he checks my ears, too, but since I'm getting older and fly piston airplanes, I guess I'm "at risk" for hearing loss... . Good thing he hasn't referred me to an audiologist to cover that "risk" (yet) while giving me 3 months more to fly.

This should be the same as every other checkbox on the form...have you ever been diagnosed with sleep apnea? No? End of story.

Applause! You have it right! My PCP (also a PPL and AME is so against OSA studies. iAW him It is driven by own AMA greed and inflated reports. The % rate of anyone failing a sleep study test is very high regardless if yo have sleep Apnea or not. It is not needed! No one have complained about the cost...who is footing the $2,500 dollars it cost to prove you dont have Sleep Apnea? Are we sendi g that bill to the AME or FAA if falsely or erronuosly asked to perfrom the test???

 

[claycookiemonster]

Yup.

The camels nose, well, heck, the whole camel is under the tent now!

I use an approved sleep aid (Sonata), have listed it as a prescription drug on every medical form I fill out, and I fly for the airlines, so I get a Class I every 6 months. After about 2 years of legal and public use, I got a certified letter from the FAA last Christmas saying that an internal audit had found my case, and I had 30 days to submit:
1. Letter from prescribing Doc describing why I took it, how often, etc.
2. Letter from AME ensuring he'd counseled me on usage, etc.
If they didn't receive this information w/in 30 days, my medical was invalid. All this had to be done in 30 days over Christmas. I scrambled and got it to them within their timeline, and waited for their reply, or any comment at all.

And waited.

And waited.

And waited.


Finally, about 4 months after my information was submitted, I got a letter which essentially said, "Well, OK, just keep doing what you're doing, but don't ever let it happen again!" or some such foolishness.

Fast forward to this year. I had a Squamous cell taken off my arm. Margins clean, no issues, no future treatment, case closed. My most recent Class I was also held up by my AME because he said you never know what those !@#$%^ types in FAA Medical will come up with, so we need to send in volumes of information on this to keep them from coming after you. Now, a squamous cell carcinoma is technically skin cancer, but it grows slowly, doesn't metastasis to other parts of the body, doesn't really do anything; it just slowly grows and eventually gets to be a nuisance. It won't incapacitate you, you don't go blind or loose your balance or judgement. It was just a little blot on my arm and it's been taken care of.

Why could this possibly be of operational interest to the FAA? In what way am I a current or future hazard to myself or the traveling public because of this? Frankly, why is this any of their business?

It's their business only because they say it is, and they throw down their trump card; "We have to ensure that the pilots flying your kids home from college...." "It's our sworn duty to make sure that those little planes that fly over your house..."

Rant over, catching my breath.