Medical Stuff for Geezers :)

[David-aviator]

I lost most of a night's sleep this week after visiting my Doctor who is also my AME. The visit was for a routine check up, but there was more to it than that. I debated long and hard whether or not to mention a persistent pain in the upper far left chest area, almost to the shoulder, and finally decided it would be best to do so as it was not going away. Every pilots night mare, right?

I like my Doctor. He came up through the Russian Army 30 or 40 years ago and somehow ended up in the U.S. with a very respected private practice in internal medicine. When I mentioned the pain and area, and suggested it probably is a pulled muscle from lifting 15 bags of crushed rock six weeks ago, he said it could be, but at my age (67), we have to check out your heart and pluming immediately. There was no discussion about it. His front desk girl set up an appointment for a "thallium stress test" first thing the next morning.

Well, "thallium stress test" sent me to Google as soon as I arrived home, not ever having heard the term before. Many readers here probably know what it is, but it was another day in school for me. Simply put, they shoot some radio active stuff into the cardiovascular system that shows up on a monitor when the recipient is stretched out on a flat table under a moving device. The moving device takes 32 shots from that many angles and a computer builds a 3D image of the heart showing where blood flow is good and not so good. This is done resting and after 8-10 minutes at WOT on the treadmill. The whole deal took about 2 1/2 hours.

A senior Dr. sat in a chair next to the treadmill while a young gal revved the thing up. He knew I was a pilot and joked about WOT, and how tough the heart is compared to most aircraft engines. He said the heart will run a hundred years without an oil change. They finally got enough data on their recorder and asked if I had had enough, to which I responded with a simple nod as I was completely out of air. He looked at all the jiggles on sheets of paper and said I could keep my shoes on. (?) I said, what? He laughed and said, we take away your shoes as you do not leave this hospital if you have a problem.

I had passed the tread mill test!!

They took more pictures 30 minutes later and I was free to leave. I have not yet seen the official radiology report, but if anything significant had turned up, they would not have turned me loose. Wow, I couldn't believe it. I was certain my flying days were over.

Getting one of these things is not a bad idea. While it could crimp a pilots life style, at least they could fix what was wrong sooner than later. From what I've read about the procedure, it is the best non-invasive test of the heart and associated plumbing going.

dd

 

[LettersFromFlyoverCountry]

I went through the same thing a few years ago (and, of course, I'm now going through another thing where I DO believe my flying days ARE over).


One thing: I was told once NEVER have your regular doctor also be your AME because they serve two different masters. Your AME has a duty to report your status to the FAA, and has no responsibility to you. Your regular doctor has only a responsibility to you.

I do admit, though, it sure would be a lot easier in these situations to have your AME be your family doctor. Getting an AME to give a **** about helping organize stuff to send to OkC is a real difficult chore, I've found.

 

[gbrasch]

Heart Scan

Lots of heart stuff going on out here, probably from lots of folks in Bob's neck of the woods coming here to get away from the cold. Anyway, we have a heart hospital here that does heart scans. I had one for piece of mind, cost $150 which insurance does not pay. It is kind of like an x ray, don't even have to take your shirt off, and takes about 45 seconds while you are laying down. Now that was easy. And I agree with Bob 100%, keep your FAA doc and personal one seperate. Just my 2 cents, glad all worked out for you.

 

[billnaz]

just don't fail a flight physical

An important consideration for us all as we age is that there is now an option to keep flying without the need for a flight physical. The new light sport rating allows for self certification of health. All ya need is avalid drivers license. The caveat is that you can't have failed a previous pysical. If you have any doubt about your health you should have a pre official physical evaluation before you get the AME evaluation. Lots of info on this at EAA and AOPA. Here's wishing everyone a long happy flying life.

 

[svanarts]

Got a question from a friend of mine that's up this alley. What if you let you license lapse for many years and wanted to get into LSA? Is it a simple as flying with an instructor to get current again?

 

[treeez]

GEEZERS

I go through the same tests every year in order to get my special issuance on my medical. Four years ago, I was feeling pressure all over my body and shortness of breath while at work one morning. Since there was a hospital just accross the street, I decided to stop in the ER. Figured they would just tell me to exercize more and lose weight. WRONG! They wouldn't let me leave. The blood tests showed that I was very close to having a heart attack. Four days later I had a 4 way bypass. Fortunatly, I did not have the heart attack and no damage was done to my heart. Six months after my recovery, I had all these tests done and submitted to the FAA. Another 2 months I had my special issuance. After all this happened, I realized that I had been showing signs of cardio vascular disease for more than 10 years before I had treatment. ( I could tell that much difference in the way I felt and my energy after the surgery.) My AME is also my best friend. We fly together often and do aerobatics in his Extra 300. I trust him completely with my medical concerns. When he tells me it's time to hang it up, I will. People that plan to just let their medicals expire and continue to fly LSA, when they expect their health is going down are doing no one any good. IMHO. They should think about their familys, the general public and all the rest of the EAA pilots. What is the general opinion of the public when one of us goes down in our homebuilt plane? For what ever reason. Sorry this was so long a post. By the way, I was 51 when I had my surgery. Mike

 

[N395V]

Thallium Stress Test

The test is actually a Nuclear Cardiac Perfusion Study Thallium is just one of many flavors of nuclear material.

This test has some limitations and there is much misinterpretation of what "passing or flunking" means.

The test when negative is acurate about 90% of the time this means it is wrong 10 % of the time.

When the test is positive it is only 85% accurate.

A negative test does not mean that you do not have heart disease, it only means that the disease you have is not bad enough to cause symptoms nor is it bad enough to do anything about.

The nuclear (thallium) portion of the test probably was not interpreted till that evening or the next day and you will not get the result till you go back and see your doc.

They let you go home probably because you had no symptoms on the treadmill and walked at least 6 minutes as well as having no EKG abnormalities during stress. 6 minutes on the stress test without chest pain and no ECG abnormalities gives you a 98% probability of not having a heart attack within the next 2 years. It does not mean you do not have heart disease.

Do not ASSUME they will call you if there is a problem with the test. Hospitals and Drs office are notoriously innefficient administratively. If you do not have an appointment to see your doc soon call him and get the result.

Also remember if the test is positive it has a 15% chance of being wrong. A positive test only means you need further testing that is more accurate.

I

 

[David-aviator]

The test is actually a Nuclear Cardiac Perfusion Study Thallium is just one of many flavors of nuclear material.

This test has some limitations and there is much misinterpretation of what "passing or flunking" means.

The test when negative is acurate about 90% of the time this means it is wrong 10 % of the time.

When the test is positive it is only 85% accurate.

A negative test does not mean that you do not have heart disease, it only means that the disease you have is not bad enough to cause symptoms nor is it bad enough to do anything about.

The nuclear (thallium) portion of the test probably was not interpreted till that evening or the next day and you will not get the result till you go back and see your doc.

They let you go home probably because you had no symptoms on the treadmill and walked at least 6 minutes as well as having no EKG abnormalities during stress. 6 minutes on the stress test without chest pain and no ECG abnormalities gives you a 98% probability of not having a heart attack within the next 2 years. It does not mean you do not have heart disease.

Do not ASSUME they will call you if there is a problem with the test. Hospitals and Drs office are notoriously innefficient administratively. If you do not have an appointment to see your doc soon call him and get the result.

Also remember if the test is positive it has a 15% chance of being wrong. A positive test only means you need further testing that is more accurate.

I

Thanks for the info. I do have an appoinment to talk about it. Like you say, this test and many others are not all inclusive but we have to start somewhere. I think we all need to keep in mind that none of us will live forever. The old Dr. at the mill asked how the men in my family died, I thought for a minute and said heart problems. He said, that's good, you don't want to go out with cancer.

dd
By the way, I was on the mill for about 9 1/2 minutes....and survived....so far so good.

 

[LettersFromFlyoverCountry]

I think the LSA is really a can of worms because people think it's a "get out of jail free" certificate for when you have a medical problem. It's not.

If you know of a medical condition that you have that COULD affect your performance as a pilot of a light sport aircraft, you cannot fly under LSA. Now there's certainly going to be a test of that provision as to what consititutes possibly affecting one's performance, of course.

But, take my case, for example. I have Meniere's Disease (vertigo). I have a medical coming due in August and people say , "just fly LSA." I can't. I know vertigo COULD affect my ability to fly an LSA airplane, and so does everyone else, for obvious reasons.

In this case, under 61.53, a driver's license is NOT all I need to fly LSA.

And I think everyone knows how this is going to be decided. Someone's going to crash in one of these things and an insurance company is going to grab the pilot's medical records from the family doc, see that -- using my case as an example -- I sought treatment for vertigo and that's going to be the end of the game right there. With any luck, I'll be dead and not have to worry about the big judgment my estate will have against it when the insurance policy is ruled invalid.

The provisions that forced me to ground myself with a medical condition under my Third Class, are not waived under LSA.

 

[az_gila]

Heart scan info Q.

The test is actually a Nuclear Cardiac Perfusion Study Thallium is just one of many flavors of nuclear material.

This test has some limitations and there is much misinterpretation of what "passing or flunking" means.

The test when negative is acurate about 90% of the time this means it is wrong 10 % of the time.

When the test is positive it is only 85% accurate.

......................

Also remember if the test is positive it has a 15% chance of being wrong. A positive test only means you need further testing that is more accurate.

I

Milt .... do you have any similar information/accuracy for the heart scan tests that Glenn mentioned earlier?

gil in Tucson

 

[frankh]

OK so here is my story

Nov 2002, 40 years old. I worked out about 3/4 times a week and am in pretty good shape. I was teaching a boxing class on Sat mornings...This one young lady had a penchant for finding a hole in my guard and frequently whacking me...So on a Tuesday I had this mild pain in my chest, probably where I got whacked..No biggie but I thought I'd better mention it to my company nurse...BIG mistake!

Now one of my jobs is I am one of the Incident Commanders for the site...Fires, toxic gas leaks, plauges of locusts...I get to run the show...So imagine the look on the faces of the medical emergency response team that got summond to my care....Most amused they were.

Anyway, it turns out I have an EKG signal that exactly mimics an accute MI (heart attack)...Sends the machine into alarm. There is nothing wrong with me...Of course it took days in the hospital an agiogram...(wire up thru the femeral artery...not fun when the morphine wears off) and a whle host of tests...Nothing.

Best overhaul I ever got and was told that whatever I was doing...Keep doing it!

Pretty funny afterwards but when realising the ambulance had its lights on and being told that yes this was real and the best thing I could do was to RELAX...year right!..

My AME tested his new EKG machine on me just to see, he thought it was a fascinating condition, and the FAA didn't say squat when I reported it like was supposed to.

Cheers

Frank

 

[Knife]

Family Docs and AMEs

As a praciticing surgeon, AME, and active pilot I am concerned about some of the comments regarding AMEs not having adequate concern for the outcome of an airman's evaluation.

I have consistently gone extra distance for the airmen coming for their medicals and have rarely, if ever, been conflicted regarding medical conditions vs. fitness for an aviation medical.

If you are going to an AME that doesn't give a ****, I suggest you find another who does, as there are many of us around.

 

[LettersFromFlyoverCountry]

I don't suppose you're within driving distance of Minneapolis are you, Knife? Because I'm at the point where I'll drive halfway across the country to find an AME who will work with me assembling tests and paperwork and getting them into OKC on those occasions when he has to refer to there.

Since I got my pilot's certificate, eEvery time I have a medical, I try a different AME, hoping I'll find one who isn't just looking for a quick $100.

A few months ago, there was an article in AOPA about vertigo. In that particular case the guy didn't have Meniere's, but it documented the process of getting his Class 1 back and the guy said the key was finding an AME who has experience with vertigo and can partner with you on the long process.

"Cool," I thought. It also had a blurb at the end that said for more information, call the AOPA medical team. So the next day I did. "We really don't know much about vertigo," the guy said. "Call around to various AMEs until you find one."

There's got to be a better way to find an experienced AME. There just has to be.

 

[LettersFromFlyoverCountry]

//Pretty funny afterwards but when realising the ambulance had its lights on and being told that yes this was real and the best thing I could do was to RELAX...year right!..

A few years ago, in the midst of a dizzy spell (I would find out years later it was Meniere's), a paramedic team rushed to the house and when listening to my heart, thought something wasn't right (it turned out to be an undiscovered bundle branch block).

So off to the ambulance we went. I don't know if I ever felt worse. They were wheeling me out of the house and I looked over on the lawn and there were my two (at that time) little boys with looks on their faces that I'll never forget. They thought I was going to die and, truthfully, I wasn't all that convinced they weren't right.

And yet, at the same time, thinking I was done for, there was this nagging thought that kept coming through all the life-and-death stuff: the FAA isn't going to like this.

 

[Ironflight]

Good Thread David!

I'll add one story about Hypertension.....

I have the gene's for it. Father, Grandfathers, etc....everbody had high blood pressure. I have struggled with being at the high end of normal for physicals for years. Of course, I was always afraid that if it actually showed up on my medical, it would be the end of flying. And, for my job (as many folks on this forum), it would be the end of what I love to do for a living! When I'd have a physical, I'd always attribute the extra 10 points to "white coat syndrome", and the Docs got used to it. We have mini-physicals before hazardous activities, such as diving, and I'd always say "yeah, it's a little high today - I'm excited about the test!"....and I'd get away with it.

A few years ago, in my early 40's, with plenty of stress in my life, I started feeling a fullness in my chest. I let this go for awhile, until I finally remembered one of my grandfathers spending 17 years in a nursing home after a stroke - wheel-chair-bound, and unable to speak. I decided that was worse than loosing what I love to do, and went to an outside doctor. He put me on BP meds, and had a cardiologist do a full work-up - stress tests, the works. My heart was fine, just a little enlarged from pumping at higher pressures for so long,. It would be back to normal in no time. I then went to my favorite Flight Surgeon, and told him the whole story, wondering what it was going to do for my flying/diving/flight control medical certificates....

"Paul, you IDIOT!!!" was his response. We (and the Air Force/NASA/FAA medical authorities) don't care if you're hypertensive, as long as it is controlled! Why in the Heck did you wait so long - oh, I know, you were afraid of what would happen..."

The timing was perfect - the FAA wanted to see six months of history of me on Meds before issuing my next Class 2, and I had six months to go. I have one advantage in that my Flight Surgeons have some pretty direct connections to the right people, so I never even had to see any of the paperwork, and my next Medical came right on time. And I wonder how close I came....and what I cut off my life....

When we're young, we like to say "If I couldn't fly, I'd rather be dead!" But ya' know what? There's more to life than that....

Hypertensive? Get in the shop, get it fixed, get back in the air...

 

[cytoxin]

//And yet, at the same time, thinking I was done for, there was this nagging thought that kept coming through all the life-and-death stuff: the FAA isn't going to like this.

bob,
i truly feel your pain i thought i was about to die at once myself and among other things the thought kept occuring will i be able to pass a flight exam if i get better. like it matters, there are so many other things to do aviation and not that i really dont care anymore. i love aircraft but it took a beatin from **** to say i'll settle just to live long enough to watch my son grow up. so far so good i seem to be pretty close to normal again but it seems like the discovery channel where the wolves just linger in wait. i try to ignore them. just do my thing..

not that i would but a person should be able to say im safe to fly a lsa. that same peorson could vey easily be seen driving a 13 pass van through the mountains to go snow ski...no it wasnt me but just a thought. you are no more lethal in a lsa than in a average size car. and i guess one could say then you shouldnt drive if you cant fly. yet people incappable of panic speed reactions fill the roads.. im not advocating flying impaired, just that i dont see the difference of driving through dallas a 5 pm with a heart attack and flying an lsa and having one..

maybe doug can change my name to 39 year old geezer

 

[David-aviator]

I'll add one story about Hypertension.....

......When we're young, we like to say "If I couldn't fly, I'd rather be dead!" But ya' know what? There's more to life than that....

Hypertensive? Get in the shop, get it fixed, get back in the air...

I've been on a BP pill for several years, prescribed by my AME. It is not a big deal....what is a big deal is getting realistic about controlling hypertension without the beta blocker....like spending 20 minutes a day on a tread mill. That works for me and I've got to make it a habit pattern every day. We have a very nice mill and I haven't been on it for a year.

dd

 

[ivana]

Lone Atrial fib.

Anyone out there with Lone Atrial Fib? It is my only medical problem. It is completely controlled with a drug called Tam-bo-cor. I have no symptoms. I am building but not flying at this time. Four or five years ago I was successful in getting a third class medical but they made me do a treadmill test and wear a monitor for a day. It was pretty expensive and I think they said I had to do it every six months, so I haven't renewed it. I heard that they have relaxed the guidlelines for this condition somewhat. Anybody know anything about this or have this condition? Thanks in advance.

 

[treeez]

Sorry Bob, Knife lives in Las Vegas Nv. You could always take a vacation. Some relaxing time off and get the blood press down. lol, Mike

 

[Captain Avgas]

I lost most of a night's sleep this week after visiting my Doctor who is also my AME. The visit was for a routine check up, but there was more to it than that. I debated long and hard whether or not to mention a persistent pain in the upper far left chest area, almost to the shoulder, and finally decided it would be best to do so as it was not going away. Every pilots night mare, right?

David, a couple of weeks ago you were concerned about the Cirrus fatality rate...you were also perturbed about the safety of IFR flight...and you were worried about YOU crashing....and you were worried about ME and EVERYONE ELSE crashing. This is the thread: http://www.vansairforce.com/community/showthread.php?t=12784

IMHO none of the above were worth worrying about because the aviation fatality rate is of statistical insignificance in the grand plan.

On the other hand pilot (and public) cardiovascular disease...usually aggravated by obesity and lack of exercise...now there's something that is definitely NOT statistically insignificant. There's something that really could be worth worrying about.

When people express concern about me being killed flying my plane I just laugh. If I do so it will probably be over quickly and perhaps it might even have a touch of the romantic to it. At the very least I'll join a select few. On the other hand wasting away to skin and bones from cancer...or being paralysed by a stroke....there's definitely nothing unique or romantic in that.

 

[jamiller]

I'd appreciate the benefit of the knowledge or experience of any of you in answering these two questions:

1. Say you make an appointment with an AME. Tell him you want a physical of the same scope as a 3rd Class Flight Physical, but that you do NOT actually want an "official" physical. Then, if nothing is discovered that would preclude one, tell him, 'OK, now I want a 3rd Class Physical - I'll pay you for both". Would an AME somehow be legally or morally precluded from going along with this?

2. Say you became aware of a "problem", either from having done the above or some other way, that is likely to lead to difficulties with obtaining your medical certificate. Let's assume this problem is not serious enough to preclude you from eventually getting a 3rd Class Medial Certificate - probably. But you decide you don't want to take the risk of a denial (thus possibly precluding forever your ability to fly under Light Sport rules) or to go through the expense and hassle of going through the process. Can you at this point just quietly let your medical certificate expire and fly Light Sport?

I fully understand that we are supposed to "self certify" and quit flying when we become aware of a condition that could adversely affect our flying abilities, but there sure seems to be a pretty big grey zone here.

 

[LettersFromFlyoverCountry]

or to go through the expense and hassle of going through the process. Can you at this point just quietly let your medical certificate expire and fly Light Sport?

In #2, you're pretty much describing my current situation. I can either try my luck at getting my medical renewed OR I can just let it expire. It's a real gamble because if I should fail the medical to get a 3rd, I can't fly LSA at all with the driver's license deal. I'd be done, finished, kaput.... AND, of course, I wouldn't be able to fly my RV (under construction at all).

Or I could go for the box Jay Stewart has on the display floor....

I can just let the medical expire, give up on the RV dream, in order to preserve the POSSIBILITY of flying LSA when I determine I no longer have a condition that might interfere with my ability to safely fly.

It's not an easy choice to make (and why I'm trying to find an AME who will work with me on this). But once you blow the physical, all the doors close. Once you let the medical expire, only one door closes.

What stinks about it, of course, is either way, doors are closing.

 

[Legal Eagle]

Waiting impatiently......

At Oshkosh the head of the FAA said medicals were getting processed in 16 days. Whatta bunch of *&^%. After waiting 6 months for my shiny new stent to NOT kill me, I went to my friendly cardiologist who administered the treadmill tests which I passed with flying colors.

Then it's onto my fav AME who submitted all of the papers to OKC. After 20 days I called OKC and asked where my app was. After all, more than 16 days had passed.

The nice woman on the phone said: "I dunno who keeps saying it takes only 16 days. It TAKES 90 days to process your med."

To which I replied: "Twas the head of the FAA who claimed 16 days at Oshkosh".

FYI: If you think you will have a prob passing the medical, ask for a consultation, not an exam. Tell the AME what the prob is and he will tell you what chance you have to get the med back.

Finally, I would love to know the number of pilots who drop dead during flight which allegedly warrants all this med procedure stuff. According to my cardiologist, the number of stents that fail is close to zero so why must we tolerate yet another gov intrusion?

Waiting... waiting...

 

[the_other_dougreeves]

If you know of a medical condition that you have that COULD affect your performance as a pilot of a light sport aircraft, you cannot fly under LSA. Now there's certainly going to be a test of that provision as to what consititutes possibly affecting one's performance, of course.

Not entirely correct. You can have conditions that could affect you and/or disqualify you from getting a medical and still legally fly as a SP. You must certify that you are fit to make each and every flight, which we should all be doing anyway.

But, take my case, for example. I have Meniere's Disease (vertigo). I have a medical coming due in August and people say , "just fly LSA." I can't. I know vertigo COULD affect my ability to fly an LSA airplane, and so does everyone else, for obvious reasons.

In this case, under 61.53, a driver's license is NOT all I need to fly LSA.

Correct. You also need to make the decision that - for every flight - you are fit to act as PIC for the flight. This is NOT the same as certifying that you don't have any conditions that might disqualify you from getting a medical. As long as you certify that you can act as PIC and have a DL, you're good to go.

The problem would, of course, be if there was an incident / accident and the FAA or NTSB disagree with your assessment. Once the Feds start point fingers, however, all bets are off, PP or SP.

 

[RScott]

Kind of off topic, but some might find this interesting.

A few years ago I underwent a thallium treadmill test because of a chest pain I regularly got when exercising. I was in the Air Guard at the time and one of my duties was to X-ray F-15's at the beginning of every phase inspection.

At the end of the test, I asked the technician if the radioactivity in my body would show on my film badge. He said it might. So I got back to the shop & fired up the radiation meter. The thing went off the scale. Checked again the next day, still off the scale. Took two weeks before enough of the stuff left my system that the meter would no longer detect any radiation from my body & I could X-ray again. Funny thing was, when we X-rayed aircraft, we took careful precautions to make sure we got little or no radiation, and here I was with my body radioactive for two solid weeks!

 

[LettersFromFlyoverCountry]

Not entirely correct. You can have conditions that could affect you and/or disqualify you from getting a medical and still legally fly as a SP. You must certify that you are fit to make each and every flight, which we should all be doing anyway.

This is the problem with LSA. This point has not been well described.

According to EAA, "In addition, Federal Aviation Regulation 61.53 requires every pilot, from sport pilot to airline transport pilot, to be able to truthfully state before each flight that he or she is medically fit to operate the aircraft in a safe manner. As pilots, it is our responsibility to ensure that our current medical health in no way jeopardizes the safety of a flight."

It seems to me if you ground yourself because you have a disqualifying condition under one's Class III medical, you are acknowledging you are unfit to fly. But that would only be my interpretation on a given day.

I have a hard time believing that the decision in these cases merely to the pilot to say, "Oh, yeah, I can fly," is not something the FAA -- nor the insurance companies, are going to allow on a long-term basis.

I was reading an EAA chapter newsletter a few months ago with a profile of one of its members. The guy had had heart problems but, the article said, "he's looking forward to flying under LSA." In the next month's newsletter, another article noted the untimely passing of the man because of a massive heart attack. He might've thought he was fit to fly under LSA. But, clearly, he was not.

As you may know, there is a list of banned substances on the FAA list. Under the current Sport Pilot rules, people taking, say, psychotropic drugs, WOULD be allowed to fly under LSA rules as long as they haven't failed an FAA medical (in other words, as long as they don't tell anyone).

These drugs are banned not so much, perhaps, because they indicate not so much because they might indicate psychiatric instability, but because of the side effects, which can include drowsiness, lack of reflex, and -- in some cases -- hallucinogenic properties.

Frankly, it's this area where I don't agree with LSA. It's hard for me to fathom how I am somehow safer in the skies when someone with as little as 20 hours of flight training, possibly using a psycotropic drug with dulled response, is sharing the same airspace with me.

Also, if I understand the point correctly, I -- with my Meniere's Disease -- can fly in your airspace as long as *I* determine on a given day that I'm fit to fly. But, the thing with Meniere's Disease, is attacks of vertigo come from nowhere and leave you pretty much incapacitated.

Now as I understand the "fit to fly" aspect of LSA, we could take two pilots:

(1) Me, saying "you know what? I better not fly today because even though I feel great today, Meniere's can come from nowhere and I could be up there endangering me and my fellow pilots should an attack come on and we'd all be in big trouble, so I'm not fit to fly today."

or

(2) Me, saying, "I have Meniere's Disease and I feel great today, let's go flying."
As I understand it, if I read all of this correctly, both would be acceptable under LSA.

Boy, I don't know. I believe that the skies are safer at this particular moment, with me on the ground. Now, maybe, most pilots are like me. Maybe they're concerned about the people they share the skies with and honor the responsibility they have to other pilots to keep the entire system as safe as possible. In other words, they do the right thing. (And for sake of argument, we're not talking about the stupid bureacratic FAA medical stuff).

Or maybe they're not. Maybe the percentage of pilots who think they are "fit to fly" is about the same as the number of drivers who think they're "fit to drive" at closing time on Saturday night.

I'm not looking forward to the way we're going to find out.

 

[jlisler]

Here is something I ran across that got my blood boiling.

http://www.phillyburbs.com/pb-dyn/news/103-03172006-628116.html

Is boiling blood a disqualifying condition?

 

[the_other_dougreeves]

This is the problem with LSA. This point has not been well described.

Here's is the test of 61.23. I see 61.23(c)(2)(iv) as the key:

(c) Operations requiring either a medical certificate or U.S. driver?s license.
...
(2) A person using a current and valid U.S. driver?s license to meet the requirements of this paragraph must?
(i) Comply with each restriction and limitation imposed by that person?s
U.S. driver?s license and any judicial or administrative order applying to the
operation of a motor vehicle;
(ii) Have been found eligible for the issuance of at least a third-class airman
medical certificate at the time of his or her most recent application (if
the person has applied for a medical certificate);
(iii) Not have had his or her most recently issued medical certificate (if the
person has held a medical certificate) suspended or revoked or most recent
Authorization for a Special Issuance of a Medical Certificate withdrawn; and
(iv) Not know or have reason to know of any medical condition that would
make that person unable to operate a light-sport aircraft in a safe manner.

The key is that you must not know of any medical condition that would make you operate in a unsafe manner. It has nothing to do with the requirements of the medical.

It seems to me if you ground yourself because you have a disqualifying condition under one's Class III medical, you are acknowledging you are unfit to fly. But that would only be my interpretation on a given day.

The issue for a SP isn't whether you have a condition that would disqualify you for a Class III medical. The issue is whether you have a condition that makes you unfit to fly. Only you can make that call.

As you may know, there is a list of banned substances on the FAA list. Under the current Sport Pilot rules, people taking, say, psychotropic drugs, WOULD be allowed to fly under LSA rules as long as they haven't failed an FAA medical (in other words, as long as they don't tell anyone).

These drugs are banned not so much, perhaps, because they indicate not so much because they might indicate psychiatric instability, but because of the side effects, which can include drowsiness, lack of reflex, and -- in some cases -- hallucinogenic properties.

I think that the reason is more that the side effects vary from individual to individual - much like every other drug, be that alcohol, nicotine, sudafed or prozac. The only person who knows the side effects is the person taking them. Thus, they should be the ones to make the call. Remember that many legal and FAA-approved drugs have psychotropic effects (e.g., alcohol).

We all have heard about pilots, from PP through ATP, who are not 100% honest with the AME and get their medical. The issue could be too much alcohol, stress, vision, etc. Most of the time, they never get caught. Sometimes they do (do we really need another media frenzy when an ATP gets stopped by the TSA and blows more than 0.04 BAC?).

The difference with SP is that you only have to be honest with yourself and, hopefully, your PAX, as well as the lower risk involved in the flight (e.g., around the patch in a Cub vs half-con in a MD-80).

 

[LettersFromFlyoverCountry]

The key is that you must not know of any medical condition that would make you operate in a unsafe manner. It has nothing to do with the requirements of the medical.).

True. Unless you believe there's a correlation between something that would disqualify you from obtaining a medical, and something that would make you unfit to fly.

The issue for a SP isn't whether you have a condition that would disqualify you for a Class III medical. The issue is whether you have a condition that makes you unfit to fly. Only you can make that call.

Sure, I get that. I guess my rule of thumb would be if I'm not qualified to get a 3rd Class, I'm not qualified to fly under LSA. I presume the argument would be that the FAA medical folks are nothing but a bunch of stuff-shirt bureacrats who know nothing about safety in flight, and maybe there's a ring of truth in that.

The only person who knows the side effects is the person taking them.

That's not exactly true, and certainly not in the case of many psycotropic drugs. Take Paxil, for example, which has been shown to cause suicidal tendencies in teens and children. Let's suppose a 16 year old decides to fly under LSA and is taking Paxil. He/she is not safe to fly under a 3rd class Medical, but would be safe to fly under an LSA. Same person, different rules. There's plenty of evidence of teens who have committed suicide who only knew they wanted to end their lives (unfortunately, I have some experience in this sad truth), they didn't know that all they had to do was stop taking Paxil.

Others may disagree, and that certainly is their right, but that person, as far as I'm concerned, is a threat to me and others in the air.

Now, you may be right (although I'm not conceding the point.) that only an individual can assess the side effects of medication. If so, then perhaps the rules on alcohol and flying should also be similarly relaxed.

The other question I have involves vision. Now on my 3rd Class medical, it says "must wear corrective lenses." Good, because I can't see a darned thing out of my left eye. Fortunately, I can still drive in Minnesota because you only need one good eye to have a driver's license.

So when I drop down to LSA status, can legally fly without glasses? Am I an equal threat to others in the sky if I do?

The difference with SP is that you only have to be honest with yourself and, hopefully, your PAX, as well as the lower risk involved in the flight (e.g., around the patch in a Cub vs half-con in a MD-80).

Excellent point, and the basis of much of my concern about LSA. You wouldn't believe the number of people who have told me, "just don't tell the FAA" about my Meniere's. I presume those same people will try to get away with stuff under LSA and LSA makes it quite easy to do so.

Between that and the relaxed rules on training, I don't see how LSA DOESN'T make the skies a less safe place to be.

 

[Captain Avgas]

Self preservation

Frankly, it's this area where I don't agree with LSA. It's hard for me to fathom how I am somehow safer in the skies when someone with as little as 20 hours of flight training, possibly using a psycotropic drug with dulled response, is sharing the same airspace with me.

Why worry about it...that same person on the psychotropic drug (and every other sort of drug) with dulled responses is sharing the road with you !!!!. And the chances of a head-on with that person are infinitely higher than a mid-air with the same person. You're not worrying about that person everytime you get in your car...why worry when you get in your plane.

Also, if I understand the point correctly, I -- with my Meniere's Disease -- can fly in your airspace as long as *I* determine on a given day that I'm fit to fly. But, the thing with Meniere's Disease, is attacks of vertigo come from nowhere and leave you pretty much incapacitated.

It's like Night VFR....if VFR-only pilots don't use discretion with it then sooner or later there's a very good chance they'll fly into a cloud in the dark and it'll be all over rover. But generally they exercise the privilege with due discretion and the reason is simply....self preservation.

I would suggest to you that if a pilot feels inclined not to fly because he has bouts of vertigo it is unlikely to be because he is concerned about killing some-one else (miniscule chance if he doesn't carry passengers) but because he is primarily worried about killing himself. Despite possible claims of altruism I would suggest that self preservation is the self regulating factor. It's like greed....you can generally count on it.

 

[the_other_dougreeves]

Now, you may be right (although I'm not conceding the point.) that only an individual can assess the side effects of medication. If so, then perhaps the rules on alcohol and flying should also be similarly relaxed.

Remember that booze is both a BAC limit (0.04?) and a personal decision that you are fit to fly. If you are below 0.04 and are impaired, you are not legal.

The other question I have involves vision. Now on my 3rd Class medical, it says "must wear corrective lenses." Good, because I can't see a darned thing out of my left eye. Fortunately, I can still drive in Minnesota because you only need one good eye to have a driver's license.

So when I drop down to LSA status, can legally fly without glasses? Am I an equal threat to others in the sky if I do?

No, you cannot ditch your glasses if your DL requires you to wear corrective lenses. You must comply with all medical requirements of your DL if you are using it instead of a medical.

Excellent point, and the basis of much of my concern about LSA. You wouldn't believe the number of people who have told me, "just don't tell the FAA" about my Meniere's. I presume those same people will try to get away with stuff under LSA and LSA makes it quite easy to do so.

Between that and the relaxed rules on training, I don't see how LSA DOESN'T make the skies a less safe place to be.

I believe that a key point of the SP / LSA rules is to allow those who are currently on marginal ground or are outright illegal to continue to fly, although with restrictions.

 

[LettersFromFlyoverCountry]

I would suggest someone comes up with an answer to that before the media REALLY takes a close look at LSA that's stronger than, "why worry about it." (g)

In all seriousness, though, at some point, someone somewhere is going to ask the question, "if it takes YOU with your high fallutin' 3rd class medical a minimum of 40 hours to be competent enough to fly, Bob, how do you figure someone who might have a medical problem is safe with 20 hours?" This would be a good time for the aviation community to practice that.

Look, I GET the whole LSA concept and the need to rejuvenate the GA industry. I'm just not sure what the point is of it sometimes. Is it to keep old fogies flying when the FAA says they shouldn't be (via a 3rd class?)? If so, seems to me the rule will shift people -- sometimes unnecessarily (they'll be afraid they might flunk a Class 3 so they won't even try, they'll just give up and fly LSA).

Is it to get a new generation into the air sooner? THIS part of LSA, I am 100% for because I think it's entirely reasonable to expect that once you fly LSA as a young person, you'll move up into other planes. I don't see how LSA could possibly fail in this endeavor (presuming FBOs are smart enough to stock up on LSA planes).

As for me... I'm in the first group. Sometime... soon.... I have to decide whether to gamble on not passing the medical and never flying again... or giving up the privileges it affords and flying LSA, even in less than perfect physical condition.

Maybe it'll work out either way. I'm building a 7A and I guess I'm one of the few people who doesn't think the RV-12 is a butt-ugly airplane.

Not sure how I'm going to flight test that 7A, though.

 

[fodrv7]

Callsign

Knife,
Got to love your callsign.
Pete. (Alias. Funky Old Dude)

 

[cytoxin]

uh huh huh

When people express concern about me being killed flying my plane I just laugh. If I do so it will probably be over quickly and perhaps it might even have a touch of the romantic to it. At the very least I'll join a select few. On the other hand wasting away to skin and bones from cancer...or being paralysed by a stroke....there's definitely nothing unique or romantic in that.

thats why i named my plane "blaze of glory" so if i die in it they can say oh he went down in a blaze of glory and i to just laugh at the nay sayers i dont know if all the "healthy people" realize they are terminally ill also. last time i checked no one makes it out of here alive.

 

[LettersFromFlyoverCountry]

Just make sure when you go, you go alone.

 

[cytoxin]

can that be done?

Just make sure when you go, you go alone.

thats a big if bob. wasnt planning on going anytime in the near future. the only way to be sure you go alone is when it intentional.when i do it wont be by choice so i cant be sure i'll go alone. sorry.

 

[ddurakovich]

I am always amazed at the passion evoked by the Sport Pilot rule in the areas of medical and piloting qualifications!

It's almost as if we totally ignore the glider pilots out there who have been self certifying forever. And I highly doubt that many of them (except for the powered transition pilots) are even aware there is an 'FAA approved' medications list! Self certification is not a new concept, and has been field tested for decades with very positive results.

I suspect that most of the issues that come to light are those few (hopefully) idiots out there that don't care, and are going to fly anyway, regardless, and the issuance of a medical (or lack thereof), isn't going to slow them down. I suspect the real issue lies between common sense and integrity! I personally take self certification very seriously, and have sat out a flight more than once because I didn't quite up to the task. And I do hold a current medical.......

And while I have no personal reference to appreciate Bob's plight, I can only commend his integrity. I hope he can find a solution to the issue, allowing him to continue to fly. However, I am less than convinced the FAA will do much to accomodate that solution under the current (medical issuance) climate without years of studies, data, and ??? However, I think the Sport Pilot rule will allow that, particularly for those WITH the common sense and integrity to make informed decisions.

As to the training and competency of Sport Pilots, I am totally confused. Once you eliminate the dual instruction required for instrument (3 hours) and night flight (3 hours), private pilots actually require 1 hour LESS dual than a Sport Pilot does! Add to that an additional 1 hour for x-country instruction for privates, and the Sport Pilot is legally required to get 2 hours more dual instruction than a private. Granted, his x-country proficiency probably leaves something to be desired, but if and when he does find an airport to land at, he should be at least as qualified as the other solo students there

I suspect the hang up is the minimum number of hours as 20. We need to keep in mind that most of the same CFI's are going to be training Sport Pilots also, and the likelihood of their reducing their standards (current tort law being what it is), especially for pre-solo students because they are only going for the Sport Pilot rating, is pretty slim. After that, the rest is pretty much up to the student, regardless of the rating sought!

For my money, ther real risk from Sport Pilots comes from guys that REALLY shouldn't be flying, but don't have the sense or integrity to realize it!

 

[az_gila]

Glider medicals...

....

It's almost as if we totally ignore the glider pilots out there who have been self certifying forever. And I highly doubt that many of them (except for the powered transition pilots) are even aware there is an 'FAA approved' medications list! Self certification is not a new concept, and has been field tested for decades with very positive results.

...............

Interestingly enough, in the 70's I believe, there was a move by the AME's to try and get glider pilots to have medicals.

A study was done on the fatal glider accidents that happened and were attributed to medical problems.

I can't remember the exact numbers but something like 40% of the fatal accident pilots had 3rd class (or higher) medicals since they also flew power.

This number was almost exactly the same % of the total glider pilot population that had medicals since they also flew power.

This shot down the glider medical requirement request...

Unfortunately, it didn't take the next step and make the power rating require the same medical requirements as glider pilots.... which seems logical to me, but would drastically reduce the $$ to the AME profession...

ADDED ITEM

Check out the letter to the editor from an AME, and the FAA response on page 9 of this FAA document.... it's interesting considering the previous discussions...

http://www.faa.gov/library/reports/medical/fasmb/media/200603_color.pdf

gil in Tucson

 

[the_other_dougreeves]

I am always amazed at the passion evoked by the Sport Pilot rule in the areas of medical and piloting qualifications!

It's almost as if we totally ignore the glider pilots out there who have been self certifying forever. And I highly doubt that many of them (except for the powered transition pilots) are even aware there is an 'FAA approved' medications list! Self certification is not a new concept, and has been field tested for decades with very positive results.

EVERY pilot has to self-certify on EVERY flight. The difference for SP and our unpowered friends is that we don't need the concurrence of the AME.

 

[David-aviator]

I am always amazed at the passion evoked by the Sport Pilot rule in the areas of medical and piloting qualifications!

As to the training and competency of Sport Pilots, I am totally confused. Once you eliminate the dual instruction required for instrument (3 hours) and night flight (3 hours), private pilots actually require 1 hour LESS dual than a Sport Pilot does! Add to that an additional 1 hour for x-country instruction for privates, and the Sport Pilot is legally required to get 2 hours more dual instruction than a private. Granted, his x-country proficiency probably leaves something to be desired, but if and when he does find an airport to land at, he should be at least as qualified as the other solo students there

I suspect the hang up is the minimum number of hours as 20. We need to keep in mind that most of the same CFI's are going to be training Sport Pilots also, and the likelihood of their reducing their standards (current tort law being what it is), especially for pre-solo students because they are only going for the Sport Pilot rating, is pretty slim. After that, the rest is pretty much up to the student, regardless of the rating sought!

For my money, ther real risk from Sport Pilots comes from guys that REALLY shouldn't be flying, but don't have the sense or integrity to realize it!

For lack of any other specific guidance, the CFI has no choice but to train applicants to private pilot standards as per the appropriate PTS. Seems to me I read somewhere that is the standard the FAA expects. I doubt most students will be ready for a check ride after 20 hours of instruction.

As for the medical requirements, that is confusing. If Bob Collins lets his medical certificate expire, it would appear he certainly has a right to self certify down the road for LSA. His condition, while distrurbing at this point, may improve. I know of one guy who went off medical from an airline job and returned some years later, all cured, or it simply went away. The decision to seek a medical renewal or let it expire at this time is difficult.

dd

Incidently, my Doctor called over the week end to report the radiology report appears to be normal. I know it does not mean everything is OK 100% for sure, but it is better than an abnormal report.

 

[OldAndBold]

A plug for a good AME...

I have a minor heart defect which I am told results in me having "supra-ventricular tachycardia". It means that I have occasional skipped beats and if under a lot of emotional stress for a long time I can start having non-serious heart palpitations - my heart will start beating fast for a short periods of time.

This became a problem for me last January when I was changing jobs, trying to sell a house and living apart from my family. Since it had never been a problem for me before, when I started having palpitations I got rushed to the hospital by ambulance. But once I was on medication the problem went away. No further treatment has been needed. But I felt I had to report this to the FAA when my medical needed renewal.

I chose to start by getting advice from Virtual Flight Surgeons - www.aviationmedicine.com . For $35 I was able to talk over the phone to an AME about my problem and get helpful advice on how to proceed. Dr. Snyder was able to refer me to a friend of his in my state (Michigan) who is a pilot/AME and who knew how to handle my case. That doctor is Dr. Greg Pinnell and his website is www.ok2fly.com . He is located in Saginaw Michigan. He was helpful, understood my condition, and was able to steer my AASI through the FAA without too much trouble. I did have to wear a holter monitor again, but once I got that done it was just two weeks to get the new medical certificate (3rd class). However, because I was so preoccupied about the heart problem I didn't try hard enough on the eye exam and now I have a condition that requires me to have glasses for near vision with me from now on.

Dr Pinnell went to a lot of extra work for me (multiple phone calls to me and the FAA, report handling and emails along with the exam) and only charged $55. I would highly recommend him for anyone in Michigan area - he'd probably be a good choice for a family physician as well, but I live too far away to use him for that.

John Babrick
N777XV (someday)

 

[cytoxin]

doctors and mechanics

well doctors are like mechanics in the way they tell you worst case scenario. so when you come to pick up/follow up they can say well it turns out your pan gasket was leaking and you dont need that 1800.00$ overhaul after all. makes you happy even though you worried 10 years of your life away in three days.

 

[CFI1513840]

Surgical procedure for Meniere's

...But, take my case, for example. I have Meniere's Disease (vertigo). I have a medical coming due in August and people say , "just fly LSA." I can't. I know vertigo COULD affect my ability to fly an LSA airplane, and so does everyone else, for obvious reasons...

Bob,

You may already be aware of this. Alan Sheppard, our first man in space, also had Meniere's which grounded him in 1963. He underwent a surgical procedure to correct the condition and returned to flight status to command the Apollo 14 mission in 1971, becoming one of a dozen Americans to walk on the moon.

Good luck and I hope some day you get to fly your RV.

 

[LettersFromFlyoverCountry]

Thanks, Ken. Paul Dye mentioned that to me the other day. Didn't John Glenn also suffer from that? (Of course, it helps to get your medical if you sit on the committee in charge of NASA )


One of the reasons I had surgery in September was not so much that I couldn't function without it (I hadn't had a real attack since May), but because I thought the FAA would see that I'd actually taken action to prevent the problem, as opposed to just saying, "hey, it went away."

The maddening thing is you're constantly quesitoning yourself. "Was I just dizzy?" I'd find myself asking during the day. So you get hypersensitive to what your brain is doing.

Even though I still have some situaitons where I get a little dizzy (flat on my back under the fuse, for example), there are days when I have no effects so I think over time I'll be able to get back in the air.

At this point, it's not so much the disease that has me flumoxxed. Between my GP, my ENT guy, the surgeon, and the AME, it's figuring out what exactly I need (paperwork wise) and who can provide it to me.

B

 

[ddurakovich]

Check out the letter to the editor from an AME, and the FAA response on page 9 of this FAA document.... it's interesting considering the previous discussions...

http://www.faa.gov/library/reports/medical/fasmb/media/200603_color.pdf

gil in Tucson

Unless reversed, or "further clarified" by the FAA (which I always consider a sure thing ), this is an absolute MUST READ for anyone who has ever considered LSA because of a medical condition!

I'm not even there and I'm thinking about printing a copy and putting in my safety deposit box!

 

[LettersFromFlyoverCountry]

Thanks for posting this (I wonder if I can subscribe to it; it's pretty interesting).

Silberman's choice of words if fascinating. He doesn't say the individuals are "legal to fly" under LSA. He says they may be SAFE to fly under LSA.

To me, that's fascinating, especially since earlier in the same issue -- page 5 to be exact -- he chastises general physicians who tell airmen that they see no reason why the patient shouldn't be allowed to fly an airplane.

"Probably the most irksome thing that treating physicians do is tell their airmen patients do is tell their airmen patients that they, "can see no reason why you cannot pilot an aircraft" and should return to flying. I never thought I would say this because I did not like it when a specialist did it to me, but the fact is that if physicians do not understand how high altitude affects the human body or know what the FAA requires of arimen with a particular medical condition, they should not say anything!"

I give the writer -- Bob Lewis -- great credit for asking the question of Silberman who SHOULD have been MUCH more explicit in his response.

I mean, geez, he put out a 13 page newsletter and then answered the man's legitimate question with but a single paragraph; a question that is perhaps THE hottest topic in general aviation today.

He also started his response with an assumption.

"Actually, if considered "safe to fly" is based on a personal physicians impression..."

Well, Warren, can it be? Should it be? And if several pages earlier you said that personal physicians often don't know the high-altitude effects of flight, then how can you say it's safe -- or not safe -- if one says a pilot is safe to fly.

When I started reading the suggested page, I thought, "Finally, we're going to get an answer."

Instead, I got more bureacratic gobbledeegook from the certification Division.

I'm sure hoping -- if I end up flying under LSA -- that guys like Silberman, the FAA, and the insurance companies all get on the same page and can actually STATE unequivocally what is and isn't legal and what is and isn't safe.

I would have thought in the years it took to get the bureaucrats to approve this rule, that someone --somewhere -- would be able to provide answers that don't involve words like "may be safe."

As it is, what the rulemakers are basically waiting for is a court somewhere to answer the questions for them. That is, an accident under LSA, an insurance company that doesn't pay, and someone with deep enough pockets to pursue it.

I'm seriously beginning to wonder how readily insurance companies will provide coverage to LSA pilots.

 

[az_gila]

What the FAA Medical Head said...

I posted the original because it seemed very relevant to this discussion...

This is the FAA reply to an AME's question on eligibility...

Dear Dr. Lewis:
Actually, if considered ?safe to fly? is based on a personal physician?s
impression, an airman can fly under Sport Pilot. So, consider, for example,
a person with a cardiomyopathy, ejection fraction of 30%, no dysrhythmias,
no CHF, and can pass a stress test. This person would, in fact, be
eligible under Sport Pilot, but not likely under third-class certification
rules. All those airman you described may be safe to fly under the Sport Pilot
rules. Thank you for these excellent questions.
Warren Silberman, DO, MPH
Manager, Aerospace Medical
Certification Division

It seems to me that we are seeing somewhat of a "turf battle" between AMEs (who stand to lose $$$) and your personal physician....

See my comments on past attempts to get glider medicals (post # 39 )

Mr. Silberman seems to be saying that self-certifying - consulting with your personal physician for any questionable areas - is OK for LSA flight... does anyone else read it differently?
After all this guy is the "Big Kahuna" for your medical certification...

UPDATE - from the previous issue of the same FAA newsletter, I found this nugget on page 11, by Dr. Deakins (was he previously an Avweb or AOPA guy?)

http://www.faa.gov/library/reports/medical/fasmb/media/200602_color.pdf

Remember: Sport Pilots must consider
themselves safe to fly, consult their physician
regarding any medical condition that
might affect flight safety, and must be
endorsed by a Sport Pilot flight instructor.

This agrees with the comments above....

gil in Tucson

 

[LettersFromFlyoverCountry]

The more I read about it, the more I can see LSA as being the principal step in getting rid of the 3rd Class medical. As soon as someone like Silberman says that the people desribed in the article are "SAFE" to fly under LSA, the obvious question then becomes, "then why aren't they equally safe to fly under the current 3rd class medical."

But I don't think Silberman is saying anything definitive here because he uses the word MAY. I think they learn that in bureacracy school.

 

[az_gila]

LSA altitude limit

The more I read about it, the more I can see LSA as being the principal step in getting rid of the 3rd Class medical. As soon as someone like Silberman says that the people desribed in the article are "SAFE" to fly under LSA, the obvious question then becomes, "then why aren't they equally safe to fly under the current 3rd class medical."

But I don't think Silberman is saying anything definitive here because he uses the word MAY. I think they learn that in bureacracy school.

Interesting Bob... I wonder if that (a medical reason) is part of the reason for the 10,000 ft. LSA altitude limit? -- It's just like driving a car...

gil in Tucson

 

[the_other_dougreeves]

Interesting Bob... I wonder if that (a medical reason) is part of the reason for the 10,000 ft. LSA altitude limit? -- It's just like driving a car...

gil in Tucson

Strangely, the SP / LSA rule specifies that the medical isn't the reason, but that training is the reason. This is a bit strange - out west, you want to fly high to stay out of the crunchy stuff (granite, etc.). Sometimes this should be over 10k MSL. However, there is no "above 10k MSL" endorsement for SP, just as there is no night endorsement, etc.

So, de facto, it is a medical reason, although this may not be what the FAA intended.