Basic Med Rules

[flyingron]

Like everything government wise, they see a thing and attempt to regulate it, on the premise that the very fact they are contemplating it has no impact on the start point, thereby assuming their actions will have predictable results. But in reality, the very act of scrutinizing and regulating something changes the initial set of conditions. This was proved on the subatomic level. The mere act of observing a particle affects its behavior.

Thank you, Dr. Schroedinger.

 

[WDD]

Thank you, Dr. Schroedinger.

Blending Quantum Theory with FAA Regulations. And this is why people of POA are definitely a cut above.

 

[Stewartb]

The reason aeromedical focuses on sleep disorders is because the FAA is part of DOT, and sleep disorders are very high on their priority list for CDL physicals. So says my RFS, anyway, who agrees with DOT.

 

[Half Fast]

Thank you, Dr. Schroedinger.

I was thinking Heisenberg.....

 

[flyingron]

I was thinking Heisenberg.....

I thought about that, but I was uncertain.

 

[Rushie]

Y’all are cracking me up.

 

[Anonymous]

OP here

Sorry about the previous odd appearing format. It doesn’t look that way when I submit.

Some of you may be thinking this guy is insane and will ignore doctors orders just to fly.
Here is what my sleep schedule has evolved to.
Go to bed sleep 1 1/2 - 2 hrs. Nature call. Immediately back to bed .
Sleep another 1 1/2 - 2 hrs- wake up and stay up about 1 hr. Read or computer. maybe
Chamomile tea . Back to bed.
Sleep another 3-4 hrs uninterrupted. This is always the longest leg.

Sleep Apnea?

I believe Rushie perceived the situation. My wife and SIL had this same physician and left saying he didn’t listen to them. I had been with him many years and finally decided the same and moved on. I’m not sure what actions on my part led to his conclusions.
New med team suggested I consider PRP (platelet rich plasma) treatments . This will be on my list. Urologist prescribing Flo-max reduced the get-ups as well. #35 mentioned the need to urinate as a trigger for Adrenalin. I wonder if short, intense shoulder pain would do the same?

Some doc-pilot buds were actually the ones that suggested I do not take sleep study.
One of them was the person that had recommended my long term PCP .
I have graduated from the formal PT sessions and will be on my own completely from now on. Avoiding surgery is motivation to do the 2 per day routines. I do not take any meds for the shoulder issue. 95 % of the time there is no need as there is no pain.No throbbing. Only when the joints are “loaded” is there momentary pain that would require a lot more than Motrin to deal with. Modifying activities and realizing limits in an on-going work in progress.

My understanding is the at-home sleep studies are limited in scope. Sleep Lab study requires sleeping on your back as your chest has numerous sensors. I think I would remain awake all night .

 

[WDD]

If the at home sleep study provides your doc with enough data then don’t worry about what a sleep lab might or might be like.

Your doc pilot buds are mistaken on apnea and basic med - probably thinking 3rd class.

 

[Stewartb]

Home sleep studies are easy and informative. You wear a chest monitor with a pulse oximeter and a nasal cannula connected and sleep in your own bed in your normal routine. It weeds out guys with conditions that require more specialized study. If wearing a CPAP makes you feel better, think more clearly, and handle everyday stress better? That’s like winding back the clock a few years. I can’t think of any good reason not to embrace that. If your PCP thinks that’s an indicator that you aren’t eligible for flying? Find a better doctor.

 

[WDD]

Oh yeah - besides much better sleep, being more alert in the day, there are “other” benefits.

 

[azure]

I was thinking Heisenberg.....

Same here, but I didn't feel like saying anything...

 

[Mason]

Blending Quantum Theory with FAA Regulations. And this is why people of POA are definitely a cut above.

You can know where something is, or how fast it is moving, but you can't know both.

 

[Half Fast]

You can know where something is, or how fast it is moving, but you can't know both.

That's how I explain my navigation methods....

 

[kath]

The Private Pilot Checkride is the most quantum mechanical thing in aviation.
Since the candidate is PIC but not yet rated, the DPE is a superposition state of (passenger) and (not passenger).
|DPE> = 1/sqrt(2){ |p> + |!p> }



(Hey, fellow nerds, how y'all doin'?)

 

[Half Fast]

The Private Pilot Checkride is the most quantum mechanical thing in aviation.
Since the candidate is PIC but not yet rated, the DPE is a superposition state of (passenger) and (not passenger).
|DPE> = 1/sqrt(2){ |p> + |!p> }



(Hey, fellow nerds, how y'all doin'?)

Not bad but I’m surprised you didn’t work “spin” into it somewhere.

 

[Anonymous]

I was hoping that someone would comment on my sleep schedule in #47 is indicative
of OSA. Also I’m 6 ft and 230 lbs. After 25+ years with now former PCP why would he now request a sleep study? Particularly since this coincides with shoulder deterioration.
I will check into home sleep study and see if it can be done while sleeping on stomach with
face hanging off edge of pillow. Will CPAP work under those conditions?

Former PCP did Basic Med exam. I mentioned to new PA/MD team about BM and they said wait until nearly due. Right now I’m unsure if anyone in the new group does the BM exam.
They don’t have any of my records yet and next visit is six months away. Still have nearly 2 years till it’s due. Winter could be a good time to address that and possible PRP treatment.
In 60 + of flying there have been challenges. This is just another one.

A bud with a second class cert has an oral device to deal with OSA. FAA does give him grief as they can’t monitor.

 

[FORANE]

I was hoping that someone would comment on my sleep schedule in #47 is indicative of OSA.

That is outside my area of knowledge so I cannot comment.

Also I’m 6 ft and 230 lbs.

That is a BMI that I would expect OSA to be likely.

After 25+ years with now former PCP why would he now request a sleep study? Particularly since this coincides with shoulder deterioration.

Just guessing here, but perhaps the shoulder issue prompted you to mention it to your PCP who suggested you sleep on your back. After hearing you couldn't sleep on your back, the PCP subsequently thought a sleep study may be beneficial?

I will check into home sleep study and see if it can be done while sleeping on stomach with
face hanging off edge of pillow. Will CPAP work under those conditions?

CPAP would work, but OSA less likely to appear when in the prone position.

A bud with a second class cert has an oral device to deal with OSA. FAA does give him grief as they can’t monitor.

Oral devices can work.

 

[Rushie]

I was hoping that someone would comment on my sleep schedule in #47 is indicative
of OSA. Also I’m 6 ft and 230 lbs. After 25+ years with now former PCP why would he now request a sleep study? Particularly since this coincides with shoulder deterioration.
I will check into home sleep study and see if it can be done while sleeping on stomach with
face hanging off edge of pillow. Will CPAP work under those conditions?

Former PCP did Basic Med exam. I mentioned to new PA/MD team about BM and they said wait until nearly due. Right now I’m unsure if anyone in the new group does the BM exam.
They don’t have any of my records yet and next visit is six months away. Still have nearly 2 years till it’s due. Winter could be a good time to address that and possible PRP treatment.
In 60 + of flying there have been challenges. This is just another one.

A bud with a second class cert has an oral device to deal with OSA. FAA does give him grief as they can’t monitor.

I’m not a sleep specialist or doctor but the waking up to pee is normal at your age especially since we already know you have BPH because you’re on Flomax. In addition, it’s common to have disrupted sleep as you get older for many different reasons. But you getting up and reading or doing computer work in the middle of the night is akin to what I do but I doubt it is caused by OSA (in me). Pain wakes me all the way up. Then I roll over or get in a better position but I’m fully conscious because the pain didn’t allow me to roll over in a half asleep state. My iPad is always there so I end up turning it on and watching a show, but if I choose a boring one I’ve seen a million times it will put me back to sleep, however, if I just leave it off sometimes I’ll go back to sleep before I know it.

What I’m trying to say is you might just be in the habit of getting up and doing stuff and not giving yourself a chance to go back to sleep.

But there’s another important factor and that is all your hormone levels, they play a vital role in your ability to sleep. All of them, thyroid, sex hormones, melatonin, etc. I assume your doctor has checked all that stuff? Mine did and I’m on corrective therapy and that has helped my sleep more than anything.

Prior to that I got help sleeping with Valarian root or simple melatonin OTC supplements. But it’s better to use those in the context of the whole picture in consultation with a good doctor.

The biggest problem is pain.

That’s me. I can’t tell you if your schedule is indicative of OSA but you do have a BMI over 30 which might have been enough for your first doctor to want to test for OSA. On the other hand that BMI might not be bad at your age:

https://www.seniorsguide.com/senior-health/healthy-bmi-seniors-ages-65/

 

[bbchien]

Ugh. Last month I issued a Basic for a fellow with complicated prostate Ca. Got a demand letter for his SI which we did not reapply for. Apparently the PCP sent a document in. This was the off year for his 3rd class.

Fortunately I think his Dana Farber record is certifiable. I just complied him and sent it in.
Brad Z sez this should never happen. WELL IT CONTINUES to happen.

 

[Rushie]

Ugh. Last month I issued a Basic for a fellow with complicated prostate Ca. Got a demand letter for his SI which we did not reapply for. Apparently the PCP sent a document in. This was the off year for his 3rd class.

Fortunately I think his Dana Farber record is certifiable. I just complied him and sent it in.
Brad Z sez this should never happen. WELL IT CONTINUES to happen.

Wow!

 

[Palmpilot]

 

[Anonymous]

Rushie
Sorry to hear of your pain issues. I’m fortunate mine goes away when I “unload” the joint.
I will bring up your comments with the new doc. With the previous one there was no discussion regarding hormones etc. Would that have been in the blood work order?

 

[Rushie]

Rushie
Sorry to hear of your pain issues. I’m fortunate mine goes away when I “unload” the joint.
I will bring up your comments with the new doc. With the previous one there was no discussion regarding hormones etc. Would that have been in the blood work order?

The thyroid should always be, at least the TSH, but my doctor prefers to also include free T3 and T4. I don’t recall the sex hormones being included in the annual checkup. For me, correcting those was profoundly helpful for good sleep but being female there’s a different set of concerns. I’m not an endocrinologist but my understanding is so called “low t” in men might interfere with sleep but supplementing might not be appropriate in men with prostate issues. (By “supplementing” I’m not talking about OTC, I’m talking about going through your doctor, I wouldn’t buy supplements for boosting testosterone on my own.) Just something to talk to the doctor about in my opinion.

Melatonin (the sleep hormone) can be naturally raised by doing things such as limiting screen time just before bed, but being sure to get bright sunshine earlier in the day, and if necessary you can consider a melatonin supplement. They say it’s important to have your bedroom completely dark, but on the other hand they also say to always have a nightlight for safety so I don’t know how to balance that.

 

[PiperW]

Today, my 3rd class medical expires and my basic med that I had completed last month with my personal physician kicks in. Dr. Chien worked his magic 2 years ago when I thought all was lost.

 

[Palmpilot]

Today, my 3rd class medical expires and my basic med that I had completed last month with my personal physician kicks in. Dr. Chien worked his magic 2 years ago when I thought all was lost.

He certainly played a crucial role in providing me with the advice I needed to preserve the sport pilot option, which later made it possible for me to take advantage of the BasicMed option.