Benign Brain Tumor

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Iggy Falco

Guest
Long story short, I had a low-grade golf ball size tumor removed from the 4th ventricle in April 2022. All went very well, and I am fully recovered! I have been trying to get my first class medical back since April of this year. The FAA had requested brain scans, COG Screen AE, all surgery reports, follow up dr. reports, and I supplied all information requested. In May I got a letter requesting another field of vision test, and an OSA assessment. I did the requested tests and submitted. Medexpress now has the stop sign again for about a week now. When calling OK city, they say I am still in review. Is it common for the Medexpress to disagree with what the people at the OK city office say? Does the FAA just keep requesting more tests until you give up? Any input would be appreciated!
 
Iggy, I'm sure hoping this was a meningioma..(?ependymoma?). And depending where it was and what size it was it chan have secondary effects in low O2 (brains swell up in low O2) situations. Also, Brain surgery creates....blood on the brain" Blood is intensely epileptogenic.....I would totally disregard the bogus "medxpress "progress-o-meter".

These situations are intensely technical. I can't believe you haven't hired someone knowledgable to run this recertification .(and, not a plug for me....I'm just about full up). Sounds like you are trying to do this yourself....
 
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Iggy, not wanting to get in a ****ing match here, but there is a lot of misunderstanding and seemingly, clearly poor management of medical certification when the FAA deals with neurological issues. In my dealings over the years (and disclaimer here...I AM NOT AN AME) I have helped a number of my patients navigate the maze and roadblocks put up by the FAA to get their medical. It takes time and patience, and is frustrating to say the least. I am not sure who your surgeon is but if he/she is willing to stay involved in the process they will be your best advocate. Working with your AME is going to be imperative. It may be a fight, but it is winnable. The problem is the old adage, a little bit of knowledge is a dangerous thing. I see this way too often when non neurospecialists try to manage neuro issues. My experience with FAA medicals with neuro issues is that you are going to be required to do all sorts of.tests (many which are expensive) that have absolutely no relevance to your condition.
 
I would sure agree with Douglas….but FAA’s view is complicated by attempting to be “predictive” as they issue you a year ahead of your certification to operate.

I just received a turndown to terminate SI on a guy who is an ag operator who is 10 years with a benign ping pong ball sized tumor, without much anatomical opportunity to obstruct CSF Flow, who has been stable 10 years each year with a Neuro visit, and MRI.



Sigh….
 
bbchien said:
I would sure agree with Douglas….but FAA’s view is complicated by attempting to be “predictive” as they issue you a year ahead of your certification to operate.

I just received a turndown to terminate SI on a guy who is an ag operator who is 10 years with a benign ping pong ball sized tumor, without much anatomical opportunity to obstruct CSF Flow, who has been stable 10 years each year with a Neuro visit, and MRI.



Sigh….
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You certainly have a huge more experience with the FAA medical certification process. In my clearly limited experience of the process for a number of pilots with neurological disorders, their methodology more often involves utilization of tests and documentation that are not predictive, nor appropriate for the "disqualifying diagnosis." Other testing modalities that are more predictive and appropriate are often not used either. I think this comes from an attitude at the level of the FAA that they need to cast a wide net and find a one size fits all to a process that evaluates conditions that often does not lend itself to such a mindset. It however is the nature of the beast.
 
bbchien said:
Iggy, I'm sure hoping this was a meningioma..(?ependymoma?). And depending where it was and what size it was it chan have secondary effects in low O2 (brains swell up in low O2) situations. Also, Brain surgery creates....blood on the brain" Blood is intensely epileptogenic.....I would totally disregard the bogus "medxpress "progress-o-meter".

These situations are intensely technical. I can't believe you haven't hired someone knowledgable to run this recertification .(and, not a plug for me....I'm just about full up). Sounds like you are trying to do this yourself....
Click to expand...
It was a subependymoma in the 4th ventricle. There was no brain bleed and no seizures. Surgeon wrote a letter explaining. I looked into hiring one of the companies and they were not helpful. The Dr. I spoke with was flat out rude! AME helped a lot but I think I’m beyond his level of expertise now. Will be looking for someone else to help soon. Hopefully it’s not too late! Thanks for the replies.
 
Iggy Falco said:
It was a subependymoma in the 4th ventricle. There was no brain bleed and no seizures. Surgeon wrote a letter explaining. I looked into hiring one of the companies and they were not helpful. The Dr. I spoke with was flat out rude! AME helped a lot but I think I’m beyond his level of expertise now. Will be looking for someone else to help soon. Hopefully it’s not too late! Thanks for the replies.
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It seems to me your surgeon is unwilling or unable to help you in the process. Hopefully, my assumption is wrong. Short of seeing someone like Dr Chien, I would suggest you speak to your AME and see what their advice is. My experience has been once you are willing to jump through the hoops, and check-off on all of the items in the FAA's squawk list the process seems to work and those who should be cleared to fly get the opportunity to fly. Once again, my experience is somewhat limited in numbers and has been always with self limited and treatable neurological disorders, but includes getting a number of military pilots flying again, as well as a larger number of private and professional pilots flying again. Again, I am not an AME, and am not an FAA consultant, but was willing to do the extra work needed to get my patients the help they need to get their medical cleared. It unfortunately, at least with the FAA takes time, patience, and hard work, but it is worthwhile. Don't lose hope.
 
No possible to say much more without reviewing the FAA medical record......sigh.
 
Iggy Falco said:
It was a subependymoma in the 4th ventricle. There was no brain bleed and no seizures. Surgeon wrote a letter explaining. I looked into hiring one of the companies and they were not helpful. The Dr. I spoke with was flat out rude! AME helped a lot but I think I’m beyond his level of expertise now. Will be looking for someone else to help soon. Hopefully it’s not too late! Thanks for the replies.
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Hey Iggy, a lot of good advice above, but I'd suggest you have your current AME call the FAA in OKC and discuss your case with the doc of the day. That should get you some answers. GL

Also...Neuro and neuropsych consults will typically happen at the FAS office in DC and this adds a lot of time for final review.
 
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