FAA adds another hoop for medicals

Change that dollar to a dime and you'd still win.

I wonder how many of those whining in this thread have a BMI > 40...or at least very close to it.

Nearly all I presume.

You know this is a fallacy, right? It's both an ad hominem and a genetic fallacy.
 
Doesn't matter how you label the group, Richard. The correlator is BMI>40 and the correlation is r>.90.

I'm not disputing that, but the BMI table you posted classifies everyone above a BMI of 29 as obese. I don't know how doctors define it, but Webster defines "obese" as "having excessive body fat." I think that's why people associate this issue with fat, and why it seems incongruous that Schwarzenegger would have been classified as obese at a time when he had only 4% body fat.

Didn't you predict that the NPRM process might result in a BMI of 30 triggering the testing requirement? I would think that a criterion of 30 would result in a lot more unnecessary testing than a criterion of 40 would.

I do think that if the FAA found ways of significantly reducing the expense and disruption of the screening process, then they would encounter less political resistance.
 
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As if throwing Schwarzenegger into the mix isn't? :rofl:

(This oughta be interesting). Explain, exactly, how "throwing Schwarzenegger into the mix" is both an ad hominem and a genetic fallacy.

:popcorn:

Don't hurt yourself now.
 
.....Didn't you predict that the NPRM process might result in a BMI of 30 triggering the testing requirement? I would think that a criterion of 30 would result in a lot more unnecessary testing than a criterion of 40 would.......
Actually, without the NPRM Tilton says "Once we have appropriately dealt with every airman examinee who has a BMI of 40 or greater, we will gradually expand the testing pool by going to lower BMI measurements until we have identified and assured treatment for every airman with OSA."

That's why many of us oppose the bureaucratic fiat approach. (NB: BMI 26.4 here). The >40 BMI arguments are a misdirection, it's really many more.
 
I'm not disputing that, but the BMI table you posted classifies everyone above a BMI of 29 as obese. I don't know how doctors define it, but Webster defines "obese" as "having excessive body fat." I think that's why people associate this issue with fat, and why it seems incongruous that Schwarzenegger would have been classified as obese at a time when he had only 4% body fat.

Didn't you predict that the NPRM process might result in a BMI of 30 triggering the testing requirement? I would think that a criterion of 30 would result in a lot more unnecessary testing than a criterion of 40 would.

I do think that if the FAA found ways of significantly reducing the expense and disruption of the screening process, then they would encounter less political resistance.
Richard, I have been hoping to just have the BMI 40 requirement and then let the agency see how crippled it is going to be when they propose 36. If it goes through congress, then when the delays go to 180 days they will simply say, "see, we need a bigger appropriation, YOU (congress) mandated that." Then the bureaucracy gets even bigger.

It goes downhill from there.
 
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(This oughta be interesting). Explain, exactly, how "throwing Schwarzenegger into the mix" is both an ad hominem and a genetic fallacy.
Well if it's helpful I seem to remember from all the TMZ publicity about the Schwartzenegger publicity about the maid-as-mistress, Maria (or Arnold?) said he snores awfully and they slept separately. But I don't pay much attention to that stuff.

It has nothing to do with % Body fat, and all to do with BMI. You put % body fat in there which has nothing to do with anything. Besides at his height (he's as tall as Leno) he wouldn't be hit by the BMI 40 rule.

For Richard I propose we re-label the BMI categories, just like Starbucks, where "tall" is actually the small size. I propose, that normal be named, "Dimunitive". Overweight be renamed, "dimunitive Plus". Obese be labeled, "Beautiful", and Morbidly Obese, "svelte". That should do it.

But the prevalance of BMI 40 with Obstructive sleep Apnea in the "Svelte" group will remain. So now that we're over that, the problem remains the same.
 
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I'm fat and I deserve to be subject to the more rigorous testing. The data show that clearly. However, I also know that OSA appears to be prevalent across the population and wonder if it is so potentially detrimental why screening isn't required for everyone. I have three empirical examples that are close to home. Two guys in my office are rail thin and both wear CPAPs at night. The third is my middle son who is 7. Earlier this year he had surgery to try an correct his OSA. He would come home off the bus and go to bed for two hours - on his own. He was just exhausted. See attached picture for his body shape.
 

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Dude, calling folks names pretty much destroys any credibility you might have in your arguments.

Another fallacy. If I don't call "folks" names or do, it has nothing to do with the veracity or soundness or, to use your vernacular, credibility of my arguments.

You're mistaking rhetoric for logic.
But I'm sure that since I didn't call you a name, you'll accept my argument.
 
Well if it's helpful I seem to remember from all the TMZ publicity about the Schwartzenegger publicity about the maid-as-mistress, Maria (or Arnold?) said he snores awfully and they slept separately. But I don't pay much attention to that stuff.

Ah but you just proved otherwise. :lol:

It has nothing to do with % Body fat, and all to do with BMI. You put % body fat in there which has nothing to do with anything. Besides at his height (he's as tall as Leno) he wouldn't be hit by the BMI 40 rule.

Yes, but that's a red herring; don't let it sidetrack you. I'm not talking about body fat %, that was simply in the quote I read. My point continues to be that BMI is a rather unstable platform to stand on.
 
Ah but you just proved otherwise. :lol:



Yes, but that's a red herring; don't let it sidetrack you. I'm not talking about body fat %, that was simply in the quote I read. My point continues to be that BMI is a rather unstable platform to stand on.
Good bye......
 
What is true is that you engaged in an ad hominem personal attack. Glad you took it down. But I am done addressing any c_ap you put up as of now.

So, stay slender!

I can see you do not understand what ad hominem means, doc. An ad hominem is not just an insult, an ad hominem is a response to an argument not tackling the issues whatsoever, instead talking about the arguer.

But suite yourself.
 
I can see you do not understand what ad hominem means, doc. An ad hominem is not just an insult, an ad hominem is a response to an argument not tackling the issues whatsoever, instead talking about the arguer.

But suite yourself.
Yeah that's you allright, Fearless Tower saved your original ad hominem attack for posterity using 'Quotes".

To POA: This guy needs a timeout.
 
Yeah that's you allright, Fearless Tower saved your original ad hominem attack for posterity using 'Quotes".

To POA: This guy needs a timeout.

Doc et al: I apologize for my behavior. I guess this topic got my goat but it's no excuse to be personal.

[BTW, I did not take down any of my posts. I'm thinking the mods did that.]
 
Well if it's helpful I seem to remember from all the TMZ publicity about the Schwartzenegger publicity about the maid-as-mistress, Maria (or Arnold?) said he snores awfully and they slept separately. But I don't pay much attention to that stuff.

It has nothing to do with % Body fat, and all to do with BMI. You put % body fat in there which has nothing to do with anything. Besides at his height (he's as tall as Leno) he wouldn't be hit by the BMI 40 rule.

Well, Schwarzenegger is anecdotal, but has anyone done a study to see if measuring fat percentage improves the OSA correlation vs using BMI?

For Richard I propose we re-label the BMI categories, just like Starbucks, where "tall" is actually the small size. I propose, that normal be named, "Dimunitive". Overweight be renamed, "dimunitive Plus". Obese be labeled, "Beautiful", and Morbidly Obese, "svelte". That should do it.

Reminds me of the fact that it's no longer possible to find small or medium eggs in the stores. Makes me wonder if chickens really are laying bigger eggs than they used to, or if they just changed the size standards.
 
Richard, I have been hoping to just have the BMI 40 requirement and then let the agency see how crippled it is going to be when they propose 36. If it goes through congress, then when the delays go to 180 days they will simply say, "see, we need a bigger appropriation, YOU (congress) mandated that." Then the bureaucracy gets even bigger.

It goes downhill from there.

Judging by the ALPA write up posted on the red board, it sounds like the FAA is backing off, so maybe they will be able to avoid the NPRM legislation. It does seem like they failed to anticipate the political palatability of their plan as originally written.
 
Reminds me of the fact that it's no longer possible to find small or medium eggs in the stores. Makes me wonder if chickens really are laying bigger eggs than they used to, or if they just changed the size standards.
My guess on that, if it's true, is that people weren't buying small and medium eggs so now they don't sell them whole and turn them into egg products instead.
 
Reminds me of the fact that it's no longer possible to find small or medium eggs in the stores. Makes me wonder if chickens really are laying bigger eggs than they used to, or if they just changed the size standards.

More than you wanted to know, but....

There are approximately 75 billion eggs produced for human consumption produced in the US each year. Of those, roughly

36% will be broken for use in egg products

5% will be Jumbo
14% will be Extra Large
38% will be Large
6% will be Medium
1% will be Smalls

Size standards have been consistent from USDA for many decades. As a general rule chickens have the ability to lay bigger eggs if we let them. Mediums and smalls are generally a loss item for egg producers and as such we try to minimize their production. Many of the mediums end up going to cooking operations to make pre-cooked hard boiled eggs. We certainly do package and sell mediums for the grocery market, but it is almost a specialty egg because of the small volume. We sell mediums to WalMart every day. It is legal for us to "downgrade" an egg from the next higher size category but we can never "upsize" an egg for a consumer pack. IOW, we can put an XL egg in a large carton, but not the other way around. There is a healthy export market for small eggs to the Asian market and that is where most of them go if they don't get broken. We also have Pee-Wee and Wee-Pee size categories that are even smaller than Smalls, but the % is tenths of a percent.

http://www.ces.ncsu.edu/depts/poulsci/tech_manuals/egg_grading.pdf

Eggman
 
Thanks, Eggman. Another of life's mysteries solved!
 
My chickens seem to lay whatever size eggs they feel like. There seems to be quite a bit of variation day to day with some but in general they seem big compared to store bought large eggs (although it has been awhile since I bought an egg). Always fun (well for us not the chicken I am sure) when you get a nice super jumbo double yolker.:D
 
My chickens seem to lay whatever size eggs they feel like. There seems to be quite a bit of variation day to day with some but in general they seem big compared to store bought large eggs (although it has been awhile since I bought an egg). Always fun (well for us not the chicken I am sure) when you get a nice super jumbo double yolker.:D

She is getting inconsistent feed, water, and light. Be alert for any signs of vent trauma such as blood on the exterior of the egg and if this occurs keep that hen separate from her pen mates for a few days to heal so that the other gals don't peck her to death.
 
I have 10, one doesn't lay because she is old. There are 3 that are 2 years old and 6 from this year. The younger ones seem to have the most variation in size it seems. They have free access to food and water. Light could be an issue. I do pretty much get 9 eggs a day every once in awhile one will miss a day. I expect the 2 year olds will start molting soon.

separate from her pen mates for a few days to heal so that the other gals don't peck her to death.
I always tell people chickens are mean like high school girls mean.

To keep this on topic none of them have sleep apnea or have a BMI over 40. They can fly but not very well anymore. :rofl::lol:
 
(This oughta be interesting). Explain, exactly, how "throwing Schwarzenegger into the mix" is both an ad hominem and a genetic fallacy.

:popcorn:

Don't hurt yourself now.

You can't figure it out? Sorry, I don't owe you an explanation.
 
ok so I understand the bmi kinda but whatof women thatcary weight in the chest area comeon the twins add weight to our bodies. is the faa gonna factor that into the their bmi thing.
 
I'm fat and I deserve to be subject to the more rigorous testing. The data show that clearly. However, I also know that OSA appears to be prevalent across the population and wonder if it is so potentially detrimental why screening isn't required for everyone. I have three empirical examples that are close to home. Two guys in my office are rail thin and both wear CPAPs at night. The third is my middle son who is 7. Earlier this year he had surgery to try an correct his OSA. He would come home off the bus and go to bed for two hours - on his own. He was just exhausted. See attached picture for his body shape.

Well, from what the FAA has stated, they will eventually get there. What they are doing is starting where the problem is worst me expand from there as workload permits so they don't incapacitate the system.
 
Well, from what the FAA has stated, they will eventually get there. What they are doing is starting where the problem is worst me expand from there as workload permits so they don't incapacitate the system.

Where they think the problem is, you mean. Still haven't seen any evidence that there's rampant sleep deprived pilots crashing airplanes from FAA yet.
 
Where they think the problem is, you mean. Still haven't seen any evidence that there's rampant sleep deprived pilots crashing airplanes from FAA yet.

Do you think they are doing this for giggles? Because they are bureaucrats who want extra paper work to review? Have you looked for what they are looking at?
 
Where they think the problem is, you mean. Still haven't seen any evidence that there's rampant sleep deprived pilots crashing airplanes from FAA yet.
90% of accidents are pilot error.
SA untreated has been shown to be the equivalent of 0.08 alcohol.
Now read 67.113, 67.213, and 67.313 and tell me he doesn't have the authority.....

Enough, Nate. Enough.
 
90% of accidents are pilot error.
SA untreated has been shown to be the equivalent of 0.08 alcohol.
Now read 67.113, 67.213, and 67.313 and tell me he doesn't have the authority.....

Enough, Nate. Enough.

The funny thing in this thread is the parallels to the SSRI and ADD threads. Only this one has a simple SI already there.
 
90% of accidents are pilot error.
SA untreated has been shown to be the equivalent of 0.08 alcohol.
Now read 67.113, 67.213, and 67.313 and tell me he doesn't have the authority.....

Enough, Nate. Enough.

Those are medical and legal fact. What hasn't been established is that it's actually causing accidents.

A more difficult question: Is the standard zero accidents? If it is, is it worth the cost?

Those are part of the overall FAA mission to answer. The Doc has the authority, but perhaps shouldn't be the final say when factoring in the overall goals of the organization.

That's what I'm questioning. Not his work. It's the groups around him that seem disconnected and unprepared for his professional medical assessment. You'd think they'd be prepared to present their data along with his, since it is the Federal *Aviation* Administration, not the Federal Pilot Medical Administration after all.

That's just his piece. He's fine.

Where's the administrator saying, "Here's our evidence to back the Doc's claim. The following accidents were found to be fully or partially caused by fatigue unrelated to unreasonable work schedules, and crew transportation issues (e.g. Commuting halfway across the country), and the airmen who survived, were found, post-accident or incident, to be afflicted with sleep apnea that was untreated."

The Administration is disjointed individual groups not working together. If this is high enough on the Doc's list to trigger a $1B bill to airmen, it's reasonable for the airmen to ask for the evidence linking the Doc's data to... Oh you know... Airplanes?

Someone pointed out that DOT did this to truckers. I have a hunch that sleep related accidents didn't drop. Why? The rest rules are changing again in June.

And there's the elephant in the room. Crew rest rules are about 1000% more likely to be the cause of accidents in commercial aviation, where one might say they *really* count... But FAA won't touch that political third rail.

Honest opinion Doc. You ever read an accident report where fatigue was a significant factor (say, Colgan) and think to yourself, "I bet the FO needed a CPAP!"

I'm sorry I'm digging this one. I know it's tilting at windmills but they're barking up the much smaller of the fatigue trees here.

There's a reason commercial pilots joke that long haul intercontinental flights are "dozing for dollars", but it's not very likely that it's because they need a CPAP. It's because it's frakking 3AM over the Pacific. Luckily that's a fairly non-risky portion of the flight.

I read a lot of accident reports. Probably not as many as you, Doc. Nor have access to "insider" info on them. But I think they've made a mountain out of a molehill with this one.
 
Those are medical and legal fact. What hasn't been established is that it's actually causing accidents.

Just tell me you have read 67.113, 67.213, and 67.313, okay, or I'm going to put you in the pile.....see the other string I started tonight. It think murph is right....it's like a kidney stone.

The most amazing thing about this, is the well treated SI, is ROUTINELY given on the phone. It's EASY!!

This tells me that airmen (YOU included) don't care about becoming better airmen. ANY guy with treated SA will tell you they NEVER want to go back to their old live before they got it fixed. To Docs and nurses, this is just self evident. To treated airmen, it's also equally obvious. I don't want to give anyone away here who hasn't volunteered, but there are at least 20 on this board, and many of them have spoken up.

Now actually read 67.113, 67. 213, and 67.313. If you post it, I will know you found it.

Nate, you are acting like the attorney who refused to hire the doc. There is a reason docs hire attorneys and attorneys hire docs. We both realize that "how can I possible think I can do it better than someone who does it all the time?". BTW, I got that guy certified and he admitted....he is better, in court, better in deposition.....better in the airplane. :) When 90% of airmen in a particular group have a condition that bears on 90% of accidents.....who is kidding whom? Now go read 67.313.
 
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I read it Doc. I said the head Doc at FAA is well within his legal authority to call anything he wants a problem ...

"(b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds—
(1) Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
(2) May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges."

You're missing what I am saying completely. I'm pointing out that the above paragraphs have a mandate that the problem must "make the person unable to safely perform" in both paragraphs.

I'm saying FAA hasn't published anything showing anyone specifically not safely performing in an aircraft due to OSA.

While I applaud Aeromedical's desire to make BETTER airmen, that's not their charter, as the law you quoted clearly states. They're supposed to determine if we can BE airmen. Making our lives and our performance BETTER through medical treatment, is between us and our family Doc.

Right now, what they have is a very solid theory that a BMI of equal or greater than 32 leads to OSA, and OSA is impairing. What hasn't been proven in any fashion is that the condition has led to accidents, or makes the airman "unable to perform" their duties.

How many airmen with a BMI of 32 or higher successfully passed check rides this year? Flight checks? Simulator recurrency? Flew over 1000 hours? Taught students who passed all their check rides?

I'd like to see that number and then ask the question again... "Are they unable to perform or would Aeromedical just like them to perform better?"

I just don't feel like Aeromedical has any obligation, nor has the rest of FAA backed them with accident reports, to be forcing testing for OSA unless they're backing it with at least ONE accident caused by OSA, without question.

I suspect some of your successful OSA treatment patients have logbooks thicker than my skeptical skull. And you know my lot in life is to be a skeptic, you said it yourself. Don't take it personally.

I'd also accept someone here who's an OSA patient saying they were unable to perform their aircrew duties as a result of their OSA. I haven't seen that in any of the stories yet. I've seen people say they feel BETTER after getting treated, but I haven't seen any who've said they couldn't perform their airman duties.

I'm more than willing to have my opinion turned. What say you, OSA patients? Were you unable to perform your airman duties prior to treatment? Does your logbook agree?
 
I read it Doc. I said the head Doc at FAA is well within his legal authority to call anything he wants a problem ...

"(b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds—
(1) Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
(2) May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges."

You're missing what I am saying completely. I'm pointing out that the above paragraphs have a mandate that the problem must "make the person unable to safely perform" in both paragraphs.

I'm saying FAA hasn't published anything showing anyone specifically not safely performing in an aircraft due to OSA.
Nate, they won't. It's in the category of "pneumonia is bad for you".
While I applaud Aeromedical's desire to make BETTER airmen, that's not their charter, as the law you quoted clearly states. They're supposed to determine if we can BE airmen. Making our lives and our performance BETTER through medical treatment, is between us and our family Doc.

Right now, what they have is a very solid theory that a BMI of equal or greater than 32 leads to OSA, and OSA is impairing. What hasn't been proven in any fashion is that the condition has led to accidents, or makes the airman "unable to perform" their duties.

How many airmen with a BMI of 32 or higher successfully passed check rides this year? Flight checks? Simulator recurrency? Flew over 1000 hours? Taught students who passed all their check rides? [

I'd like to see that number and then ask the question again... "Are they unable to perform or would Aeromedical just like them to perform better?"

I just don't feel like Aeromedical has any obligation, nor has the rest of FAA backed them with accident reports, to be forcing testing for OSA unless they're backing it with at least ONE accident caused by OSA, without question.

I suspect some of your successful OSA treatment patients have logbooks thicker than my skeptical skull. And you know my lot in life is to be a skeptic, you said it yourself. Don't take it personally.

I'd also accept someone here who's an OSA patient saying they were unable to perform their aircrew duties as a result of their OSA. I haven't seen that in any of the stories yet. I've seen people say they feel BETTER after getting treated, but I haven't seen any who've said they couldn't perform their airman duties.
Psychological problems which result all fall in to the category of "my "how'm I doing thing isn't working correctly, any longer". This is in a similar manner to manic depressives, not quite the same, but so said to make a point.

Is there any data for "pilot with retinal detachment runs into tree?" No.
Is there any data for "pilot with foot injury looses control on rollout?" No.
Is there any data for "pilot with 0.08 crashes airplane"? Yes.
Is there data that show 0.08 has the same effect on performance (in the lab) as sleep apnea? Yes.
Controllers falling asleep on duty? yes.
NWA overflying MSP because the pilot has SA (and we KNOW that now)? Yes.
I'm more than willing to have my opinion turned. What say you, OSA patients? Were you unable to perform your airman duties prior to treatment? Does your logbook agree?
We removed a surgeon from our medical staff for having untreatable narcolepsy. He would actually doze off, standing, at the side of the operating table. Now the crew would rouse him and/or take the knife out of his hand when he would doze off.....Tell me that's acceptable for a surgeon. That's a bit extreme, but now tell me that's okay for an airman. Or a NWA crew. Or an ATC staffing solo.....

None of them will say they were incapable, including my surgeon friend. Yeah, with everybody helping out. The will all say, "well my record is fine". The guy with 0.07 who successfully lands thinks, "well hey it was no problem".

Nate, if it came to it, I'd probably have to decline you as a patient (liability reasons!). Say I did back surgery and got rid of that sciatic pain, but told you no driving for six weeks. You'd be out there in a week driving around..... (cringes)
"well, I felt fine and didn't see a problem...."
 
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I'm kind of two minds on this issue. When I was diagnosed with OSA, according to the sleep doctor report my BMI was 38. I felt and looked like a tired, old, beat up Orca. BMI 40 is really dangerous to one's long term health. And not one in a thousand people with a 40 BMI are particularly athletic.

I must say that I never came close to falling asleep at the yoke. If I had been a night cargo pilot it might have been an issue, but not for the personal flying that I actually do.

Once I went on CPAP I lost over 70 pounds, my BMI is now about 28, I'm off of all medications, and I feel much better in all respects. If you have a BMI above 30 and/or sleep poorly or snore loudly discuss this with your doctor.

On the other hand:

I understand that legally the FAA can probably throw out this big OSA net. But I really am concerned that the FAA has shown no data that indicates that a single accident has been caused by a non-professional pilot with OSA.

I don't think it's unreasonable to require the FAA to at least get some input from stakeholders before unilaterally imposing such a sweeping regulation on the entire pilot population.
 
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