Heart Attack - What's Next?

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sarodude

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saro marcarian
Had a heart attack last week - at all of 42 years old.

Aside from whatever that enzyme test is, bloodwork looks great. BP / heart rate look great. Lifestyle & diet look great. Still, here I am.

I have self grounded. I'm not posting anonymously. I just need to know what to expect from anyone who's been through this.

Bummed. Disappointed. Wanting to move forward legally and ethically.

-Saro
 
Don't waste your money on aopa - if you sneezed wrong before signing up they'll refuse to help you.

Next, find out what caused the heart attack and fix it- one is bad enough, you don't need a repeat, especially in the air.

Lastly, look up the SI process for heart issues - you're going to be very familiar with it before you fly again.
 
Light sport may be an option which allows you to avoid the FAA medical process.

The best thing to do for obtaining an FAA medical would be to consult a Senior AME. Find one that actually works for the pilot and cares about getting you back in the air if at all possible.
 
Go light sport and let your medical lapse.

If you lose your medical, you lose light sport as well.
 
txflyer said:
Go light sport and let your medical lapse.

If you lose your medical, you lose light sport as well.
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This is good advice I think. How tall are you? how much do you weigh? FIRST, You need to visit a real good cardio specialist and have him run you through some tests, if you haven't already done so. He will be able to tell how much damage has been done to your heart, etc. he may run a cath up thru your groin to your heart and look around as this tells him if your arterys are for the most part in decent shape, etc. AN excellent heart specialist is the first step. Good luck. !!!
 
sarodude said:
Had a heart attack last week - at all of 42 years old.

Aside from whatever that enzyme test is, bloodwork looks great. BP / heart rate look great. Lifestyle & diet look great. Still, here I am.
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So which do you believe, your lifestyle and bloodwork or your lying heart? Almost everybody has coronary heart disease, but you and I now know we have it and they don't yet. I would make sure your cardiologist has worked with pilots before and has experience dealing with the FAA. Make sure nothing is written in your medical record by anyone who doesn't understand the FAA's medical requirements, and if they haven't got prior experience--they don't.

Also, please read this article by Dr. Esselstyn. He has treated heart disease with diet at the Cleveland Clinic and published two studies demonstrating partial reversal and cessation of further cardiac events. Please watch every video you can too, then decide whether your lifestyle is "great". I'm into my third year of his vegan, no-oil diet after needing a stent. I've never felt better. Good luck! :)

dtuuri
 
Clark1961 said:
Light sport may be an option which allows you to avoid the FAA medical process.

The best thing to do for obtaining an FAA medical would be to consult a Senior AME. Find one that actually works for the pilot and cares about getting you back in the air if at all possible.
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Uhhh...no. He knows he does not qualify now for a 3rd class medical. Therefore he is not medically qualified to fly sport either

Next - get well and tend to your health. Then come back and jump through the hoops to see if you can fly again.
 
bflynn said:
Uhhh...no. He knows he does not qualify now for a 3rd class medical. Therefore he is not medically qualified to fly sport either

Next - get well and tend to your health. Then come back and jump through the hoops to see if you can fly again.
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There is no such requirement to know one qualifies or is disqualified from a third class. Does he hold a drivers license in his state? Does his Dr think he's ok? Does he think he is ok? Those are the standards. He is not 'disqualified' from SP at all.

Considering all the airline pilots out there after heart attacks, the cardiac protocols can't be that tough.
 
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Sigh.

Please read 61.23 (c) (2) (iv).

(2) A person using a U.S. driver's license to meet the requirements of this paragraph must—

(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.

Do you really think that the FAA would say "oh, you had an MI and didn't know that was an issue. Gee, sorry, no problem". The grim truth is that despite how people treat it, when you know you have a condition, you cannot certify yourself. But you also cannot certify yourself if you should have know, your lack of knowledge on the topic doesn't matter.

Now maybe this means you can jump through the hoops faster because you don't have to prove it to an AME and then to the FAA, but your fitness still needs to be shown if you want to be legal.
 
bflynn said:
Sigh.

Please read 61.23 (c) (2) (iv).

(2) A person using a U.S. driver's license to meet the requirements of this paragraph must—

(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.

Do you really think that the FAA would say "oh, you had an MI and didn't know that was an issue. Gee, sorry, no problem". The grim truth is that despite how people treat it, when you know you have a condition, you cannot certify yourself.

Now maybe this means you can jump through the hoops faster because you don't have to prove it to an AME and then to the FAA, but your fitness still needs to be shown if you want to be legal.
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Where do you see any reference to a Class 3 medical?:dunno:
 
Well, he is a pilot who holds a 3rd class medical. He knows he has a problem and cannot qualify to fly under that medical. That problem does not magically disappear just because he certifies himself. He still knows there is a problem.

Furthermore, he knows there are tests required and a program to follow to show his fitness to fly again under 3rd class. Failure to carry out that program just means he would be ignorant of his true medical condition and he should have known that he can't just guess.
 
bflynn said:
Well, he is a pilot who holds a 3rd class medical. He knows he has a problem and cannot qualify to fly under that medical. That problem does not magically disappear just because he certifies himself. He still knows there is a problem.

Furthermore, he knows there are tests required and a program to follow to show his fitness to fly again under 3rd class. Failure to carry out that program just means he would be ignorant of his true medical condition and he should have known that he can't just guess.
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It says none of that. It says 'safe to fly a light sport plane'. That is determined by the ability to maintain a drivers license, your personal physician, and yourself. There are no other requirements. It's not like you can't get a third class after a heart attack, first class is still available.

You are reading what doesn't exist. Don't believe me, search for some of Dr Bruce's posts on the same subject.
 
So you're making the argument that someone with a medical condition they know is a problem can make the choice to certify themselves while ignorant of their condition?

That would fall under "should have known". If you have a condition and you ignore it so you can fly sport, you're not following the rule. You need to recover, you need to know that you're recovered, I would say with a reasonable expectation that it is unlikely to happen again. How are you going to do that with knowing your condition? You don't have to prove it to anyone else.

Btw, I didn't quote 61.53, but it says basically the same thing.
 
bflynn said:
So you're making the argument that someone with a medical condition they know is a problem can make the choice to certify themselves while ignorant of their condition?

That would fall under "should have known". If you have a condition and you ignore it so you can fly sport, you're not following the rule. You need to recover, you need to know that you're recovered, I would say with a reasonable expectation that it is unlikely to happen again. How are you going to do that with knowing your condition? You don't have to prove it to anyone else.

Btw, I didn't quote 61.53, but it says basically the same thing.
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There is no condition that allows you to maintain a DL that disqualifies you from flying as SP. It is up to you and your physician to determine if you are safe to fly at any given time. Period, that is is, there is no more or less to it.
 
Except that you cannot willfully ignore a medical conditions when you certify yourself. You also must ensure you have the relevant information. If you know or should have know about a condition that could be a problem, you can't fly sport.

Relevant here is that the FAA will decide what you should have known, not your doctor.
 
bflynn said:
Except that you cannot willfully ignore a medical conditions when you certify yourself. You also must ensure you have the relevant information. If you know or should have know about a condition that could be a problem, you can't fly sport.

Relevant here is that the FAA will decide what you should have known, not your doctor.
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No one is saying anything about willfully ignoring. When he and the doc agree he is good, as long as his DL is good, he's good. That is the rule.

If you haven't noticed, the FAA is trying as hard as possible not to have anything to do with LSA or SP.
 
If people have had a heart attack and are flying commercial how would...

"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."

...apply. If he says he is good. Dr. says he is good to go then he has no reason to know of a medical condition that would make him unable to operate the LSA in a safe manner.

Now if his Doctor said your heart is severely damaged and you could literally fall over dead at any minute the same could not be said.

Why read more into it than is there?
 
Henning said:
No one is saying anything about willfully ignoring. When he and the doc agree he is good, as long as his DL is good, he's good.
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Actually, a lot of people are saying that you should willfully ignore health conditions and fly sport.
 
bflynn said:
Actually, a lot of people are saying that you should willfully ignore health conditions and fly sport.
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You are entirely misreading the SP regs. If the FAA insisted on SPs qualifying for a third class medical, they would make them get one.

The standard is that you can operate the aircraft in a safe manner. That has nothing to do with any class of medical, it's a judgement call of the pilot based on his knowledge of his condition in consultation with his physician.

Nobody is sayin to willfully ignore a condition. We are simply saying that a particular condition may not impact your ability to pilot an LSA, that condition's applicability to obtaining a medical of any class notwithstanding.
 
bflynn said:
Actually, a lot of people are saying that you should willfully ignore health conditions and fly sport.
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No, everyone is saying (and they have always said here) to make sure your doctor OKs you to fly light sport. That is what is required. Are you trolling?
 
bflynn said:
Sigh.

Please read 61.23 (c) (2) (iv).

(2) A person using a U.S. driver's license to meet the requirements of this paragraph must—

(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.

Do you really think that the FAA would say "oh, you had an MI and didn't know that was an issue. Gee, sorry, no problem". The grim truth is that despite how people treat it, when you know you have a condition, you cannot certify yourself. But you also cannot certify yourself if you should have know, your lack of knowledge on the topic doesn't matter.

Now maybe this means you can jump through the hoops faster because you don't have to prove it to an AME and then to the FAA, but your fitness still needs to be shown if you want to be legal.
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In the end, it still gets down to what the pilot and the physician decide. If and when they both agree that the pilot can safely perform piloting duties, then the pilot is legal.

From the horse's mouth: https://www.faa.gov/licenses_certificates/medical_certification/sportpilots/response4/

Rich
 
sarodude said:
Had a heart attack last week - at all of 42 years old.

Aside from whatever that enzyme test is, bloodwork looks great. BP / heart rate look great. Lifestyle & diet look great. Still, here I am.

I have self grounded. I'm not posting anonymously. I just need to know what to expect from anyone who's been through this.

Bummed. Disappointed. Wanting to move forward legally and ethically.

-Saro
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Sorry to hear about your condition. I hope things go as well as you're forecasting. If that's all true, there is most likely a return of your medical in your future. Lot's of us here fly on a special issuance. When I went through my deal, the first thing I did was solicit medical advice. Didn't like the first few things I heard, so I reached out to Dr. Bruce. (That's the referral you got earlier.) I didn't like what he had to say either, but I kept probing him for more info, and eventually we got it worked out.

He's in Peoria, and you're in LA, so almost a world apart, but his rates are reasonable and his advice is spot on. He'll tell you what you need to do, and, probably even have a referral for you in the area. He's fairly well connected in the FAA world. See some of the photos on his website with the FAA Cheif Medical Officer, among others...

My advice is to leave the LSA discussion until the Doctor says you're past this. Don't re-apply for your 3rd class until you know you can pass the medical requirements. A denial does make you ineligible for sport pilot. But that decision comes down the road.

I let my medical lapse for almost 10 months until Bruce and I knew I could pass, then I applied. I found it beneficial to travel to Peoria to do it directly with him, but that's a call you can make when the time is right.

As you can see here, folks love to argue about who is right. But that's not the deal. In my case, the deal was - could my paperwork convince the FAA that I was safe to fly? I figured out how to do that, and they issued a special issuance. Feel free to PM me if you'd like an introduction to Dr. Bruce. I have him on speed dial.... :wink2:
 
F01LA said:
No, everyone is saying (and they have always said here) to make sure your doctor OKs you to fly light sport. That is what is required. Are you trolling?
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It's the pilot and no, I'm not trolling.

I keep hearing people saying over and over - "Oh, you had a heart attack? Well don't try to get a new medical (don't tell the FAA), just switch to sport so that even if there's a problem, you can still fly".

If there's a medical problem, it needs to be evaluated and dealt with. After a heart attack or any other medical issue, you still have your driver's license, but you have a medical condition that may prevent safe operation of the airplane. You can't just self-certify the next day and go jump into the cockpit tomorrow because you think you feel fine.

After treatment and evaluation, you can make the decision.

I'll give you an example - I had a kidney stone, my first one. The standard for this is that you don't want the opportunity to have another one in the air because they can hit suddenly and can be painful to the point of incapacitation. The day I got the stone cleared, I didn't know if I had another one waiting to drop. I couldn't just ignore my ignorance and say that I was good to go. But now I have gone through the evaluation for it and I could self-certify myself to fly sport now...because I've been treated. Meanwhile I'm working with an AME to get my 3rd class medical restored.

The advantage of sport is that once I am convinced by the medical evidence that I'm OK, then I'm done, I don't have to wait on an AME or the FAA to agree. Otherwise I have should know that I have a condition that might make me unable to operate the aircraft in a safe manner.

Realistically - is anyone going to say anything about it? Probably not unless there's an incident, at which point they're going to pile a 61.53 violation onto the list. And a pilot should know that anything that disqualifies you from a 3rd class medical probably disqualifies you from light sport until you deal with it.

If people treat sport pilot as a way to hide something from FAA medical, there's going to be problems.
 
There is a difference between a medical problem and a problem medical. There can be a large gap in time between when he is healthy enough to fly SP, but will not be able to attain a medical. If he doesn't apply for the medical until that time, he can continue to fly SP until he has his new medical.
 
bflynn said:
If people treat sport pilot as a way to hide something from FAA medical, there's going to be problems.
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I don't think anyone here is advocating that. There's no way to read the Flight Surgeon's mind, so there's no way a pilot can know whether a given case qualifies for a SI until they apply. On the other hand, since the Flight Surgeon is out of the loop for sport pilots, the medical decision is left to the pilot's personal physician for sport aircraft--according to the FAA (see RMJ62's link). In my case, my cardiologist "cleared me" to resume flying, but that doesn't negate the need for the Flight Surgeon's approval if I want to fly anything other than SP.

dtuuri
 
Also from the horse's mouth:

"§61.53 Prohibition on operations during medical deficiency.
(b) Operations that do not require a medical certificate.
For operations provided for in §61.23(b) of this part, a person shall not act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner."

So, the issue is whether a pilot is "unable to operate the aircraft in a safe manner" rather than the ability to meet all requirements of a particular medical certificate. Why does the FAA use this language ("operate the aircraft in a safe manner") if they actually meant able to meet the requirements of the first, second, or third class medical?

Some will argue that all of the requirements of a third class medical certificate are necessary for a pilot to fly in a safe manner. Never offered however, is empirical evidence that this is true.
 
pilot1956 said:
Also from the horse's mouth:

"§61.53 Prohibition on operations during medical deficiency.
(b) Operations that do not require a medical certificate.
For operations provided for in §61.23(b) of this part, a person shall not act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner."

So, the issue is whether a pilot is "unable to operate the aircraft in a safe manner" rather than the ability to meet all requirements of a particular medical certificate. Why does the FAA use this language ("operate the aircraft in a safe manner") if they actually meant able to meet the requirements of the first, second, or third class medical?

Some will argue that all of the requirements of a third class medical certificate are necessary for a pilot to fly in a safe manner. Never offered however, is empirical evidence that this is true.
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That argument has nothing behind it, and several statements that have been made by FAA people countering it. The FAA does not want to regulate SP/LSA any more than absolutely necessary.
 
I am no lawyer but based on the actual wording you could easily argue you don't even need your doctor to say so or agree. Now if your doctor said something to you at a visit that made you believe you were unfit then you have reason to know.
 
Henning noted: "That argument has nothing behind it"

I could not agree more. Hence, my comment, "Never offered however, is empirical evidence that this [argument] is true."
 
42 is terrifying -- doubly for me, as my paternal grandfather died at the same age of the same thing. Were there any particular signs leading up to it, or just, random whammy as you were going about your day?

Glad you survived it. :)
 
Congrats to the OP for surviving the MI. Not everyone does at that age, little collateral circulation around the heart. You have a problem. Heart attacks don't occur for no reason. Is your lifestyle that good? Diet, exercise, BMI and all that? If so, whatever caused the MI isn't fixable by lifestyle and is still there.
 
I keep seeing folks making reference to getting an OK from your doctor. There is no requirement for a doctor's approval for you to fly SP. If you have any doubt, then I think getting an opinion from your dr is a good idea, but they have no authority to OK or deny you SP flying.
 
JohnWF said:
I keep seeing folks making reference to getting an OK from your doctor. There is no requirement for a doctor's approval for you to fly SP. If you have any doubt, then I think getting an opinion from your dr is a good idea, but they have no authority to OK or deny you SP flying.
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If you have read the link posted earlier I don't see how you can say that. Here it is verbatim, FWIW (my emphasis):

Sport Pilot Medical Certification Questions and Answers

If I suspect I have a significant medical condition, but have never had an FAA medical certificate denied, suspended, or revoked, can I exercise sport pilot privileges using my current and valid driver's license, if otherwise qualified?

Response by the Federal Air Surgeon
Long-standing FAA regulation, 61.53, prohibits all pilots--those who are required to hold airman medical certificates and those who are not--from exercising privileges during periods of medical deficiency. The FAA revised 61.53 to include under this prohibition sport pilots who use a current and valid U.S. driver's license as medical qualification. The prohibition is also added under 61.23 (c) (2) (iv) and 61.303 (b) (2) (4) for sport pilot operations.

You should consult your private physician to determine whether you have a medical deficiency that would interfere with the safe performance of sport piloting duties. Certain medical information that may be helpful for pilots can be found in our Pilot Safety Brochures.​
The standard the FAA would expect is pretty clear to me: Pilot's aren't qualified to self-diagnose suspicious medical conditions which might affect safe sport piloting duties. That may not be what some want to hear though.

dtuuri
 
dtuuri said:
The standard the FAA would expect is pretty clear to me: Pilot's aren't qualified to self-diagnose suspicious medical conditions which might affect safe sport piloting duties. That may not be what some want to hear though.
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This. And they obviously do not want to hear it.
 
timwinters said:
Actually, I think that link works more to support Brian's position rather than refute it.
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I wasn't trying to refute it, but merely clarify it. There are conditions that are disqualifying for a third-class medical that are not disqualifying for flying SP. The FAA's position is that the airman should consult with his or her personal physician to determine whether they're able to exercise SP privileges, not to determine whether or not they'd qualify for a medical. The two have nothing to do with each other.

pilot1956 said:
Also from the horse's mouth:

"§61.53 Prohibition on operations during medical deficiency.
(b) Operations that do not require a medical certificate.
For operations provided for in §61.23(b) of this part, a person shall not act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner."

So, the issue is whether a pilot is "unable to operate the aircraft in a safe manner" rather than the ability to meet all requirements of a particular medical certificate. Why does the FAA use this language ("operate the aircraft in a safe manner") if they actually meant able to meet the requirements of the first, second, or third class medical?

Some will argue that all of the requirements of a third class medical certificate are necessary for a pilot to fly in a safe manner. Never offered however, is empirical evidence that this is true.
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Exactly.

JohnWF said:
I keep seeing folks making reference to getting an OK from your doctor. There is no requirement for a doctor's approval for you to fly SP. If you have any doubt, then I think getting an opinion from your dr is a good idea, but they have no authority to OK or deny you SP flying.
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Also correct. The FAA says that the SP "should," not "must," consult with his or her personal physician. However, I think that this is one of those sorts of things that could bite the SP (or their estate) in the gluteus maximus if they had an incident and it was later found that they'd had a serious medical condition that they'd never discussed with their doctor.

When my doc feared that I had pancreatic cancer (and even afterwards after a bazillion tests determined that I actually had the mother of all gall bladder problems), my doctor told me explicitly to stay on the ground. I made an entry to that effect in my log book. Two weeks after the surgery, I made another entry when the doc had cleared me to resume flying, and stuffed his handwritten scrip to that effect into the pocket in the binding.

None of that was required, of course, but I think it was prudent.

Rich
 
I am not familiar with many (if any) "private physicians" who are able to reliably determine whether a pilot has a medical deficiency that would interfere with the safe performance of sport piloting duties. Sure, anyone can figure out that uncontrolled seizure disorder, unstable angina, or recent stroke, for example, interfere with the safe performance of sport pilot duties.

But, what about well-controlled diabetes? What about antidepressants not on the approved list? What about stable peripheral neuropathy? What about well-controlled asthma requiring inhaled steroids? Can your private doctor decide if those conditions interfere with the ability of a pilot to fly in a safe manner? How could they? Using what criteria?

If the FAA wanted a doctor's formal approval to ensure that a pilot was able to fly in a safe manner, why do they not require that doctor's name or signature? Why even use the DL at all in this regard?
 
pilot1956 said:
I am not familiar with many (if any) "private physicians" who are able to reliably determine whether a pilot has a medical deficiency that would interfere with the safe performance of sport piloting duties.
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The doc doesn't make the decision, the pilot does and is held resposible for it. Again, but only the salient points:
"If I suspect I have a significant medical condition...

Response by the Federal Air Surgeon

Long-standing FAA regulation, 61.53, prohibits all pilots... from exercising privileges during periods of medical deficiency.

You should consult your private physician to determine whether you have a medical deficiency that would interfere with the safe performance of sport piloting duties.​
The mere suspicion of a medical deficiency is enough to hang a pilot unless, after consulting with a doctor, there either is 1) no "medical deficiency" or 2) a minor one that doesn't interfere with sport flying. How minor? "Can you still drive a car safely?" comes to my mind. I wouldn't try it with my leg in a plaster cast.

dtuuri
 
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