I am in for a tough time getting my 3rd Class medical, and I could use any advice or encouragement.

[Nick C]

[UPDATE]: Thank you to everyone who has helped and given advice. I'm seeing a lot of responses to my original post rather than my update further down in the thread. While it's appreciated, I now have a VERY clear understanding of every aspect and outcome of the "tough certification" pathway. I spent no less than 2 months researching, speaking to multiple AMEs (including Dr. Lou), and corresponding with advocacy groups. I'm leaving the thread up for the sake of others who could use the advice!

 

[Matthew]

Not a doctor, and don't pretend to be. Your health comes first. After that, you just have to deal with what life has given you. It won't be easy, it won't be fast, and it won't be cheap. The worst part is that it's easy to feel like you won't be in control of the process, but you CAN make informed decisions that you will be able to control. I wish you well.

 

[Nick C]

Not a doctor, and don't pretend to be. Your health comes first. After that, you just have to deal with what live has given you. It won't be easy, it won't be fast, and it won't be cheap. The worst part is that it's easy to feel like you won't be in control of the process, but you CAN make informed decisions that you will be able to control. I wish you well.

Thank you! Yes, my health is at the forefront. Setting the goal of aviation is not mutually exclusive from maintaining my health, but something I see as a positive motivator for that maintenance. Though I realize that my current approach to that maintenance will require a change, I have no intentions on letting one side fail to benefit the other.

 

[TCABM]

@bbchien would be the AME to consult with. Start here: http://www.aeromedicaldoc.com/how-to-start.html
There is no guarantee of path to medical certification but if one exists, he would be the one to find it.

 

[AggieMike88]

@Nick C ...

Dr. Bruce Chien (aka @bbchien) is a regular participant on PoA. In addition to being a very well respected AME, he is one of the four authors of the protocol for SSRIs that the FAA currently follows.

Outnif anyone here that can provide you the right and proper advice, it is him.

Follow this link to initiate a private conversation and get started: http://www.aeromedicaldoc.com/how-to-start.html

 

[Nick C]

@Nick C ...

Dr. Bruce Chien (aka @bbchien) is a regular participant on PoA. In addition to being a very well respected AME, he is one of the four authors of the protocol for SSRIs that the FAA currently follows.

Outnif anyone here that can provide you the right and proper advice, it is him.

Thank you. I am aware of Dr. Bruce Chien, and he seems like an excellent resource. The only reservation I have in consulting with him is simply the travel distance required. I have a consultation scheduled for next week with Dr. Steven Villegas outside of Cincinnati, OH (which is still 3.5 hours away from me). Knowing that I will likely need to do a lot of in-person visits before I have the ability to fly, I must consider the amount of time it would take me to travel.

 

[kath]

Why do you want to learn to fly? If your goal is to make flying a career, then you've got a difficult road indeed. But from your post, it sounds as though the reason is for sheer JOY -- which is the same reason many of us have taken to the skies!
If this is the case, then look into something called "Sport Pilot." It's a kind of pilot's license that is restricted to small planes (two seats, light weight) which are called "Light Sport Aircraft". A 3rd class medical is not required to fly or train in one; the same is true for gliders. Both are tons of fun to fly.

Stay healthy,

 

[AggieMike88]

Equine hydration conundrum

 

[Ravioli]

With all of the oversharing you left out your goal. If you want to fly for fun: Sport Pilot.

Anything more, get that checkbook out, roll them dice, and see what comes of it.

 

[Nick C]

Why do you want to learn to fly? If your goal is to make flying a career, then you've got a difficult road indeed. But from your post, it sounds as though the reason is for sheer JOY -- which is the same reason many of us have taken to the skies!
If this is the case, then look into something called "Sport Pilot." It's a kind of pilot's license that is restricted to small planes (two seats, light weight) which are called "Light Sport Aircraft". A 3rd class medical is not required to fly or train in one; the same is true for gliders. Both are tons of fun to fly.

Stay healthy,

Thanks for the tip. And I didn't exactly state my goal, did I? My primary goal is the utility of flying. I live in a small town with a big airstrip. There's not a lot to do here, and the freedom of being able to load my wife and kids up in a plane and fly down to the beach for the weekend would be great. The close second is obviously the pure joy of flying. I am well aware of the light sport category, and it honestly wasn't a consideration because it didn't meet my primary goal. However, I now feel that perhaps it is something I could do while also working with a HIMS AME to seek all the proper treatments I would need to be considered for the class 3. Obviously I would be rolling the dice by applying, and it could end up with having wasted a lot of time and money, but I don't have a whole lot of choice!

 

[Nick C]

Equine hydration conundrum

Fortunately the pond you suggested is not the only pond in existence. I'd appreciate some feedback on other HIMS AMEs rather than a snarky comment.

 

[Jared V]

AA! Get going! You’ll definitely want to start building a solid recovery program. Just being sober or abstaining from alcohol won’t cut it. .224 is way up there.

 

[Nick C]

AA! Get going! You’ll definitely want to start building a solid recovery program. Just being sober or abstaining from alcohol won’t cut it. .224 is way up there.

Do you think certified alcohol counseling or something similar would be a sufficient alternative? I have actually attended AA to great effect in the past, but I have a handful of significant disagreements with their philosophies on recovery which led me to discontinue my attendance ("it's alcohol's fault, not yours" and "only God can heal you" as a couple examples).

 

[Jared V]

Do you think certified alcohol counseling or something similar would be a sufficient alternative? I have actually attended AA to great effect in the past, but I have a handful of significant disagreements with their philosophies on recovery which led me to discontinue my attendance ("it's alcohol's fault, not yours" and "only God can heal you" as a couple examples).

It’s my understanding that counseling may be an option but it'll be quite costly. AA is free though.

 

[Nick C]

It’s my understanding that counseling may be an option but it'll be quite costly. AA is free though.

Good point. I'm already in counseling anyway, though. I might as well swap over to a more pointed approach.

 

[Tools]

All the FAA really cares about is abstinence. You’ll have to convince your AME the rest. So it kinda depends on your AME.

The original HIMS “program” only lifetime requirement was abstinence. The step down “program” is abstinence and a HIMS AME for life, and monitoring longer than before.

It’s pretty simple Prohibitionism. AA is a sore subject. FAA says they can’t REQUIRE it, HIMS says they do... so you’ll have to see how your AME reads between those lines.

So like ANY other medical problem, find and interview your team, do what works for you.

Can’t be just any medical professional, but those on the FAA “approved” list.

The FAA is simply risk adverse, if your team believes in you, they will too. As long as they believe in your team. The transverse property as I remember from high school math.

 

[dans2992]

Yet another case of the FAA punishing people for seeking help...

 

[Nick C]

All the FAA really cares about is abstinence. You’ll have to convince your AME the rest. So it kinda depends on your AME.

The original HIMS “program” only lifetime requirement was abstinence. The step down “program” is abstinence and a HIMS AME for life, and monitoring longer than before.

It’s pretty simple Prohibitionism. AA is a sore subject. FAA says they can’t REQUIRE it, HIMS says they do... so you’ll have to see how your AME reads between those lines.

So like ANY other medical problem, find and interview your team, do what works for you.

Can’t be just any medical professional, but those on the FAA “approved” list.

The FAA is simply risk adverse, if your team believes in you, they will too. As long as they believe in your team. The transverse property as I remember from high school math.

That all makes sense. Like I said, drinking isn't important to me. If I have to choose between bottle or throttle, the choice is obvious. It's unfortunate that I will likely suffer the same scrutiny as someone who's drinking landed them with criminal charges or other irreversible consequences, but I made my bed nonetheless.

 

[Nick C]

Yet another case of the FAA punishing people for seeking help...

I do agree to an extent, but I also understand their point of view. I don't mind jumping through hoops, I just don't want to jump through hoops and still be denied.

 

[Tools]

Well, they don’t punish for seeking help per se, but they sure do without consequence for not following administrative procedure PERFECTLY, even though they do not...

And they don’t publish ALL their requirements, thus forcing you to ANTICIPATE... that’s where it gets REALLY dicey.

Do as I say, not as I do.

 

[Nick C]

And they don’t publish ALL their requirements, thus forcing you to ANTICIPATE... that’s where it gets REALLY dicey.

That's been the hardest part of my own research. There are some very obvious gaps in available knowledge when it comes to the entirety of what the FAA requires/expects. It seems like no matter who I talk to or what I read, there is never a clear answer. What I know for certain is that my initial approach to this process is going to be incredibly important. I want to get it right the first time.

 

[PaulS]

Op, just an observation, from your own original post, you don't seem to follow advice that well, you need to change that.

I think you may have more issues than alcohol with your medical. I'm not a doc but the drugs you are on or have a history of taking for your condition look concerning. You need to talk to a HIMS AME, tell them everything, and see what they say. You should be prepared for either a no, or a long, uncertain road to certification.

 

[Nick C]

Op, just an observation, from your own original post, you don't seem to follow advice that well, you need to change that.

I think you may have more issues than alcohol with your medical. I'm not a doc but the drugs you are on or have a history of taking for your condition look concerning. You need to talk to a HIMS AME, tell them everything, and see what they say. You should be prepared for either a no, or a long, uncertain road to certification.

Yes I know I have other issues apart from the alcohol ahead of me, but I recognize that the alcohol is the most severe. How exactly have I not followed advice well? I have done nothing but follow advice.

 

[KeepWatch]

Yes I know I have other issues apart from the alcohol ahead of me, but I recognize that the alcohol is the most severe. How exactly have I not followed advice well? I have done nothing but follow advice.

Alcohol may be the most severe, but it actually is one of the more straightforward problems to deal with, I think likely due to the fact that it can be monitored externally to some degree. The psychiatric issues, I think, will be more of an issue. Especially if the FAA ever gets wind of the "S" word in your medical history.

 

[Nick C]

Alcohol may be the most severe, but it actually is one of the more straightforward problems to deal with, I think likely due to the fact that it can be monitored externally to some degree. The psychiatric issues, I think, will be more of an issue. Especially if the FAA ever gets wind of the "S" word in your medical history.

Understood. Proper treatment and a good psych evaluation would clear those up would they not?

 

[KeepWatch]

Understood. Proper treatment and a good psych evaluation would clear those up would they not?

Maybe. In listening to Dr. Bruce, I've seen more brick wall denials around the psychiatric stuff than anything else, especially since the FAA seems to be very choosy about the medications they will allow with a SI. But I'm getting way way outside my wheelhouse in this area. Interested to see Dr. Bruce's opinion on this thread since you have been very detailed in your situation.

 

[Nick C]

Maybe. In listening to Dr. Bruce, I've seen more brick wall denials around the psychiatric stuff than anything else, especially since the FAA seems to be very choosy about the medications they will allow with a SI. But I'm getting way way outside my wheelhouse in this area. Interested to see Dr. Bruce's opinion on this thread since you have been very detailed in your situation.

Yeah that makes sense. Though I know the history of medication is something I can’t work around, the medications are something I intend to eliminate by working with my providers. I think at the time it was easy for me to blame depression and add for my alcohol problems when the blame was most likely reversed. I think I would evaluate well so long as I commit to recovery from alcohol use.

I have also emailed Dr. Bruce, by the way.

 

[SoCal 182 Driver]

I have also emailed Dr. Bruce, by the way.

Smartest thing you've done yet!

 

[RussS]

Dr Bruce will tell you if you have a chance. Sounds like a tough one. Like Matthew said above. IF it’s possible, it won’t be cheap, easy, or fast. Having a record of a .224 BAC will, I would think, be labeled as tolerance from the FAA, which is lifetime of monitoring. So, your drinking days are over if you want to fly....the psychiatric stuff will be the big initial hurdle. I’m hopeful for you.

 

[Nick C]

Dr Bruce will tell you if you have a chance. Sounds like a tough one. Like Matthew said above. IF it’s possible, it won’t be cheap, easy, or fast. Having a record of a .224 BAC will, I would think, be labeled as tolerance from the FAA, which is lifetime of monitoring. So, your drinking days are over if you want to fly....the psychiatric stuff will be the big initial hurdle. I’m hopeful for you.

Thank you. I just want to move forward in life, and doing what I can to accomplish this goal is important to me. Drinking days are over? Well, let’s be honest, they should have been over a long time ago. I won’t miss it.

 

[PaulS]

Yes I know I have other issues apart from the alcohol ahead of me, but I recognize that the alcohol is the most severe. How exactly have I not followed advice well? I have done nothing but follow advice.

This line from your OP: "My mother-in-law, who works at the local ER, advised my condition was not serious enough to warrant the visit, but I did not listen."

You need to listen, especially to those with experience dealing with the problems you are having. You've contacted Dr Bruce, hopefully he can help, but you need to listen to what he says, you seem to have made up your mind as to how this is supposed to go and I think you are in for a shock when you learn from an expert what will be needed, or if it can be done at all. Listen to the expert, follow the advice.

 

[Lindberg]

Sure is. I've opened up to a community I hope desperately to become a part of about what is quite literally the most difficult, challenging series of events I have faced in my life hoping for some feedback and advice. But you've figured me out. You caught me making the whole thing up for anonymous attention on the internet. Or maybe it's all true, and you just decided that kicking someone while they're down makes you a big man.

You used a couple thousand words to say that you're an alcoholic with a history of mental illness require treatment with medication. That may lead some to conclude that 1) you're in denial/still rationalizing your disease or 2) you're a troll.

I'm not qualified to tell you what the hoops look like that you'd have to jump through for a third class, but my completely armchair opinion is that you're not even ready to start that process yet. So my suggestion would follow the lines of @Matthew and @kath:

Get your health taken care of first. Quit the booze. Figure out your mental health issues and get stable.

Then, and only then, discuss with your doctor whether you have "any medical condition that would make [you] unable to operate the aircraft in a safe manner." If you and your doctor agree that you do not have any such condition, pursue a Sport Pilot rating. It won't get you flying four seaters (under the current law), but it will get you flying.

 

[Lindberg]

This line from your OP: "My mother-in-law, who works at the local ER, advised my condition was not serious enough to warrant the visit, but I did not listen."

You need to listen, especially to those with experience dealing with the problems you are having. You've contacted Dr Bruce, hopefully he can help, but you need to listen to what he says, you seem to have made up your mind as to how this is supposed to go and I think you are in for a shock when you learn from an expert what will be needed, or if it can be done at all. Listen to the expert, follow the advice.

Also bragging about checking out of the CSU early, AMA.

 

[Nick C]

This line from your OP: "My mother-in-law, who works at the local ER, advised my condition was not serious enough to warrant the visit, but I did not listen."

You need to listen, especially to those with experience dealing with the problems you are having. You've contacted Dr Bruce, hopefully he can help, but you need to listen to what he says, you seem to have made up your mind as to how this is supposed to go and I think you are in for a shock when you learn from an expert what will be needed, or if it can be done at all. Listen to the expert, follow the advice.

I understand where you are coming from. Not listening to my MIL's advice in a drunken panic is not reflective of me entirely. I plan to completely submit to what the experts say is right. I haven't made up my mind as to how I think this is supposed to go, I have only gathered how the process may work based on the massive amount of advice and information I have been given.

 

[Nick C]

You used a couple thousand words to say that you're an alcoholic with a history of mental illness require treatment with medication. That may lead some to conclude that 1) you're in denial/still rationalizing your disease or 2) you're a troll.

I'm not qualified to tell you what the hoops look like that you'd have to jump through for a third class, but my completely armchair opinion is that you're not even ready to start that process yet. So my suggestion would follow the lines of @Matthew and @kath:

Get your health taken care of first. Quit the booze. Figure out your mental health issues and get stable.

Then, and only then, discuss with your doctor whether you have "any medical condition that would make [you] unable to operate the aircraft in a safe manner." If you and your doctor agree that you do not have any such condition, pursue a Sport Pilot rating. It won't get you flying four seaters (under the current law), but it will get you flying.

I used a couple thousand words to detail exactly what I experienced. I am not rationalizing the disease. I am not in denial (though I know that sounds like an oxymoron). I recognize how serious of a problem alcohol has been in my life. I also recognize that I have not had a drop since this experience and have no intentions to start again. I have been actively working on my health every day since. I feel that I am stable, but I know that there are certain requirements I must abide by while maintaining that stability. As far as "bragging" about leaving the CSU? No. I was simply trying to illustrate how quickly I was able to stabilize my condition in the hopes that it would paint a picture of my overall mental health.

All in all I am trying to hold onto what shred of dignity I have left. The whole experience has been quite demoralizing and has filled me with an unquantifiable amount of shame, but I know that a positive outlook no matter the circumstance is what I must maintain.

 

[idahoflier]

OP,

Unless you have deep pockets, a lot of time and the ability to deal with frustration I wouldn't even go down the path of trying to get a medical certificate. As others have said, you can get the enjoyment of flying with Sport Pilot. If you start down the medical certificate path and get denied, which you will, then that is off of the table and now you're looking at ultralights as the only way to get off of the ground.

With a few exceptions the utility of loading up the family and flying somewhere for the weekend is pretty rare as the automobile will get you there in close to the same or at least acceptable door to door time. If you really want to experience that type of flight, hire a CFI to go with the family for the weekend, it will be cheaper and much less frustrating in the long run...

Good Luck and Blue Skies!

 

[Anon]

I agree with idahoflier, I’m not gonna lie, it doesn’t look good. But only Dr. Bruce can say for sure (on this board). And he’s the best on or off this board. Do exactly as he says, if there is any chance. Otherwise if you haven’t yet been denied go for sport pilot.

Some of your story is very familiar to me. I had a crisis (similar to you, the stacking of several bad things too close together) resulting in suicidal thoughts, never any intention of acting on them, but I let myself be talked into getting admitted to a psychiatric unit for two days. In retrospect it was a big mistake. In my heart I knew I wasn’t really a danger to myself or others and there were other options to get help without having “psychiatric inpatient” in my official record to follow me the rest of my life, but at the time I hadn’t figured out the other options and it seemed the only way. But that’s water under the bridge for you now as it was for me.

They put me on several drugs including an antidepressant and fixed me up, however the big difference is I had zero alcohol or substance abuse of any kind. The official diagnose was reactionary depression to circumstances or however they termed it. I reported it to the FAA, they had me jump through some hoops and I got certified. That was decades ago and I’ve not had a recurrence of that depression.

So in your case, the exact diagnosis code(s) will matter. It also matters if it’s a single instance or recurring. But the record of alcohol use is a huge problem. Note I said record. Even if you in reality only had one or two benders, and were never tolerant, it’s now engraved in stone and with you for life, due to the diagnosis code. But you aren’t in denial that you were using alcohol inappropriately to self medicate, and I think you said your wife even found it a problem, so yes, you have a problem with alcohol. So I’m sure Bruce will say it’s the full HIMS treatment at minimum, and that’s even if you can get past the other stuff.

He won’t mislead you, if he thinks there is no hope of certification he will say so, and you can take to the bank that’s the bottom line. He’s the last stop for impossible cases.

For what it’s worth I don’t mind the long story. I appreciate that other people have had similar painful experiences to the one I had. I understand the need to talk about it.

 

[Nick C]

I agree with idahoflier, I’m not gonna lie, it doesn’t look good. But only Dr. Bruce can say for sure (on this board). And he’s the best on or off this board. Do exactly as he says, if there is any chance. Otherwise if you haven’t yet been denied go for sport pilot.

Some of your story is very familiar to me. I had a crisis (similar to you, the stacking of several bad things too close together) resulting in suicidal thoughts, never any intention of acting on them, but I let myself be talked into getting admitted to a psychiatric unit for two days. In retrospect it was a big mistake. In my heart I knew I wasn’t really a danger to myself or others and there were other options to get help without having “psychiatric inpatient” in my official record to follow me the rest of my life, but at the time I hadn’t figured out the other options and it seemed the only way. But that’s water under the bridge for you now as it was for me.

They put me on several drugs including an antidepressant and fixed me up, however the big difference is I had zero alcohol or substance abuse of any kind. The official diagnose was reactionary depression to circumstances or however they termed it. I reported it to the FAA, they had me jump through some hoops and I got certified. That was decades ago and I’ve not had a recurrence of that depression.

So in your case, the exact diagnosis code(s) will matter. It also matters if it’s a single instance or recurring. But the record of alcohol use is a huge problem. Note I said record. Even if you in reality only had one or two benders, and were never tolerant, it’s now engraved in stone and with you for life, due to the diagnosis code. But you aren’t in denial that you were using alcohol inappropriately to self medicate, and I think you said your wife even found it a problem, so yes, you have a problem with alcohol. So I’m sure Bruce will say it’s the full HIMS treatment at minimum, and that’s even if you can get past the other stuff.

He won’t mislead you, if he thinks there is no hope of certification he will say so, and you can take to the bank that’s the bottom line. He’s the last stop for impossible cases.

For what it’s worth I don’t mind the long story. I appreciate that other people have had similar painful experiences to the one I had. I understand the need to talk about it.

You may never know how much your kindness means. Thank you. I know how bad this looks. If it is hopeless, then it is hopeless. I won’t give up until I know, though.

 

[Dana]

As others have said, you can get the enjoyment of flying with Sport Pilot. If you start down the medical certificate path and get denied, which you will, then that is off of the table and now you're looking at ultralights as the only way to get off of the ground.

Or gliders, including motorgliders.

 

[idahoflier]

Or gliders, including motorgliders.

Or baloons...