Passed my BasicMed exam- butt---

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Bob S

Filing Flight Plan
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Bob S
I passed my BasicMed and now I am good for 4 years. But my doc was puzzeled at how the anus exam has anything to do with flying. Good question. It is unfathomable to me.
 
Also to make sure your jet exhaust is clear.

@Brad Z ... what is the real explanation for this being there?
 
Bob S said:
I passed my BasicMed and now I am good for 4 years. But my doc was puzzeled at how the anus exam has anything to do with flying. Good question. It is unfathomable to me.
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To answer your question,best bet is to look at the entry in the AME guide. Look for ITEM 39. It doesn't say much either, but you'll note the doc doesn't actually have to look at the anus:

II. Examination Techniques
1. Digital Rectal Examination: This examination is performed only at the applicant's option unless indicated by specific history or physical findings. When performed, the following should be noted and recorded in Item 59 of FAA Form 8500-8.
2. If the digital rectal examination is not performed, the response to Item 39 may be based on direct observation or history.​

I came across this one a while back and looked at the guide out of curiosity. When I do mine, I'll show it to my doc.
 
All joking aside, you over 45 male pilots should not hesitate to get that exam to check the prostrate, 5 seconds of discomfort to catch a deadly mostly curable cancer, seems like a no brainer to me.
 
Bob S said:
I passed my BasicMed and now I am good for 4 years. But my doc was puzzeled at how the anus exam has anything to do with flying. Good question. It is unfathomable to me.
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lol ... some doctors are well ... anal. I have never performed.
 
lbfjrmd said:
I prefer blood test PSA for cancer detection.
Click to expand...

No prostate screening at all for me. Not my decision — the major hospital where I go for checkups now has a policy of not screening because they say that, on the whole, the good that these tests do is offset by the harm of false positives.
 
lbfjrmd said:
I prefer blood test PSA for cancer detection.
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That appears to be a significant school of thought these days - that the digital exam doesn't detect enough and has had too many false positives leading to unnecessary biopsies, at least with normal range PSAs. I first heard about it a few years ago when I went for my physical and my doctor (at one of the top medical schools in the US for primary care) and I both sighed in relief.

Edit: I see @NoHeat has had the same experience.
 
My doc said both PSA and exam were optional, I had both, told her we would deal with the possibility of a false positive if we had one, none yet thank God. Note female doctor, small fingers.
 
AggieMike88 said:
Also to make sure your jet exhaust is clear.

@Brad Z ... what is the real explanation for this being there?
Click to expand...

It's there because it's one of the items listed on sections 25-48 of the 1999 version FAA form 8500-8 (which Congress used to develop the statutory directive). This is the form for an application for a medical certificate (this form has been replaced by medxpress). Why is it on the original medical application? I couldn't tell you, I'm not a doctor. Most AMEs in the business know that a visible (or digital, for that matter) examination isn't necessary. I suppose if you have a condition that would make sitting for long periods of time a problem it could be worthy of further discussion, but honestly I have no idea.
 
Given that all of my AMEs have been male, I'd be a little uncomfortable with a rectal exam. Fortunately none has ever so much as asked whether I wanted/was okay with one - including my latest (BasicMed) exam, which was also performed by an AME.
 
I get my exam yearly from my primary care Doc. Have only had one AME offer to do the test wich I refused.
 
I'm pretty sure that traditional medical certification is based on ICAO treaties since your first/second/third class medical is valid anywhere in the world. And, as previously mentioned, the BasicMed standards are based on the third class standards.

ICAO says:
"ANUS, RECTUM – Clinical examination is mandatory only when indicated by history. If not examined, state so."
https://www.icao.int/publications/Documents/8984_cons_en.pdf
which doesn't seem to indicate that any anal exam (either visual or digital) is required.


-Paul
 
Basic Med item 9 on checklist:

Anis (not including digital examination)

with a checkbox that says only "examined"
 
NoHeat said:
No prostate screening at all for me. Not my decision — the major hospital where I go for checkups now has a policy of not screening because they say that, on the whole, the good that these tests do is offset by the harm of false positives.
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Unfortunately, that's old news... the problem was that biopsies have their own risks, and of course, the false positive issue. However, the standard of care now is to perform the PSA test, and if the result doubles within a year, or the absolute number is above the threshold for your age (4.0 for those under 60), then perform a multi-protocol MRI, MPMRI. This non-invasive test identifies the location of any prostate tumors, and gives a VERY good idea on whether any tumor found is likely to be cancerous or not.

Then, you can proceed to have a biopsy, if suspicious tumors are found, and the biopsy can be guided by the MRI. In fact, some facilities have computer power to merge the biopsy doctor's ultrasound image with the MRI image to give a real-time roadmap for biopsy needle placement. Pretty cool stuff.

If you only have one tumor, there are now laser treatment options that are one and done. No surgery, no multiple trips to the radiology lab.

It's a brave new world to prevent prostate cancer running away... you don't want to be the 1 in one thousand with serious, invasive prostate cancer that goes untreated and leads to a rapid, painful death (our neighbor did that, not recommended).

So, insist on the PSA test, and proceed accordingly.

On another note, many general practice docs don't prep you for the PSA properly. To get a representative number, you have to avoid stimulating the prostate for three days before the blood test. That means no sex, no bicycle riding, no hard bowel movements, and no digital exam (finger up the butt). My internist used to give me the finger wave during his physical exam, and THEN send me for my blood draw. That's certain to get a high PSA result, due to the trauma to the prostate immediately before sampling. Bad doctor!

Paul, prostate cancer survivor mode
 
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It’s to make sure your head will fit up there if you are willing to fly an airplane without an AOA
 
PaulMillner said:
Unfortunately, that's old news... the problem was that biopsies have their own risks, and of course, the false positive issue. However, the standard of care now is to perform the PSA test, and if the result doubles within a year, or the absolute number is above the threshold for your age (4.0 for those under 60), then perform a multi-protocol MRI, MPMRI. This non-invasive test identifies the location of any prostate tumors, and gives a VERY good idea on whether any tumor found is likely to be cancerous or not.

Then, you can proceed to have a biopsy, if suspicious tumors are found, and the biopsy can be guided by the MRI. In fact, some facilities have computer power to merge the biopsy doctor's ultrasound image with the MRI image to give a real-time roadmap for biopsy needle placement. Pretty cool stuff.

If you only have one tumor, there are now laser treatment options that are one and done. No surgery, no multiple trips to the radiology lab.

It's a brave new world to prevent prostate cancer running away... you don't want to be the 1 in one thousand with serious, invasive prostate cancer that goes untreated and leads to a rapid, painful death (our neighbor did that, not recommended).

So, insist on the PSA test, and proceed accordingly.

On another note, many general practice docs don't prep you for the PSA properly. To get a representative number, you have to avoid stimulating the prostate for three days before the blood test. That means no sex, no bicycle riding, no hard bowel movements, and no digital exam (finger up the butt). My internist used to give me the finger wave during his physical exam, and THEN send me for my blood draw. That's certain to get a high PSA result, due to the trauma to the prostate immediately before sampling. Bad doctor!

Paul, prostate cancer survivor mode
Click to expand...
Still a very relevant post and highly recommended. PSA test result that was wavering around 8 to 9 over last 2 years. MPMRI confirmed a 1.5cm lump with no invasion of bones or lymph nodes so far. Next step is biopsy. Likely outcome is radiotherapy or laser. I am one of the lucky ones that checked, followed up, and found it early (I am turning 60 and very healthy / fit in all other areas). Don't die because someone told you its not worth bothering - this desease is subtle and easily missed. you don't always get all the classic symptoms.

Does anyone know how to manage BasicMed during this process? Do I have to de-certify myself even though I'm taking no drugs and have no symptoms?
 
SausageMark said:
Still a very relevant post and highly recommended. PSA test result that was wavering around 8 to 9 over last 2 years. MPMRI confirmed a 1.5cm lump with no invasion of bones or lymph nodes so far. Next step is biopsy. Likely outcome is radiotherapy or laser. I am one of the lucky ones that checked, followed up, and found it early (I am turning 60 and very healthy / fit in all other areas). Don't die because someone told you its not worth bothering - this desease is subtle and easily missed. you don't always get all the classic symptoms.

Does anyone know how to manage BasicMed during this process? Do I have to de-certify myself even though I'm taking no drugs and have no symptoms?
Click to expand...
Yeah, maybe start a new thread; I go in for a biopsy later in the month, very high PSA, enlarged prostate, and mass "suspicious for malignancy" found in MRI. I'd love it if I could be treated during the "fusion" biopsy and skip a step, but insurance protocol must be followed.
 
My doctor notes that all pilots are a-holes and checks that box.
 
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