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RedBingo

Filing Flight Plan
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RedBingo
I went to an ENT for nose issues back in December. He said he didn’t see anything wrong, but this ENT is also a sleep specialist. I told him that I was diagnosed with sleep apnea in 2019 (reported), and that I had jaw surgery in 2021 to correct it (also reported). A sleep study after the surgery showed no obstructive apneas and no sleep disordered breathing. So the ENT asked how I was sleeping now. I said my sleep wasn’t great because I have issues with my nose, but it’s nowhere near as bad as with sleep apnea. He convinced me that my work schedule was the problem and prescribed me Trazodone for sleep (half of a pill). He was pretty convincing, so I walked out with the prescription and picked it up from the pharmacy on my way home.

When I got home I looked up Trazodone in the database and saw that it’s not allowed, so I never took it. I didn’t even go to the ENT for sleep issues, but ended up waking out with this prescription.

I recently heard that AMEs can see all of your prescriptions and I’m paranoid because I never called to report it. Should I report this now? Should I wait until the date of my flight physical? Can the AME actually see all your prescriptions when you go in for your flight physical? I know the 8500 only asks what medications you’re currently taking, and as far as I know he didn’t diagnose me with anything.

Need advice. Thank you.
 
I think I recall Dr. Bruce (@bbchien) saying that the prescription records are discoverable should there be cause for the FAA to go hunting for the information.

But I also recall him saying that airmen with your situation that filled the prescription, but later found it is verboten by the FAA, can return to the pharmacy and surrender the pills. And to ask for something from the pharmacist that documents the pills were returned, and the quantity of pills.

In other words, create a paper trail that documents you never swallowed the medication.

If I'm guiding you incorrectly, hopefully Dr. Bruce will be along eventually to provide the right information.
 
Well I guess I’m screwed in that aspect. I flushed them a few days after picking them up.
 
Nah, you aren't screwed. If you don't take the medication, don't list it. If you want to be extra careful go back to this doctor, or your primary care, and discuss that you did not intend to get a sleep aid, let alone one that is a psychotropic medication and ask to turn in the full quantity, have it documented that the full quantity was turned in for disposal.
 
WingmanMed said:
Nah, you aren't screwed. If you don't take the medication, don't list it. If you want to be extra careful go back to this doctor, or your primary care, and discuss that you did not intend to get a sleep aid, let alone one that is a psychotropic medication and ask to turn in the full quantity, have it documented that the full quantity was turned in for disposal.
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That’s the thing, I don’t have them. I flushed them down the toilet a few days after picking them up. The only thing I can document is that I never picked up any refills. But I wasn’t diagnosed with anything.
 
Well then, just don't report it as a medication since you aren't taking it. You are unlikely to be called out for it.

For future reference any sleep aids are going to be disqualifying for regular use.
 
I did see that the 8500 asks which meds you are “currently” taking, but I was worried that if they dig into my medical records for some reason and that that it could be an issue.

WingmanMed, your name suggests you’re a flight doctor. Is that the case?
 
The problem with flushing drugs down the toilet is that they leach into the water table and can show up in well or spring water, but don't get removed with filtration.

The problem with telling your doctor they got flushed is that doctors are usually skeptical about that because it's typically used to try to get refills for narcotic drugs - which seem to be the only drugs that end up the toilet. :eek:
 
Yeesh. So the problem is, if the record is demanded for ANY reason, you will get teh full FAA psychiatry division treatment. After all, it's a psych med.

I would get the ENT's record, and further I'd get his commentary that the sleep disturbance was clearly transitory, as related to temporary shift work, and resolved in less than a month. If that is your only episode in your life, that would then be with an AME's authority to issue. And that would be a yawn @ FAA.

But I cannot like wingman, advise you to nonreport. You are going to have to report going to the ENT visit....and there it is.

The one thing I will do during a busy day- if a known airman calls and hes' at the doc's office I realize how important it is to TAKE THAT CALL. It just crushes predicaments when you say to the prescribing doc, "what is the diagnosis for whcih this pscyh med is being used"?
And he reconsiders......Teh nonreporting window for psych meds is 90 days but the appointment is still there.

sigh.
 
dbahn said:
The problem with flushing drugs down the toilet is that they leach into the water table and can show up in well or spring water, but don't get removed with filtration.

The problem with telling your doctor they got flushed is that doctors are usually skeptical about that because it's typically used to try to get refills for narcotic drugs - which seem to be the only drugs that end up the toilet. :eek:
Click to expand...


Yeah, I get that. But I can show them my pharmacy records that show that I never got refills.
 
RedBingo said:
I did see that the 8500 asks which meds you are “currently” taking, but I was worried that if they dig into my medical records for some reason and that that it could be an issue.

WingmanMed, your name suggests you’re a flight doctor. Is that the case?
Click to expand...

Yes, we are board certified in Aerospace Medicine and HIMS qualified Senior AMEs. We offer consulting services for pilots.
 
RedBingo said:
Yeah, I get that. But I can show them my pharmacy records that show that I never got refills.
Click to expand...
Not to be too cynical, but the FAA will just consider that you only took them until the prescription ran out (unless you can prove otherwise).
 
bbchien said:
The "what it was for" statement by the ENT is totally important, here. If he can write that statement, this will skate.
Click to expand...

He said he was writing because he said he thinks shift work is affecting my sleep, even though I didn’t go there for sleep problems. So I guess I need to make an appointment with him ASAP and get a note from him, and then report it. Tomorrow is actually 90 days from that appointment date.
 
Scenario A: You volunteer information to the FAA and get to jump through a bunch of hoops that will cost you money out of your pocket and delay your medical. Odds are good that you'll get your medical after that, but there are no guarantees. And when you barf up unnecessary medical records, the FAA might even find something else in there it doesn’t like.

Scenario B: You answer the questions asked on the form truthfully without volunteering any information that's not requested and walk out of the AME's office with your medical.

If the FAA ever does have reason to dig through your medical records and finds the prescription, then you'll revert to Scenario A, and you'll have done nothing wrong because you answered truthfully. So why not just cross that bridge when you come to it (most likely never)?

Choose wisely.
 
bbchien said:
Yeesh. So the problem is, if the record is demanded for ANY reason, you will get teh full FAA psychiatry division treatment. After all, it's a psych med.

I would get the ENT's record, and further I'd get his commentary that the sleep disturbance was clearly transitory, as related to temporary shift work, and resolved in less than a month. If that is your only episode in your life, that would then be with an AME's authority to issue. And that would be a yawn @ FAA.

But I cannot like wingman, advise you to nonreport. You are going to have to report going to the ENT visit....and there it is.

The one thing I will do during a busy day- if a known airman calls and hes' at the doc's office I realize how important it is to TAKE THAT CALL. It just crushes predicaments when you say to the prescribing doc, "what is the diagnosis for whcih this pscyh med is being used"?
And he reconsiders......Teh nonreporting window for psych meds is 90 days but the appointment is still there.

sigh.
Click to expand...

When you list visits to health professionals on the 8500, does the FAA pull medical records or call those doctor offices for those visits?
 
RedBingo said:
When you list visits to health professionals on the 8500, does the FAA pull medical records or call those doctor offices for those visits?
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To approve the application? No.

But if you provide them cause to go digging…
 
bbchien said:
The "what it was for" statement by the ENT is totally important, here. If he can write that statement, this will skate.
Click to expand...

Hey Doc, I called today and the receptionist said he diagnosed me with Shift Work Sleep Disorder. I didn’t know that was even an actual disorder. So I guess I need to report this, but I don’t even know how to go about getting my medical back afterwards.
 
RedBingo said:
Hey Doc, I called today and the receptionist said he diagnosed me with Shift Work Sleep Disorder. I didn’t know that was even an actual disorder. So I guess I need to report this, but I don’t even know how to go about getting my medical back afterwards.
Click to expand...
That is easy peasy. If that's what on the record, get the record. But also be sure to make a visit to the doc to get it to record that this is done, over, gone, pfft!.

The AME should yawn and issue.
 
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RedBingo said:
Hey Doc, I called today and the receptionist said he diagnosed me with Shift Work Sleep Disorder. I didn’t know that was even an actual disorder. So I guess I need to report this, but I don’t even know how to go about getting my medical back afterwards.
Click to expand...
You must report the diagnosis for sure. If you disclose the medication in response to the question about medications you're taking, the FAA will assume that you're taking it because that's what the question asks. This would be a perfect situation to have a consult with an AME.
 
The AME is going to ask for doctors notes anyway, and that will reveal the prescription.
 
I can't believe the amount of terrible advise here as to "find a way to not report it". It WILL bite you in the rear eventually.
Get it well documented and stop looking over your shoulder. WIthout the documents, everything said is "just an assertion" and gets treated in that manner.

(Of course, you can pay for a Knowledgable AME's time to review the documents and advise, WITHOUT a flight phyiscal, at which point you can decide to not apply, preserving light sport privileges....sigh).
 
bbchien said:
I can't believe the amount of terrible advise here as to "find a way to not report it". It WILL bite you in the rear eventually.
Get it well documented and stop looking over your shoulder. WIthout the documents, everything said is "just an assertion" and gets treated in that manner.

(Of course, you can pay for a Knowledgable AME's time to review the documents and advise, WITHOUT a flight phyiscal, at which point you can decide to not apply, preserving light sport privileges....sigh).
Click to expand...


Hey Doc,

Im not really looking for a way to avoid reporting. Just looking for an easy way out of this mess.

I went to the ENT’s office yesterday and had them give me the notes from that appointment. The nurse practitioner wrote that I was there for sleep apnea, and that I’m intolerant to CPAP. She also wrote that I had jaw surgery to correct the sleep apnea (I did), but it was unsuccessful (it wasn’t). She I present with a sleep disorder, and that my symptoms are excessive daytime sleepiness, unrefreshing sleep, impaired concentration, morning headaches, and memory problems. She also said that symptoms are exacerbated by fatigue.

In the doctor’s notes he listed all of these symptoms as “not present.” Some of the symptoms he listed as “not present” were anxiety, change in sleep pattern, depression, insomnia, memory loss, and trouble falling asleep. The doctor listed every single symptom on his chart as “not present.”

It concerns me because I didn’t tell the nurse practitioner that I was there for sleep apnea. I went there to ask about a DISE procedure, which is related to sleep apnea, but I wanted them to look at my nose. I think the jaw surgery affected my nose in some way, but the oral surgeon told me there’s no way that the jaw surgery could affect the anatomy of my nose. When I talked to the nurse, I told her everything I went through, and told her the symptoms I was having before jaw surgery. I brought copies of my sleep studies with me because I thought he might want to see them.

When the doctor came in the room, he was kind of a fast talker and I didn’t really get to say much. It seemed like he reviewed what the nurse wrote down, looked at my sleep studies, and then came in the room to tell me I don’t have sleep apnea (I know this) and that my problem was shift work. He then wrote me a prescription for Trazodone and I was walking out. It all happened really fast.

The weird thing is he didn’t write the prescription anywhere in the doctors notes or in my record. His assessment and review was “After reviewing the patient’s PSG and discussed daily shift work which changes every day, I told the patient he does not have OSA but rather Shift Work disorder and to try to set up a normal every day wake time and go to sleep 8 hours prior.” No mention of the Trazodone.

Obviously I’m concerned about the medication being prescribed, but his doctors notes sound like I have a sleep disorder. I have a history of sleep apnea, and then jaw surgery to correct that, so now I’m worried that this will look even worse.

I did make an appointment to go back to the ENT on April 6th to try to straighten this out, but I need to be sure that his notes will reflect that I don’t have a sleep disorder and that the symptoms she listed during the first appointment aren’t accurate.
 
I have made it a point to make sure any new prescription is on the FAA approved list BEFORE I pick it up!
 
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