Super Fun Thrombus Post

[TMV5423]

Can anyone tell me what I am in for with the FAA when I furnish the below information?

Me:
An inflammatory arthritis patient awaiting a FAA decision on a special issuance. I have not held a medical certificate before. No prior history of clotting issues.

Story Time:
While waiting for my special issuance, I had a period of painful swelling in the ankle and calf. I went to the emergency room after my rheumatologist told me that it was probably a blood clot. After an ultrasound, the doctor stated that I had a superficial thrombus in the right calf. Since the thrombus had stuck around for a few weeks, he also put me on xarelto for 45 days.

Follow up:
After starting the xarelto, the blood clot dissipated. However, I had another swelling episode due to bleeding into the knee joint. This was fixed by draining the joint and discontinuing the xarelto early.

The hyper coagulable workup was all negative. One of the proteins that inhibits clotting was actually in the high range. However, I now have “scary” words including hemarthrosis and superficial thrombus on my medical records. To make matters worse, one of my doctors accidentally called it a DVT on my records. As for the cause of the clotting, my doctors seem to think it was some type of trauma to the knee joint. I did have orthopedic surgery on my leg several months earlier.

Am I in for another slog with the FAA? Should I wait to notify the feds until after I receive my special issuance? I don’t want to complicate my special issuance any more than it already is.

thank you!

 

[mcmanigle]

Hopefully the real experts will be along to answer shortly, but from an administrative standpoint, I hope you're in the final stages of waiting on an actual decision for the inflammatory arthritis special issuance. I think if you're still in the "back and forth" stage where the FAA is still gathering information, this new stuff will come up somehow, and you'll have to go through a new rigamarole on clotting/bleeding (and may as well get started now).

If you're just waiting on the outcome of the SI, take what they give you, go BasicMed (assuming it fits your use case) and don't apply for another medical...

 

[TMV5423]

Hopefully the real experts will be along to answer shortly, but from an administrative standpoint, I hope you're in the final stages of waiting on an actual decision for the inflammatory arthritis special issuance. I think if you're still in the "back and forth" stage where the FAA is still gathering information, this new stuff will come up somehow, and you'll have to go through a new rigamarole on clotting/bleeding (and may as well get started now).

If you're just waiting on the outcome of the SI, take what they give you, go BasicMed (assuming it fits your use case) and don't apply for another medical...

thank you for the reply.
To clarify, I am in the final stages of waiting for my special issuance.

However, I also have aspirations of being a commercial pilot. I think I have to make a choice here of whether to take basicmed and a PPL or whether to maintain a first class medical and slog through the medical issues each year.

 

[Cervieres]

Make sure the diagnosis of DVT doesn’t end up in your chart. As you found out, not all clinicians know that superficial vein thrombosis and deep vein thrombosis are very different entities. I’m a little surprised you got Xarelto and a hypercoaguability workup for superfical thrombosis. It’s usually just NSAIDS and a warm compress.

 

[TMV5423]

Make sure the diagnosis of DVT doesn’t end up in your chart. As you found out, not all clinicians know that superficial vein thrombosis and deep vein thrombosis are very different entities. I’m a little surprised you got Xarelto and a hypercoaguability workup for superfical thrombosis. It’s usually just NSAIDS and a warm compress.

Well, my mother was with me in the ER and she insisted on blood thinners due to a family history on her side on blood clots.

As for the hypercoagulable workup, the hematologist tried to steer me away from it. However, I had a feeling that I might need it if word of this incident found its way to the Feds. So I insisted on that.

 

[Cervieres]

Since the hypercoag workup turned out negative, it was ultimately a good move, especially with a family history. Superfical thrombosis is common and generally inconsequential. Hope your SI goes fine.

 

[lbfjrmd]

what you describe is a reportable incident. get with your AME and discuss it.

 

[bbchien]

Yes you are. But when this episode is resolved, deal with that. Your situation is changing. As you are currently not authorized, gather the information (over time) required for getting this complcation issued, as well.

This pirncipally requires TIME.

 

[TMV5423]

Thank you to all of the pilots and doctors who took the time to give input.

I will stay patient and get through this new hurdle.

 

[EdFred]

Been through this sort of thing around 2 years ago. Different cause, but same manifestation. 4 years ago was the procedure I had done, and 2 years ago was the FAA boondoggle. Expect a letter saying "we can't determine your eligibility, please provide us information you already gave us because we are too stupid to know what we have."