What were the alternatives? Well, I could have started taking a serious dose of aspirin, get down to lower elevation, get some offshore coumadin and run a PT-inr test at home for six months. Of course, I wouldn't have the benefit of knowing where the clot was, and how dangerous it was but that could have been done. Of course, that's not the appropriate way to deal with medical issues, but with the increase in costs, and the complete hassle that the medical industry has become, I was actually considering it, as I had a very good idea that my diagnosis was correct.
A little knowledge is a dangerous thing.
In the past year I have lost two friends. The first self diagnosed her acute gallbladder and decided to finally get scanned at work one night. Stage 4 ovarian cancer. She had been an ER physician for about 20 years, and one of the smartest people I have known.
The second made several comments to his staff one morning about being short of breath after a minor fall at home over the weekend. His office stuff jokingly told him it was a PE. He had a full clinic that morning and did not feel it was worth getting checked. He was found dead in his office by his nurse after lunch. He had been a trauma surgeon (and faculty at a local medical school) for almost 30 years. It was, in fact, a PE.
"We are practitioners of medicine, not consumers."
Read 67.313 and get back to me. The medical officers will say you have some 'splaining to do if you went flying without their blessing.
When you have four out of five consequitive INRs in the 2.0 to 3.0 range, you send your current status letter (you DO have a treating doc who isn't YOU, no?) telling the story, the results of the Protein A and C assays, and the INR values and ask for a Special.
Or you you could let someone who knows if it's going to go well at the agency look at it before sending anything to the agency, tell you whether to just step down to LSA and say the heck with it, rather than risk a denial. 'Lotta variables here.
Hey I'm just glad you didn't have the "big one" while waiting, procrastinating.....the other night.
To the MDs who've provided mostly non-judgmental advice, thank you, I've found it useful, and I'm following it. This will be my last post EVER in this sub-forum.
Nothing gray about it. You need his blessing before you fly again. You only wish it to be gray.OP here: Yeah - that's the reg I found before, when I referenced that there's gray areas. How is an amateur to know what the Fed air surgeon reasonably considers grounding? Of course, with my specific history, and knowing what I know from that episode, it would be a grounding event. It's still interpretive, but the tea leaves to seem to indicate that the clot is an organic defect that MAY(hate those kind) make it unable to perform those duties....
The Federal Air surgeon. the mere existence of 67.313 tells you that 61.53 is superceeded.OTOH, I MAY be able to perform those duties just find for the duration. Who's to say?
That's fine.I don't know anyone in the med branch. I have an appt with my internist this week, and my PT-inr is being taken on Mon.
At this point, I'm leaning toward LSA because if I do send it in, and the data isn't to their liking, that as they say, is the end of that(except for UL).
Is the real problem that you are too cheap to hire someone who can accurately tell you if your stuff will win approval? I mean, its just barely into 3 figures! I suppose to each his own. But after a homily like that I'd sure be reluctant to be that person.....~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
I've defended my decision to handle things the way I did. Knowing that it would stir some resentment, and frustration and/or anger. None of you were there. You don't have the history with the medical profession that I have. You know about me, and my situation only what I've told you, nothing more. There are MDs here who never make mistakes, never misdiagnose, and never mis-treat symptoms. They are the most perfect MDs ever, and I'm certain that any negative outcomes, are the result or fault of the patient. Now, all facetiousness aside, I have both a healthy respect, and a healthy mistrust working about some aspects of the profession.
We've heard a few homilies, about this or that person dying because they didn't seek or get treatment right away. Stubbornness is the common denominator, but I'd like you to consider that maybe, in some cases, that's not the only thing going on. Who knows, the patient is now dead. Why do somewhat rational people stay away from being treated? Why would a person with pain or some indication of a problem not seek out the diagnosis right away? You all know what a hypochondriac is, what do you call a person who is the opposite?
MDs are afforded and in most cases deserve the respect that we give. However, none of them are perfect, for if they were, there wouldn't be a need for any M&M conferences.
None of this is in any way an excuse for not seeking medical treatment. MDs are skilled at the kind of stuff I'm an amateur at in their field. I wouldn't expect them to be an expert in my fief, and I'm pretty good at what I do. I've made mistakes though, and those mistakes lead to unpredictable outcomes that can have negative consequences. Apparently, this 'concern' I have is shared by some within the MD community. In fact, I know a OB/GYN, who would do the same as I did, and he's been in the 'biz' for 30 years. When I called him, his advice was the same, and I had already decided to go once he called me back. In fact, I was already on the way to the ER when we spoke.
To the MDs who've provided mostly non-judgmental advice, thank you, I've found it useful, and I'm following it. This will be my last post EVER in this sub-forum.
Email Dr Bruce Chien through this site, or google him for his web page and contact him directly. He can counsel you on the process for keeping your medical certification, or if you go without, at least how to be smart about it.
Randy, the spec. is officialy worded: 4/5 REAGULARLY SPACED INRs between 2.0 and 3.0. So if you are testing weekly, you can get this done pretty quick. A word to the wise, however, you have to have dietary discipline and eat the same amount of greens day by day over time, or it becomes impossible to do.
If you have that, the earliest you can apply after a DVT is 60 days. I would take the weekly values and run with it (e.g, reapply) before you get one out of "the slot"....if you have it.
You will need a current office visit from your doc saying completely resolved without sequelae, no swelling nor tenderness in the calf, etc. As you had chest symptoms the signoff needs come from a pulmonologist. You will need the doctors' hospital Discharge Summary AND the VQ scan, d-dimer-that's all in the hospital record. For the first episode, they will not insist that you remain on an anticoagulant (after the 6th month). For the second episode, you need Protein C, Protein A Leiden factor V workup and a hematologist's commentary.
Randy, the spec. is officialy worded: 4/5 REGULARLY SPACED INRs between 2.0 and 3.0. So if you are testing weekly, you can get this done pretty quick. A word to the wise, however, you have to have dietary discipline and eat the same amount of greens day by day over time, or it becomes impossible to do.
If you have that, the earliest you can apply after a DVT is 60 days. I would take the weekly values and run with it (e.g, reapply) before you get one out of "the slot"....if you have it.
You will need a current office visit from your doc saying completely resolved without sequelae, no swelling nor tenderness in the calf, etc. As you had chest symptoms the signoff needs come from a pulmonologist. You will need the doctors' hospital Discharge Summary AND the VQ scan, d-dimer-that's all in the hospital record. For the first episode, they will not insist that you remain on an anticoagulant (after the 6th month). For the second episode, you need Protein C, Protein A Leiden factor V workup and a hematologist's commentary.
I have thought about this too in the event I ever need it (and welcome informed answers, unlike mine) but I concluded that there is only so much reasonable "patient direction" to your own health care that will be tolerated (without there being other consequences).is there anything the pilot should ask for/request to avoid in order to prevent OKC from becoming a royal pain in the arse?
Randy, the spec. is officialy worded: 4/5 REGULARLY SPACED INRs between 2.0 and 3.0. So if you are testing weekly, you can get this done pretty quick. A word to the wise, however, you have to have dietary discipline and eat the same amount of greens day by day over time, or it becomes impossible to do.
If you have that, the earliest you can apply after a DVT is 60 days. I would take the weekly values and run with it (e.g, reapply) before you get one out of "the slot"....if you have it.
You will need a current office visit from your doc saying completely resolved without sequelae, no swelling nor tenderness in the calf, etc. As you had chest symptoms the signoff needs come from a pulmonologist. You will need the doctors' hospital Discharge Summary AND the VQ scan, d-dimer-that's all in the hospital record. For the first episode, they will not insist that you remain on an anticoagulant (after the 6th month). For the second episode, you need Protein C, Protein A Leiden factor V workup and a hematologist's commentary.
Okay I'm going to revisit this since the Basic Med process is now a thing.
Current situation: after several months of being off of Warfarin treatment, I've had another episode of PE's. They did not originate from DVT's. I caught it early enough that it wasn't a major crisis like the first time. Now....
I'm on blood thinners for life. After another initial Lovenox treatment, they put me on Pradaxa (INR's are now irrelevant.) I have consulted with a local AME, and informed that a) the local AME would neither perform Basic Med exams, nor did the AME have a definitive answer on whether I could do Basic Med in lieu of a SI third class, and b) that the door was not closed on the possibility of receiving an SI. That is a route for which I could pursue but it would take a lot of work.
So, given that, is Basic Med currently an option for me, in lieu of a third class SI?
If it does then you need a one-time SI before flying under BasicMed. If not then you need to have held a medical since at least July 15, 2006, your last medical cannot have have been been revoked, withdrawn, or suspended, and your last application for a medical cannot have been completed and denied.(3) A cardiovascular condition, limited to a one-time special issuance for each diagnosis of the following:
- Myocardial infarction;
- Coronary heart disease that has required treatment;
- Cardiac valve replacement; or
- Heart replacement.
Okay I'm going to revisit this since the Basic Med process is now a thing.
Current situation: after several months of being off of Warfarin treatment, I've had another episode of PE's. They did not originate from DVT's. I caught it early enough that it wasn't a major crisis like the first time. Now....
I'm on blood thinners for life. After another initial Lovenox treatment, they put me on Pradaxa (INR's are now irrelevant.) I have consulted with a local AME, and informed that a) the local AME would neither perform Basic Med exams, nor did the AME have a definitive answer on whether I could do Basic Med in lieu of a SI third class, and b) that the door was not closed on the possibility of receiving an SI. That is a route for which I could pursue but it would take a lot of work.
So, given that, is Basic Med currently an option for me, in lieu of a third class SI?
Okay I'm going to revisit this since the Basic Med process is now a thing.
Current situation: after several months of being off of Warfarin treatment, I've had another episode of PE's. They did not originate from DVT's. I caught it early enough that it wasn't a major crisis like the first time. Now....
I'm on blood thinners for life. After another initial Lovenox treatment, they put me on Pradaxa (INR's are now irrelevant.) I have consulted with a local AME, and informed that a) the local AME would neither perform Basic Med exams, nor did the AME have a definitive answer on whether I could do Basic Med in lieu of a SI third class, and b) that the door was not closed on the possibility of receiving an SI. That is a route for which I could pursue but it would take a lot of work.
So, given that, is Basic Med currently an option for me, in lieu of a third class SI?