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BMI & OSA: New Hurdles To Jump Thru For Medical Certification

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stay on topic, please

Careful friends, this thread is getting very close to being shut down due to leaving the original topic and veering into the political realm.....
 
I have a simple non-political question that may have been answered previously - I haven't read all 11 pages. Does this BMI test apply to all medical classes (1st - 3rd)? I suppose I'll find out next month when I get my possibly last 1st class medical.

I tried Dr. Concannon's simple weight test and it agrees exactly with what my doctor tells me - "it wouldn't hurt you to loose about 10 pounds". I had a sleep study performed on me about 20 years ago at a hospital here in Cincy, where I had to spend the night in the hospital wired up like the six million dollar man. It was found then that I had no apnea or other muscle problems that were interfering with my sleep (I was dealing with insomnia). My question for Milt, or another doctor is, is one sleep apnea study good enough, or is there a statute of limitations? I think I know the answer, so I'm going to loose those 10 pounds.

Incidentally, my insomnia was caused by my bizarre sleep pattern flying international for Delta at the time. Insomnia is another bad one and if not medically disqualifying, it can have some very negative side effects. The answer for me was, don't fly international (trans-oceanic) anymore. Problem solved. Some pilots can handle it, but not me. I need my beauty rest.

Milt was a friend from long ago - I'd heed his free advice......
 
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Scott check your PMs

As for the hypothetical I think Brian or Mike S can best advise as to the process of evaluation, treatment and it's impact on your medical. In this area they are my "betters' as I have never been through the process, they have.
 
I tried Dr. Concannon's simple weight test and it agrees exactly with what my doctor tells me - "it wouldn't hurt you to loose about 10 pounds". I had a sleep study performed on me about 20 years ago at a hospital here in Cincy, where I had to spend the night in the hospital wired up like the six million dollar man. It was found then that I had no apnea or other muscle problems that were interfering with my sleep (I was dealing with insomnia). My question for Milt, or another doctor is, is one sleep apnea study good enough, or is there a statute of limitations? I think I know the answer, so I'm going to loose those 10 pounds.

Scott,

In reading what the FAA has published so far, I have not seen anything exempting any medical class(I through 3) and don't think there would be any rationale for doing so. Sleep studies, and probably you, have changed significantly over the past 20 years. Your original sleep study is going to be of no interest to them, this many years after.

Jim Berry
RV-10
 
Self diagnosed OSA

One doesn't really need a sleep study IMHO. When you go on a Mule Deer hunt and your buddies make you sleep outside the cabin in a van 50' from the house; you've got apnea. When your spouse/significant other jabs that bony elbow in your ribs screaming "shut the blank up"; you have apnea. When you wake yourself up snoring & have a raw throat; you have apnea.

Well, that's me. :( So I went to my Doctor and told him I wanted a CPAP (constant present air pressure) machine. He said I needed a sleep study so I could get the proper settings. I knew my sister's settings so I insisted on them. He gave in and wrote me a script when I assured him that if he didn't; I would go hire a couple of illegal aliens, get a bicycle pump, jury rig a mask and make my own stink'n CPAP machine. That seemed to convince him I was serious and he was kind enough to help me out.

I will tell you all that I now have 5 CPAP machines and am terrified at the thought of being without one. I sleep so sound & well now that I am unable to take a nap since using them.

Having said that, I am vehemently opposed to this FAA proposal. I have 4 pilot friends that I've been working judiciously on to get them re-engaged in flying. We were all hangar flying earlier in the week; and they are livid about this. So am I. More hoops to jump through. One was definitely fired up about a -4. Another wants a -6. The other two want Piper Cherokees. I'm truly afraid this may prevent them from renewing their aviation activities. I would fly with any one of them. We all commented on the fact that for us to arrive at our destination; we were driving vehicles on a 2 lane highway head on to oncoming traffic doing 70 mph and only separated by a yellow line and TRUST. :eek:

Geez folks, this proposal is just OUT of all proportions. ... thanks Sam & Doug for letting us continue this as I see it as one of the greatest threats to GA yet. I've been around for a long time; and I cannot recall being this concerned for our future.
 
"Snoring Is Not Necessarily Sleep Apnea"

"Snoring Is Not Necessarily Sleep Apnea"

This quote is taken directly from American Association of Oral and Maxillofacial Surgeons Site.

Just to clarify, there is and can be a difference.
 
Apples and Oranges ...

When your spouse/significant other jabs that bony elbow in your ribs screaming "shut the blank up"; you have apnea. When you wake yourself up snoring & have a raw throat; you have apnea.

I will tell you all that I now have 5 CPAP machines and am terrified at the thought of being without one. I sleep so sound & well now that I am unable to take a nap since using them..

Lots of folks cry before they try but few ever go back ..... what's that say ?

The random application of this new FAA policy is a completely different "abuse of power" subject. Mixing the two isn't very productive and tends to hide a real health issue that affects a lot of folks, not just pilots.

BTW, generally OSA is a symptom/result of other health related issues not a causal factor in and of itself.

Just another random .02
 
BTW, generally OSA is a symptom/result of other health related issues not a causal factor in and of itself.

Hmm...not sure the sleep medicine community would agree with that.

My sleep doctor specifically called this out as being a big misconception.

Most modern info on the subject claim all kinds of health conditions that can be a result of untreated OSA.

Make no mistake about it....Untreated OSA is bad stuff...
 
"Snoring Is Not Necessarily Sleep Apnea"

This quote is taken directly from American Association of Oral and Maxillofacial Surgeons Site.

Just to clarify, there is and can be a difference.

True but I am betting that if someone's snoring is significant enough that it bothers others, that there is 98% chance or more that they have some form of Apnea.
 
BTW, generally OSA is a symptom/result of other health related issues not a causal factor in and of itself.

Just another random .02

Maybe, maybe not. Because OSA occurs so frequently in the obese and other thick necked individuals, it is commonly thought that obesity is the cause. That may be exactly correct for many, but probably not all, of the obese. Since OSA also occurs in normal weight, and thin pencil-necked individuals, it is possible that there are multiple causes of OSA. Or, on the third hand, it may be that some people have a predisposition for OSA that is exacerbated by gaining weight; much like some people have a predisposition for diabetes that is triggered by weight gain.

That said, it really doesn't matter which is the chicken; which is the egg. Even if it doesn't cause you to crash your plane, untreated OSA is deadly. If you think you might have it, get tested. If you know you have it, get it treated.

Jim Berry
RV-10
 
Hmm...not sure the sleep medicine community would agree with that.

My sleep doctor specifically called this out as being a big misconception.

Most modern info on the subject claim all kinds of health conditions that can be a result of untreated OSA.

Make no mistake about it....Untreated OSA is bad stuff...

You're right of course but the message was just that OSA is "generally" caused/made worse by other health factors usually ( but not always) related to excess weight (similar to adult diabetes). It's a link in the chain of health issues each building upon the other. Most FAA Standard folks don't just wake up with OSA, its caused by one thing and then it becomes causal for the next link which is usually worse. If you just break the excess weight link, you don't eliminate the odds for OSA or adult diabetes but you sure improve them a lot!

Lucky us that we had the wake up call and it wasn't a stroke or worse. We're splitting hairs .... You said it 100% right .... Untreated OSA is just bad stuff !

All done ... And all said from experience with no medical expertise at all!
 
You understood perfectly well.

Milt, my comments were out of line and I sincerely and publicly wish to apologize for them. I am sure we are on the same side on this issue. One minor point of correction. It was 26 years and I must admit that 95% of it was a blast. The only way it could have been better is if I could have flown them more than the one ride that I got. Once again, please accept my apology.

Semper Fi

Tom
 
Here is a good graphic that represents what some major well known and trusted organizations are now preaching when it comes to obesity and its treatment for long term success....

fvb3ty.gif

Look at who made that pyramid diagram Ethicon Endo-Surgery, (Ethicon Endo-Surgery, Inc., a subsidiary of Johnson & Johnson, is a company that designs and manufactures medical devices and surgical instruments with the intent of minimizing the invasiveness of surgery.) They sell the very expensive surgical stapling systems that enable bariatric surgery to be done quickly and endoscopically (minimally invasive surgery ( keyhole surgery)). Therefore they have a financial incentive to promote bariatric surgery. Bariatric surgery is not without risks, while newer techniques which include using the products made by Ethicon and other companies have made bariatric surgery safer than before, but it still is major surgery with significant risk mortality and morbidity.

Having worked with patients before and after bariatric surgery, I think the choice to have surgery should be undertaken only when all other non surgical options have failed. Unfortunately too many patients do not make a serious attempt to loose weight with diet and exercise, and they lack the proper support to ensure success with diet and exercise, before choosing weight loss surgery.

The middle step pharmacotherapy is another problem area there are few good drug choices for promoting weight loss. The drugs with the best chance of working are the very addictive, amphetamines.
 
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Look at who made that pyramid diagram Ethicon Endo-Surgery, (Ethicon Endo-Surgery, Inc., a subsidiary of Johnson & Johnson, is a company that designs and manufactures medical devices and surgical instruments with the intent of minimizing the invasiveness of surgery.) They sell the very expensive surgical stapling systems that enable bariatric surgery to be done quickly and endoscopically (minimally invasive surgery ( keyhole surgery)). Therefore they have a financial incentive to promote bariatric surgery. Bariatric surgery is not without risks, while newer techniques which include using the products made by Ethicon and other companies have made bariatric surgery safer than before, but it still is major surgery with significant risk mortality and morbidity.

Having worked with patients before and after bariatric surgery, I think the choice to have surgery should be undertaken only when all other non surgical options have failed. Unfortunately too many patients do not make a serious attempt to loose weight with diet and exercise, and they lack the proper support to ensure success with diet and exercise, before choosing weight loss surgery.

This pyramid is almost universally used by those that specialize in weight related issues both surgical and non surgical. I just pulled the first graphic I saw on Google.

With all surgery comes risk. Many common and what people call everyday surgeries also carry a significant risk for mortality and morbidity. Many even more so than bariatric options. What are the risk associated with morbid obesity?

Obesity is an epidemic in the USA. Just look around. I would argue that in more cases than not, this epidemic is fueled by the old school advice that is handed out by the average PCP and NUT.

Anyway... time to close this thread. We are not here to treat obesity. There are millions of forums for that.
 
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