Aspiring pilot with single fainting incident, regaining medical certification?

[halvorka]

Hi All,

I'm seeking advice on behalf of my son, who is 17 and an aspiring pilot (he has 30+ flight hours and completed his first solo). Nobody in the family is a pilot, so our "network" of help/advice is very limited or nonexistent. Because of this, I think we already made several mistakes in how we handled his situation.

About 1 year ago he had an isolated fainting incident at home with brief loss of consciousness (~5-ish seconds). His flight instructor told us we had to report to FAA, so we did. He's been grounded since the incident, and it has been frustrating to say the least to try to figure out if/how/when he could ever get his medical back. His AME has been unhelpful. He went through a barrage of medical appointments with neurologists including MRI, MRA, EEG and neurology looked all "normal" with no evidence of any siezure disorder. Neurology referred to cardiology to investigate as a fainting incident. Cardiologist attributed the faint to a sudden drop of blood pressure from laying to quickly standing that he said was relatively common (esp. in tall and skinny teenage boys). Also said often outgrown after puberty and controllable by knowing the signs before fainting. Cardiologist had no concerns about it limiting any activities including driving and flying.

We sent all the information to FAA and his request for medical recertification (after 5 months) was outright rejected. No indication if it is permanent, or temporary, or what we would do as a next step. In the time since, our son has been totally healthy with no other incidents, physically active in running track and other sports. He has now been accepted into his top choice aeronautical college for flight training but there's so much uncertainty about his medical certification.

We do not know what step(s) to take next - is there a reasonable chance he can regain his medical certification (by Fall 2024)? What strategies would be best to pursue? I thought the fainting incident was "explained" by the cardiologist report but the FAA seemed to disagree. I appreciate any advice from those who know the system - I certainly do not.

Ken

 

[DE727UPS]

I had a similar thing happen about seven years ago. Mid-50's. Good health but not like your kid. The difference is my AME was super helpful and advocated for me with the FAA. I was out for maybe three months to prove it wasn't going to happen again. AME wrote a letter to the feds with an explanation and backed it up with evidence from the hospital (it happened in the ER) and was able to get my medical back with no special tests. Just the waiting period.

Since you've gone so far in the process without success, I'd get a consult at leftseat.com and see if they can come up with a better option. If you've done that already, I'm not sure what to tell you. Once the medical history with the feds is in the computer, it never goes away. Maybe, in time, find another AME that is more useful and will advocate based on time with no recurrence since the episode. Best of luck. The system is broken.

 

[CFI A&P]

Hi All,

I'm seeking advice on behalf of my son, who is 17 and an aspiring pilot (he has 30+ flight hours and completed his first solo). Nobody in the family is a pilot, so our "network" of help/advice is very limited or nonexistent. Because of this, I think we already made several mistakes in how we handled his situation.

About 1 year ago he had an isolated fainting incident at home with brief loss of consciousness (~5-ish seconds). His flight instructor told us we had to report to FAA, so we did. He's been grounded since the incident, and it has been frustrating to say the least to try to figure out if/how/when he could ever get his medical back. His AME has been unhelpful. He went through a barrage of medical appointments with neurologists including MRI, MRA, EEG and neurology looked all "normal" with no evidence of any siezure disorder. Neurology referred to cardiology to investigate as a fainting incident. Cardiologist attributed the faint to a sudden drop of blood pressure from laying to quickly standing that he said was relatively common (esp. in tall and skinny teenage boys). Also said often outgrown after puberty and controllable by knowing the signs before fainting. Cardiologist had no concerns about it limiting any activities including driving and flying.

We sent all the information to FAA and his request for medical recertification (after 5 months) was outright rejected. No indication if it is permanent, or temporary, or what we would do as a next step. In the time since, our son has been totally healthy with no other incidents, physically active in running track and other sports. He has now been accepted into his top choice aeronautical college for flight training but there's so much uncertainty about his medical certification.

We do not know what step(s) to take next - is there a reasonable chance he can regain his medical certification (by Fall 2024)? What strategies would be best to pursue? I thought the fainting incident was "explained" by the cardiologist report but the FAA seemed to disagree. I appreciate any advice from those who know the system - I certainly do not.

Ken

There are a few AMEs that specialize in difficult medicals, try contacting AMAS out of Colorado or Dr. Bruce Chien in Illinois.

 

[guywhoflies]

Where are you located? I know an AME in FL that is very good with special issuance medicals. His name is Dr. Francis Le, he is a cardiologist, and he serves on the Cardiology board for the FAA.

It sounds like your son has POTS. My wife has it, although she isn't trying to be a pilot. What you said about adolescents growing out of it is true, and hopefully your son doesn't experience another episode. I would tell him to really watch his electrolytes. My wife has a bad habit of drinking too much water, which throws her electrolytes out of whack, and then she starts feeling pretty terrible, up to and including passing out. She now drinks electrolyte beverages along with water, and that seems to help her. (Of course, talk to your son's doctor instead of taking medical advice from a random dude on the internet.)

Good luck! I hope your son can get cleared soon!

 

[halvorka]

Where are you located? I know an AME in FL that is very good with special issuance medicals. His name is Dr. Francis Le, he is a cardiologist, and he serves on the Cardiology board for the FAA.

It sounds like your son has POTS. My wife has it, although she isn't trying to be a pilot. What you said about adolescents growing out of it is true, and hopefully your son doesn't experience another episode. I would tell him to really watch his electrolytes. My wife has a bad habit of drinking too much water, which throws her electrolytes out of whack, and then she starts feeling pretty terrible, up to and including passing out. She now drinks electrolyte beverages along with water, and that seems to help her. (Of course, talk to your son's doctor instead of taking medical advice from a random dude on the internet.)

Good luck! I hope your son can get cleared soon!

Thank you, will look into that! His cardiologist also mentioned that he should increase salt intake, so very well might be similar to your wife's situation. We are in the northeast, but might be willing to travel if it's going to solve his issue.

 

[guywhoflies]

Salt definitely helps raise the blood pressure. My wife eats rather large chunks of Himalayan pink salt when she starts to feel "woozy". A couple other techniques to trick the body into raising it's blood pressure: an ice pack on the back of neck and drinking an ice cold beverage (water or electrolyte). Both of these will help prevent syncope.

I truly hope your son makes a full recovery and doesn't experience another episode. Good luck!

 

[TUCKnTRUCK]

It can be a challenge without a positive diagnosis- syncope can be attributed to a wide range of issues. Where in the North East? Alan Meckler is in NH and has some decent experience getting through them.

AOPA aeromedical may be able to help - largely with an unexplained loss of consciousness from my understanding it’s a two fold- testing and monitoring period. The rejection letter or appeal should offer some guidance.

 

[halvorka]

It can be a challenge without a positive diagnosis- syncope can be attributed to a wide range of issues. Where in the North East? Alan Meckler is in NH and has some decent experience getting through them.

AOPA aeromedical may be able to help - largely with an unexplained loss of consciousness from my understanding it’s a two fold- testing and monitoring period. The rejection letter or appeal should offer some guidance.

Thanks this is useful. I reached out to Dr. Meckler - we are in upstate NY but other people have advised going to Drs in FL and TX so NH is pretty reasonable by comparison.