Bum ticker? Really?

[Duck_Twacy]

My 1st class was denied this morning. I turned 35 in October so this was the first time I was required to take an EKG. The synopsis at the top says:

"Sinus rhythm with borderline 1st degree A-V block. Inferior/lateral T changes may be due to myocardial ischemia."

None of that sounds good, but I was naturally shocked to be denied. I guess perfectly healthy young people drop dead every day, but I've never had any prior symptoms, eat right (except for my coffee addiction) and work out intensely 5 days a week.

I'm working with ALPA medical in Denver, my physician, and the AME in question, but wanted to see if there was anything additional you could offer that would be helpful/encouraging. My wife's co-workers were quick to denounce the EKG as unreliable, all telling stories of false positives they've received. I wasn't very confident in the clinician performing the test - she seemed unsure of exactly how to hook me up and had troubles with the printout and transmitting it to the FAA - but if they are so terrible why use them? What else should I be doing? Can I get a 2nd opinion? Naturally, I'm freaking out for a number of reasons....

 

[My Flight Surgeon]

Was it denied or did the AME defer it? The 1st degree AV block is considered normal and I suspect the T-wave changes may be early repolarization that is alos normal. Wait for the FAA to let you know. My experience is that if there is an abnormal ECG, they request a cardiovascular evaluation to get you cleared.

Life is not over yet

 

[Duck_Twacy]

He said he had to defer it, I take it there is a difference?

I did some reading on 1st degree AV block last night, and it doesn't sound too serious, in fact, it said in many well trained athletes the signal interval from from the atria to the ventricle can be longer, triggering the result (not saying I fall in that category).

The AME gave me a list of things the FAA would want to see, including fasting blood work and a ETT cardiolite [sp] test. I'm trying to be aggressive with this, so I had the blood work done this morning and the stress test is tomorrow. Does this sound like the correct course of action?

 

[My Flight Surgeon]

It sounds like the way to go if there is an issue. The first degree AV block is considered normal by the FAA. If you are going to get a cardiac evaluation, the FAA will want http://www.faa.gov/about/office_org...isease_prot/cardiovascular/index.cfm?print=go and http://www.faa.gov/about/office_org...sease_prot/graded_exercise/index.cfm?print=go. The cardiolyte is a great test that includes the stress test. It is important on the stress test to get to 100% of maximal predicted heart rate (220-age).

Let us know what happens.

 

[Duck_Twacy]

Took a stress echo test today, and according to my nurse everything looks normal. She said as soon as I started walking on the treadmill my ECG normalized. Guess my heart is just bored at rest

She was very thorough. She recommended the stress echo because as soon as she looked at my original ECG she noticed an ST wave abnormality (I'm probably butchering the terminology) at rest, which requires either a echo or the nuclear test. She advised against the nuclear test because a false positive would then require a cath (which is what ALPA medical said too). Once I was on the treadmill, because it normalized she said she could have gotten away with just the stress test, but it wouldn't hurt to do the echo anyway.

Now I'm furious that the original AME didn't just hold my medical, because I'd have it in my hands right now, by the end of the month, but what can you do...well, wait for the FAA I guess.

Thanks!

 

[My Flight Surgeon]

At least it is good news.

I don't know how many flight physicals this AME does but those who do 50+ a month are more comfortable with either holding the medical for the test results or in just issuing. They also know how the FAA looks at things because they deal with them more.

 

[moxiepilot]

Good to hear that your career is not over, DT.

 

[bafanguy]

.
I wasn't very confident in the clinician performing the test - she seemed unsure of exactly how to hook me up and had troubles with the printout and transmitting it to the FAA - but if they are so terrible why use them? Naturally, I'm freaking out for a number of reasons....

Duck,

Been watching your story and really feel bad you're going through this thing. Sounds like you'll have a good outcome...hope so.

They do EKGs because they do EKGs...life in the Big City. And, I bet you are freaking out. They'd have to tie me down someplace if I'd had your experience.

Maybe you have the condition in question; maybe you don't.

Your first clue should have been when Little Nursey Lursey fumbled with the EKG leads. That's when you should have called a halt and asked to see the doc. You're not some slab of meat; it's your ticket and when you go to some busy doc's office, you're likely to be run through the "easy money" mill. That'll probably work most of the time but when the office staff fumble, it's time to stop the show. Your story isn't unique.

I say stay away from busy doc's offices where they understandably do FAA physicals for the easy money. Go to the av med specialist...who "gets it".

Sure hope you turn OK. Report back...and find another AME. :bandit: