Migraine with aura -- any hope at all?

aircapybara

aircapybara

New Member
Hi y'all, so it's always been my dream to be an airline pilot, but unfortunately it seems as though it may not be possible. I suffer from migraines with aura, which I know are generally pretty much disqualifying. I was hoping (probably naively) that there might be some outside chance that I could get a special issuance in one of two ways:

1. Considering that the migraines are extremely infrequent (on the order of <1 a year, maybe 2 every 3 years), is there any chance I could get a special issuance because of that?

2. Is it possible to get on some sort of preventative medication (despite the relative rarity of my migraines) that would lower the odds of one occurring such that the FAA might grant a special issuance?

Thanks for your help!
 
alaskadrifter said:
Is there an official medical record of migraines? How do you know they aren’t just “really bad” headaches? I’m not saying you should lie to the FAA…
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I have been officially diagnosed with migraines and prescribed triptans for them as an abortive unfortunately. They aren't just really bad headaches since I do have visual symptoms (the disqualifying part). Frankly, I wouldn't want to skirt around the FAA here even if possible, as I think the rules are pretty justified -- if I got a migraine while flying, that would be no bueno. I'd have to land immediately and if I couldn't land within maybe ~30 minutes I would be incapacitated. However I think it's a difficult risk assessment, considering how rare they are. If I could lower the odds any more (through preventive medications normally only prescribed to ppl with chronic migraines, for example) I think it could be safe to fly. Maybe I'm just being desperate though, idk.
 
aircapybara said:
I have been officially diagnosed with migraines and prescribed triptans for them as an abortive unfortunately. They aren't just really bad headaches since I do have visual symptoms (the disqualifying part). Frankly, I wouldn't want to skirt around the FAA here even if possible, as I think the rules are pretty justified -- if I got a migraine while flying, that would be no bueno. I'd have to land immediately and if I couldn't land within maybe ~30 minutes I would be incapacitated. However I think it's a difficult risk assessment, considering how rare they are. If I could lower the odds any more (through preventive medications normally only prescribed to ppl with chronic migraines, for example) I think it could be safe to fly. Maybe I'm just being desperate though, idk.
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Do you know what your triggers are? For my wife’s “bad headaches” it was artificial sweeteners, strong scents like perfume, and MSG. If you do talk to an AME make sure they aren’t your primary care Dr. I wish I could be more help.
 
I was able to renew my 1st class medical after I started getting migraines a few years ago. However I have never taken any prescription medication for them so I don't know if that would make a difference.
 
Yakob said:
I was able to renew my 1st class medical after I started getting migraines a few years ago. However I have never taken any prescription medication for them so I don't know if that would make a difference.
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do you have aura with your migraines?
 
alaskadrifter said:
Do you know what your triggers are? For my wife’s “bad headaches” it was artificial sweeteners, strong scents like perfume, and MSG. If you do talk to an AME make sure they aren’t your primary care Dr. I wish I could be more help.
Click to expand...

unfortunately they're so infrequent its hard to pin down a trigger. currently my best guess is physical strain (i have a habit of clinching my jaw while lifting heavy stuff and ive noticed i sometimes get a migraine the next day) but honestly I have no idea for sure
 
Hi aircapybara,

As others have said, often migraines are triggered by something external, such as a type of food or a specific sleep pattern. I encourage my migraine patients to keep a food and sleep journal to see if they can identify a trigger pattern and then obviously limit that triggering stimulus. The good news is that for many, migraines can burn out and you may not have to deal with them forever.

On to your specific question. A disclaimer, this is only my interpretation of the rules. See the following link to the FAA CACI (meaning that the AME can issue):


Note that "classic migraine" is an acceptable migraine form for issue. Classic migraine by definition is migraine with aura. Also note that certain preventatives are allowed.

What I typically see in this situation is language in a letter from the FAA warning the airman not to fly if they are symptomatic. The final flight safety decision lies with the airman. I suppose in some circumstances the FAA may impose a special issuance on the certificate but I feel that a denial is unlikely.

Warm Regards,

Aaron Florkowski, MD
FAA designated Senior Aviation Medical Examiner
www.kansascityame.com
 
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