AOPA Pilot Magazine - September 2014 - 22

FLY WELL

Is your wiring firing
correctly?

BY DR. JONATHAN M. SACKIER

Neurology knowledge for the pilot

DR. JONATHAN SACKIER

is a British-trained
medical professional and private
pilot who now lives
in Virginia.

DURING PREFLIGHT we check switches; inoperative
systems may be caused by defective items, blown fuses,
or dodgy wiring. But what if your wiring is the problem? Don't blow a fuse from overload; let's explore a
few common and interesting human wiring issues.
Our nervous system is astounding. Stimulating one
of our senses, electrical nerve impulses travel at light
speed, jumping across synapses-relays ensuring messages are delivered appropriately. The brain processes
information instantaneously, colored by prior experience, intellect, and instinct; appropriate action is taken.
This complex, elegant mechanism can be adversely
affected by internal problems or from adjacent or
supporting systems; the aviation corollary would be
a burned-out bulb for the former, or an exhaust hole
blowing hot gas onto a wiring bundle for the latter.
The brain is our flight computer and relies on a
good supply of well-oxygenated blood, otherwise
neurological problems ensue. Referring to that great
movie, as we magnificent men (and women) in our
flying machines go up, tiddly up, and hopefully come
down, tiddly down in organized and not chaotic fashion, ensuring there is oxygen for our blood to carry
is key. With age, heart function deteriorates, blood
vessels narrow, and lungs lose efficiency; all are exacerbated by being overweight, unfit, or smoking. So
even if you do not routinely use supplemental oxygen,
reconsider with each passing year, especially at night.
When tired or at altitude, if you notice narrowed visual
field, pins and needles, headache, or other sensations,
breathe oxygen, descend, and get examined for a precipitating cause. If symptoms recur or manifest on the
ground, get to a doctor "FAST"-Facial drooping, arm
weakness, speech difficulty-signs of a stroke, which
is brain damage from impaired blood supply.
Backache is common; a sedentary lifestyle, obesity,
and age all contribute. Spinal bony vertebrae are bound
together by tough, fibrous ligaments and separated by
spongy, resilient discs acting as shock absorbers. If a
disc outer core pops, its gelatin-like interior presses
on nerves traveling to and from the spinal cord. Disc
intrusion nerve damage produces symptoms in the
area served by that nerve such as numbness or a weak
foot. Such symptoms merit urgent attention, or damage might become permanent.

22 | AOPA PILOT September 2014

Diabetes is caused by glucose-processing issues,
but may induce wiring worries. For instance, diabetes is a frequent cause of blindness, and nerve damage
elsewhere may cause neuropathy-"sick nerves"-
experienced as severe, unremitting pain; loss of
bladder, bowel, or sexual function; and inability to
register touch. None of these is commensurate with
a long and happy flying career, so avoid diabetes like
the plague it is; eat well, exercise, watch your weight,
and have regular checkups.
Infections also can cause nerve nightmares. A common example is Lyme disease, caused by a black-legged
deer tick, which carries a bacteria, Borrelia burgdorferi.
Soon after a bite, a red, migrating "bulls-eye" rash may
appear. We doctors call that erythema migrans, which
is medispeak for "a red rash that migrates around the
body." Known for causing muscle and joint pains,
Lyme also produces Bell's palsy, facial nerve paralysis
where one side of the face droops. In regions and seasons where ticks abound, wear long pants and shirts;
apply bug spray; and check for ticks after a walk, carefully removing any with fine tweezers. If a fever or rash
develops, see your doctor for treatment.
Montel Williams, well known as a TV personality, was a decorated officer who considered a military
aviation career, but visual field disturbance issues
precluded him from flying. Eventually confirmed as
having multiple sclerosis (MS), he now deals with
gait and neuropathy symptoms. A disease usually
associated with Caucasian women, Montel's delayed
diagnosis was partly because as an African-American
male he did not fit the profile; his vision issues probably were an early indicator. The condition need not
preclude flight. Currently there are 49 first class, 15
second, and two third class medicals issued to pilots
with MS. Some MS drugs are allowable, although the
FAA does require documentation-a perfect place for
Pilot Protection Services to be helpful.
Prevention always is preferable; leading a healthy
lifestyle is paramount. If problems arise, seek help
early, deal with the problem, and then address how it
will impact flying-but do not give up. Montel said it
best: "I have MS but MS does not have me."
AOPA
EMAIL jonathan.sackier@aopa.org

AOPA Pilot Magazine - September 2014

Table of Contents for the Digital Edition of AOPA Pilot Magazine - September 2014