AOPA Turbine Pilot Magazine - June 2020 - 26

FLY WELL

BY DR. JONATHAN M. SACKIER

Reading Camus
Taking stock of your health in uncertain times

DR. JONATHAN
SACKIER helps

members through
the AOPA Pilot
Protection Services
program.
aopa.org/pps

26 | AOPA PILOT June 2020

ALBERT CAMUS' STARK NOVEL The Plague was published in 1947. In this allegory, Dr. Bernard Rieux
recognizes and seeks to address an epidemic. Many of
his challenges ring true for us today.
COVID-19 has fundamentally changed the world,
and men seem to have a poorer prognosis than women.
It is unknown if this is a function of a weaker immune
system or because men have a higher incidence of health
issues, including heart disease or smoking-induced lung
damage. Men generally are less likely to attend to their
personal health, but those of us who are pilots must
undergo some level of evaluation, either personally or
with an aviation medical examiner (AME), to enjoy the
privilege of flight. Now is a good time to discuss fitness
to fly through the lens of this plague.
The level of medical evaluation depends on class of
medical required. Sport certificate holders need only
possess a valid driver's license, meaning they satisfy
Department of Motor Vehicles criteria such as no seizure
history and sufficiently good eyesight, and must selfassess they are fit to fly-just as every pilot must do prior
to every flight. One cannot stress this enough: Be honest with yourself and only fly if you are 100-percent fit.
Improving your general health by consuming a good diet,
exercising regularly, sleeping well, and avoiding tobacco
and too much alcohol will improve your immune system
and protect your heart and lungs, thereby helping you to
avoid illness and improving likelihood of recovery if sick.
A third class medical certificate is required for private, recreational, or student pilots, unless flying under
BasicMed. This lasts for 60 months below age 40 and 24
months above age 40, the duration reflecting a higher
likelihood of disease as we age. Other than completing
the MedXpress application, the airman will undergo a
physical examination and provide a urine sample. This
is tested with a "dipstick," a strip of plastic or paper with
around 10 chemically treated pads that react to the presence/absence of certain urine constituents. One obtains
results by comparing color changes to a standard reference chart. Among the tests are indicators of infection;
diabetes; and liver, kidney, or blood disease. I have previously recommended purchasing these online or from a
pharmacy and self-testing ahead of your AME appointment, so any aberrant result can be evaluated further
while self-grounded, and any necessary treatment

instituted and delays in obtaining clearance to fly obviated. And the chance to live longer enabled!
A second class medical is required for those pilots
wishing to exercise commercial pilot privileges and is
valid for 12 calendar months after the month of issuance.
A first class medical is required to serve as an airline
transport pilot. This expires 12 months from issuance
below age 40 and six months if age 40 and older. In
addition to the examination and urine tests, an electrocardiogram, or EKG, is added at age 35 and then yearly
after age 40.
Why the letter "K" and not "C"? Purportedly to prevent confusion with a brain test called an EEG. An EKG
provides a window into the heart and detects abnormalities of rhythm or poor blood supply that might
be totally asymptomatic. Better an abnormal test than
being permanently grounded, in the ground.
This system of physical evaluation is deployed to
limit the chance that medically compromised pilots
might unwittingly put themselves or their passengers at
risk. While an irritation to many, the principle is sound.
Obviously, flying low-power, small aircraft represents a
much lower risk to all concerned, hence the sensible and
well-used driver's license medical option for sport pilots.
Certain silent conditions can be picked up by a
diligent AME, avoiding an imminent stroke or other
life-threatening condition. For people who might otherwise never have a physical, the benefits are obvious.
The advantages of not waiting for your flight physical to have a vision and hearing test are clear: earlier
therapy and avoiding medical certification delays. FAA
guidance on blood pressure states that the systolic should
not exceed 155 mmHg and the diastolic, 95 mmHg. While
this may be fine from a regulatory medical perspective,
that is too high for most younger people and should be
addressed. So get your blood pressure checked regularly.
The pandemic may have limited your flying, so use
this time to think about your health and what you can do
to improve it. Although blood tests are not a component
of FAA medicals, they are a sensible part of a regular physical. Which reminds me, did you hear the one about the
chap who stayed up all night studying for his blood test?
Stay safe and be well.
AOPA
EMAIL DrJonathanSackier@gmail.com
http://www.aopa.org/pps
AOPA Turbine Pilot Magazine - June 2020

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