Four No-brainer Health Tips Almost Every Pilot Forgets

Is it a pilot’s health matter or passengers’ safety matter?

Based on psychology it is known for centuries that you are what you eat so we don’t need to mention that health is the most crucial element in someone’s life. So we can see now the importance of a healthy pilot, which goes beyond the personal side to approaches the sides of people whom he is transporting.

In other words, a pilot can’t fly if he doesn’t feel good as a result he must take care of his health. Imagine this; you are drinking alcohol, eating so much fast food, lazy, smoking, and just few hours later you are obliged to carry hundreds of bags and deliver them as fast as you can but under one condition; the delivered items must be handed out safely, Can you do this task? Normally and under the pressure of not handling properly your health you won’t be able to accomplish the task, so we can see it clearly now, how can a pilot fly if he is not healthy, that will undoubtedly be unsafe for the passengers.

So, unhealthy aspects shape together several advices for a good pilot’s health, these advices are exposed as the following tips;

Don’t smoke

as it is proven by so many professional studies; smoking decreases the level of concentration, and a non-concentrated pilot will be absolutely not needed in this industry. Moreover smoking always makes it hard to breathe which causes the full concentration on next breath. Not to mention the massive number of diseases that can be caused by smoking and a pilot won’t definitely want them.

Avoid a lot of sitting

being physically active is the key for a healthy life, ones a pilot is active his concentration levels will automatically increase and the urge to bad health habits will disappear. And that have a really close relation with sickness; active body is the cure to a sick body; in this sense we can clearly notice that increased physical activity means low sickness potentials. Being active is simpler than you can imagine, just by avoiding a lot of sitting and sleeping directly after eating instead you may have a walk and enjoy the weather or the company. It is so easy to be lazy but it’s easier to be active, just try to break up your relationship with television and explore the world.

Keep your brain always active

being mentally active is as important and being physically active, how can a car work without engine, is the same situation for a brain, and pilot is obliged to have enough fuel for his brain as it is the first factor that make his reactions effective. A pilot’s brain can be easily active by reading, talking to people, learning and also by debating and these activities will definitely take you away from television, that tool that hypnotizes you brain and thoughts and stops its development forward.

Eating habits

will this tip can be generally approved by anyone but for pilots without this tip that completes the previous ones it looks like a piece is missing and the full body can work without it. And as learning fuels a pilot’s brain, food fuels a pilot’s body so it is a relation of balance and complementariness. So pilots must watch out what the eat and if it tastes good then it is no good for you dear pilot

These tips institute one unit homogeneous to give a chance for a pilot to be identical to the shape of a perfect pilot, and as I wrote this article I believe that these simple tips will guide a pilot to build a good health. And before I sum up I recommend consulting the doctor before making any changes according to your health just for your safety we definitely don’t want to hurt a pilot. As a last word I will say live healthy and have unlimited flies dear pilot!

“Miracle on the Hudson” … and the “Sully” movie

Ray Basri, MD, FACP on the day Miracle on Hudson with survivors

Ray Basri, MD, FACP on the day Miracle on Hudson with survivors

Ray Basri MD, FACP with Mayor Bloomberg in NYC after the plane crash, Miracle on Hudson

Ray Basri MD, FACP with Mayor Bloomberg in NYC after the plane crash, Miracle on Hudson

Sully, the movie is being released in a couple of weeks. I’m asked if I’m in it.
Short answer, no. Disappointed? A bit. So how did this big Hollywood movie with Tom Hanks and made by Clint Eastwood miss my role of a lifetime?

My guess is that they cut me in editing the film and I’m on some acetate lying in a dumpster. My version of the story is that I was there in fact and did make the reality version of “Miracle on the Hudson”.

For those that didn’t read my chapter in “Brace for Impact”, I did respond to the scene of the rescue being the first and only physician there. I did so after being broadsided by an NYPD truck and still limped over to help.

When I got there, the first passengers and crew were coming into the passenger ferry terminal on the West Side of Manhattan. I sent the injured stewardess to the hospital by ambulance and met the rest of the flight crew, Sully and Capt. Jeff Skiles before all the passengers were accounted for.

Not to miss my other job as a Senior Aviation Medical Examiner for the FAA, I called the regional flight surgeon and the Federal Air Surgeon to let them know that everyone was safe when they didn’t even know any plane was down in the Hudson.

But most “too good to be true” part was that 2 of my neighbors were passengers on the plane. Diane Higgins and her mother Lulu were the last passengers off the plane. They were my connection to the event more than anything.

So in the movie “Sully”, Diane Higgins is listed in the cast as being played by Valerie Mahaffey. There is a doctor listed in the cast as “Dr. Elizabeth Davis” being played by Anna Gunn. being played by Anna Gunn.

However, there is no “Dr. Elizabeth Davis” and I get no mention. I was hoping to have Brad Pitt take my part but they made it a woman. So there is a fictional doctor being played by an actress.

That’s my claim to Hollywood Legend and I’m sticking to it.
Should be a great flick. Hope you all see it on the big screen.

THE BASRI DIET – THE OTHER PASSOVER DIET

healthy eating

yet another Passover diet

 

THE BASRI DIET – THE OTHER PASSOVER DIET

I’m going to ask you not to eat four things.

If you don’t eat these three things, you will lose a lot of weight.

But you must adhere to the diet 100% — not 90% or 95%.

But it’s a simple diet.  It’s very straightforward.  You can go into a restaurant, look at the menu and easily know what you may or may not eat.

If you stay on the diet for 30 days, following it completely, with no exceptions, you will have excellent results.

The four things you cannot eat are:

1) Yeast or dough — This means no bread, cake, cookies, pasta, crackers, pizza, or anything with dough or a crust. You cannot have whole wheat or wraps because they are made with yeast and dough.

2) Potato. Do not eat anything to do with potatoes

There is more…

You can order full copy of the book here:

“e-book”

“Print Book”

 

 

 

The Injured Workers’ Bar Association, Inc. (IWBA’s) 2015 Fall CLE Conference at Saratoga Springs, New York

The Injured Workers’ Bar Association, Inc. (IWBA’s) 2015 Fall CLE Conference was held this weekend September 18-19, 2015  in Sarratoga Springs, NY.

About IWBA – The Injured Workers’ Bar Association, Inc

The Injured Workers’ Bar Association, established January 7, 1997, is comprised of attorneys from throughout New York State who concentrate their practice in representation of injured workers. Continue reading

Balloons Festival

This weekend balloon festival was a unique experience bringing together aviation, photography, beautiful sunsets, and ballooning.

The weather in mid July could not have been better. It was clear bright sunshine and warm. When the balloons took flight at 7 PM there was a setting sun and a gentle breeze from the west.

I came to learn that evening from the public address announcer that there was $100,000 competition for accuracy and blooming. Apparently the first plane to take off is the lead balloon in Marks and ask where it lands. The Chase balloons then try to drop a bag as close as they can to that X. I think this is serious prize money and would love to see some video footage.

The worry numerable balloons and some were quite memorable. There was the cat and Darth Vader. There was a huge American flag and my personal favorite is strawberry.

That’s because the owner and pilot of the strawberry is a friend and commercial pilot. Rich Wiedenhaefer invited me to join his chase team which I hoped would let me see the preflight.
It was choreographed beautifully.

Balloon Festival

Each balloon would carry passengers who booked tickets through the promoter. There were two tethered balloons at the site that would take passengers 100 feet in the air for five minutes.

All the balloons took flight over a half an hour beginning at 7 PM. Most stayed fairly low to the ground and were only partially visible as they moved 3 to 4 miles from the field. There were a good number of balloons that had a higher flight profile.

I’m sure everyone was smiling as brightly as I was. It was like seeing a triple rainbow or a performance by the Blue Angels.

It was a perfect evening midsummer warm and as I was told we were lucky that The fields were not muddy as they had been in some previous years.

Balloons came from all over the East Coast and I was amazed at the variation and balloons. I would highly recommend going next year to this balloon festival in mid July.

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Aeromedical Certification after alcohol or drug infractions *****8500-8 Section 18.v.

FAA Medical Exam

FAA Medical Exam

Aviators are a special breed, often close to adventure and active socially. When they are not flying, they may be subject to indiscretion and bad choices. A few may be involved in an incident involving alcohol or drug abuse that becomes a police matter.These are very serious situations both for the individual’s health and well-being, family, and aviation certification. The FAA medical application Form 8500 screens for these two issues in item 18 V

if there have been any administrative proceedings, arrests or convictions.

Many times the infraction involves driving a motor vehicle after consuming alcohol.  While drug offenses are far less common, they clearly pose a very significant issue for medical certification. Pilots that use narcotics clearly cross a boundary of good judgment. A history of substance dependence is disqualifying and requires review by the Federal Air Surgeon.

The FAA routinely reviews every Medxpress application for alcohol offenses in every state department of motor vehicle databases. This is also true for all criminal arrest and convictions for drug related offenses.  Failure of the aviator to disclose these issues on the era medical certification examination also constitutes grounds for administrative and criminal proceedings for falsifying the application.

The FAA says that a single arrest or conviction for driving while intoxicated will not be grounds for denial.  However it will trigger the aviation medical examiner (AME) to defer if adequate documentation is not provided to the AME within 14 days of the examination.  Necessary documentation includes a number of criteria that must be met to reach the threshold for issuance by the AME.Often the next step will be a review by the Aeromedical Certification Division in Oklahoma City. The pilot will receive a letter from them within a couple of weeks asking for documentation as to the offense:

  • the legal proceedings such as court records and arrest reports
  • a detailed personal statement as to the history of alcohol use and any legal matters related to it
  • a complete copy of the driving record for the last 10 years in any state where the individual has held a motor vehicle license
  • a substance abuse evaluation by a psychologist, psychiatrist, or addiction specialist

The FAA has a protocol in assessing the severity of alcohol related motor vehicle offenses. The number of offenses is a crucial factor in the review.  Having more than one is an indicator of a pattern of abuse and disregard for the law.

The FAA has a worse view of individuals that refuse to cooperate with authorities to obtain a blood alcohol level. So simply refusing to take the test creates assumptions that are worse for gaining certification.

Another key issue is a blood alcohol level at the time of the arrest. Usually a driver suspected of driving while impaired will be given a field sobriety test or breathalyzer.  The next step is a blood specimen which is the gold standard.  In most states the threshold for impairment is 0.08 mg/dL of alcohol.

The FAA looks at a blood alcohol level greater than 0.16 mg/dL as indicating a more severe alcohol problem. The FAA views this threshold of double the legal limit more closely for three reasons.

  • First, it indicates that the aviator was operating a motor vehicle with enough alcohol to show a significant impairment in judgment.
  • Second, that driver probably had some degree of chronic alcoholism such that their level of comfort driving was a practiced behavior.
  • Third, this would indicate that the arrest was somewhat random and there were other times that the individual thought they could drive while impaired.

So the blood-alcohol threshold of 0.16 mg/dL will open the FAA investigation to a more thorough review of the potential for chronic alcohol abuse. The in-depth review of legal and medical records and a new psychological profile will be necessary for the recertification.

When I review the medical application with a new DWI offense, I try to counsel the aviator that they need to be cooperative and proactive. They will need to provide the necessary documentation and immediately begin to put together that package of reports and legal forms.

As with other medical issues, the FAA needs to do a thorough review before recertification. However as I said before, a high blood alcohol level indicates a more chronic pattern of abuse or that there is a disregard for the safety of others.

The FAA can also mandate that a pilot go to a recognized expert in the field that they will designate. These examinations are quite comprehensive and go beyond the issue of alcohol use. They are truly global psychological evaluations that encompass underlying motivation, personality, and cognitive function.

Commercial airline pilots can ask their employers and unions to access dedicated counseling and assistance programs. Aviators with alcohol related issues also have programs in the FAA has its own HIMS program.

Aeromedical Deliberations in the Germanwings Tragedy

Germanwings crash 4U 9525

Germanwings crash 4U 9525

The Germanwings tragedy this week brought to the forefront the mental health assessment for commercial airmen.  There are reports that the copilot had another serious health issue with his vision.   I would like to raise the possibility that there is a connection between the suicide, mental health issues, change in vision, and perhaps a brain tumor that was not detected.

Flight surgeons and aviation authorities will seek to avert another tragedy if airmen with serious mental health issues continue to fly.   My expertise as a senior aviation medical examiner over the last 27 years with thousands of commercial airmen gives me some perspective on the screening process in the United States. I have also attended European aviation conferences some of which were sponsored by the Lufthansa aeromedical service.

Commercial airline pilots have both physical and mental examination to maintain their medical certification every six months after the age of forty and younger airmen are examined every year.

The basic examination is straightforward. The pilot completes an online medical application containing a detailed health questionnaire that includes medications, doctors’ visits, and arrests or legal infractions. The airmen are also expected to self-report if there any mental health issues by answering if they have had any visits with psychologist or psychiatrist we’re taking any medication.  These questions are answered every six months and are often one of the tripwires to detecting a pilot with alcohol or drug problems. Airmen are required by law to answer truthfully. There is an exchange between the FAA database and government registries for serious driving offenses such as DWI and DUI infractions.

The physical examination is comprehensive particularly involving vision.  There is a urine analysis but it is not a toxicology screen or drug screen.  The FAA monitors the online questionnaire and the medical examination so that all medical certifications are confirmed by their medical staff in both the federal medical division in Oklahoma City and by the regional flight surgeons.

My ability to detect emotional or psychological instability is fundamentally based in detecting any aberration in their well-being. Many airmen come twice a year, often for the duration of their professional career. While there is no specific mental status examination that is a routine part of the examination, I do engage the pilot in conversation asking their schedule and days off. I look for eye contact, facial expressions, and in particular, the facial muscles will reveal their state of mind. Simple questions such as when they last flew and their next trip gives me some indication of stress or fatigue.  I like to ask about family, kids, and vacations.  Sometimes this leads to news of divorce or an illness in the family. Sometimes I find out through there are financial problems or a need to relocate.

At times airmen are based in another city from where they live. This requires them to commute to an airport far from home. This situation contributed to the Colgan Air Flight 3407 in February 2009 in Buffalo, NY. The extra travel can make their workday extremely long and stressful. New duty rules adopted after the Colgan Air mishap addressed some of these concerns but airmen are often have non-restorative sleep by traveling through many time zones without proper acclimation.  Commercial airline pilots may be away from home for several days at a time while some airmen flying a corporate jet maybe away for 2 to 3 weeks.

I am intrigued by the constellation of symptoms of altered personality, depression, and some vision disturbance that may affect his ability to continue as a professional pilot.  Why would a commercial airline pilot intentionally committed suicide and murdered 149 other souls. Is there a common medical causation to explain these findings?  We should have a high index of suspicion when there is a new illness and subtle neurologic changes are currently in an individual who was otherwise asymptomatic.

There are three health issues currently being mentioned in the news: mental illness, personality disorder, and vision difficulty.  Each of them occurs sporadically in the general population. However some conditions are more likely in his mid-20s age group. One of the most common conditions is the onset of schizophrenia. While there may have been significant mental health issues previously, we don’t have enough detail to know if he fits the criteria for new onset schizophrenia. However the manifestations of schizophrenia include auditory or visual hallucinations. Features of paranoia are also well-known.

The personality disorder has features which may correspond to the disrupted social relations that a young adult would experience at the onset of schizophrenia. It is difficult to maintain personal relationships and there is often an element of paranoia or a tendency to distrust a close friend or family.  Hence reports in the media of his girlfriends’ ending relationships.

The incidence of mood disorders is also compatible with news reports and are a common mental health issue in this age group. Frequently this takes the form of an anxiety or panic disorder. They may self-medicate either self-medicate with alcohol or through a prescription that is not revealed to authorities such anxiolytic drugs such as Xanax or Valium.

A severe form of a mood disorder may be major depression. This condition likely to affect somebody attempting suicide.  These individuals typically have dysfunctional social interactions and would have a great deal of difficulty maintaining an uninterrupted work schedule.

News reports indicate that he appeared physically healthy. He also had an eye disorder.  If he was to self-report visual disturbances, the most common would be blurred vision, double vision, or loss of peripheral vision. Proper examination by a medical doctor or ophthalmologist could reveal the disorder. Some reports have said that he had a problem with his lens. This condition may have been floppy lens has been associated with Marfan’s syndrome. This condition has been associated rarely with familial mental disorders such as schizophrenia and personality disorders.

If we consider structural abnormalities of the brain or organic brain lesions we should consider the ideology as emanating from cerebrovascular injuries, demyelinating conditions, inflammatory, infectious, or miscellaneous causes.

My synthesis of the mental and psychiatric conditions brings me to consider an underlying brain lesion. In clinical practice, any patient presenting with new psychiatric illness over the age of 40 would merit referral for brain imaging such as an MRI. This would include older individuals at risk for Alzheimer’s. However in this case of a young adult, we are considering a neurologically silent organic brain lesion manifesting it’s presence with mental illness.

There are a number of common features to organic brain lesions occurring in a specific part of the brain. Lesions of the temporal lobe commonly cause depression. Temporolimbic lesions may present as auditory and visual hallucinations, panic or anxiety disorders.

So in reviewing the preliminary reports about the airman fitness to fly, I find the symptoms and history to be intriguing.  Was there a common denominator to his illness?  Can we learn from this tragedy?

We are all asking ourselves why a doctor would write a note to keep him from flying but not notify the airline or authorities.  Is it reasonable to expect a pilot to self-report his mental problem to his employer?  Did the doctor not know that the copilot was still continuing to fly after the previous warnings and notes went unheeded and unused?  Why wasn’t there a holistic approach to this pilot’s wellbeing that might bring together other health issues such as his vision disturbance and personality changes?

The accident investigation is also a criminal investigation now. For the flight surgeons and aviation medical examiners, we should pay very close attention.

Botox

Watch the years fly off with botox treatments — Achieve and maintain a youthful appearance!

Botox

For years, botox treatments and injectable fillers have been used for the rejuvenation of the face and neckline, with botox also being used to diminish headaches and to minimize excessive perspiration.

These days, instead of waiting to see the deep lines and “crow’s feet” which develop with aging, people are taking control of their appearance by getting botox treatments before the deep lines and tell-tale creases set in, postponing the process. This way, the deep lines never have the chance to develop, and all that is required a required is a low maintenance routine of touch ups.

Whereas much is known about botox, there are still a few myths and misconceptions which we have clarified below:

  • Myth #1 – The injections are very painful.

Prior the treatment there is topical solution applied to your skin, on the areas to be treated. The degree of pain is a subjective thing—some people feel almost nothing, while others may feel a little bit discomfort.  It depends on the individual’s threshold for discomfort.

  • Myth #2 – My face will be horribly bruised for days!

To prevent bruising, after the injections you can use Troxevasin gel (usually provided buy your doctor after the treatment) to  reduce capillary permeability of small blood vessels, thereby preventing endothelial damage  It also has membrane stabilizing, anti-bleeding, anti-inflammatory, liver-protective, radio- protective, poisoning, and anti-allergic effects. Troxevasin inhibits platelet aggregation and leads to a shadow with a syndrome occurring in trophic disorders recovers.

  • Myth #3 – Botox and fillers do not work for me.

Do not panic! It usually takes 3-5 days to see real results, and sometimes can even take up to ten days. Do not rush to the doctor for more units!  If you still feel in 2 weeks that there is a need for more, you can make appointment for a follow-up treatment. Remember, you do not want to over treat yourself and lose your face expressions completely.

  • Myth #4 – Botox and fillers are for women only.

We ALL desire a youthful appearance! Believe it or not, men also want to be able to write off five years off from their faces, and a large percentage of our clients are men. It can be a real confidence booster, and many men see it as another way of taking care of themselves.

Things to keep in mind:

  1. Make sure your doctor/ esthetician /nurse is board certified from reputable school. The Botox needs to be approved by the FDA and don’t be afraid to ask to see the original packaging.
  2. Follow all post-treatment instructions. You will be provided with a list of specific post procedural instructions. For example, After treatment, you should not lay down for at least 2 hours, you should avoid the sun, etc.