FLYING AFTER SCUBA DIVING

scuba-diving

I have enjoyed scuba diving for many years. As a physician, I am fascinated with the physiology of barometric pressure and offloading gases within the body.  I did advanced hyperbaric training through Divers Alert Network and through New York Medical College where I am a Clinical Assistant Professor of Medicine.

Decompression sickness is the medical condition arising from dissolved gases coming out of the bloodstream and producing bubbles within the body. This condition is also known as the Bends.

These bubbles can migrate within the body and cause joint pain, paralysis and even death. The most common symptom is local joint pain. Pain in the arms is twice as frequent as pain in the legs. Almost all of the decompression sickness occurs within the first eight hours.

There are various forms of decompression sickness including arterial gas embolism and barotrauma. Some of the most severe conditions arise when air bubbles form in the central nervous system, spinal cord, or brain.  There are so many manifestations of decompression sickness that almost any symptoms occurring after diving could be explained as a consequence.

We typically think of decompression sickness is occurring in scuba divers. However, this also occurs to astronauts when they perform a spacewalk and the pressure in the spacesuit is lower than the pressure in the spacecraft.

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Congratulations Marcos Franca to become private pilot!

OFC happily announces that today our student and friend MARCOS FRANCA passed his checkride to become a Private Pilot!  Congratulations Marcos, and well done.

MARCOS FRANCA passed his checkride to become a Private Pilot!

MARCOS FRANCA passed his checkride to become a Private Pilot! (Marcos on the right)

Orlandi Flight Center

Orlandi Flight Center

Obstructive Sleep Apnea (OSA) – Pilot – FAA Medical Exam

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Pilots are concerned about a new medical standard for Obstructive Sleep Apnea (OSA) by the Obstructive Sleep Apnea (OSA). The concern is that pilots with a serious weight problem will be adversely affected in their recertification. I would like to present my perspective as a senior AME. My thoughts are my own and not necessarily shared by the powers that be.

Obstructive sleep apnea may cause functional impairment for safe aircraft operations. OSA literally means that someone stops breathing during sleep or effectively loses the ability to oxygenate the blood stream. This is because the upper airway is partially or completely blocked during sleep. Therefore the chest muscles and diaphragm must work much harder to open the airway and maintain respiration.

Sometimes a spouse or significant other will notice that during sleep an individual has difficulty maintaining normal respiration or, in fact, there are long pauses between breaths. Patient will come to the office with this clear witnessed account of sleep apnea and we request that a sleep study be done.  This involves going to a sleep lab and spending the night while being monitored.

However doctors also should be looking for symptoms of daytime sleepiness, excessive fatigue, non-restorative sleep, difficulty concentrating, forgetfulness, snoring, and inability to stay awake during common activities during the day.

Overwhelmingly the patients at risk for this are not aware of the condition. Therefore, prospective screening is the best way to diagnose and manage patients with OSA.  There are estimated to be more than 12 million people in the United States at this time with sleep apnea. More than half of those individuals are overweight. It tends to occur in middle-age man and older woman.  The risk factors for obstructive sleep apnea include obesity, thick or large next, and smokers.

The FAA’s concerned that OSHA will result in impaired pilot performance. The FAA has published the Guidelines indicating that mild to moderate obstructive sleep apnea can show performance degradation equivalent to 0.06 to  0.08% blood alcohol levels which is the measure of legal intoxication in most states.  There’s also the increasing risk of hypertension and atherosclerosis with the resulting increasing the risk of heart attack and stroke.  In fact 30 to 50% of patients with heart disease and 60% of patients suffering strokes are found to have obstructive sleep apnea.

The FAA medical guidelines indicate that OSA is present in almost all obese individuals with a body mass index over 40 and the next circumference greater than 17 inches.  Untreated obstructive sleep apnea is a disqualifying condition for airmen and air traffic control specialists.

The next steps in the process will be for the pilot to have a BMI and neck circumference measured during the medical examination. Those airman with high BMI above 40 and neck circumference greater than 17 will be asked to undergo specialized evaluation by a sleep disorder specialist.

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Duration of FAA Pilot medical certificates

Many pilots ask if we could recap the duration for their medical certificates. and the frequency for the EKG for the first class airmen.

  1. First Class Medical Certificate: A first class medical certificate is valid for the remainder of the month of issue; plus

o    6 calendar months for operations requiring a first class medical certificate if the airman is age 40 or over on or before the date of the examination, or

o    12-calendar months for operations requiring a first-class medical certificate if the airman has not reached age 40 on or before the date of examination, or

o    12 calendar months for operations requiring a second class medical certificate, or

o    24 calendar months for operations requiring a third class medical certificate if the airman is age 40 or over on or before the date of the examination, or

o    60 calendar months for operations requiring a third class medical certificate if the airman has not reached age 40 on or before the date of examination. *

EKG is first done on the first medical exam after the airman’s 35th birthday.

The next EKG is done on the first medical exam after the airman’s 40th birthday.

After that one EKG is done every 12 months.

Please note that having the EKG in proper sequence with the medical is vital to maintaining the first class certificate.

After 12 months, an airman who does not have a current EKG will lose the first class certificate as it reverts to a Second class automatically.

    2. Second Class Medical Certificate: A second class medical certificate is valid for the remainder of the month of issue; plus

o    12 calendar months for operations requiring a second class medical certificate, or

o    24 calendar months for operations requiring a third class medical certificate, if the airman is age 40 or over on or before the date of the examination, or

o    60 calendar months for operations requiring a third class medical certificate if the airman has not reached age 40 on or before the date of examination. *

     3. Third Class Medical Certificate: A third-class medical certificate is valid for the remainder of the month of issue; plus

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6th Annual International Aviation Medical Examiner Seminar – presenting cutting Edge Technology

Cool gadgets in Aviation! Check out the latest: X2 Biosystem (TBA) and Heart Rate & Pulse Oximeter Monitor – Cutting Edge Technology.

Once every 2 years, the FAA sponsors a medical education program in Europe for Senior Aviation Medical Examiners.  It is a terrific opportunity to learn directly from the top FAA medical leadership.  This year traveling to Munich from Oklahoma City and the FAA medical headquarters were 3 senior staff.  We learned about the new EKG transmission standards, CACI and special issuance rules, and discussed the future of aviation medicine with our colleagues from all parts of the world.

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The Oculus Rift Made Me Believe I Could Fly

 

by Joshua Batson

Yesterday, I flew over downtown San Francisco. I swooped past the Transamerica Pyramid, taking care not to get speared, and winged it out towards the water. A heavy fog covered the bay, as usual, so I decided to head back into the city. I dove sharply, and the wind started whipping across my face. I slipped under the Bay Bridge, banked hard and promptly slammed into a warehouse. The wind died, and my screen went black.

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Lasik Correction for Pilot

Lasik

Lasik

From: Raymond Basri <xxxxxxxxxxxxxxxxx >
Date: June 24, 2014 11:03:41 AM EDT
To: <xxxxxxxxxxxxxxxxxxx>
Subject: Re:  LASIK

That is very good news indeed. I’m happy you are satisfied with the results. You should bring the report from the eye specialist as well as completing your Medxpress online application listing it as a surgical procedure.

I look forward to seeing you on your next visit and removing your vision restriction from your certificate.

Best
Ray

On Jun 24, 2014, at 09:14 AM,  < xxxxxxxxxxxxxxxxxxx > wrote:

Hey Dr. Basri – how’s things?  Hope your summer is off to a good start.

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