First Class Medical after episodes of vertigo?
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In early 2015 I was going through a very stressful time in my life, wasn't taking care of myself with my diet and exercise regimen, and experienced what I would call "persistent brain fog" from about February - June/July. During that time I had about 2 or 3 episodes of dizziness that I described to my GP as vertigo. I am not sure this was the correct descriptor or if I was experiencing lightheadedness. Either way, it was unusual. Each episode lasted about 2-5 seconds and I had not experienced anything like it before or since. I had a PT evaluation done during this time which came back negative for vestibular dysfunction and the PT commented that I have excellent balance. The only finding from this physical examination was that I should lose some weight and that my vitamin D was low. I have a history of ear infections (maybe once every 10 or so years) and I believe I might have OME in my right ear at the moment (crackling noises when I breathe deeply at times and a slight fullness feeling accompanied with a possible reduction in hearing in that ear but no pain). I earned my pilot's license in 2003 as a 17 year old kid wanting to pursue aviation as a career but decided against it. Now as an adult I am looking for a career change and have the resources to earn the remainder of my ratings to once again pursue this dream. My 3rd class medical is long expired and this would be my first application in 18 years. I am concerned this issue I had in 2015 might hinder my ability to be certified. What should I do proactively before applying for another medical certificate? Should I expect to be deferred for a decision? How likely am I to be able to get a 1st class medical certificate? This will be the only change to my application from my first application in 2002.
12 Replies
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Adam:

Careful about the record describing "Brain fog".  That triggers all sorts of things @ FAA medical- alcohol use, ADD, Cognitive problems, sleep apnea.....Wha'ts actually in the record becomes VITALLY important.

Now that being said, if the diagnosis is "viral vestibulitis" the FAA wants 90 days, documentation by the doc as to NO hearing loss and NO repeat symptoms for 90 days and you can go about your way.   NB you have to document this- "MEDICAL RECORD". It that takes an ENT, so it is.

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Thank you for the reply. So, I would have to visit an ENT before applying for a new medical? This was 5 years ago now, would getting a diagnosis this far after the event be possible? I had no diagnosis of any pathology that would explain the dizziness at the time, just the Physical Therapist who said I didn't have any vestibular issues. Also, Could you clarify your last two sentences starting with "NB..."? I am not sure I understand. Thanks again!
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Bruce:  I think what I'm reading here is two or three episodes of 2-5 seconds each five years ago with no diagnosed pathology and no recurrence.  Where do you go with that?
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Oh.  Five years ago is "magic" @ FAA ((except for the psychiatry branch).  Just have the PCP write that.  It'll be fine. Actually, an agressive AME would make that historical statement (@ >5 years) and I'd bet it'd be sustained.

If i were doing that in my office, I'd do the audiogram and if it were normal, that would eliminate all the "aeromedical back actors".


 
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Thank you Bruce, this has helped to ease my worry about being certifiable. Do you think I'll be deferred by the AME or issued on the spot?
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He shouldn't,  but I would have the audiogram to show for it.  This is called, "issue and defend the issuance".
 
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I gather from Bruce's response that he's more concerned about the question of your auditory acuity due to OME than about the dizzy spell five years ago.  From what I gather (and Bruce will have to confirm), dizziness is not a symptom of OME, so the OME wouldn't be the root cause of that event, but OME can affect your hearing, and hearing is part of the medical certification exam...
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It's that vestibular dysfunction (the dizzies) in the presence of hearing loss has a much different prognosis for recurrence than an episode (even x 4 or 5) of isolated vestibulitis.
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I am not sure I even have hearing loss. I think I just have some middle ear fluid in the right ear and it feels slightly differently than my left ear and I don't even notice it unless I am concentrating on it or if I breathe deeply sometimes I hear it get a crinkly sound (if that makes sense). I just did one of those online screening tests where they play some back ground noise first at a level lower than a narrator telling you to select certain pictures or numbers and the background noise gets progressively louder and the narrator harder to understand. The result of this basic test was that I don't currently have hearing problems in either ear.
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.....and that assertion needs substantiation. Thus the office audiogram.

See, you can beat your chest all you wish and declare "but I am fine" and the FAA will say, "substantiate that!". So woe be unto he who overconfidently approaches with "but I am fine!".

If the AME does not have an audiometer handy (hearing loss would be one ear and the other would be covering it for function, so the six foot voice check would not be of use) I'll bet he defers.  Alternatively you could bring a letter from the PCP bringing it into recorded medical record- "5 years no episodes, no hearing loss"

In favor of not deferring is the time period.  But YMMV and those who have been deferred call it "Deferral he_l".  Woe unto the under_documented pilot.

B