Aspiring pilot, Crohn's Disease?
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Hi folks,

Aspiring private pilot here. I was hoping I could get some pointers on my situation and what it means for my medical certificate .
  1. I have Crohn's disease, treated with Entyvio (Vedolizumab) for the past year and change. I just had my most recent colonoscopy and am waiting on (randomly distributed, not apparent-problem) biopsy results, only hospitalization was in 2011. I have had zero Crohn's-related surgeries. (I had a knee arthroscopy for a rugby injury in college, and I had LASIK 3 years ago.)
  2. I was previously treated with low-dose Nortriptyline for IBS symptopms as part of my pre-Entyvio medication cocktail; those symptoms have disappeared completely since I started Entyvio and I'm in the final stages of tapering off the Nortriptyline now. I understand this medication is on the naughty list, which is why I'm coming off of it.
  3. I witnessed a murder right in front of me and had provided first aid to the victim in 2014; I voluntary went to a psychiatric facility to help with a panic attack the next day after the police told me the victim did not survive and was discharged within a couple hours after a quick "it's not your fault, you did everything you could, here's a single pill to suppress the acute stress reaction so your brain can take over again". I have zero other mental-health related issues, concerns, history, etc.
  4. I have a gigantic stack of doctor visits, etc., because I believe in being proactive when something doesn't feel quite right. Also, I need labs every 3 months and a GI doctor visit every 3-6 to ensure my gut is still behaving properly., plus the annual dermatology screening because Crohn's, plus an annual physical, plus insert-random-exercise-injury-here.
My big questions are:
  • Because I have Crohn's, my understanding is that I will need an AASI? I should therefore plan on seeing a doctor who is willing to help on that end of things instead of just filling out their boxes? Is this CACI still valid? https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/C-CACIColitis.pdf
  • Should I fill out the psych visit in 18u, even though it was not strictly speaking a hospital admission?
  • What paperwork, letter, reports, etc., should I get from my GI (or other) doctor to prepare for my AME visit? I read somewhere that a letter with a phrase along the lines of "It is my professional opinion that Nathaniel is no more likely to be suddenly medically incapacitated than the general population." helps a lot?
That said, I completely understand that flying is a privilege and that when and if I encounter symptoms, I should not be in the air.

Thank you all,

Nate
4 Replies
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Thank you all for the pointers!
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Nate: (1) You're going to need your Crohn's record, and a current exam and statement as to what you are taking and that the disease is considered stable in remission.  "No side effects of Entyvio" is a REQUIRED doc's statement.
(2) Yes, they can see if if the have cause (Insurance codes form the visit). And to not do so is falsification of the record a class 4 felony. Let's not go there.
(3) FAA will require the whole record of your care and more likely than not a qualfied statement that
(a) The date of treatment and the date of ending, and what was used.
(b) That this was to the caretaker's knowledge the sole event in your life.
(c) That there was no suicdality in this event
(d) That it's > 90 days from any treatment and that the current situation is fully resolved, there are NO SYMPTOMS left to treat.
(e) Because you have had nortryptyline AND the murder event, this best come form a psychiatrist as he has to uncouple "two events".

HIMS AME

 
Votes
Hi Nathaniel.
Make an appointment with an AME for consultation only.  The AME should be able to assist you with your questions and possibly make the path to a certificate less painful.  I suggest doing this before submitting an application in MedXPress.  I received that advice in this discussion group.

Steve

 
Votes
Hi Nate,

Thanks for your post.  Since you have a few things to discuss, I suggest talking with one of the medical specialists at AOPA.  They will be happy to talk with you about a plan of action.  The number is 800-872-2672 option 3.  In the meantime, we do have a lot of good resources in the medical resources section of the AOPA website.  Feel free to poke around in it at the following link.  https://www.aopa.org/go-fly/medical-resources