Not a pilot (yet) but I went for my 3rd class medical- questions

Posted by Exercise-Klutzy@reddit | flying | View on Reddit | 15 comments

I'm a 57 yr old man that wants to fly. As such I did my 3rd class medical exam with an AME to nake sure I didn't spend money on flight lessons only to find out I didn't pass my physical. I was surprised by 2 things at the exam. My BP and urine were normal, which I expected but was slightly worried because my BP can run into the 130s any time I've had it checked. Whew! He proceeded into the rest of the exam with vision and listening to my heart and lungs. My normal vision was fine. We then went to the new requirement of Digital color vision testing, no longer the Ishihara plates. He only had one option- the Waggoner test. Well, I failed that one. I was extremely surprised by that one. I have absolutely NO issue seeing colors for any part of my daily life including a 10 year photography. I can see color variants just fine on photo processing. So from what I've read I will need a different test to prove my color is fine, or be relegated to a daytime VFR limitation. I'm pursuing that test with an opthamologist. Now the fun part- Lungs sounded good but Dr. thought he heard an extra heart beat every 10 beats or so. Any time I've seen doctors for anything, including my primary care physician just a week before the AME exam, I've had NO mention of any irregularities. I was really caught of guard by that one. So my primary submitted a summary of my prior visit that the AME was including with his documents for Oklahoma to review. That's long- but my question for anyone that has had similar experiences- what might I be looking at for testing and proving my heart is good to go? I know it depends, is a perfectly valid answer, but maybe there's a common baseline test? AOPA listed about 8 different tests that could be required to prove I'm healthy. Here's from the AOPA site: For a first time special issuance medical certification consideration for AFIB, the [FAA ](https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/AtrialFibrillationDispositionTable.pdf)[evaluation](https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/AtrialFibrillationDispositionTable.pdf) requires: * a [**cardiovascular evaluation**](https://www.aopa.org/go-fly/medical-resources/health-conditions/heart-and-circulatory-system/cardiovascular-evaluation-specifications) with maximum [**Bruce protocol exercise treadmill stress test**](https://www.aopa.org/go-fly/medical-resources/health-conditions/heart-and-circulatory-system/bruce-protocol-stress-test); * 2D and M-Mode echocardiogram; * 24-hour Holter monitor done after treatment has resulted in stability; * Current thyroid function studies with TSH level * Sleep study to rule out Obstructive Sleep Apnea * Clinical summary from the cardiologist using the [Non-Valvular Atrial Fibrillation/A-Flutter Initial Status Report](https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/nonvalvularAFibAFlutterInitial.pdf) That groups of tests could run my thousands of dollars and I haven't had one hour of flight time. Can anyone talk me off the ledge? Thanks

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rFlyingTower@reddit

This is a copy of the original post body for posterity: --- I'm a 57 yr old man that wants to fly. As such I did my 3rd class medical exam with an AME to nake sure I didn't spend money on flight lessons only to find out I didn't pass my physical. I was surprised by 2 things at the exam. My BP and urine were normal, which I expected but was slightly worried because my BP can run into the 130s any time I've had it checked. Whew! He proceeded into the rest of the exam with vision and listening to my heart and lungs. My normal vision was fine. We then went to the new requirement of Digital color vision testing, no longer the Ishihara plates. He only had one option- the Waggoner test. Well, I failed that one. I was extremely surprised by that one. I have absolutely NO issue seeing colors for any part of my daily life including a 10 year photography. I can see color variants just fine on photo processing. So from what I've read I will need a different test to prove my color is fine, or be relegated to a daytime VFR limitation. I'm pursuing that test with an opthamologist. Now the fun part- Lungs sounded good but Dr. thought he heard an extra heart beat every 10 beats or so. Any time I've seen doctors for anything, including my primary care physician just a week before the AME exam, I've had NO mention of any irregularities. I was really caught of guard by that one. So my primary submitted a summary of my prior visit that the AME was including with his documents for Oklahoma to review. That's long- but my question for anyone that has had similar experiences- what might I be looking at for testing and proving my heart is good to go? I know it depends, is a perfectly valid answer, but maybe there's a common baseline test? AOPA listed about 8 different tests that could be required to prove I'm healthy. Here's from the AOPA site: For a first time special issuance medical certification consideration for AFIB, the [FAA ](https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/AtrialFibrillationDispositionTable.pdf)[evaluation](https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/AtrialFibrillationDispositionTable.pdf) requires: * a [**cardiovascular evaluation**](https://www.aopa.org/go-fly/medical-resources/health-conditions/heart-and-circulatory-system/cardiovascular-evaluation-specifications) with maximum [**Bruce protocol exercise treadmill stress test**](https://www.aopa.org/go-fly/medical-resources/health-conditions/heart-and-circulatory-system/bruce-protocol-stress-test); * 2D and M-Mode echocardiogram; * 24-hour Holter monitor done after treatment has resulted in stability; * Current thyroid function studies with TSH level * Sleep study to rule out Obstructive Sleep Apnea * Clinical summary from the cardiologist using the [Non-Valvular Atrial Fibrillation/A-Flutter Initial Status Report](https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/nonvalvularAFibAFlutterInitial.pdf) That groups of tests could run my thousands of dollars and I haven't had one hour of flight time. Can anyone talk me off the ledge? Thanks --- Please downvote this comment until it collapses. Questions about this comment? [Please see this wiki post before contacting the mods](https://www.reddit.com/r/flying/wiki/index/rflyingtower/). --- I am a bot, and this action was performed automatically. If you have any questions, please [contact the mods of this subreddit](https://www.reddit.com/message/compose?to=/r/flying).

15 Comments

Mad_Rooster_7164@reddit

“including a 10 year photography” A what

Exercise-Klutzy@reddit (OP)

sorry, 10 yrs as a photographer and editing photos. Always dealing with color variants

flying-ModTeam@reddit

Medicals can be confusing and even scary, we get it. Unfortunately, the medical process is very complex with many variables. It's too complex, in fact, for any of us to be able to offer you any specific help or advice. We strongly suggest you discuss your concerns with a qualified aviation medical examiner before you actually submit to an official examination, as a hiccup in your medical process can close doors for you in the future. Your [local AME](https://www.faa.gov/pilots/amelocator/) may be able to provide a consultation. Other places that may provide aeromedical advice include: [AOPA](https://www.aopa.org/go-fly/medical-resources), [EAA](https://www.eaa.org/eaa/pilots/pilot-resources/pilot-medical-resources/eaa-aeromedical-advisory-program), [the Mayo Clinic](https://clearapproach.mayoclinic.org/), and [Aviation Medicine Advisory Service](https://www.aviationmedicine.com/). For reference, [here is a link to the FAA's Synopsis of Medical Standards](https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/standards/) and for more in-depth information [here is a link to the FAA's Guide for Aviation Medical Examiners](https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/). Also, feel free to browse [our collection of past medical write-ups and questions in our FAQ](https://www.reddit.com/r/flying/wiki/index). Finally, we suggest you read the instructions on the medical application very closely. Do not volunteer information that isn't asked for, but also do not lie. Some people may urge you to omit pertinent information, or even outright lie, on your medical application in order to avoid added hassle and expense in obtaining a medical certificate. Know that [making false statements on your medical application is a federal crime](https://www.law.cornell.edu/uscode/text/18/1001) and that people [have been successfully prosecuted for it](https://www.justice.gov/usao-ndca/pr/california-aviator-convicted-making-false-statements). But for heaven's sake, don't tell the FAA any more than you absolutely have to. If you're not in the United States, the above advice is still generally correct. Just substitute the FAA with your local aviation authority. Good luck!

usd2bfast@reddit

Most people your age with extra heartbeats do NOT have AF. A resting ekg and possible 24 hour a Holter monitor may be all you need. To add, I read thru a couple times and don’t see where the “AF” diagnosis came in, sry

no diagnosis. just observed by the AME.

Slick-62@reddit

Got my third cl at 64. My cardiologist looked over the requirements for SI and as a cardiac patient found the tests to be ‘medically necessary’. Insurance paid, no problem. See a cardiologist. He may indicate since you have a potential issue, the stress test and echo would be medically necessary. After getting the SI, I immediately went basic med when the med expired.

LeagueResponsible985@reddit

I'm also a 57 year old male. Cant really help with the color vision part. I don't have that problem. Can talk about the cardiac stuff. I had a vaso vagel event in a doctors office. I went to my GP who referred me to a Cardiologist. When I got there, I gave the cardiac workup that the FAA wanted to the doctor and told him that I'm a pilot and this is what the FAA wanted. He orderd them and miraculously, my insurance company approved and paid for them. The FAA accepted them and my medical was issued. Perhaps you could try something similar with your possible afib diagnosis. Finally, beware of [Dr. Jellyfinger!](https://www.faa.gov/ame_guide/app_process/exam_tech/item39)

While they may discount, I have a high deductible plan so I'm sure I'll be out of pocket for a good portion of this.

Icy-Bar-9712@reddit

Same boat, had to do all these tests from a weird EKG. Cash price negotiation is often less than what you pay with insurance rates. Needed a CT, insurance rates were 750. Cash pay up front 250. Just ask your provider, how much for cash pay? You'll be shocked, but really regular office visit co-pay is about the only thing we use it for.

EVERYTHING is negotiable! A fair amount of the "price" of medical services is the cost to process insurance claims. The doctor is not incurrint that cost with you. She if he or she will share that cost savings with you.

flyingron@reddit

What were the results of the Waggoner numbers? There are two ways of passing that test and AMEs often miss the second one because it’s not called out by the exam pass/fail screen. You can retake it. You can call around and find someone who has either of the other tests (Rabbit Cone and CBT). If you can’t pass any of these, you get the limitation on your certificate, but you can apply to the federal air surgeon to reconsider.

He did let me retake the Waggoner, using a short version of my name and similar results. I want to say I had 16/21. As for the afib, did you wait for the inital decision before scheduling tests? if they move at typical speed is this a half-year thing before I get to a decision?

Anthem00@reddit

Most people with some color deficiency don’t even know they have it. Go and try another test or have your Opthamalogist issue one. Most AMEs only have the Waggoner because it’s the cheapest for them to subscribe and utilize. You have nothing to worry about with your blood pressure. They don’t want to see above 155. As for the heartbeat, yeah make sure you get a cardiologist checkout and summary report. They are going to want to see that - maybe with some more detailed testing - multi-day ekg etc. but check with your AME as to what they actually want to see.

AutoModerator@reddit

Hi, I'm a bot and it looks like you're asking a question about medical issues: color vision. Medicals can be confusing and even scary, we get it. Unfortunately, the medical process is very complex with many variables. It's too complex, in fact, for any of us to be able to offer you any specific help or advice. We strongly suggest you discuss your concerns with a qualified aviation medical examiner before you actually submit to an official examination, as a hiccup in your medical process can close doors for you in the future. Your [local AME](https://www.faa.gov/pilots/amelocator/) may be able to provide a consultation. Other places that may provide aeromedical advice include: [AOPA](https://www.aopa.org/go-fly/medical-resources), [EAA](https://www.eaa.org/eaa/pilots/pilot-resources/pilot-medical-resources/eaa-aeromedical-advisory-program), [the Mayo Clinic](https://clearapproach.mayoclinic.org/), and [Aviation Medicine Advisory Service](https://www.aviationmedicine.com/). For reference, [here is a link to the FAA's Synopsis of Medical Standards](https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/standards/) and for more in-depth information [here is a link to the FAA's Guide for Aviation Medical Examiners](https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/). Also, feel free to browse [our collection of past medical write-ups and questions in our FAQ](https://www.reddit.com/r/flying/wiki/index). Finally, we suggest you read the instructions on the medical application very closely. Do not volunteer information that isn't asked for, but also do not lie. Some people may urge you to omit pertinent information, or even outright lie, on your medical application in order to avoid added hassle and expense in obtaining a medical certificate. Know that [making false statements on your medical application is a federal crime](https://www.law.cornell.edu/uscode/text/18/1001) and that people [have been successfully prosecuted for it](https://www.justice.gov/usao-ndca/pr/california-aviator-convicted-making-false-statements). But for heaven's sake, don't tell the FAA any more than you absolutely have to. If you're not in the United States, the above advice is still generally correct. Just substitute the FAA with your local aviation authority. Good luck! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/flying) if you have any questions or concerns.*

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