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4 Lessons from a Deferred Medical

Well, I've hung up my headset.

At least for the time being. You see, I've had my medical deferred.

Yup - I got a deferred medical due to hypothyroidism, meaning my thyroid gland does not work as well as it should, and I have to take a daily pill to keep my metabolism and other functions up to speed.

AME Clipboard

My Deferred Medical Story Begins

A not awesome combination of factors collided to cause this deferred medical situation - most of which were my own fault. I had been on the same dose of the medicine I take for hypothyroidism - levothyroxine 112mcg - for several years with no change, so I assumed all was well before my medical came due in July. I also procrastinated on scheduling my medical appointment, so that I ended up going in early in August, after my medical had expired. I can't blame anyone but myself for that. Oh, yeah - I also had not gone in to see my eye doctor in over a year - again - my prescription had not changed in several years.

So when I went in to the Aviation Medical Examiner (AME) for my appointment, I was unprepared to leave with a deferred medical... I had always gotten it without any problems before. Last time, shortly after my hypothyroism diagnosis, I even got a first-class medical, with no info from my doctor or anything regarding the diagnosis. I feel like I should mention that for convenience, I went to a different AME this time, (I work about 10 minutes from the new AME, but at least 30 minutes from the old one).

Let me also add that, only about two weeks prior to my medical appointment, I had my blood drawn to check my thyroid levels at my family physician - and my prescription did need to change. I guess that was my first indication that we might have a problem.

And a problem we did have. I left the AME with a deferred medical and instructions to get a letter from my family physician that included specific information and wording regarding my hypothyroid condition, and to include a copy of my most recent (within the past 90 days) labs. Since my thyroid was out of "normal" range (hence my dosage changing), the AME couldn't approve my medical there, we had to defer to the FAA (gulp). Additionally, my vision was not 20/20, so I had to do a third class and not a second class medical. Fortunately, I can continue to instruct with a third class medical, once I get approval from the FAA.

So third class medical, deferred to the FAA's Office of Aeospace Medicine. The AME told me to expect a letter from the FAA in a couple of weeks, telling me what I need to submit to them to receive my medical - most likely it would be a continuance of the deferred medical for up to 30 days to give time to prove my thyroid is back in normal range. As long as I keep in touch with the FAA Aeromedical Division - in writing - the deferral can be continued if necessary. This is good, since thyroid medication can take up to six weeks to really take effect, and there is no guarantee that my new dose will be correct initially - it may need to be raised again after my next blood draw and lab results.

Worst-case scenario, I was told, would be that I would be notified that I have to do a special issuance now - and the communication from the FAA will include numerous other bits of medical information and tests that I will have to supply to them. I'm still waiting to hear which it will be...

Now What?

Leaving the AME's office in a sort of daze, my mind immediately flipped to "What happens to my students now that I have a deferred medical?"

I currently only have three active students, so it's not as if I have many to find new instructors for, but will other instructors have the time and capacity to take my students on, at whatever level they are at now? I had one student who had just soloed, one who was probably going to solo on our next lesson, and one who was still just starting and very early on.

Fortunately, aviation people are awesome, and there was no problem finding good instructors who I trust to take my students. I happened to be teaching a Discover Aviation course the following weekend at The Ohio State University, so I asked my two OSU Flight Training Clinic students to come to that class so we could talk before &/or after the class.

My newest student requested the instructor who had taught her ground school, and he was able to take her, so that worked out very well. My student nearly ready to solo was taken on by another Flight Training Clinic instructor as well, so they were covered. My student at Capital City Jet Center at Bolton Field airport (KTZR) was taken on by another fantastic instructor there, so it did not take long before all my students were covered by new instructors.

I do fully expect to get my medical back, and I do want my students back, as I really feel that I have a connection with my current students. Naturally, I told all of my students that I would love to have them back once my deferred medical is re-issued, but that I would not be offended if they chose to stay with their new instructors instead.

So this medical situation was doubly painful, as not only do I not get to fly, I also don't get to see my students for the time being!

Important Lessons

Oh my goodness, there are just so many things to learn here. PLEASE PLEASE learn from my mistakes and don't make them on your own. It is depressing and scary and nerve-wracking.

Lesson 1: Know whether any medical condition you have might affect your medical certification.

I should have taken advantage of AOPA's medical service to find out whether my hypothyroidism might be an issue. If you have any kind of medical issue or take a prescription of any kind regularly, KNOW WHETHER IT WILL AFFECT YOUR MEDICAL APPLICATION. Once you know, you can continue to follow up on it and do your best to make sure all is in order when you visit your AME to renew your medical.

If I had it to do over, I would have had my blood draw and labs done with my family doctor at least 90 days prior to visiting my AME. That way I would have known earlier that my labs were out of bounds, and would have had a little bit of time to get it corrected and possibly have avoided the whole deferred medical situation.

Lesson 2: Don't wait until the last minute to schedule your appointment with your Aviation Medical Examiner.

I am still kicking myself for waiting until mid-July to schedule with my AME when my medical expired at the end of the same month. I told myself that it would all be fine, since nothing had changed since my last medical. I told myself that it was silly to renew before the month it was due in - that would be like losing months and money in paying for it early, and hence allowing it to expire earlier. Is that logical? I sure am paying for it now by losing students, pay, and even the ability for me to fly myself at all. Ugh.

Lesson 3: Don't fall behind on ANY Of your medical appointments.

Just get yourself in the habit of always staying up-to-date on your medical stuff. Get your eyes checked yearly. See your family doctor for a basic checkup at least once per year. Go to the dentist every six months (whether you floss or not). Just KEEP UP WITH IT! It will give you an earlier indication of whether there might be an issue, and you can start researching and fixing whatever might come up before it causes a deferred medical, a special issuance, or worse - a denied medical!

Life After Flight

It can't be helped, I beleive, to start thinking about what you might do as a pilot if you all of a sudden can't fly anymore for some reason.

That was the second thing that started running through my head - after worrying about getting my students covered - "What am I going to do with myself if I can't legally fly anymore?"

I would continue to instruct, though it would be in simulators and doing ground schools. I would also hold myself out to commercial students, since they would be legal to fly as PIC, I could still instruct them, and be able to get in the air. Also, I hope that I have made some good friends in aviation over the years who might be willing to suffer me in an extra seat once in awhile.

I might get into RC flying. I might try ultralights or hot air baloons or gliders. I might try hang gliding. I might attach helium baloons to a lawn chair. I might spend more time on Flight Simulator X.

I WILL spend more time with my family and less time at the airport. I will learn to do some computer / website programming. I'll do some more internet business work a la Pat Flynn and Jason & Jeremy of Internet Business Mastery. I'll learn more about copywriting and do some of that on the side.

Youngest Daughter

Where my time will go while I'm not flying...

The point is, I'll live. I'll stay involved in aviation as I am able to, but I'll do some other things I am interested in, too.

Lesson 4: Have other interests!

If your entire life is focused on aviation, it can be incredibly depressing and frightening when aviation is taken away from you by a deferred medical (or, god forbid, a denied medical). Cultivate some other passions and interests, and - as they would say in investing circles - diversify. Don't put all your eggs in one basket. Create a backup plan.

I'm lucky - I have a 9-5 job that is in aviation, and I instruct on evenings and weekends. It is not the end of the world for me to have a deferred medical. And while I fully intend to get it back - and I honestly believe that I will - this has been eye opening for me as a process and as a possibility.

Moving Forward

This thread will continue, as I hope to interview some people who have had deferred medical issues and have beaten them and ended up getting their medical, as well as some people who have lost their medicals and have survived and thrived. If you are one of those people and want to tell your story, please let me know. The great folks who make up the Blogging in Formation team have offered a few names of people who might be interested, but I'd like to hear from anyone else who reads this and has some input or a point of view on this to please speak up in the comments or contact me so we can talk and I can keep this discussion going!


Andrew Hartley IS a certificated flight instructor and commercial pilot in Columbus, Ohio. He WAS medically certified until this month. He WILL be medically certified again - whatever it takes.

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Comments

  1. Andrew, your story is amazing. There are a lot of people who delay and are not proactive in monitoring their health because the subconscious does not want to know. A bit of fear, a ton of denial, and a lot of hope. But dealing with issues, such as your health, is so very important getting it fixed early. Taking action. Sharing your story will help someone else not make the same errors. Your lesson is a gift to other. There is life after medical….

    Did you read about Rick Watson? I don’t think you need the same medical for sport aircraft. Check this out… http://karlenepetitt.blogspot.nl/2014/08/rick-watson.html
    Might provide another option to get you into the sky!

    Thanks for a great post!

    • Karlene: Thanks for the info about Rick Watson! How amazing is that – losing a medical not once but twice, and still powering through and making it happen to stay in the air. THAT is insirational. I’m just starting the process for the first (and hopfully LAST) time. Maybe Rick would be willing to be one of my interviewees…

  2. I read somewhere that the majority of pilots will lose their medical at some point in their careers, but that with sufficient determination to deal with the bureaucracy it’s almost always possible to get it back. Your situation sounds like just a temporary hitch. But it is certainly worth thinking about what we’d do without the ability to fly as PIC, especially if we do this for a living. I admire your positive attitude and the sense of balance you have toward life.

    As Karlene noted, there are options for those without a medical, from Sport Pilot to gliders to the possibility of the third class going away altogether. And you can do plenty of instructing without a medical, so I think you’ll be airborne soon either way!

    • Ron: Certainly as a pilot ages, I would think it is more likely for them to end up with some medical issue that might cause a deferral or denial that might cause a special issuance. I need to get in touch with AOPA at 800-USA-AOPA to talk to their medical people, but in this case I’m hoping a simple deferral until my blood work is back to normal.

      Regardless, this has made me an even stronger proponent of the movement to eliminate the third class medical for private pilots. As a CFI I don’t know if it would have helped me, but if we can keep more people flying for longer, it can only help keep General Aviation stronger, longer!

  3. This is an informative essay on a topic most pilots hope to avoid, but medical issues can pop up at any point in our careers. Kudos for posting this. Cheers, MLB

    • Mark: It was certainly a topic I tended to avoid, not that there is tons of discussion about it in general. As frustrating and – honestly – frightening as this is for me, I definitely thought that putting it out there as it happens to me might help others who are dealing with similar issues right now, or who initially gave up on their dreams because of something like this. If this can inspire even one pilot to keep going and fight through a medical issue to stay in the air, it will be worth the effort. And I’m a big proponent of transparency anyway – so it’s doubly important to me to be real.

  4. Andrew, thanks for approaching what could have been a difficult topic. You covered it with grace and poise! I had a squadron commander once who was diagnosed with Type 2 diabetes, which is a disqualifying condition in the military. He didn’t know his last flight before the diagnosis was going to be last. The good news, it wasn’t. He controlled his diabetes and got medically cleared to fly again, but what if it had been Type 1? My point here is that you never when and if your last flight was LAST FLIGHT. Any of us could be medically disqualified tomorrow due to some unforeseen circumstance. We need to do what we can to stay medically qualified as you pointed out – and I’d like to add to that: We need to enjoy every flight as if it’s our last. Somber topic, but one that deserves some thought nevertheless!

    • Rob – funny you should mention diabetes – Eric Auxier specifically asked about that when I mentioned I was going to cover this topic this month, and I’m still hoping to have someone who has beaten diabetes and gotten their medical back (or not) as an interviewee as I continue this saga / series.

      Any chance your squadron commander might be willing to discuss his journey? Are you still in touch with him?

  5. Andrew,
    This is probably the most important post I have read all year. Every six months I go to my AME on the assumption I’ll leave with my medical. Heck, since mine is at the DLZ airport I usually fly in. What a shock that must be! Thank you for the great advice and I wish you all the luck in getting it back – I’m sure you will.
    I also appreciate the alternatives that you plan to explore if not. All good stuff!

    Brent

    • Brent: Thanks! The only thing I can say is: Don’t take it for granted that you will walk out with your medical. Like Karlene said – subconciously, you might not want to think about it, but staying on top of it is really the only way to protect your medical. Don’t let it surprise you! Like the Boy Scouts teach: Be Prepared!

  6. I agree, Brent!
    Andrew, thank you for this post. We all tend to procrastinate and wish for the best, but one wrong move at the medical examiner and it’s all over–at least till you wade through an ocean of hassle! Lots of tips here for us all to pass around.
    Thank you especially for the important links.
    Does anyone have any experience with working through the FAA issues on colorblindness and diabetes, such as Rob’s squadron commander? I’ve had several readers contact me with those issues, and I’m really clueless when it comes to these things.

    • Eric: Thanks… I hope those links get used and help at least one person avoid my current fate!

      I’m going to continue this series as long as it takes for me to get my medical back, and through the process I hope to get some of those answers for you regarding diabetes and colorblindness. Knowing thst it is possible is one thing, but the general silence on these issues is disheartening to people. That’s one of the reasons I didn’t want to avoid the topic as it happened to me, but to actually highlight the process and maybe clear up the muddy waters that are medical deferrals and denials and special issuances.

  7. Andrew thanks for addressing all pilots biggest nightmare. We are all just one medical or injury away. That’s why professional pilots must always have a back up plan!

    • Chip: You’re welcome, and I agree 100% that having a backup plan and other interests is crucial… as I am learning first hand unfortunately. Ironically, full-time flight instruction was my backup plan from my day job, in case I should lose my 9-5… now I need a plan C as a backup to my backup!

  8. Rick Watson says:

    A great story and one I can totally relate to. Hang in there Andrew and enjoy life on your journey. There is a great saying from a recent movie ” It will be alright in the end and if it’s not alright it’s not yet the end” I look forward to following your journey.

    Cheers
    Rick

  9. James Carlson says:

    I was deferred a few years ago on Sleep Apnea. It was expensive, confusing, and difficult to get back, but I did. Now it’s just a yearly annoyance. Yes, I’d also like to see the 3rd class removed. I’d still use C-PAP for health reasons, but I’d waste less time and moneyon pointless paperwork that does nothing to make anyone any safer anywhere.

  10. My CFI found out quite by accident that he had Leukemia and passed away suddenly before they could take action against his ticket. After 32 years in the USAF and having handled agent orange, we think that was part to blame. I know a senior captain at American Eagle who lives in NH who is colorblind. He couldn’t work for American even after applying several times as he has a waiver and they were big on no waivers. He has a certificate of demonstrated ability. I’ll have to see if I can get in touch with him and see if he’d be willing to share. Good luck on your medical. I’m sure with the right planning you’ll be fine. Go on the Eric plan, b 40 some and still look 20 some…must be that PHX sun…

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