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Articles written by james d. lakin


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  • Aeromedical Forum

    James D. Lakin PhD MD FACP, CFI, CFII, MEI, Airline Transport Pilot, FAA Sen. aviation Medical Examiner|Feb 1, 2020

    What better flying weather than a crisp clear February day in Minnesota. You’d think you were flying a helicopter with the short takeoff runs. The air is smooth and the visibility unlimited in bright sunshine. The reflection from the snow is dazzling. I sure hope you didn’t forget those sunglasses! Sunglasses are a very important and often underappreciated piece of a pilot’s equipment. They are critical to optimize visual performance in the cockpit. If you have a good pair, they will reduce eye fatigue, reduce the negative effects of harsh...

  • Aeromedical Forum

    James D. Lakin PhD MD FACP, CFI,CFII,MEI, Airline Transport pilot, FAA Senior Aviation Medical Examiner|Jan 1, 2020

    It's winter flying season! Some of the best conditions imaginable can be had on a clear crisp winter morning in Minnesota. You ease the throttle forward and suddenly your C172 feels like a P52 Mustang as it takes off in nothing flat. Same with the climb as you plow through that calm solid air. So what could go wrong on a day like this? Unfortunately, weather that's good for aerodynamics isn't necessarily good for pilots. Of course, I'm talking about cold injury, something I try to touch on...

  • Aeromedical Forum

    James D. Lakin PhD MD FACP, CFI, CFII, MEI, Airline Transport Pilot, FAA Sen. Med. Examiner|Dec 1, 2019

    Aviation training doesn’t come cheap. So, when the FAA offers it for free, you might want to take a hard look. Of course, there’s a catch. Training is done in Oklahoma City, the headquarters of the Civil Aerospace Medical Institute (CAMI) which does take a few gallons of avgas to reach. However, this time of year, odds are it’s a good deal warmer and sunnier than here at home. Now that I’ve almost talked you into it, what training is available? The two big programs are CAMI’s Physiological Training Course and Basic Survival Skills for Gener...

  • Aeromedical Forum

    James D. Lakin PhD MD FACP, CFI, CFII, MEI, airline Transfer pilot, FAA Sen. Med. Examiner|Nov 1, 2019

    The weather is cooling down and you probably are cranking up the cockpit heater more often now. That’s fine. It’s hard to keep her straight and level when your teeth are chattering. But with the comfort of cockpit heat comes the possible discomfort of doing yourself in. Do I have your attention? Most general aviation aircraft use a time honored heating system where intake air is passed over the exhaust manifold of the engine. If you’ve ever bumped against a tailpipe you know that it’s red hot and has plenty of heat to spare. Using that heat to...

  • Aeromedical Forum

    James D. Lakin PhD MD FACP, CFI, CFII, MEI, Airline Transport Pilot, FAA Sen Medical Advisor|Oct 1, 2019

    A couple of months back an older gentleman came in for a flight physical. He’d flown a number of years ago and wanted to “get back in the game” now that all the kids were through college and on their own. His health record looked good. He seemed a reasonable candidate for hopping back into the cockpit. Then we tested his vision. Much to our mutual surprise he was blind as a bat! Well, not really blind but he was having trouble seeing 20/100. In case you’ve forgotten what the funny numbers...

  • Aeromedical Forum

    James D. Lakin, PhD,MD,FACP,CFI,CFII,MEI|Jun 1, 2019

    One thing that endlessly confuses airmen (and occasionally AMEs) is the processing of Special Issuances. First of all what, you might ask, is a Special Issuance (SI)? An SI is granted by the FAA to a pilot who has a medical condition that otherwise would disqualify him from obtaining a medical certificate. The list of disqualifying conditions is a very long one. Basically anything that might suddenly or insidiously impair your ability to physically or mentally carry out the duties of pilot in co...

  • Aeromedical Forum

    James D. Lakin, PhD,MD,FACP,CFI,CFII,MEI|May 1, 2019

    The days are getting longer. The temperatures edging upward along with the cumulus build ups. It will soon be summer flying time! But before you start buzzing off to all those great pancake breakfast fly-ins you should be adding one more item to your I'M SAFE checklist-sun safety. All that time out on the tarmac and around the FBO adds up. If you're flying open cockpit, that can drastically increase UV ray exposure. UV or ultraviolet rays are high frequency light waves invisible to the human eye...

  • Medications on the Mind: Flying (or not) with Drugs:111

    James D. Lakin, PhD MD FACP CFI CFII MEI Airline Transport Pilot FAA Sen Med Examiner|Feb 1, 2019

    Over the last two months we’ve been talking about the many problems that can pop up when using medicines while flying. Side effects to watch for in the labeling of over-the-counter medications include light-headedness, drowsiness, dizziness and visual disturbance. Allergy, cold and sinus medicines are some of the most common culprits. Be very careful if you are thinking about taking any of those. Prescription medications usually don’t come with a list of side effects so it’s important to ask y...

  • Medications on the Mind: Flying (or Not) with Drugs: II

    James D. Lakin, PhD MD FACP CFI CFII MEI Airline Trans Pilot FAA Sen Aviation Med Examiner|Jan 1, 2019

    Last month we covered things to think about before taking a medication and hopping into the cockpit. Medications can cause a world of trouble for a pilot including idiosyncratic reactions and side-effects as well as failure to control the underlying condition for which you’re taking the drug. Light-headedness, drowsiness, dizziness and visual disturbance are the tops of the pops for side-effects that can cause a flight into the glass mountain. So what are some of the drugs to for-sure stay a...

  • Can Arthritis Ground You?

    James D. Lakin, PhD,MD,FACP,CFI|Aug 1, 2018

    As we get a little older its par for the course to get a little stiff and have a few aches and pains. If you fall into that silver-hair category, try sitting in a GA cockpit for five hours and then spring onto the tarmac. Make sure there’s somebody there to catch you! Sometimes however, those aching joints can get out of hand. Swelling, redness, pain, warmth and loss of function in a joint mean you’ve got arthritis. Arthritis happens frequently and comes in many forms. The most common type is...

  • Aeromedical Forum

    James D. Lakin, PhD,MD,FACP,CFI,CFII,MEI|Jul 1, 2018

    It’s been a long time since we’ve talked about the medical issues of high altitude flying. Since then General Aviation pilots have been spending more and more time at higher altitudes. The ubiquity of turbocharged single-engine GA craft has made it easy to crank an unpressurized cabin up to the flight levels and get that big tailwind. Before you do that though, make sure you have the right equipment for supplemental oxygen delivery and know how to use it! Your risks of oxygen starvation or hyp...

  • Aeromedical Forum

    James D. Lakin, PhD, MD, FACP, CFI,CFII, MEI....|Jan 1, 2018

    If you've looked out the window recently, you've probably noticed its winter in Minnesota. Thus, it's time to talk about how you can easily loose bits and pieces of your anatomy on the tarmac if you are not respectful of the cold. Not all of us have the luxury of a heated hangar. When we're flying cross-country in winter, it usually means doing some pre-flights on a windy, frigid stretch of concrete. That's an ideal set-up for freezing some part of you-Frostbite! The mildest form of Frost Bite...

  • Flying with Glaucoma: A CACI Condition

    James D. Lakin, Phd,MD, FACP, CFI, CFII, MEI,|Dec 1, 2017

    I don't know about you but that kind of call from ATC always gives me the willies. Someone is buzzing around out there. They don't have enough sense to turn on their transponder, if they have one, and I'm not picking them up with my peripheral vision. It makes you realize how difficult "See and Avoid" really is. Imagine how much more so that would be if hunks of your peripheral vision were gone. That's what happens in early glaucoma. That's why the FAA is really concerned if you have it....

  • Flying with High Blood Pressure: A CACI Condition

    James D. Lakin, PhD,MD,FACP,CFI,CFII,MEI|Nov 1, 2017

    Back in March of 2013, the FAA started defining “Conditions AMEs Can Issue (CACI).” They realized that many uncomplicated illnesses that had required a decision by the FAA in Oklahoma City could be monitored by a local Aviation Medical Examiner (AME). It’s been nearly five years since the FAA started granting this discretion to AMEs and it seems to have worked out well. There has been no increase in accidents attributed to this delegation of oversight and life has become a lot easier for pilot...

  • Sudden Pilot Incapacitation: Yikes!

    James D. Lakin, PhD, MD, FACP, CFI, CFII, MEI|Oct 1, 2017

    March 29 this year, a Boeing 737-300 (AA 1353) was on short final heading into KABQ down in Albuquerque when the First Officer suddenly slumped forward, unconscious. Fortunately, the Captain noticed, summoned paramedics, and landed the plane safely. Attempts to revive the First Officer were unsuccessful, the presumed cause of death being a heart attack. Fortunately, life-threatening incapacitation of pilots in a commercial setting is rare. Even more rare is the flight's safety being...

  • The FAA's New Approach to Sleep Apnea

    James D. Lakin, PhD, MD, FACP, CFI, CFII, MEI|Jul 1, 2017

    It's been almost five years since we talked about sleep apnea (September, 2011) and the FAA's approach to this problem has been updated. Obstructive sleep apnea (OSA) is very common. .It affects anywhere from 9% to 28% of adults. It happens when the upper airway becomes obstructed during sleep causing disruption of normal sleep patterns. It is usually caused by overweight. Fat tissue in the neck can block the airway, causing an interruption of air flow. It seems to occur more commonly in men...

  • Melanoma:The dark spot that can do you in!

    James D. Lakin|Jun 1, 2017

    Our cousin had a dark black spot on her lower leg for a couple of years. Her local doc told her not to worry. It got bigger. She let it slide for a few months as she and her husband were moving up here to The Cities. I got her in to a dermatologist who biopsied it and confirmed what we both were thinking and dreading-malignant melanoma. It had spread throughout her body. She was dead six months later. Unfortunately, this tragic story is a common one. The incidence of this form of skin cancer...

  • Aeromedical Forum

    James D. Lakin|Apr 1, 2017

    Last month we took a look at some of the provisions of BasicMed, a new way to legally fly without a Third Class Medical Certificate. We talked about the restrictions on aircraft type and operation as well as the basic procedures a pilot will have to follow if she/he elects to go this route to establish medical qualification. Bottom line-if you are a healthy person under the age of forty, it's probably easier and more cost effective to stick with the traditional Third Class Medical. If, however,...

  • Aeromedical Forum

    James D. Lakin|Mar 1, 2017

    Last month we took a look at some of the provisions of BasicMed, a new way to legally fly without a Third Class Medical Certificate. We talked about the restrictions on aircraft type and operation as well as the basic procedures a pilot will have to follow if she/he elects to go this route to establish medical qualification. Bottom line—if you are a healthy person under the age of forty, it’s probably easier and more cost effective to stick with the traditional Third Class Medical. If, how...

  • Aeromedical Forum: January 2016

    Dr. James D. Lakin, Minnesota Flyer|Jan 1, 2016

    A few months ago I had a chance to listen to a presentation by a staff attorney from the Enforcement Division of the FAA’s Washington office, Amanda Bruchs. She talked quite a bit about the issues of falsification of the application for medical certification that most of us fill out periodically. I’m talking about FAA Form 8500-8, that miracle of fine print and little boxes into which you pour your life history. Indeed, down in the lower left hand corner of page two we are informed that “Whosoev...

  • Aeromedical Forum: December 2015

    Dr. James D. Lakin, Minnesota Flyer|Dec 1, 2015

    Every time I get a new edition of Federal Aviation Regulations/ Aeronautical Information Manual (FAR/AIM) I’m amazed that it’s grown as fast as my three-year-old grandson! Pilots operate under an increasingly complex matrix of regulations and aviation medicine is no exception. So I thought it was high time to take a look at some of the legal issues and procedures affecting medical certification. This month we’ll touch on the application and certification process. We’ll also cover the options...

  • Aeromedical Forum: November 2015

    Dr. James D. Lakin, Minnesota Flyer|Nov 1, 2015

    Mackinac Island sits in the Straights between Lakes Huron and Michigan. It is a magical, special place. Unfortunately for the pilot it is also a realm of mist, fog and low-hanging clouds with convection currents at each end of the approach and squirrely cross winds pouring over the forest-lined runway. Deb and I were departing from KMCD last September into a 300-foot ceiling. The clag was confined to the island and it was CAVU across the straights in Cheboygan, so we had a good Plan B, if...

  • Aeromedical Forum: October 2015

    Dr. James D. Lakin, Minnesota Flyer|Oct 1, 2015

    “If you want keep her on the runway it helps to see the centerline.” Supporting this truism, the FAA has a maze of regulations to make sure that the intrepid pilot can locate the runway environment. So let’s look at a few common questions airmen ask about their eyeballs. “First of all, just how good does my eyesight have to be?” It depends. For a Third Class Medical Certificate which is all you need unless you’re flying for compensation, you have to see at least 20/40 in both eyes for both di...

  • Aeromedical Forum: September 2015

    Dr. James D. Lakin, Minnesota Flyer|Sep 1, 2015

    In July we talked about migraines. Last month, strokes. Now, brain tumors. I know this is starting to look like “The Grim Reaper Report” but these things are more common than you’d think and sure can affect your flying! As a matter of fact, if you were to do a brain scan (MRI) on every healthy adult that walked in the FBO, you’d find one brain tumor in every 2,000 exams. So these things are by no means rare. How do you know if you have one? Symptoms can vary, but headache is common. The trouble...

  • Aeromedical Forum: August 2015

    Dr. James D. Lakin, Minnesota Flyer|Aug 1, 2015

    My father-in-law Harry was one of the greatest guys you’d ever hope to meet. He always had a ready laugh, a twinkle in his eye. He was a wonderful father to my wife and a kind and supportive grandpa to our kids. And, of course, he loved flying with us! How heartbreaking it was to see him decline mentally as a series of strokes progressively reduced his ability to function in his last years. Unfortunately stroke or cerebrovascular accident (CVA) is a common health issue, and it’s not con...

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