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  • Aeromedical Forum

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

    This spring I received a note from an airman wondering about his odds of getting off a Special Issuance. Five years previously he had a heart artery calcium scan which showed heavy calcification in one of his coronaries-arteries that supply the heart muscle with blood. He reported this to the FAA. They promptly requested additional studies including a stress test and imaging studies. These looked OK, according to the airman. However, they placed him on a Special Issuance requiring these tests... Full story

  • Aeromedical Forum

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

    A couple of months ago we talked about the then looming pandemic. Well here it is and it looks like it's going to be around for a while. The good news is that Minnesota has done an effective job of slowing the rate of viral transmission of SARS Cov 2 (Serious Acute Respiratory Syndrome Coronavirus 2) and reducing the rate of development of clinical Covid 19 (Coronavirus 2019) illness. The bad news is that the duration of the epidemic may be prolonged, albeit at a lower intensity. So assuming that you're not going to spend the next two years... Full story

  • Aeromedical Forum

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

    As I sit in my office at Airlake, a King Air is revving up its engines. Good Lord it's loud and I have the benefit of 30 yards separation and a wall between me and it. Pity the lineman that's out there waving his batons. Ever since Wilbur and Orrville ran their Flyer down the sand at Kitty Hawk the business of powered flight has posed a threat to the hearing of pilots. So how to retain what hearing you have after an adolescence of rock concerts? First of all, let's talk about sound. You may... Full story

  • Aeromedical Forum

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

    How many months are we into winter? How many pounds have we put on? Since you can only get so much exercise from throwing around snow, it's hard to avoid the "Late Winter Couch Potato Syndrome"! Lack of physical fitness and overweight are bad enough for the Average Joe. It sets you up for anything from lower back pain to hypertension to heart attacks. For a pilot, deconditioning can lead to problems in stamina, alertness and the ability to respond to the emotional and physical stressors... Full story

  • Aeromedical Forum

    James D. Lakin PhD MD FACP, CFI,CFII,MEI,Airline Trans Pilot,FAA Sen. Aviation Medical Examiner|Mar 1, 2020

    One thing about the aviation community, we get around. We are exposed to many different terrains, population, cultures and, unfortunately infections. If you’re flying under Part 121 or 135 you often cover a lot of territory and come into contact with a lot of people and a lot of viruses. Many General Aviation operations also fall into that category. Given all that, a lot of pilots have been wondering about the Coronavirus epidemic that started in China in January. It is spreading. The possibility of coming in contact with it is not as remote a... Full story

  • 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... Full story

  • 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... Full story

  • 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... Full story

  • 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... Full story

  • 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... Full story

  • Aeromedical Forum

    James D. Latkin PhD MD, CFI,CFII,MEI,Airline Transpost Pilot, FAA Senior Medical Examiner|Sep 1, 2019

    Stop by the pharmacy section at the grocery or drug store and you’ll find a dietary supplement for just about everything you want to be: strong, big, potent, smart, handsome. You name it and somebody will sell you an extract of herbs and vitamins to fit the bill. Now I know that there are folks that swear by whatever they’re taking to achieve whatever they want out of life and that’s fine, sort of. Indeed more than 50% of adults in the US consume dietary supplements to the tune of $35 billi... Full story

  • Aeromedical Forum

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

    Over thirty states have legalized the use of marijuana or its active ingredients (cannabinoids) either for medical or recreational use. Here in Minnesota medical marijuana has been available for several years although its use is strictly regulated by the State Department of Health. To get in the door of a cannabis (marijuana) dispensary you first have to be seen by a certifying physician approved by the health department. If you have any of the approved conditions inclusive of cancer associated... Full story

  • Aeromedical Forum

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

    Last month we talked about Special Issuances, the route to medical certification when you have a significant medical condition that might affect your flying. This involves getting reports from your treating physician along with tests, sending them to the FAA, getting a flight physical from your AME, waiting four to six weeks and, if all is well, getting your medical. A few years back the FAA took a look at sorting out those airmen that had a medical condition that might be an issue but were... Full story

  • 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... Full story

  • 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... Full story

  • Aeromedical Forum

    James D. Latkin PhD MD, FACP CFI CFII MEI Airline Transpost Pilot FAA SR. Aviation Med. Examiner|Apr 1, 2019

    Back in September of 2015 on a trans-Atlantic Air Canada flight a two year old asthmatic boy started to develop cough, wheezing and progressively worsening shortness of breath. The parents had put the kid's asthma medicines in their checked luggage. Duh! Fortunately the aircraft medical kit had oxygen and some asthma medication. Even more fortunately a Canadian doc who specialized in medical robotics was on board. He jerry-rigged a makeshift nebulizer, using a plastic carton and a paper cup to... Full story

  • Attention Deficit Hyperactivity Disorder or Not?

    James D. Latkin PhD MD, CFI,CFII,MEI, Airline Transport Pilot,FAA Senior Aviation Medical Examiner|Mar 1, 2019

    I know you’ll find this hard to believe but diseases sometimes can be fads. In other words some disorders catch the public fancy and all of a sudden “everyone’s got it”. Entities such as Chronic Fatigue Syndrome, fibromyalgia, Lyme’s Disease all are documented illnesses and can be very serious but a lot of people decide they have them because they don’t have any better explanation for their problems. Sad to say, sometimes a health care provider erroneously tags someone with one of these label... Full story

  • 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... Full story

  • 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... Full story

  • Aeromedical Forum

    James D. Latkin PhD MD, FACP,CFI, CFII, MEI, Airline Transport Pilot, FAA Senior Medical Examiner|Dec 1, 2018

    In 2011, the FAA reviewed the toxicology reports of 1,353 recent fatal General Aviation accidents. They found that 42 percent of all pilots involved had drugs in their blood stream that impaired performance. It's a stark reminder that the most common cause of aviation accidents is pilot error, and that a frequent contributor to those errors is drugs, legal or illegal. If you're using crack, ecstasy or heroine, you've got no business going near an aircraft, much less trying to fly it. Now, I'm... Full story

  • Central Serous Retinopathy: AKA Blind as a Bat!

    James D. Latkin PhD MD, CFI CFII MEI Airline Transport Pilot FAA Senior Medical Examiner|Nov 1, 2018

    One morning a while ago, a pilot friend awoke and noticed his eyesight was funny. His Venetian blinds looked wavy instead of straight. It seemed that colors weren’t as vivid as they should be. Things seemed a little fuzzy in one eye. He went barreling over to his eye doc and was told he had central serous retinopathy (CSR). This is caused by fluid buildup between the retina and its underlying support on the back of the eye. This leads to a partial a separation of the retina, causing the v... Full story

  • Aeromedical Forum

    James D. Latkin PhD MD, FACP,CFI,CFII,MEI, Airline Transport Pilot, FAA Senior Medical Examiner|Oct 1, 2018

    Question 17b on your FAA MedXpress Form 8500-8 which you fill out before a flight physical, is one that gives folks a hard time: “Item 17b Do You Ever Use Near Vision Contact Lenses While Flying?” Some airmen will say yes if they wear any lenses at all, including eyeglasses. That’s wrong. Some airmen will say yes if they wear any type of contact lens. That’s wrong. Some airmen will say yes if the wear contacts with bifocals. Wrong again! What the FAA is looking for, and wants you to avoid,... Full story

  • To Sleep: Perchance to Dream - in the Flight Levels

    James D Latkin, PhD MD FACP CFI MEI Airline Transport Pilot FAA Sr Aviation Med. Examiner|Sep 1, 2018

    Going to sleep in flight can be a big problem. If you are the Pilot Flying going to sleep is really bad. If you're a long haul relief pilot, not going to sleep can spell trouble. A number of the airline pilots we see have difficulty sleeping in flight on trans-oceanic runs. If you're part of the cockpit crew or flying first class you at least have the option of lying down. That's a big help. Our pilots seem to prefer the newer Boeing 787's or Airbus 380's flight crew rest compartments that provi... Full story

  • 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... Full story

  • 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... Full story

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