went for class 2 today...

[ayavner]

Ok went and saw him today, I actually like the guy and he seems to know what he's about... I do have to do the sleep test, but it will be with my mask and he is just using that to demonstrate proper control of the OSA. Then there's this thing he wants me to do next day, basically sitting in a room all day and trying to stay alert for 40 minute stretches... can't remember what that's called, just sounds like boredom haha.

 

so this is mid to late april, so now looking like at least May before i can start my PPL... i've already been spinning my wheels 2 months with this stuff, i could conceivably be well into it or even done by now at the rate i was planning to go...

 

but, progress!

 

 

[Jaba-who]

I'm glad to hear its getting somewhere, albeit at glacial pace with plenty of cost attached. :-(

 

Keep us posted as to how it all goes.

 

The staying awake for 40 minute stretches seems a bit onerous and i wonder what its going to prove.

 

If your sleep test shows obstructive sleep apnoea (OSA) they will pull your medical whether you nod off to sleep next day or not.

 

If your test shows some small amount of OSA and you don't doze off it might suggest that small amounts are tolerable to you. But I doubt CASA would be generous.

 

But Now lets say:

 

Your sleep test shows no OSA but then you do doze off during the day.

 

That will prove you are tired but since you had no sleep apnoea it must be another cause of it.

 

Remembering that the deleterious effects of sleep apnoea are related only to the actual events of OSA. Essentially there are a bunch of sleep deprivation issues that arise from the cycling of sleep- obstruct - wake - sleep that occurs. And then a number of cardiovascular issues arising from the carbon dioxide retention and low oxygen levels that go with the obstruction.

 

If you fix the obstruction ( with CPAP) there are no residual deficits.

 

No other pilot is required to prove they don't get sleepy during the day from causes other than OSA.

 

Starting to sound like discrimination rather than medical rationale.

 

 

[jetjr]

Many CPAP machines can log comprehensive monitoring data

 

Resmed has a software program which shows OSA and fequency

 

From formal sleep test will get a number per hr, then compare to longterm data. This can gove BETTER monitoring than a one night test at clinic.

 

Data can go from 20-30 to 2-3 with CPAP, very few therapies have as sucessful result as CPAP

 

 

[Bandit12]

Then there's this thing he wants me to do next day, basically sitting in a room all day and trying to stay alert for 40 minute stretches... can't remember what that's called, just sounds like boredom haha.

When you remember/go through with it and if you feel like it, would love some more information about what that test is, and to see what justifications there are for it.

 

 

[pmccarthy]

My brother has OSA and lost his taxi license, now he drives a bus. Says he would rather die peacefully in his sleep than screaming in terror like his passengers.

 

 

[DrZoos]

A bad consequence of the CASA inflexibility is that people with serious sleep apnea allow it to go undiagnosed and untreated because of the hassle diagnosis would cause with a Class 2. Apnea leads to cardiac problems. I reckon more people are dying unnecessarily from this than would die from falling asleep at the stick if CASA allowed treated sufferers a Class 2.

And when CASA procedures and policies can be demonstrated to lower safety there should be an ombudsman that can be consulted to slap them back into shape.

Its unacceptable to have a governing body that lowers safety intentionally or unintentionally.

 

If it where just OSA, well its a simple problem to address but it seems to be everything from maintenance, to MTOW etc etc etc .... CASA seems to do a good job in passenger transport but they are appalling in GA and for RAAus.. When everyone avoids anything to do with CASA at every possible turn we have a systemic problem. Hopefully the senate inquiry will address this issue. I believe they are encouraged to keep accepting submissions and this is a great case to put to them.

 

 

[metalman]

Very good advice to only give CASA what they ask for and nothing more, I've had kidney stones and had to have a CT. Done this time, I wonder how many clear scans before they stop wanting my testicles fried with radiation , this time I've had a joint replacment done ,so far the DAME was happy with no issues ,but I'm waiting for a AVMED letter,

 

Matty

 

 

[ayavner]

Well let's see how we go. This Dr. seems pretty well versed in dealing with CASA and seemed fairly certain that he's doing as much as he needs, but no more, to satisfy the question they asked. Part of the problem is I don't have the records for my initial diagnosis... But, will see how it goes. Bandit12, and indeed everyone - I will certainly keep this thread updated to the best of my ability, because I suspect I won't be the last one with this situation.

 

The actual overnight is on 7/4, with a follow up in a week, so I suspect awhile after that for CASA to stroke their beards over it. Bureaucracy at its finest... they don't really know, so they have you do everything "just in case" then when its done, there's more hoops basically to avoid making a decision.

 

DrZ, how do i find out about this inquiry? Not sure I want to put myself "out there" just yet, as so far I have no reason to suspect a "no"... but, just in case...

 

 

[pmccarthy]

My last post was a bit frivolous but what I intended to say was that you can get a bus drivers license with OSA but not a taxi licence. It's not just aviation that is quite illogical.

 

 

[DrZoos]

http://www.aph.gov.au/binaries/senate/committee/rrat_ctte/casa/report/report.pdf

 

Your case highlights why others would avoid diagnosis or telling the doctor about it. Cost cost cost, hassle hassle hassle and it all lowers safety.

 

 

[pj8768]

I work in the Sleep Medicine field.

 

For private and commercial vehicle holders with a diagnosis of OSA, a Sleep Physician report is needed to indicate that the patient is compliant with effective therapy for OSA. This either means CPAP or some other therapy. In this group, a report is required annually from a specialist (not a GP), e.g. Grafton RTA medical unit in NSW for example spits out a form every year to put people through the ringer, regardless of whether it is medically indicated or not. Some patients have had resolution of their OSA with weight loss confirmed with a sleep study, but still receive the RTA green form - once on - you're on for life.

 

A national document from Austroads is often referred to (on PDF online).

 

For PPL, pretty much the same process as above, but I suspect every 2 years for class 2 although not sure, could be annual.

 

There should still be concern about OSA though, but with balance - tiredness and fatigue are on a spectrum and affects people in different ways. For fatigue related accidents, a microsleep is not required, as the disturbed sleep from OSA can impair reaction times, tracking and judgment.

 

A vexed issue for commercial truck drivers - inadequate screening and no incentive to seek medical attention as automatically singled out and earmarked for life. Stats are bad - more than 50% compared with 10% general population, but most avoid diagnosis. Commercial pilots look a healthier bunch.

 

A broad sword approach to all-comers is just stupid. CASA and RTA should respect medical judgment - the example above of annual CT scans indefinitely for a kidney stone is negligent at best. Knowing you're going to be screwed over by a regulator that does not listen to specialist medical advice does not inspire confidence to seek medical advice in the first place- places safety in jeopardy for the long-term. Motivated by self-preservation and easier to say "computer says no" I suspect.

 

Read in one of the American flying mags their regulator was considering mandatory sleep screening if weight/BMI was above a certain limit. They're not happy.

 

First victim of bureaucracy is common sense. Medicos now have to routinely negotiate with dim-witted genY public servants on a daily basis to manage patients. That felt good typing that sentence.

 

 

[Jaba-who]

Fortunately the Americans have seen some sense. The FAA have been forced by someone higher up ( think it was congress but not sure ) to take it all back to the drawing board and they have to show justification why they should make the rule.

 

In effect they have to show a real benefit and show it justifies the cost.

 

Doesn't mean they won't get it up again. But I doubt they will because they will have an almost impossible task showing that a sleep study (costing $thousands) in an elevated BMI alone can reduce risk in a problem that already contributes almost zero to the accident profile in the USA.

 

 

[naremman]

G'day Ayavner. Whilst I wish you well in you pursuit of a Class 2 Medical, rather than comment on your individual case I would prefer to make some more general comments.

 

I see maintaining a Class 2 Medical not as an imposition, but rather an investment in my own health. With the mean age of those engaging in aviation seemingly acquiring more maturity every year, we seem to be forever managing imperfect bodies. North of 50 and all of a sudden hypertension, blood sugar levels, respiratory effectiveness, gunk in our blood, creaking joints, mass acquisition, astray hormones, sight degradation, auditory efficiency and the incipient stages of old timers disease can come to us either individually, or more worryingly, cumulatively.

 

I have been lucky, that despite living in a small Wheatbelt country town where you would anticipate not having the best medical facilities, I have had the same brilliant GP for the past 14 years, supplemented by a DAME who visits the practice every six weeks. for about the same period. My medical about 12 years had an issue cross the line, and we worked to get the issue resolved to the point where my medical was reissued after 3 months. Problem identified, and managed and no issues subsequently. I will live with the issue for the rest of my days, but it is monitored regularly, medication adjusted where necessary and as they saying goes: "I will be fine while I take the medication". The three of us work together to the benefit of my health. The GP once advocated a new medication, and after talking with the DAME I informed the GP: "your proposal was discussed and put to the vote, and it was two votes to one, with you being the one." Luckily the GP and I are good mates.

 

I underwent a steep learning curve when I trained as an Advanced Ambulance Care Volunteer Ambulance Officer with St John Ambulance WA. Then I learned a lot more about monitoring the body's vital signs. These days the average person can set themselves up with a digital blood pressure machine, blood sugar level tester and pulse oximeter for $3-500. At the beginning of the week in about five minutes I can record blood pressure, blood sugar level and oxygen saturation and have it noted in my diary. This data gives me good feedback on how I am travelling, but importantly I can supply the data to my health professionals to assess. You then have the means of being a good advocate for your own health. Ambulance skills are not necessary, anybody can easily learn these simple skills and use them effectively.

 

This week I fronted my DAME six weeks post a total hip replacement to have my pilot medical revalidated. All went well so I am fit to commit aviation again. The biggest pain was spending a heap of time on CASA's website finding the relevant regulations to deal with the issue. 30 days to notify either your DAME or CASA, at pain of 50 penalty points, or whatever the currency is these days!

 

Hang in Ayavner, the road from Earth Angel to Angel Flight pilot will have the occasional pothole. I have found in matters medical, you can forget the watch, but sometimes a calendar can be useful!

 

 

[Yenn]

I hope somebody here put in some comments to the government inquiry into CASA.

 

 

[facthunter]

They just cover their Ar$e and if you can't provide almost absolute assurance that they won't have a problem with YOU, (which is impossible) they can (and do) just not issue you with a licence.

 

Zoos, Do a better job with with "passenger Transport" ?? NO the same situation applies. What has changed is that THEY would accept highly qualified opinion, at times in the past, because it is from a superior knowledge source and gives them the ar$e covering assurance . They don't pay high salaries in the avmed dept, so they don't have experts. But now go down the line of "looks like it needs looking into, deny the licence" That way they don't lose their job (because they are nor really doing it) but you lose your entitlement to fly. (At ANY LEVEL)

 

The first post coronary bypass ATPL holder to go back flying was in 1989 in this country and there would be large numbers since. Responsible people have themselves tested and monitored and treated and should be safer than those out there with bad lifestyles etc but the hand grenade hasn't gone off yet so on paper they look OK. Nev

 

 

[DrZoos]

Fortunately the Americans have seen some sense. The FAA have been forced by someone higher up ( think it was congress but not sure ) to take it all back to the drawing board and they have to show justification why they should make the rule.In effect they have to show a real benefit and show it justifies the cost.

Doesn't mean they won't get it up again. But I doubt they will because they will have an almost impossible task showing that a sleep study (costing $thousands) in an elevated BMI alone can reduce risk in a problem that already contributes almost zero to the accident profile in the USA.

Wow i love that idea. CASA should be forced to assess whether each of its rules has a benefit or detriment. And how they can get rid of most or all of the detriment to safety... Then they might change there ways

 

 

[facthunter]

They are required to support aviation, not eliminate it. Nev

 

 

[DrZoos]

Exactly nev who is safer, someone diagnosed and treated or someone undiagnosed because they are scared oft he ramifications. Also what is CASA duty of care to both the public and the pilot , in having procedures that stop that person taking the proper action. Its certainly a foreseeable event, that a single pilot aircraft goes down because the pilot was scared of losing his career if he sought treatment.

 

 

[DrZoos]

Wow i love that idea. CASA should be forced to assess whether each of its rules has a benefit or detriment. And how they can get rid of most or all of the detriment to safety... Then they might change there ways

I mean in relation to thes rules that prevent people from seeking treatment.

 

 

[DrZoos]

In aviation it seems you need two seperate doctors. One to go to with all your basic problems like an ear ache. And one to go to with all your real problems you dont want n the record.... Then just tell the CASA medico about one...... Now thats god policy isnt it...

 

 

[facthunter]

I pointed out that a certain process would result in people not being tested and as a consequence their eventual outcome would be jeopardised. They completely agreed but wanted me to do about 2 weeks work getting information they should have. All they would have had to do was write a few letters to the right people. Those who have never been near doctors can slip through a lot easier. This is not the way it should be. Nev

 

 

[ayavner]

Well, got through my sleep study with predictable results (perfectly controllable with CPAP) and even sat a full-day Maintenance of Wakefulness Test and did not get drowsy or fall asleep once - which should be pretty compelling evidence that the CPAP works AND that I don't have any issues staying awake though the day - so its all in their hands now, spoke to them yesterday and was told they have everything they need and should have something in the next few days... assuming of course no one else decides they need more info... seriously, 4 months to get this thing, I surely could have finished up my PPL by now.

 

Anyway, here's hoping! :)

 

 

[coljones]

Wont the rpl make getting a ppl a waste of time... In regards to being allowed in cta. I thought the rpl has a cta endorsement in the legislation.

You still need a medical with any CASA licence. Minimum is either a Class 2 or a Drivers Licence (Aviation) Medical

 

 

[Jaba-who]

Dr Zoos wrote, "Wont the rpl make getting a ppl a waste of time... In regards to being allowed in cta. I thought the rpl has a cta endorsement in the legislation."

 

An RPL is basically the new name for a GFPT (old name = restricted pilot licence), with some minor changes. To my mind it's the RPL that's a waste of time.

 

If your base is inside CTA you will have to get an endorsement, if your base is more than 25 nm from the CTA its irrelevant. You can't travel the distance to get there unless its part of a training flight.

 

If your base is within 25 nm and you want to go in then yep you can get an endorsement.

 

But if you have a recreational medical then you can only carry one other person. That may suit or may not.

 

In reality there are now so many combinations that any one pilot may have multiple combinations that may suit them or their preferences may change during their training and turn what they have done upside down. It's making it very hard to advise prospective pilots what on earth they should do or get. :-(

 

 

[ayavner]

aaaannnnd, got mine in the mail yesterday!

 

I am a little confused, they have made it for 1 year - at 44, i thought they were still good for 2 years? I'll have to look it up. Also they made it 12 months from the date of application, NOT the date they issued it, so 4 months of slogging for essentially an 8 month medical certificate... the last few months of which will no doubt be consumed in trying for the renewal... should i even bother asking? or just take it and be grateful?