The Medical Exodus - by Dr Robert Liddell

[old man emu]

This is the stupid part about this. I can understand a very stringent medical for someone in commercial ops like flying a jet with 800 pax etc...but I can drive a B-double weighing 65 tonne at 100 kph or a bus or a train carrying 500 pax...yet I can not pass the CASA version of the Ausroads medical let alone a class 2 with all the crap. I just want to fly with 2 people total in any aircraft up to 1500kg I don't want to fly in CTA at all I have no interest in it. I am sure there are many pilots in the same boat.

I think I said something along these lines a month or so ago.

 

Somehow I don't think all the tests in the world can predict when your number is up. I've seen young, fit blokes drop on the spot with heart attacks and fat old bastards go on and on and on.

 

OME

 

 

[Kyle Communications]

I hope I am one of those fat old bastards then

 

 

[poteroo]

The Stress ECG combined with an ultrascan is one of the most valid of tests

Yes, this is what I have annually. It detected a Left Ventricle Branch Block in 2013, which my DAME believed was due to a 'cholesterol plaque' - due my higher bad cholesterol level and generally highish total ch levels. I was also just on 5.5 BSL - the bottom end of caution range for type 2 diabetes. So, onto the statins, (40mg) plus 1 aspirin daily. Have added to that with stricter diet, (5:2 fasting), plus an hour on the bike every day, (burn at least 600-800 Cals). Seems to be working as everything is way down and tests looking better each run. Kyle is right - don't let things get away in respect of your health because it's damned hard to recover it.

 

happy days,

 

 

[old man emu]

My issue was diabetes got me. I still have this issue with the diabetes but early next year I think that will hopefully be fixed and if all goes well after a operation and I will no longer be a diabetic.

I'm interested in what you are going to undergo next year. What surgical intervention will beat your diabetes? I take it that you are Type ll.

 

(An aside - isn't it tragic that we'll natter away about diabetes and cardiac problems , but we are backward in coming forward about stress and depression?)

 

OME

 

 

[Flying Librarian]

I failed my class two medical due to depression. This was despite it being diagnosed as moderate. Four seperate psychiatrist reports stating that I was "fit to fly", we're all simply rejected by Avmed. I'm still legal in Ra Aus and a road train though. Seasons greetings all. Flying Librarian

 

 

[rankamateur]

I reckon I'll just keep operating in ground effect.OME

So says the large flightless bird.

 

 

[BoxFat]

I failed my class two medical due to depression. This was despite it being diagnosed as moderate. Four seperate psychiatrist reports stating that I was "fit to fly", we're all simply rejected by Avmed. I'm still legal in Ra Aus and a road train though. Seasons greetings all. Flying Librarian

I think this gets to the nub of the problem: if CASA is going to ignore the advice of our best medicos, obtained by pilots clearly actively involved in managing their own health (and not just at the time of the exam), what's the point ? I do it now for reasons of health alone because I now have the uncomfortable feeling that the more info I provide the LESS likely it is my class 2 will remain valid. If this is the case it encourages avoidance behaviour and makes the average licenced pilot less healthy. I think this was one point Dr. Liddell made in the letter quoted at the start of this thread.

Merry Christmas

 

BF

 

 

[rankamateur]

An aside - isn't it tragic that we'll natter away about diabetes and cardiac problems , but we are backward in coming forward about stress and depression?

Not backward at all, have a beer with you anytime Emu, but mine will be Bundaberg Ginger, I just don't need any more depressants in my system than I already have.

 

 

[Kyle Communications]

I'm interested in what you are going to undergo next year. What surgical intervention will beat your diabetes? I take it that you are Type ll.(An aside - isn't it tragic that we'll natter away about diabetes and cardiac problems , but we are backward in coming forward about stress and depression?)

 

OME

OME

 

Yes I am a bad type II diabetic. I take so much insulin it drives me to distraction the only good side is that I am monitoring it all the time I take blood samples usually around 3 to 5 times a day to try to keep it under control so my sugar graph looks like a roller coaster some times. My liver is a sugar factory it does not get the turn off command to stop producing sugar. My doctor has been at me to look at getting a gastric bypass. This removes the lower part of your stomach which produces this enzyme that tells my liver to keep producing sugar. I got a band in back in 2005 to help me lose weight. it worked to a point but didn't stop or even slow the diabeties problem. My band is now starting to give me some issues and this is apparently common with long term stomach bands that is why they don't do them anymore. Weightloss surgury now comes in 2 forms, a gastric sleeve and a gastric bypass. The byproduct of both of these is that the sleeve for diabetics only has around a 30 to 40% success rate of lowering or getting rid of diabetes. The gastric bypass has around a 90% success rate of getting rid of diabetes or at least it reduces your diabetes to a very manageable level. Because I have had a band my only option is the bypass as the band creates a lot of adhesions and damage and they won't do a sleeve if you have had one. Both remove the bottom part of the stomach but the sleeve still leaves you a partial part of the bottom. The bypass when they do it takes the most of the stomach away and because of this when you eat food not as much is adsorbed by what is left of the stomach and the gut then does most of the digestion but it does not absorb the carbs in the same way.

 

There are some side effects of course but quite liveable with and it doesn't really impact very much. After 9 years with the band it has its own issues too so that doesn't phase me. I have done a lot of research about both methods and the bypass is the one I would have to have anyway. Geoff13 and I had a discussion about it and he knows 2 trucks that had the bypass and the results were very successful to the point both guys were now off insulin. both said they wish they had it done 20 years ago. Its not cheap as it is elective its around $15,000 but really its nothing in the scheme of things if it helps you live longer and gets rid of the diabetic issue to a point where it is not a huge health issue. The weightloss of course is a good thing and obviously helps the diabetes issue. As you may or may not know when you inject insulin it is soul destroying when trying to lose weight. Because you are pumping yourself with insulin anything you eat pretty much gets turned into fat this is why you will see most type II are overweight and can never seem to lose it. I am the same and struggle every single day trying to at least keep my weight on a flat ride but just need one or 2 indulgences and bang on goes a kilo

 

http://www.lapsurgeryaustralia.com.au/weight-loss-solutions/laparoscopic-gastric-bypass

 

This link is only one of thousands but gives a good idea of the procedure and the outcomes. I have a appointment with my surgeon gorgeous George (George Hopkins) he is the most experienced in this field in Australia he did my band also fixed my hiatus hernia and took out my gall bladder all the same time back in 2005. I drove home the next day and was at work the next day after it pretty much was a no brainer. This operation is a bit different of course and you need around 2 weeks off work. So I will know more after the 16th of January. If you are interested I will keep you informed or anyone else who would like to know as well.. I use a blood sugar device that downloads to my iPhone it is magic for tracking as it attached directly and downloads to the phone and stores all the data which can be emailed etc. This is just a chart version of my last month

 

 

Mark

 

 

[jeffd]

OMEYes I am a bad type II diabetic. I take so much insulin it drives me to distraction the only good side is that I am monitoring it all the time I take blood samples usually around 3 to 5 times a day to try to keep it under control so my sugar graph looks like a roller coaster some times. My liver is a sugar factory it does not get the turn off command to stop producing sugar. My doctor has been at me to look at getting a gastric bypass. This removes the lower part of your stomach which produces this enzyme that tells my liver to keep producing sugar. I got a band in back in 2005 to help me lose weight. it worked to a point but didn't stop or even slow the diabeties problem. My band is now starting to give me some issues and this is apparently common with long term stomach bands that is why they don't do them anymore. Weightloss surgury now comes in 2 forms, a gastric sleeve and a gastric bypass. The byproduct of both of these is that the sleeve for diabetics only has around a 30 to 40% success rate of lowering or getting rid of diabetes. The gastric bypass has around a 90% success rate of getting rid of diabetes or at least it reduces your diabetes to a very manageable level. Because I have had a band my only option is the bypass as the band creates a lot of adhesions and damage and they won't do a sleeve if you have had one. Both remove the bottom part of the stomach but the sleeve still leaves you a partial part of the bottom. The bypass when they do it takes the most of the stomach away and because of this when you eat food not as much is adsorbed by what is left of the stomach and the gut then does most of the digestion but it does not absorb the carbs in the same way.

 

There are some side effects of course but quite liveable with and it doesn't really impact very much. After 9 years with the band it has its own issues too so that doesn't phase me. I have done a lot of research about both methods and the bypass is the one I would have to have anyway. Geoff13 and I had a discussion about it and he knows 2 trucks that had the bypass and the results were very successful to the point both guys were now off insulin. both said they wish they had it done 20 years ago. Its not cheap as it is elective its around $15,000 but really its nothing in the scheme of things if it helps you live longer and gets rid of the diabetic issue to a point where it is not a huge health issue. The weightloss of course is a good thing and obviously helps the diabetes issue. As you may or may not know when you inject insulin it is soul destroying when trying to lose weight. Because you are pumping yourself with insulin anything you eat pretty much gets turned into fat this is why you will see most type II are overweight and can never seem to lose it. I am the same and struggle every single day trying to at least keep my weight on a flat ride but just need one or 2 indulgences and bang on goes a kilo

 

http://www.lapsurgeryaustralia.com.au/weight-loss-solutions/laparoscopic-gastric-bypass

 

This link is only one of thousands but gives a good idea of the procedure and the outcomes. I have a appointment with my surgeon gorgeous George (George Hopkins) he is the most experienced in this field in Australia he did my band also fixed my hiatus hernia and took out my gall bladder all the same time back in 2005. I drove home the next day and was at work the next day after it pretty much was a no brainer. This operation is a bit different of course and you need around 2 weeks off work. So I will know more after the 16th of January. If you are interested I will keep you informed or anyone else who would like to know as well.. I use a blood sugar device that downloads to my iPhone it is magic for tracking as it attached directly and downloads to the phone and stores all the data which can be emailed etc. This is just a chart version of my last month

 

[ATTACH=full]33305[/ATTACH]

 

Mark

hey kyle there r ways to beat /turn around diabetes on the internet ,u probably hav seen some of these anyways but i hav found some myself to be quite an interesting read.dont expect to much help from doctors to beat this as it is a billion dollar a year medical condition.i am renewing my flying training in the new year so will send u a friend request on facebook to talk more about it although like i said u probably know of them already cheers

 

 

[Gnarly Gnu]

Well I had a stress test on a treadmill and it all showed clear no issues. 6 months later I had a angiogram and was found to have all 3 arteries 90% blocked...

Not quite in the same category but I had a check-up and associated blood tests done and the results cam back bordering on pre-hypertension so got a bit of a talking to about this. Then 13 days later it so happened that I had another check-up through a different doctor (they had a special promotion thing & I thought it may be more comprehensive) which also included a blood test done by the same lab. The results were excellent, many of the major factors were quite different numbers and the doc said less than 5% chance of cardiac problems.

 

The other funny thing was the first doctor was looking at me strangely when I came in for a check-up, apparently men don't do this. She ended up asking me if I was worried about something such as.... ah having sex with other men!! I was so shocked & stunned I could hardly speak; it never occurred to me she may have thought like this. Haha, pretty funny in hindsight.

 

 

[Kyle Communications]

Gnarly you would have to pick me up from the floor if my doctor said that.

 

My doctor always errs on the caution side he is extremely good. He even picked up I had legionnaires disease once before it got too far along and got me on the right meds ..once that bloodiest came back which takes a couple of days he rang me and told me to get my bum up there right now and he changed the antibiotics I was on and told me to get them then and there and take them. When he has been "suggesting" to e and to my Mrs that this is what I should get done I listen to him and pretty much nothing else works so its a last resort for me. I will see what happens after the 16th

 

JeffD the drugs they keep everyone is the money train...I have tried numeral diets carb free juices so many I have lost count...nothing works really. The protein diet was looking good and eating 6 times a day but it is almost impossible to maintain long term....not to mention the side effects when it comes to doing number 2's. I have been living with this since the mid 1990's and I have tried almost everything out there

 

Send me the FB request and I will add you

 

Mark

 

 

[old man emu]

Kyle,

 

Thanks for that detailed post. I didn't realise that the liver was the culprit in high blood sugar, but since it's the industrial centre of the body, it makes sense. MY wife's doctor has been talking about some type of surgery if she doesn't get her bloods down. He's put her on to forxiga (dapagliflozin 10 mg), which he told her would "flush" the sugar from her blood. She's watching her intake of simple sugars. Her BS readings have come down to average out at 8 in the middle of the day. I've noticed that if she has a reading of around 10 at the start of the day, and then does a fair bit of walking (weekly shopping etc) she can drop down to nearly 5 by dinner time. With this in mind, we bought a treadmill so she can get the walking exercise inside as she can't take the heat and humidity we are having at the moment. Of course all thought of exercise has stopped for the Silly Season, but she's still eating light. We have until March to lose 10 kg to make the quack happy for starters.

 

Keep us informed of your progress.

 

OME

 

 

[Kyle Communications]

A few years ago I was under a Professor here who was supposed to be a guru...yeah well I don't see him anymore... He told me exercise was the key for me so I started doing tests I would exercise before breakfast i would go for a brisk walk before I ate then did that for 2 weeks. Sugar went up when I got back...then I ate a correct low carb meal and went for a walk did that for 2 weeks...sugar went up. He couldn't explain it just kept telling me to increase the insulin I was injecting. Maybe exercise would work if you did it 5 hrs a day but we all have to work and we have to have some sort of life it wasn't practical. I have tried all sorts of different drugs and none seemed to work very well at all. All they were doing ws killing my kidneys. If you are on metaformins be very careful because they will kill your kidneys its best to try to get off them. Try to stay off insulin it is the devil... the more you take the more weight you will eventually put on so its a vicious circle

 

Mark

 

 

[old man emu]

Strewth, there are more conflicting opinions about treating diabetes that there are about the quality of Jabiru engines.

 

Anyway,

 

Is there anything like an Administrative Appeals Tribunal at the Commonwealth level? I reckon if there was, we should band together to back someone's appeal against disqualification due to cardiac anomoly that has been OKd by a cardiac specialist. Make CASA prove that its decision if fair and equitable.

 

OME

 

 

[Kyle Communications]

Sound good to me OME but CASA seems to be like ASIO a law unto themselves

 

 

[kaz3g]

Dr Arthur Pape took CASA to the AAT regarding his colour vision blindness and won (at significant financial cost). I seem to recall that Avmed later tried to change the rules so that they would be able to enforce the decision they wanted. That's simply not cricket!

 

I guess I must have been lucky that my medical was renewed many years ago after very bad medicated depression had finally improved to the point where I wanted to get off the SSRIs. The Avmed person then was very helpful and interested to know the details of why I had become ill and how I dealt with it.

 

I'm now almost 71 and just renewed my class 2 without any issues at all. My weight was up a little from the previous examination but I am exercising and watching my diet, so all good. And I just purchased a new set of bathroom scales!

 

Kaz

 

 

[facthunter]

Hopping on and off the scales is exercise.. Nev

 

 

[old man emu]

Dr Arthur Pape took CASA to the AAT regarding his colour vision blindness and won (at significant financial cost). I seem to recall that Avmed later tried to change the rules so that they would be able to enforce the decision they wanted. That's simply not cricket! Kaz

According to CASA's site, http://www.casa.gov.au/scripts/nc.dll?WCMS:STANDARD::pc=PC_101277 there are two options

 

Reconsideration

 

Reconsideration is a formal process in which a doctor other than the one who made the initial decision leads the process of decision making. If the initial decision was made by a single individual, the case is submitted to a special panel of doctors who consider the matter afresh. If the decision had formerly been referred to the Complex Case Management Panel, an external consultant is asked to provide input into the matter.

 

Please note that reconsideration of the decision that has been made will require a processing fee of $150.

 

Review by the Administrative Appeals Tribunal

 

Any person whose interests are affected by CASA’s decision, may, subject to the Administrative Appeals Tribunal Act 1975, apply to the Administrative Appeals Tribunal (AAT) for a review of the decision within 28 days from the date of the decision. You should seek and rely upon your own legal advice in relation to your rights of review.

 

The fee for an AAT review is $861.

 

Old Man Emu

 

 

[davebutler]

Review by the Administrative Appeals Tribunal

 

Any person whose interests are affected by CASA’s decision, may, subject to the Administrative Appeals Tribunal Act 1975, apply to the Administrative Appeals Tribunal (AAT) for a review of the decision within 28 days from the date of the decision. You should seek and rely upon your own legal advice in relation to your rights of review.

 

The fee for an AAT review is $861.

 

No wonder some are leaving in droves, this is ridiculous!!

 

 

[facthunter]

Aviation will be at it's most safe when there is virtually no one doing it. That appears to be the logic prevailing. Nev

 

 

[Gnarly Gnu]

The fee for an AAT review is $861.

So if the decision is reversed do they then pay the $861 to you for getting it wrong the first time?

 

Out of interest how does this fee compare to the fine for flying with a license?

 

 

[Flying Librarian]

Review by the Administrative Appeals TribunalAny person whose interests are affected by CASA’s decision, may, subject to the Administrative Appeals Tribunal Act 1975, apply to the Administrative Appeals

So if the decision is reversed do they then pay the $861 to you for getting it wrong the first time?Out of interest how does this fee compare to the fine for flying with a license?

Doubt it. The other concern is, what happens next time CASA makes a determination, if you have challenged them. Do they put more roadblocks in place, make things even harder or grease the wheels to keep you happy?

 

 

[facthunter]

Heads.... We win... Tails you lose Nev

 

 

[jeffd]

I just finished another round of tests recently..in the last 6 months which had a heart 3D angio catscan probably what you just had then a cardio perfusion test where they inject radioactive stuff into you and then measure how well your heart chambers pump and how big they are and also of course a cardiac echo. The report from the cardiologist after all these said I had had a good outcome from the bypasses done 2 years ago. My issue was diabetes got me. long term diabetic that was not under good control is what caused the blockages. I still have this issue with the diabetes but early next year I think that will hopefully be fixed and if all goes well after a operation and I will no longer be a diabetic. If I continue the way I am my bypasses may last 5 or 6 years not the roughly 15 they usually last for. You only ever get done twice and you run out of spare parts after the second set of bypasses

well good luck with it all kyle hope they can sort out something positive for u