V1VRV2 Posted January 27, 2021 Report Posted January 27, 2021 I’m an insulin dependent diabetic and trying to get my 1st class medical back under the FAA’s new special issuance guidelines. The FAA has been accepting special issuance medical applications for insulin dependent diabetics since Jan 2020. I hear only 6 airline pilots have received a special issuance 1st class for insulin dependent diabetes. I’m ready to submit my paperwork this coming Fri. Was cleared by my endocrinologist, my cardiologist, my ophthalmologist... no problems anyone could find. It’s quite a process. 12 mo of continuous data from my constant glucose monitor showing no lows or highs, dilated eye exam, endocrinologist every 3 mo, blood work, Bruce maximal stress test. Keeping healthy with blood sugars constantly in range has been a task requiring extreme sacrifice and dedication. Been eating keto to keep my blood sugars stable. Haven’t had a carb in 14mo... no lie! Last A1C was 5.0. Lower than most people without diabetes! Anyone here flying as an insulin dependent diabetic? 1 Quote
carusoam Posted January 27, 2021 Report Posted January 27, 2021 Congrats on your successful monitoring and and diet modification... You were probably the healthiest guy on the Bruce treadmill! Like having a JPI for the body... Do you use a Dexcom G6? https://www.dexcom.com/get-started-cgm/111?sfc=7014y000000yxYNAAY&gclid=Cj0KCQiAmL-ABhDFARIsAKywVacMWg7yuTOrvW5xkuUdT7xmL5CY6oE4GDvzA_a0WskExOpmY6OCHXEaAsipEALw_wcB Going through the SI process takes a lot of document precision... I had success with the class III SI... a genetic cholesterol level challenge... Words of wisdom... it took me 6 months to acquire all the data the FAA required... the SI only lasted one year... the six months of data gathering was lost time off from flying... You can probably do better than me... just keep both eyes open to avoid the litanny of delays... MS has a good AME... aka Doc John... I’ll invite hike to the conversation... @M20F-1968. Good luck, not that you will need it... it’s just a proper thing to say. PP thoughts only, to a med tech guy... Best regards, -a- 1 1 Quote
RLCarter Posted January 27, 2021 Report Posted January 27, 2021 My buddy with the 172 I fly lost his medical 4 yrs after getting is PPL. Will be following to give him info..... got to get him back in the air, should be a lot easier at least after the 1st issuance seeing how he’ll only need a 3rd class 1 Quote
V1VRV2 Posted January 27, 2021 Author Report Posted January 27, 2021 Carusoam.... not looking forward to waiting. With Covid the wait has been around 8mo from submission of requested records. But if that’s what it takes to get back into airline flying then so be it. Yes... I have a Dexcom G6 CGM. I bought an Apple Watch and my BS is displayed on my watch face. Amazing times we live in! Without a CGM a class 1 wouldn’t be an option. I’m upset the FAA has waited so long to enact this protocol. Canada has allowed insulin dependent pilots to fly 121 since 2003. The 1st class they issue me will only be good for 3mo. Then I need an exam from my endocrinologist with blood work to extend another 3mo. RL.... the FAA has allowed insulin dependent diabetics to hold 3rd class medical since 1996. If your buddy needs any info I’d be glad to help. Since I’ll be one of the first there was no one to help me along. It would have been nice to have someone guide me. I’m 50 now. Hopefully covid ends soon and someone will be hiring and I get a good 10 years to fly the line somewhere. 1 Quote
M20F-1968 Posted January 27, 2021 Report Posted January 27, 2021 Hello. I am a senior AME located in the Boston, MA area and also a Mooney owner. I am a board certified internist for over twenty years and have been an AME since 2005. I do work to assist pilots through the SI process, and recognized the angst the process and instill when the pilot is a first class airline pilot whose livelihood is on the line. It sounds like you have done a good job getting your ducks in line. The good news is that the FAA really does not want to pull your medical. You and society have made a large investment to get you to where you are. You need to provide the FAA everything they have asked for. Focus on the process you need to follow to get your medical. Unless you have a choice to move elsewhere, focusing on what is done elsewhere is an exercise in futility. If you need AME assistance, my cell phone is (617) 877-0025 and my e-mail is john.breda@gmail.com. John Breda 6 2 Quote
Matt Ward Posted January 27, 2021 Report Posted January 27, 2021 Nothing to add except to say that as a dad of a T1D kid, it's awesome to see you doing this! It's a terrible disease but you seem to be managing it better than most. There isn't really anything T1Ds cannot do, except it seems, fly airplanes for a living without a hell of a challenge. There was a guy on the Juice Box podcast not too long ago that was the first airplane pilot with T1D. Check it out and good luck! 1 Quote
Nick Pilotte Posted January 27, 2021 Report Posted January 27, 2021 In addition to Dr Breda that chimed in above, I would recommend Dr Bruce Chien as well, even if for no more than a consult. I used him for my SI and I couldn’t have done it without his guidance/services. You can Google him, or go to his website: aeromedicaldoc.com. Good luck, my flight school owner has a T1D son who is/has been working on his Class 1 with hopes of becoming an airline pilot. It’s been a long road. 2 2 Quote
carusoam Posted January 27, 2021 Report Posted January 27, 2021 When you get a chance... See what AOPA has on the subject... Every now and then AOPA can surprise us with the type of legal work they have done for pilots... Allowing us to fly with all types of challenges... with the proper support... Thanks to doc John above for your awesome support of the MS community! Go MS! Best regards, -a- 1 Quote
Terry Moser Posted January 27, 2021 Report Posted January 27, 2021 Make sure you average sugars are 80-180 80% of the time below 80 less than 4% and above 250 less than 5%. I submitted my package April 2020 after numerous requests for updates I was denied December 31st and they took my Basic Medical away. I was never told about the % requirements or I would have worked on my numbers the sent them. I was told this is such a new program that there is no guidelines. (Bad info). I’m on a Medtronics 670, going to switch to Dexcom as it seems true FAA prefers even though they say they are indifferent. Good luck!! Looking forward to hearing the your results. 1 1 Quote
MB65E Posted January 28, 2021 Report Posted January 28, 2021 1 hour ago, Terry Moser said: Make sure you average sugars are 80-180 80% of the time below 80 less than 4% and above 250 less than 5%. I submitted my package April 2020 after numerous requests for updates I was denied December 31st and they took my Basic Medical away. I was never told about the % requirements or I would have worked on my numbers the sent them. I was told this is such a new program that there is no guidelines. (Bad info). I’m on a Medtronics 670, going to switch to Dexcom as it seems true FAA prefers even though they say they are indifferent. Good luck!! Looking forward to hearing the your results. Welcome Terry!! Awesome group of guys on this website. -Matt Quote
carusoam Posted January 28, 2021 Report Posted January 28, 2021 Welcome aboard Terry! Thanks for sharing your experience... That is in the category of most valuable first post... The immediate challenge of losing your Class III medical... it now has to be restored to be able to use the lesser Basic Med medical... When dealing with the large government organizations... be sure to have all the proper docs and data organized... Hopefully we can get this Blood sugar debacle straightened out.... Reminder, AOPA can be pretty helpful with topics like this... AOPA = Friendly, FAA = Not so much... Wait til you have memory challenges while trying to jump through all the hoops... Best regards, -a- 1 Quote
V1VRV2 Posted January 28, 2021 Author Report Posted January 28, 2021 Wow... great bunch of guys here! ❤️ As always! My worry is that the G6 data is tainted with compression low reading. If you sleep on the sensor and put pressure on the area it doesn’t get fresh bodily fluid and the CGM reading goes low when your blood sugar is actually in range. There is nothing that can be done about that. Terry.... I’ll post on this thread any updates as they come my way. Are you going to submit again? Dr. Breda... I’m getting very little input from my AME on the data/test results the FAA is requesting. I don’t think he has gone down this T1 diabetics SI path before. Could I submit my medical records to you for an evaluation before I submit? I have them all in digital format. I could also link you up to my Dexcom Clarity portal. Of course I’d be a paying customer. Quote
M20F-1968 Posted January 28, 2021 Report Posted January 28, 2021 V1VrV2 - sent you a PM. John Breda 1 Quote
V1VRV2 Posted February 3, 2021 Author Report Posted February 3, 2021 Package of medical records sent overnight to OK City! Now I wait! 1 Quote
RLCarter Posted February 3, 2021 Report Posted February 3, 2021 7 minutes ago, V1VRV2 said: Package of medical records sent overnight to OK City! Now I wait! Hopefully it won’t sit on a desk and they’ll push it through 1 Quote
hammdo Posted February 3, 2021 Report Posted February 3, 2021 On 1/27/2021 at 3:06 PM, carusoam said: When you get a chance... See what AOPA has on the subject... Every now and then AOPA can surprise us with the type of legal work they have done for pilots... Allowing us to fly with all types of challenges... with the proper support... Thanks to doc John above for your awesome support of the MS community! Go MS! Best regards, -a- I did this and to be honest, AOPA were no help for me - in fact, they said I would not get it. My AME was very helpful and knew all the steps I had to do to get mine ( I had heart failure, 20% EF and, with his help/guidance, hard work on my part, I got my 3rd class - oh, and I have type 2 diabetes and sleep apnea too). It took from End of February to middle June of last year for me to get mine - and the date/medical starts from when you submit (so, my medical was from Feb-2020 to Feb 2021). Yep, have to do The Whole thing again this year too... -Don 2 Quote
Nick Pilotte Posted February 3, 2021 Report Posted February 3, 2021 2 hours ago, V1VRV2 said: Package of medical records sent overnight to OK City! Now I wait! Let me dig through my records. There is a certain amount of time that must pass and then you can call OKC and “express interest” in your application. Once you do that x number of times your file gets flagged and pushed for a manual review. Unfortunately others can do this too but it’s like a Disney FastPass. Better than nothing. 1 Quote
V1VRV2 Posted February 3, 2021 Author Report Posted February 3, 2021 2 minutes ago, Nick Pilotte said: Let me dig through my records. There is a certain amount of time that must pass and then you can call OKC and “express interest” in your application. Once you do that x number of times your file gets flagged and pushed for a manual review. Unfortunately others can do this too but it’s like a Disney FastPass. Better than nothing. If you find that magic phone number pass it along. It would certainly be appreciated! Quote
hammdo Posted February 3, 2021 Report Posted February 3, 2021 I gave it a week then started calling once or twice a week — never consecutive days. Sometimes I waited a week between calls. At least a call once a week will help keep the ‘queue’ hot ;o) My last call in the middle of June (after waiting 2 days from my previous call) was the report I got my medical... persistence and being ‘respectful’ to the agent on the phone (they were workin from home mind you) helps... FAA https://www.faa.gov/licenses_certificates/medical_certification/faq/response15/ https://www.faa.gov/other_visit/aviation_industry/designees_delegations/designee_types/ame/amcs/phonenumbers/ I’ll see if I still have that # and will update my post... edit: 405.954.4821 they’ll ask for a PA# (after you get through all the menus and wait) . Just say I don’t have one but I have ssn or pilots license #... BTW, if you are flying or flying with a CFI while you are waiting (which is what I did while waiting) I’d mention it while chatting with the agent... -Don Quote
V1VRV2 Posted July 27, 2021 Author Report Posted July 27, 2021 (edited) Thought I’d update this post. Exactly 6mo from the date of the original post… July 26 which also happens to be my B’day I received an email from the Federal Flight Surgeons office that I should be expecting my 1st class special issuance letter soon. Soooo…. I was approved and will be back flying commercially hopefully in a few mo. Time to start looking for a job! Tough road but I made it! I have my life and my identity back! Never thought I’d see the inside of an airliner cockpit again! Edited July 27, 2021 by V1VRV2 11 4 1 Quote
MooneyMitch Posted July 27, 2021 Report Posted July 27, 2021 12 hours ago, V1VRV2 said: Thought I’d update this post. Exactly 6mo from the date of the original post… July 26 which also happens to be my B’day I received an email from the Federal Flight Surgeons office that I should be expecting my 1st class special issuance letter soon. Soooo…. I was approved and will be back flying commercially hopefully in a few mo. Time to start looking for a job! Tough road but I made it! I have my life and my identity back! Never thought I’d see the inside of an airliner cockpit again! Congratulations to you!! Delightful you’ve got your life back...... so precious life is. Ya gotta love MS too!! 1 Quote
GeeBee Posted July 27, 2021 Report Posted July 27, 2021 13 hours ago, V1VRV2 said: Thought I’d update this post. Exactly 6mo from the date of the original post… July 26 which also happens to be my B’day I received an email from the Federal Flight Surgeons office that I should be expecting my 1st class special issuance letter soon. Soooo…. I was approved and will be back flying commercially hopefully in a few mo. Time to start looking for a job! Tough road but I made it! I have my life and my identity back! Never thought I’d see the inside of an airliner cockpit again! I think you are also seeing a "change of the guard" at FAA Aeromedical. Dr. Northrup is all about getting pilots flying, as it was her job for years at Delta. She does not cut corners, but she knows it is important to get pilots back to work. I know for a fact she is hard over on clearing out the backlog of SI in OKC. I would look for a future where more discretion is yielded to AMEs. 3 Quote
Matt Ward Posted July 27, 2021 Report Posted July 27, 2021 Congrats! If you missed it, JDRF did a webinar this week with Pietro Marsala who Beyond Type 1 profiled earlier in the year. https://beyondtype1.org/commercial-pilot-diabetes/ 1 Quote
4cornerflyer Posted July 27, 2021 Report Posted July 27, 2021 I would like to believe Dr Northrup will succeed at improving the aeromedical bureaucracy, but I think it is premature to sing her praises. I'm afraid I don't remember the exact publication, maybe AOPA Pilot, but she recently wrote a column in which she took pride in the fact that an astronomical percentage of medical special issuance applications are eventually approved by the FAA. Not sure of the exact number, but it was at least 95%, probably higher. If you subtract the cases which clearly will never qualify, the ones my grandmother could tell you should never be flying, that leaves a pretty small number. Rather than boast about the FAA's high eventual approval rate, I would interpret this to mean they are bothering far too many pilots and delaying issuances for months to years unnecessarily. The bottom line is that if the pilot's own physicians and his AME agree that he is safe to fly, it is very unlikely that the FAA will have any meaningful input in the matter. Instead am FAA physician not of the relevant specialty will practice CYA medicine. When Dr Northrup comes out in favor of reducing the burden on pilots and AMEs rather than boasting about how well they do, I will be more impressed. For now, if they do one thing only, it would be to accept electronic submission of medical records instead of requiring deliver of hard copy by mail, waiting weeks--yes weeks --for a government employee to scan the documents into their computer system. I'm told this is happening...we'll see. I know this won't help the original poster if he flies for the airline, but for the average Mooney pilot, remember that once you get that special issuance, even if it is only good for less than a year, if your operations are within the Basic Med limitations, you can fly under that rule and not deal with renewing the FAA medical. Jon (MD) 2 1 Quote
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