Facing a Medical Review Board

[Megawart]

Hi guys,

Well, after 25 years flying and 6,000 hours without a hitch, the dreaded ECG (Electro-Cardiagraph) has decided to attempt to halt the party!

Despite my having always been A1 G1 Z1 with absolutely no symptoms of any kind, the ECG reveals a 'sinus rhythm with sinus arrhthymia with occaisional premature ventricular complexes and fusion complexes. Otherwise normal'.

As I understand it, I have occaisional missed heart beats (and I thought that was all part and parcel of military flying!)

The SMO is content that it's within normal parameters, and indeed is unchanged from my previous ECG which was also asssessed as acceptable, but the powers that be recommended I underwent Echo cardiagraph, stress test and 24 hour heart monitor to be absolutely sure. After these tests, the reviewing Doc assessed me as 'Fit to fly'.

Fantastic, thinks I, I'm not about to die! However, apparently there is a 'new system' of medical assessment commencing 1st September and I have been downgraded pending a Medical Review Board.

Sorry to be so long-winded, but does anyone understand the new system, or has experienced my ECG problem, or faced a Medical Review Board in the past? Any info that would help me prepare for this would be gratefully appreciated.

The cruel irony of the situation is that I fly a 2 pilot aircraft with a paramedic onboard, the mission of which is to take a casualty to hospital as soon as possible. So I'm probably better of whilst flying than I am typing this now!

I can tell you, I'm more stressed as a result of this, than I ever am flying!

Sob story over. Feel fre to chip in with sarcastic, unsympathetic and generally unhelpful but witty comments.

Trash

[Seldomfitforpurpose]

All I can say with confidence is that the Med Board are not there to chop you and will bend over backwards to try and give you what you want.

Manning on the other hand are less than helpful and were looking to fire rather than hire.

Feel free to pm if you want more details but I walked away with a med cat, not a great one but it was enough to keep me employed for my final 2 years or so :ok:

[Specaircrew]

I wouldn't stress about it, I spent the last 20 years of my RAF flying career with an A3 G4 Z1 category(bad back!) and the only thing it stopped me doing was flying on bang seats! Even the badly worded and misleading 'unfit service outside base areas' caveat didn't stop me being deployed to the sandpit or operating as a multi-eng captain worldwide!

The medical board Doctors are very sensible and will do everything they can to keep you flying but it's important that you discuss any restrictions they place on you with them to make sure there's no ambiguity in the paperwork which could be misinterpreted by a layman at a later date.

If necessary ask the board to put in writing what you ARE allowed to do so that you can wave it at dimwit 'cover my arse' execs when they panic because you've been downgraded!

[olddog]

I had a similar condition to yours diagnosed at the age of 50 after a very stressful year at work. Like you I had a string of "abnormal but acceptable" ECGs prior to being tempoarily grounded by extremely high blood pressure. I wish you luck in the future and know nothing of any new procedures for Medical Boards. When I actually got to the board I found the doctors sympathetic and wound up with an A3G3Z1 Cat which let me fly as or with a copilot. However, I had to fight the ineptitude of medical admin staff both at Station and Command level at every stage to get the necessary specialist appointments at Peterborough and had resort to letters from my Sqn Cdr to the Stn Commander and Command Medical Officer to resolve the issue. It took nearly 2 years! When it came to the Med Board despite a clear requirement that I should be provided with an advisor of my own branch from PMA to advise on career/posting implications none was present. The pesident of the Board gave me the option of returning at a later date but I elected to go ahead as I wanted to get the issue resolved. I returned to flying and left the RAF 3 months before my 60th birthday after a very happy
5 years flying Nimrod R1 as FTRS. If the Board try to confine you to "Base Areas" ask them for the caveat "Waiver Permitted" This allows you to deploy to places without major medical facilities on a det by det basis after consulting your SMO. PM if you want more. Good Luck - Persevere - It's worth it!!!

[glad rag]

Echo cardiagraph, stress test

Had this done only recently, must say that watching your heart in action in 3D, full colour flow rates etc is quite interesting....

Found out that I had mild scarring/tissue "marking" to the septum, cue the balloon going up [hehe gettit?] and numerous nursing staff also turning up and telling me not to worry [!!] and looking closely at the monitors.

At the debrief it was all one way [down] until I felt it necessary to remind them that I had been born 6 weeks premature in 1960 and would this have a bearing on things?

Result NFA. :ok:

[Ali Barber]

Had my single pilot cat revoked due to a heart condition (only detected by computer analysis of ECG rather than docs looking at print-out) that had existed through all my life and one major prang. In theory, could have caused black outs, but they only happened on Friday nights a long time ago. Referred to civvy docs who operated (key hole surgery) and fixed in no time. Took over a year for medical board to be convened to finally give my cat back, but by then I was in a ground job. While I was still waiting for the axe to drop as an F3 instructor pilot, I was still allowed to be captain with a student pilot on board who would presumably bring my body back to earth - just not allowed to fly with navs (blessing in disguise? - banter:ok:). If you're 2-seat pilot already, hopefully there shouldn't be too much impact. Just get it sorted before you go for your ATPL medical.

[Megawart]

This is all fantastic information guys, much appreciated. I'm damn near certain there's nothing wrong with me, but need to face the board fully prepared for swerve balls.

Thanks again!

Trash

[NutLoose]

Absolutely no idea or any knowledge or experience in this matter......... but would just like to take the time to wish you good luck............... :ok:

[hval]

NutLoose,

Sound sentiments that man.

Megawart,

Good to hear your positivity. Wishing you well.

[Pontius]

I reckon there are are some very reassuring key points in your post, of which "unchanged from my previous ECG", is the most telling. Having spoken at length in the past to a heart mending chap, I remember him saying this is the most important bit of an ECG. You are built how you are built and if that doesn't change (as far as your motor is concerned) then the docs will almost certainly be happy. The machines that give an instant diagnosis work on a fairly simple standard deviation bell graph. If your heart is slightly different to Joe Average, then the machine will give its best guess at the reason and, of course, this is normally pretty well 100% accurate. However, nothing beats a properly qualified heart specialist having a gander at the squiggles and giving you the thumbs up. It's also important to remember that an ECG can only show/give an indication of what has already happened, not what might happen. This is normally the reason for a 'stress ECG', where the bods can look at your heart working under pressure and get a better idea that it is doing its job properly.

I'm not a doctor but having had many chats with a mate who is (being interested in this stuff myself) and hearing of similar stories to yours I would be willing to place a fair few liver-damaging ales on the fact that you'll be signed off as good as new.

[A2QFI]

Megawart I wish you the best possible outcome on your review. Someone else has pointed out that the board are keen to keep you flying if it is possible.

Perhaps you recall this bit of medical history?

Heart and lung transplant [Archive] - PPRuNe Forums (http://www.pprune.org/archive/index.php/t-41424.html)

[SirToppamHat]

Had a couple of Med Boards myself.

The most stressful part appears to be the waiting. I was also at Henlow for 3 years and saw a fair few people come through - one of the things people struggled with was the concept of a 'Board'. I felt as if I was going to be sat in front of 5 men and good and subjected to an interrogation prior to being given the bad news and taken out to be shot.

Of course in practice, it was nothing like that at all. They have all your records and you will be given a thorough interview by an experienced Air Med Specialist, and you will in that informal setting get every opportunity to explain your position as well as refute any errors or omissions.

I don't even recall a medical by the Board per se. Just an interview with the President or his Deputy to run through their conclusions. I didn't entirely agree with their findings, but came out still employable, despite (the second time) the Doc at my Unit saying she'd been through the Medical Employment Manuals and reckoned there was no chance of me being able to continue to control ac. Within 24 hours I was back on console, albeit with some limitations.

I'd be very surprised if there were anyone from command manning there.

Whatever happens, The Very Best Of Luck To You!

STH

[alfred_the_great]

24 hours tapes are a pain, but don't be surprised if you are found to have "benign" abnormalities. I've got SVT, and my long trace found some interesting heart patterns, but the Service Cardiologist I saw was very much onside in keeping me in service.

I had my med cat reviewed by the INM, and after a quick discussion about what I wanted to happen in my career I came away with something that made us all happy.

Long and short of it - get in touch with everyone involved in the process and outline what you want to happen, and they generally work with you to achieve it.

[olympus]

Megawart

I'm not RAF (or even ex-RAF) but I had a similar diagnosis to yours whilst employed as a short-haul jet-airliner captain. I have to say that the CAA Medical Dept people were brilliant. After reporting the problem to them I was 'downgraded' to 'as or with a co-pilot' (although nothing ever appeared in my licence) until the problem was sorted.

I had a 24-hour ECG (two trips to Gatwick from Central London on consecutive days!) and then spent at least two months waiting for an appointment with the CAA's consultant cardiologist who was to read the printout and pronounce thereon; I continued to fly in the meantime.

You can imagine the state that I was in by the time I finally got to see Dr (Mr?) Chamberlain. In the event it was a non-event. Dr C dictated his report to Dr Tony Evans of the CAA Medical Dept in my presence and all was well. His advice to me was 'try not to worry about it'(!) and 'don't drink coffee prior to your medical renewals'. The licence restriction was lifted and I continued to fly until I retired.

At no time did I feel that the CAA's Medical Dept were doing anything other than trying to keep me flying; I'm sure the RAF's Review Board will be the same.

Good luck.

[Megawart]

Thanks, once again, for the kind words of support and advice. I'm heartened to hear that the system is not actively trying to throw me out, but will actually try to keep me in - coupled with the fact that I feel right as rain!

Hopefully I'll be back in the cockpit of the mighty Sea Queen using my 'dodgy ticker' to save other people's lives again by early September!

Regards to all.

[drugsdontwork]

I think you just need to man the f@@k up and get on with it.

Only joking!! I would say get well but there is clearly nothing wrong with you.

Except maybe your musical ability.

Good to hear positive stories of the docs though. Certainly do not look forward to the annual medical. God willing we all get old and knackered.