DVT Problem

[Dysonsphere]

Just to explain have being told I have ongoing "deap vein thrombis" does anyone know how this would affect my medical. If nono for PPL would it be ok for NPPL. And yes I do have ongoing clots in my leg.

[BackPacker]

No idea, but I would look in EASA Part-MED to find out.

Two parts to this. First is the decision of the EC which lays down the law, but is sometimes vague:

http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2008:079:0001:0049:EN:PDF

A lot of implementation details are left to EASA. For this, EASA publishes Accepted Means of Compliance (which are basically specific interpretations of the law) and Guidance Material (which is just good advice with no legal value):

Here are all the current AMCs, GMs and such for all parts that EASA has implemented so far:
EASA - Acceptable Means of Compliance and Guidance Material (http://easa.europa.eu/agency-measures/acceptable-means-of-compliance-and-guidance-material.php#AMCPart-MED)

And this is the Part-MED document:
http://easa.europa.eu/agency-measures/docs/agency-decisions/2011/2011-015-R/AMC%20and%20GM%20on%20the%20medical%20certification%20of%20p ilots%20and%20medical%20fitness%20of%20cabin%20crew.pdf

In that last document, the cardiovascular stuff starts on page 9.

[abgd]

Though a doctor I'm not an AME so don't know the actual 'answer' to your question. I can discuss it a bit, and ask a few further questions to which you may or may not wish to give the answers here .

I'd have to ask what you mean by 'ongoing deep vein thrombosis'. A deep vein thrombosis is a blood clot, normally in the leg. We normally talk about either 'recurrent deep vein thrombosis' - i.e. clots that have come back after initially going away - or people who are undergoing treatment for 'acute deep vein thrombosis', which normally resolves within days to weeks after treatment. Neither situation would normally be described as an 'ongoing' deep vein thrombosis. However, you can stay on a 'treatment' dose of anticoagulation for some time after the clot has disappeared as you're still at higher than normal risk of recurrence.

People who have recurrent deep vein thrombosis are normally on long term warfarin or injections of low molecular weight heparin such as clexane or tinzaparin. If this is the case then you should have contacted your AME already to discuss this, as you should not be flying if you're taking any regular medication unless you have discussed it with them.

A deep vein thrombosis is medically important primarily because bits of the clot can detach and be carried off to the lungs. Large pulmonary emboli (the clots) can cause sudden incapacitation, which is exactly what we don't want to suffer as pilots. Secondly, because they interfere with breathing, they make you more susceptible to hypoxia at altitude. Thirdly, they can cause long term scarring to the lungs which could make you more susceptible to hypoxia, even after the clots have dissolved away.

For most people, the connection between DVTs and flying is that they're sitting still for long periods and are more at risk of developing them. For pilots this is less likely to be a risk as we're more physically active, and the main risks are likely to be sudden incapacitation due to an embolus or hypoxia, or bleeding as a side effect of the anticoagulants. This could either cause incapacitation, or could make injuries sustained in an accident more serious.

The other question is why you developed a DVT in the first place. There are a number of possible causes and this is something that should be looked into unless it was obvious. The most common cause is immobility after operations or being in a plaster cast. There are also some blood disorders that can't be tested for whilst you're still on anticoagulation.

~~~~~~~~~~~

Here's the relevant section from the second pdf posted above:

(g)
Thromboembolic disorders
Arterial or venous thrombosis or pulmonary embolism are disqualifying whilst anticoagulation is being used as treatment. After 6 months of stable anticoagulation as prophylaxis, a fit assessment with multi-pilot limitation may be considered after review by the licensing authority. Anticoagulation should be considered stable if, within the last 6 months, at least 5 INR values are documented, of which at least 4 are within the INR
target range. Pulmonary embolus should require full evaluation. Following cessation of anti-coagulant therapy, for any indication, applicants should require review by the
licensing authority.

~~~~~~~~~~~~~

The distinction between therapeutic and prophylactic treatment, is that therapeutic anticoagulation is stronger and used to dissolve away an existing thrombus. Prophylactic treatment is weaker and is only meant to stop such a clot from developing in the first place.

In short, what I'm saying is that there's no simple answer. You need to talk to an AME, and you will need to be able to provide a reasonable amount of detail about your medical history. It may be helpful to get your GP to print out a summary or collect any hospital discharge letters together before seeing them. If you're still on treatment dose of anticoagulation you could always talk to a haematologist - or get your GP to talk to one - as there may be some leeway in terms of how long you remain on the high dose. Most other doctors would tend to stick rather tightly to the protocols the haematologists have written.

[mad_jock]

We had an old boy that was on warfrin or as he put it rat posion due to clotting after a nasty accident.

He couldn't fly on a JAR PLL but was able to get a NPPL under those rules. The medics wern't happy at all about it.

He was very sensitive to altitude changes and rarely went above 1500ft and didn't fly on low pressure days. He tended to take a safety pilot with him anyway.

I ain't a medic just a pilot and it all seemed a bit dodgy apart from the bloke in question was extremely sensible about it all. He loved flying and was a great member of the club.

If you do fly your going to have to be extremely carefull, the guy did get forced up to 5000ft by wx once and ended up in hospital afterwards.

Personally I think I would have got another hobby but I know how it is.

And the gentleman in question was proved right and he passed away not recovering from a general for an op nothing to do with flying.

[abgd]

It sounds as if he had significantly more problems than were caused by his DVT though, MJ. Most people with DVTs or on warfarin don't have such severe symptoms, thankfully.

[mad_jock]

The rest of the stuff wrong with him was fine it was just the warfrin they objected to.

And according to him it was the guts with the low pressure that started bleeding.

As I say I am only a pilot and the gentleman in question was well know for not only his intelligence but also his sense of humour.

When one of the youngesters was asking about "Muffin the Mule"

Well young man it depends if you are starting with a Noun or a Verb.

Completely lost on the teenager but made me laugh.

It could very well have been something more but if it wasn;t funny he wouldn;t have said. I also had a theory he just used to like flying everywhere at 600ft agl.