Iron Infusions and Class 1 Medical

[iatethemacaroni]

Hi all,
I'm about to start a university program to get my CPL, and before I invest the $$ I want to make sure a certain medical issue I've been having won't preclude me from a Class 1 medical (CASA). I keep getting fairly anaemic (Hb around 8-9.0, ferritin of 2-4) and end up having iron infusions to get me back to normal.

I'm 25, F, and have no major medical conditions. I'm an active runner, my diet is full of red meat and green veg, and I don't drink tea or coffee. I've tried supplementing with oral iron which didn't work, and I've had the ever delightful colonoscopy/endoscopy, both of which found nothing. Are iron infusions something I can continue to have while maintaining a Class 1 medical? In the meantime, I will certainly continue to have the cause investigated. Thanks for any advice.

[PigeonVoyageur]

You are quite right in ascertaining whether you are fit for a Class 1. Anyway, any reputable flying school should not be enrolling you and taking your money unless you've had a Class 1 before commencing the course.

I'm in no way related to the medical profession and by no means trying to demoralise you, but this is an extract of the "Acceptable Means of Compliance and Guidance Material to Part-MED" of the European Aviation Safety Agency. I would think that it might be the same in your country which I assume is Australia (since you mention CASA).

AMC1 MED.B.030 Haematology
(a) Abnormal haemoglobin
Applicants with abnormal haemoglobin should be investigated.
(b) Anaemia
(1) Applicants with anaemia demonstrated by a reduced haemoglobin level or haematocrit less than 32 % should be assessed as unfit and require investigation. A fit assessment may be considered in cases where the primary cause has been treated (e.g. iron or B12 deficiency) and the haemoglobin or haematocrit has stabilised at a satisfactory level.
(2) Anaemia which is unamenable to treatment is disqualifying.

I would suggest that you contact a aero-medical examiner recognised by CASA who will be able to advise you on this.

[gingernut]

Your negative investigations are very reassuring.

In medicine nobody likes to say never, never, or always, always:) Anaemia is sometimes a symptom, sometimes something the docs find.

I suspect that your AME would be more interested in how you feel and act, rather than you're Hb level.:) Has anyone asked you why you are anaemic? Has anyone asked you about your periods ? What dose of iron were you taking and over what period of time ? Iron infusions would usually be the last resort.

[mad_jock]

Just to note most of the replys are from pom`s you have to get past your own lot. Who by all accounts can be different

[localflighteast]

HAve you actually started flying yet?

I ask because this statement "but running and hiking can make me feel a little bit like I'm dying - lightheadedness, heart working overtime, pins and needles in my limbs. Major postural changes like going from crouching to standing make me dizzy too. I'm fine once they pump me full of the good stuff of course"

is a little worrying. Flying can be a lot more physical than you think ( at least I find it so) and I would not be flying with Anaemia so bad that exercise "makes you feel like you are dying"

not a doctor but someone who was suffering from anaemia similar to yours for a very long time. Luckily for me the cause was very obvious and eventually sorted out surgically.

Personally I found that although I didn't realise it at the time, it affected my cognitive processes massively as well

You really shouldn't be flying with Anaemia bad enough o cause physical symptoms like the ones you mention.

I hope you get some answers soon

[obgraham]

I too think you should be fully evaluated before you invest a large sum in pilot training. It's possible you would qualify, and then at some future time fail, throwing all your plans into disarray. Best to work it through now.

Anemia to your degree, with Hgb below 9, virtually always has a reason, usually a simple one, occasionally complex. Once you know that reason, you and your AME's will be in a better position to make a decision about flight training.

Best of luck to you.

(still willing to comment on these things here!)

[gingernut]

These are the guidelines I try to follow, think I've got some post 2005 at work, but can't seem to find them :-) http://www.bsg.org.uk/pdf_word_docs/iron_def.pdf

[Mac the Knife]

Hmm..

Agree with obgraham - " virtually always has a reason"

Time to see a specialist Haematologist

:ok:

[iatethemacaroni]

Thank you all for your input, I appreciate it. I actually put off replying for a while because I didn't want to put it in writing, but it looks like I'll be postponing for at least a year. A capsule endoscopy is next so hopefully that finds something. If nothing else, I'll have some great pictures of my insides to show the family :\

[localflighteast]

Sorry to hear about the postponing , but probably the best thing long term for your health.

I hope it all works out for you and you are flying as soon as possible and yes those will be awesome pictures.

All the best

[gingernut]

I don't seem to have been privy to this statement....

I ask because this statement "but running and hiking can make me feel a little bit like I'm dying - lightheadedness, heart working overtime, pins and needles in my limbs. Major postural changes like going from crouching to standing make me dizzy too. I'm fine once they pump me full of the good stuff of course"If this is the case, then obviously flying at altitude (oxygen desaturation curve and all that), could cause problems.

If your problem relates to the number itself, then this could be less of a problem:)You need someone who can sift your symptoms (if you have any), your signs, and a look at your blood work in detail.

Your dose of iron was sub-therapeutic.

[Mac the Knife]

Be nice if you could update us!

Mac

:cool:

[iatethemacaroni]

Hi Mac,
Unfortunately I don't have much of an update as yet. I'm on the public health system so it'll take a few months before the capsule endoscopy is scheduled. I've just had another iron infusion so my numbers should be good for the next 4-5 months at least. In the meantime, I just heard from CASA and it seems I've cleared my Class 1 medical! I'm still a bit wary of starting the uni program and going $90k in debt before I get this sorted, so I've taken up a second job instead and will be trying to self-fund the PPL stage. This way I still get to fly but won't have committed to the debt and full-time study. Of course, I'll be sure to monitor my numbers and make sure they're safe :)