Failed my Class 1 and my Class 2's gone. What now?

[Dring]

Hi all,

You may remember me from a few months ago as the person who had a needle phobia. Unfortunately I had a letter from the CAA after my case was referred to them by my AME stating that I was unfit for purpose. My Class 2 certificate was also revoked for 6 in the process with an OSL restriction placed on it for a further 5 years. 5 years is also the time period until I can re-apply for a class 1. I was also told that I would've had an OML restriction placed on my Class 1 however because it was an initial assessment, I was assessed as unfit. Even after all the reports from consultants that were required deemed me fit.

The reasoning behind failing it is that I was asked to write a report regarding all 3 episodes of syncope that have ever occurred in my 18 years of living, all of which have been prior to receiving an injection or blood test (or pinprick in terms of the initial). The CAA used the neuro-cardiogenic flowchart for Recurrent Syncope. Now, my argument is that it is not at all a 'Recurrent' issue as it is infrequent and has a known cause. Instead I would say it is more a psychological/psychiatric issue. My other argument is that my issue is not "likely to interfere with the safe exercise of the privileges of the applicable licence(s)" as stated at the start of all conditions in EASA Part-MED. I do understand that because it is a phobia involving fainting, it is a vasovagal syncope due to a trigger being involved, however the phobia is that mild, it will not interfere with any flight operations as my phobia is only of syringes being inserted into myself.

Of course, I am devastated at finding this out as I was just about to do my Solo XC for my PPL and about to book my skills test, I was also due to start training at Oxford for my ATPLs. I am definitely appealing the decision. I contacted BALPA who referred me to a flight safety specialist and I am hoping he could point me in the right direction. Obviously this is just a secondary review from the AMS however, should it reach the final stage of appeal, I need some arguing points.

Does anybody have any experience on the appeals process and how long it may take? Seeing as how I have no Class 2, could I instead finish my training and gain an LAPL instead of a PPL?

In the meantime, I've started to look at apprenticeships in engineering as my qualifications are quite broad and I have limited experience. I'm certainly never going to give up on the dream, 12 years and counting.

Anything is appreciated. Thanks.

[B2N2]

Disclaimer: I am by no means an expert as far as medicals, their issuance or their denials are concerned.
Having said that; you posted on a public aviation forum and therefore I’ll give you my opinion for what it’s worth.

I think you’re omitting a step in your thought process and your argumentation.
The medical has been denied for you having a fobia which is characterized by an ‘unreasonable fear’.
For butterflies or needles or heights.
Instead of being at the most uncomfortable there is a level of ‘unreasonableness’ to it.
That’s the disqualifier, not the needle.

You’re forgetting blood tests and mandatory inoculations for pilots flying internationally. Just to name two examples of the top of my head.

[Dring]

denied for you having a fobia

I completely understand what you are saying, however, the CAA's reason for rejecting my application was 'Recurrent syncope' not the phobia, although I am aware that blood tests and inoculations are compulsory, I don't believe it will stop me from safely exercising my license privileges, especially now that I have a method of preventing fainting. Especially when recurrent suggests it is a common occurrence when its only been twice. I think they're looking at the issue in general, not the specific precipitating factors. I am also aware of others flying with their Class 1's who have the same issue. I believe the issue lies in the fact that EASA has no regulations in Part-MED regarding phobias.

[tescoapp]

Seems a bit weird.

I know several pilots that will not go up in the cherrypicker to inspect the tail for icing.

And ladders are not an option either.

Its a phobia as well

[artschool]

isn't the doctor just worried you could faint while flying?

[Dring]

I think that is their argument. However, mine is that I have only ever fainted before knowingly being injected and been perfectly fine after regaining consciousness. (Only been out for 15 seconds max)

I am unaware of any time I would receive an injection whilst flying and regardless if I do, there must've been a larger issue in the first place.

[B2N2]

Seems a bit weird.

I know several pilots that will not go up in the cherrypicker to inspect the tail for icing.

And ladders are not an option either.

Its a phobia as well

No that’s called being “uncomfortable”.
If they would faint that would be disqualifying also.
So would be Chlorox wipe brigades.

[Dring]

My other issue lays with the fact that other licensing authorities directly address phobias as an issue, such as the FAA which states phobias associated with some aspect of flying, are considered significant CASA also states that CASA may grant aeromedical certification where an applicant’s specific phobia is unrelated to the aviation environment or is unlikely to affect aviation safety adversely This however is not the case in Europe. At no point in EASA Part-MED are phobias addressed as an issue.

The difference with my phobia is that I faint, however I have significant warning prior to this happening which the CAA is using as the main reason to stop me flying, that I don't have any warning. But the whole idea of the medical is for flight safety, when is anyone ever going to inject me/put me on a drip/take my blood whilst flying. If it ever gets to that point, a greater issue must've occurred in the first place. I even made it clear to the CAA, I only faint because of my phobia of people using syringes on me. If it was on others, I couldn't care less.

My phobia is classed as a type of a Blood-Injection-Injury phobia, the only family of phobias in which fainting can directly occur as a stimuli. As the fainting occurs due to a stimuli, in my case it is just being on the receiving end of a syringe, it is a vasovagal syncope. Due to the infrequency of being round needles, it is not recurrent. The CAA are saying it is as they only have procedures for recurrent vasovagal syncope. Phobias are not categorised under Psychiatry or Psychology.

Vasovagal syncope can also be caused by many other things: standing up for too long, pain, emotional stress, sight of blood, changes in the surrounding magnetic field. For these issues, it could be classed as recurrent as they are exposed to the stimuli frequently, unlike my case. To the CAA this is a Cardiovascular issue, to which I had an exam from a cardiologist and he deemed me fit to a Class 1 standard. Even when I am receiving injections or having blood taken, I do not always lose consciousness as I use applied tension before hand and during I listen to music, have something to squeeze in my other hand and wear a blindfold. In total, consciousness has only ever been lost twice since I was born.

[Radgirl]

I am not an AME but surely the CAA is concerned that you lose consciousness ie you become disabled, and that is it current ie it occurred at your recent medical. Although it is unlikely you will be asked to give blood whilst flying, it is possible you might cut yourself and it is unknown whether you would then lose consciousness. you might say no, but the CAA must play safe

Harsh though it is, there is logic is not granting a medical to a pilot who loses consciousness. It is the core concern of the CAA

I really think you would be better advised to deal with the underlying condition, in the same way as if you had a heart problem that causes a loss of consciousness. There are several specialists who deal with phobias and help people cope with their fear. A good example are the small number of patients who cannot undergo an operation and run out of hospital or faint on being brought into theatre. Once you can demonstrate you have had this treatment and can successfully give blood without fainting you will have a much stronger argument

[Dring]

You have a fair point and I can't blame them for that, It's just frustrating knowing that my phobia is so specific. Plus I had that many blood samples taken at the initial, I think the sheer exposure to having my finger pricked solved that issue ahah.

I have been considering potentially hypnotherapy but I'm still sketchy on the idea.

[B2N2]

I think you need to consider that it’s YOU and not THEM.
They’re just simply upholding the system they’ve been entrusted with to protect the general public and they have a responsibility and a liability.
I think you need to focus your efforts on how to “fix” YOU instead of fighting THEM.
If the law is wrong then the law must be changed.
Write your political representatives.

[Naki Boy]

I appreciate your frustration with this. I think you need to understand it from their point of view. You say you are only needle phobia specific. What you don't seem to be taking into consideration enough is that you actually are fainting through a stimuli that affects your state of consciousness. There are a lot of things that can potentially set off an episode that at this stage you are unaware of. It could be a major weather event, system failure, inflight emergency. You just don't know. It hasn't happened yet but it could, and that's a risk the authorities just can't take lightly.

[pilotmike]

Had you considered a therapy based on acupuncture?

[Dring]

I am currently treating myself with exposure therapy by using diabetes finger pricks, so far so good. I've also discovered that if I use a sterilised safety pin in place of a pricking device, I get no adverse reaction at all. I think it must be the medical nature of it.

It could be a major weather event, system failure, inflight emergency.

In regards to this, my local AME has the same phobia as me and he has been flying for decades. A needle phobia is one of the only phobias that can cause fainting, it is not anxiety based, it is a fight or flight reaction. At a fitness review, the AME said that as I did not lose consciousness or sight, incapacitation is less of a risk as initially thought. I have been in many situations where I have been anxious or stressed and I have never even remotely thought I was going to lose consciousness. It's frustrating but I do understand the authorities stance, the most frustrating part is that I know of people who have the same issue as me and they got their Class 1's with little issue. Even the cardiologist deemed me fit.

[B2N2]

I am currently treating myself with exposure therapy by using diabetes finger pricks, so far so good.

And you’re doing this on your own without supervision or having reciv d training in the process of learning to deal with fobia’s?
Like a professional?

And it’s not the actual act..it’s the irrational fear of the act.
So being asked to donate blood in flight is an ignorant example.

[Dring]

And you’re doing this on your own without supervision or having reciv d training

I have been told how to do so by my auntie who is a pharmacist. My GP has given me several coping strategies that work such as applied tension or exercise prior to having such a procedure. I have figured that if I can administer a pinprick on myself (as was offered at my Class 1 initial) then it will be no issue. This, in turn, will hopefully reduce the irrational fear as I can train my body into not having an adverse reaction. Regarding training, the person who performed the pinprick on me at the Class 1 initial was the AME's secretary so I would hardly call her a medical professional.

being asked to donate blood in flight

Now correct me if I am wrong, no situation has ever arisen and will not ever arise as the blood type would need to be known (I have no clue what my blood type is, neither do many others). Even being asked I would be fine with, watching someone else give blood I AM fine with. Pre-syncope ONLY occurs when I am given warning of such a procedure being performed on myself and happens seconds before the event with a recovery of about 30 seconds.

[tescoapp]

Having tried to cure a Yorshiremans phobia about getting his wallet out in a pub with very little success I wish you luck Dring.

BTW 2 people that I have taken through fear of flying courses. One of them the first flight was 5 mins of circuit with me getting seriously concerned that they were going to pass out due hyper ventilation/shock so much so I refused to take them on the afternoon flight.

Are now ATPL holders in the LHS of big tin.

[Mac the Knife]

I'd give you a "fake" injection (0.5cc of sterile water) 3x a day for a week after which you'd be cured. Habituation therapy.

(or insane . . .)*


*only joking

:cool:

[Dring]

Just an update regarding my situation. Since last posting, I have attended therapy for my needle phobia and the issue is no longer present. I also visited an AME near Stansted who worked wonders. He referred me to the right people and arranged a repeat tilt table test for me which was negative. About 2/3 weeks after submitting all the paperwork to the CAA I received a Class 1 OML in the post (albeit expired as it had been over a year since the class 1 initial). The restriction is 5 years since the last episode of syncope which means in December 2022, they will consider removing the restriction should there be no further syncopal episodes.

I am due to visit the same AME within the next two weeks for my renewal and FAA Class 3 initial. I will hopefully have my PPL by the end of next month and be starting my ATPL ground school towards the end of November. :) It's been a tiring and expensive year (but hey, that's aviation) but it's all paid off.

Edit 30/12/18: Been a while since I've been here, I was informed by the FAA I was unfit for any sort of medical issuance so I was unable to start my training with CAE. I have since applied to FTE Jerez and been accepted where they will allow me to train with my OML.

[PDR1]

Hah! I got rid of my vacuum cleaner - it was just gathering dust.

PDR