Originally Posted by
Radgirl
I am afraid any pulmonary embolus is pathological and there is a need to assess risk. Whether to anticoagulate or permanently anticoagulate is debatable and I suspect if you ask several doctors you will not get the same response from any two. The best advice would be to sit down with your consultant - does he or she know your occupation? Does he or she know you need a 'medical' and the affect his decisions can have on your career? Only after that explanation from you can your consultant discuss the options. At that stage you might want to ask for a second opinion. No proper doctor will ever complain so if yours does, change him,
Armed with the facts you can then discuss with the CAA. I am sorry I havent answered your question more succinctly but it would be impossible without having all your notes and images
With respect to subsegmental PE (I am assuming very small clots) Dr Google is suggesting that a positive diagnosis is incorrect on something like 59.4% of occasions. That when a positive diagnosis is made and a second opinion from another Radiologist is taken that 60% of these second opinions differ from the first. Diagnosis is wrong more often than it is right. Additionally with improvements in scanning smaller and smaller PE s are believed to being found (they may just be artifacts) leading to more and more diagnosis of PE being made but with the increasing diagnosis has come no consequent increase in mortality from PE strongly suggesting that that these newly observable subsegmental PE are clinically insignificant. Autopsies show subsegmental PE in 63 % of cases yet the subsegmental PE played no part in the death. With such an unreliable diagnostic tool and no evidence of any harm being done in fact some think that part of the lungs function is to filter small clots finding filtration occurring is quite normal. If you genuinely can not determine if there is a clot or not and if you genuinely do not do know if that clot is causing any harm or not it seems disproportionate to treat with long term anticoagulation despite the risk of bleeding is much lower with DOACs. I find the logic of the medical profession utterly confusing and would hate to have two Doctors one in the left hand seat and one in the right hand seat on a flight deck. OMLs are imposed for using anticoagulation to decrease risk for something that probably does not exist and if it did is probably doing no harm . While i have no idea of the process involved I think I smell flawed judgement in the logic somewhere.