Combined Asthma, peak flow, and spirometry thread

[Blind_Pilot]

Hi everyone! This is my first thread here, I hope it won't lead to a depressing result...

I've got an appointment for a JAR Class 1 Initial in 10 days exactly, and I was wondering if anyone could answer the two questions that haunt me when I think about this thing. I've read all there is to read on the JAR web site, and read a lot of stuff here, but I'm not sure what to think of all of it. That's why I'm asking directly.

1- I suffer from mild asthma. I'm allergic to cats and feathers, and don't have an outstanding lung capacity while making physical efforts. If I'm very tired I'll have very mild problems breathing, that will immeadietly dissapear with a small intake of Ventolin. I'm now nearly 23, and my last attack that lead me to the hospital (in fact the last one at all) happened when I was 7, so 16 years ago. Will this end up being a problem?

2- My heart will, from time to time, go nuts, pounding like a madman for about 1 minute and this will make me feel a bit weak. I've been diagnosed with mild tachycardia, and this will only happen if I'm very tired AND very hot AND very stressed. It's happened about 4 or 5 times in the past 3 years. Will the doctors see this on the day of the medical, and will it end up being a problem?

Other than that, I'm in pretty good form, my eye sight is perfect and my hearing also. I'm 1m89 and weigh about 75 Kgs...

Thanks in advance for any answers, any, as long as you think it may help :ok:

[Albert Driver]

....and this will only happen if I'm very tired AND very hot AND very stressed.

But this is exactly what flying is!

.....and, quite correctly, that is the view the medics will take.

Why do so many people with a history of these kind of problems want to put themselves into the position of potentially being unwell in the air?

[Blind_Pilot]

When I mean hot, it's being in the south of France in the middle of the day, at temperatures around 40°C, tired would mean after a mean hangover, and stressed would be emotional and sudden. Somehow, I don't think all of this would happen in a cockpit, especially the 40° and the hangover part...

[gingernut]

My heart will, from time to time, go nuts, pounding like a madman for about 1 minute and this will make me feel a bit weak. I've been diagnosed with mild tachycardia, and this will only happen if I'm very tired AND very hot AND very stressed.

Doesn't everyone get like this ?

Try a search on asthma, chill out and go for your medical.

[Albert Driver]

Somehow, I don't think all of this would happen in a cockpit.

I can assure you, Monsieur BP, that I've experienced tired and stressed and 40C in the cockpit on many occasions!
... and I wouldn't have wanted to add "a bit weak" and "very mild problems breathing" to my troubles at the time.

Gingernut takes a different view so follow his advice, which is usually good.
But for your own safety and for everyone else's, please give your full history at your medical.

[Blind_Pilot]

Of course I'll give my full medical history, I'm not stupid/naive enough to not do so. Nevertheless, the breathing has nothing to do with it (apparently there are many asthmatic pilots, even with Ventolin allowed, which won't even be my case, as I said my asthma is VERY mild), and many times I've been in pitiful states and my heart didn't do anything. So the conditions I've given are arbitrary and may even have no direct link. The doctor I saw today said that it could possibly be linked also with my horrible eating habits.

Anyway, I imagine that if my heart really does have a problem, the medical test will point it out...

[Albert Driver]

Then since you know all about it, you don't need any further input.

Let us know the outcome. Good luck.

[gingernut]

Yeh, sorry to appear flippant, of course, tell the truth at your medical, the docs there will be able to tease out what they consider to be relevant (they're pretty good at that).

Remember to chill, and keep us updated.

[Thomas coupling]

There is absolutely no point in with holding information or disguising symptoms from the AME. The problem being that 'should' you get through "this time" you then make plans to set off on your chosen career path only to find years down the road that it is taken from you because of something that has cropped up in your medical!!! One career and lots of your time wasted.

Bets you tell them everything NOW and let them advise you. They really aren't out to ruin your day, many of them are there to help. At the end of the day it's all about your health first and everything else second eh?

[Blind_Pilot]

It's not really about my health, but more about EVERYONE's security... Don't worry, I've had this in mind since the beginning...

[Put1992]

i had light asthma when i was 11 and i grew out of it.
I am now 15 with no need for treatment for the illness.
i was reading this on the CAA site:
"and have no current or previous illness which might interfere with the safe exercise of the privileges..."
Would it affect my Class 1 medical when/if i go for it?
Thanks

[redsnail]

If it doesn't affect you now, then no. Keep reasonably fit and that usually manages it just fine. I have mild asthmatic tendencies which was picked up by my aviation doctor.

It's not a problem and I rarely use the puffer.

[Molokai]

To whom it may concern : for the Korean KCAB and Japanese JCAB, asthma is a no no.

[Raj Merlion]

I guess that applies to the Taiwanese aviation medical board too. Anybody has any insights?

[flyboy2508]

Hi,

I am 33 and moving onto my second career and aiming to fly for the airlines. I had childhood asthma and failed the peak flow test in the class 1. The doctors seems to think after 6 weeks on an inhailor I will be fine and pass the test. I do not normally use an inhailor and have not need to since a kid.

I will have a class 1 medical and offically on the record as having asthma and my record will state I use an inhailor daily which is allowed for class 1 as long as you have not had an attack in 5 years.

What do the airlines ask about your medical, do they just see that you have a class 1 cert and not ask any more or do they want to know if you are on any medication and therefore I have to declare I have asthma. In a job situation for Cityjet, Aer Arann, Air Contractors for example I will be up against others for the job and I am the only one that has asthma then I expect I would be knocked off the list as asthma sounds like a complication an airline does not need.

Be great to hear what the airlines actually need to know about you medically and what I have to decare or can I avoid bringing the asthma up at all. I aiming to work for the regionals.

Thanks for the help.

[captain_flynn]

Whats the minimum requirement on the Class 1 peakflow test? I only ask because I had asthma as a child but when I moved to Milton keynes recently my new doc gave me a peakflow test and seemed surprised I managed to do so well on it after I told him I had asthma.

[flyboy2508]

You can pass the peak flow test that the standard doctor has which is just blow in the tube but for the class 1 they have a machine connected to a computer which is very percise. I passed it all except for the exhale which should I have low level asthma. I haven't used an inhailor for 20 years and thought I had grown out of it. Anyway you can be on an inhailor and get a class 1 as long as you can meet the peak flow test and have not have an attack within 5 years.

I have to take the inhailor for 6 weeks and then go back and do the test which the doc expects will be fine.

[RemotecUK]

I developed asthma last year - convenient timing when I wanted to start a career in aviation.

I did the honest things and declared to the CAA that I was using a daily inhaler and they asked me to do the excercise test - which I failed. This involves you running around the building at Gatwick for 5 minutes or whatever until you are out of breath. They then repeat the peak flow.

After consulting with my doctor we increased my medication and the next time I did the test I passed so it is possible to pass it.

My theory is as follows - this is all my own personal thinking and not backed my medical opinion - so make of it what you will !!

Asthma is a constriction of the airways. This can be caused by many things. One of the things that makes an episode worse for sufferes is that when the symptoms start they start breathing faster - this irritates the airways more and hence makes the episode worse.

I could be totally wrong but I think that this is why the CAA make you run around. Now, I think if you are fit and excercise regulary then your body needs less air for a given amount of excercise. Therefore you dont irritate your airways as much running around Aviation House!

Getting back on subject, you can have asthma and be a pilot and have *certain* types of inhaler providing you can pass the excercise test if you are given one.

My advice is to be prepared.

This is going to become more common in future years as more and more people are developing forms of asthma.

[Shaft109]

I have had asthma since year dot, and found out the hard way that it is incompatible with the military and even a VGS gliding medical.

However I wrote to the CAA and was asked to forward a GP letter and Recent Spirograph (lung fucntion graph) and was told it was acceptable so £422 later for the initial I was/am the proud owner of a JAA Class 1 without any restrictions. I didn't even have to do any running test.

I only use Seretide 50 once a day now which is very effective for me.

OK so Yes it is possible but

1. I prepared by going to the gym and doing lots of cardio, gently at first though.

2. I now run 4 miles about 3 times a week and boy can I feel the difference!

So swim, cycle or run or whatever that gets your lungs working. Don't need to go mad but certainly train them!!

Practice peak flow techniques on a PF meter - they're maybe a couple of quid on prescription.

Go to your doctors and get a spirograph done on a regular basis to see the improvement.

I was classed as having the worst asthma as a kid and was in hospital often with all the most potent meds but prepare and you shouldn't have a problem.

PM me if you want more information.

[sharman_uk]

Can anyone please give me a rough guide to what peak flow readings should be to pass the class 1 medical.I am 24, and of slim build?? Any help would be very appreciated.

[Shaft109]

It isn't so much the peak flow (you should be within "normal " limits) but FEV-1 in other words Forced Expiratory Volume - 70%.
You should be able to blow (exhale) 70% volume of your peak flow in one second. This will produce a distinctive shape on the graph which shows how good your lungs are. Do a google search and you will see.

[flyboy2508]

Hi,

If you have asthma and have to take a preventitive inhailor every day is this noted in some way on the class one medical as maybe a restriction ?

Tks,

[joey168]

hi my name is joe
and im actually 13 years old
.

i have asthma and hayfever and i am trying to join the united states air force when im older.
i was annoyed when i found out about people with asthma arent aloud to join. so i have started having runs at 7:00 am so my asthma can get better.

can specialists delete your history of asthma once your de diagnosed?

[gingernut]

Unfortunately the term "asthma" gets banded around quite a lot in medicine.

Patients may be labelled whether they have a mild wheeze when they get a cold, or whether they have to take shed loads of medication on a daily basis.

Sorry, can't answer specifics re: airlines / raf etc, but it would appear that asthmatic pilots do exist. (It may be worth performing a search for your specific enquiry).

Being pilot's you are fixating on numbers, the answers you are looking for can be found amongst this lot http://www.brit-thoracic.org.uk/Guidelinessince%201997_asthma_html

I suspect that your examining doc would be more interested in the frequency and duration of your symptoms, how they affect your day to day life, whether or not you've needed hospital admission etc, rather than relying on figures alone.

On a positive note, symptoms can usually be well controlled, with patience and accurate treatment.

PS Joey, it may be worth having a word with your doc, to ensure he has made the correct diagnosis.

[Raptor_]

Can anyone please give me a rough guide to what peak flow readings should be to pass the class 1 medical.I am 24, and of slim build?? Any help would be very appreciated. (http://www.peakflow.com/top_nav/normal_values/index.html)

http://www.peakflow.com/top_nav/normal_values/index.html

[Bob the Doc]

From memory, current asthma is a complete no-no for pilots in the RAF. If you were asthmatic as a child but have grown out of it then I think you need to be symptom free for 5 years with no treatment to be considered. The CAA rules will be more relaxed.

Generally, if it's well controlled and the Peak Flow is OK then you may well be lucky.

Certain asthmatics are worsened by exercise, just the same as some are made worse by cold or certain allergens (animal fur, house dust mites, etc) so that is why the CAA make you run round the block!

[redsnail]

If I go for a run in cold air there's a very good chance I'll get the asthmatic cough that's just such fun...

So, if you're someone who gets that cough and you suspect you might be made to go for a run for your Class 1, take up jogging before the medical (be careful though) and don't do the medical in winter. :ok:

[joey168]

why shouldnt you start joggin in the winter
? :}

[Wear the Fox Hat]

According to the CAA document detailing respiratory requirements you need to satisfy the following for a Class 1 medical:

FEV1/FVC Ratio needs to be more than 70%, not just FEV1 - there is usually a marked difference between the two with FEV1 being the higher figure by quite a margin (well in my case anyway)....An FEV1/FVC Ratio of less than 70% needs to be examined by a specialist in respiratory disease.

For a Class 2 medical you need to have a peak flow of more than 80% of your predicted value, anything less and once again this will be reffered to a specialist.

Hope this helps....

WTFH

[Bob the Doc]

To clarify, the FEV1/FVC ratio should be about 70% in healthy subjects. It is the ratio of the volume expired in 1 second during forced expiration (the FEV1) and the total volume expired in the same expired breath (the Forced Vital Capacity) the FVC is therefore ALWAYS higher than the FEV1 (unless, you complete the expiration in less than 1 second!)

An FEV1/FVC ratio of less than 70% suggests an obstructive disease (like asthma). A ratio of greater than 80% suggests other respiratory disease so 100% is definitely NOT the target to aim for!

The FEV1/FVC ratio is just one of the tests used to check respiratory function.

You need to be careful whether you are talking about a ratio between two values in the same patient or whether you are comparing a patient's value with the predicted value for a patient of that age and sex.

Sorry for the long post but it is important to get this distinction right

[RemotecUK]

I got my class 1 in winter with asthma.

Initially I had to run around the block a few times at Gatwick and failed it.

It then took up jogging to *train* my lungs to use less air at excercise. This meant that there were not breathing in so much irritating cold air that would bring on my asthma. That is my advise - it worked well for me.

Also, I agree with the other poster that asthma can be well controlled with patience. You need to find out...

- What medication is acceptable to the CAA.
- What from that list works the best for you.
- What are your main triggers and how to avoid them.
- Techniques to use when you feel a bit tight chested e.g. abdominal breathing.
- Natural remedies - I think Apples help me and coffee induces it for example.

The CAA want to see that your asthma is well controlled. That means your peak flow does not drop below (whatever) FEV1 after excercise. If you can control your Asthma then you can get your class 1.

Also, there must be asthmatic pilots as its becoming more and more common.

Also :) if you have allergies you may have a post nasal drip causing inflamation. Try getting a Neti Pot (google it) and give your nose a good rinse out. Slightly off topic but might help some people!

[EmiratesCCMad]

Ok Guys n Gals,
I have applied to Emirates for Cabin Crew, and pass through group stages and interview, waiting for approval and then get my medicals done.

Now I have asthma, but I did'nt touch on this on the Open Day, and now I am really 'regretting' it.

Basically. I am 21 years old. I had asthma diagonosed when I was a lickle baby (1 or 2) and it got worse and worse from (7-15) when I was 13.8 stones. (Now, Im 10 stones, slim, perfect shape!!!) I got admitted to local hospitals every year for asthma attaks (mild), in winter because winter triggered me off!So basically, i got nebulisers and ventolin/servtide. I was getting better as the dose got up. When I was 14.5, I got worse and doctor/pead. prescribed me tablets: Singulair/Montelukast. ITS AMAZING! Just 2 months of this, my PF reading went woosh! and a lung test results comapred to previous went WOOSH!. As, my asthma got better, I exercised,eat healthy,worked out at gym and lost weight in 7 yrs. Now I can run miles without coughing and wheezing.
However, I have the slight cough in winter, when its snowing.
My asthma paed. discharged me at 15 and my asthma had improved LOADS. I dont smoke,I dont passive smoke etc.

Will this show up on medicals?Is it good to tell EK?Will they say 'NO' to me? *Lol.Shall I keep my mouth shut and turn a blind eye on it?:oh:

Because Dubai is hot, really hot! So I just dont know?

I think I should ring up EK Recruitment and tell them, but I'm really scared they might dissmiss me. I worked so hard!

HELP PEOPLE. I need advice.


P.S: Emirates might phone me in 2 weeks time to confirm and then get my medicals done and sent over and I could be in Dubai in November/October/Dec. If they find out in DXB, they can't send me back, can they?:yuk:

Going to ring EK on Monday 3rd Sep.

[Sam-MAN]

By no means do i know anything about cabin crew, but i very much doubt you'd be accepted with bad ashma :sad: Just my opinion tho! Although i doubt you would.

many thanks

[EmiratesCCMad]

Thats ok!
Basically, in my "teen years" from like 7 years to 14 it was bad. Then I was prescribed this 'Singulair' tabbo once a day (I was told to stopped taking it at 19 as my asthma improved dramastically with my weight!) and now I only have a special inhaler on a low dosage, incase I have the odd cough on a winter night which is really rare (i mean really), saves me making a trip to A&E just for a neb!

So, I can run long distances without a wheeze.

Anyways, I heard that DXB medical is very basic, like dental,xray of chest?,ECG,Disease check i think and more or less on the lines of that.

In training, they will assess on swimming (which I love) and probarly light work outs but I very much doubt they will send me back half way through CC training because I can't run around the building three times without panting for breath!

Also, the Medical here is also nothing to do with breathing,(i think) just health wise like jabs,dental,disease etc!

I think best way forward is to contact Louise or Mariah at recruitment in dubai and see what they say or should i just be quiet about it?

Thanks for your reply

[Sam-MAN]

I would contact someone at the airline if i was you. Get some advice on whether or not you would be able too.

regards, sam

[EmiratesCCMad]

WOHOO!
Thanks so much.
On Sunday (DXB Business week start) I will email or phone them.
They said we will ring you in 4-6 weeks. About 3 weeks passed so the early the better. I will tell you bout the outcome

As on this forum mentioned before "No news is good news" lol

Are you a pilot or...?

[Bad medicine]

My advice is to be honest with the company.

If your asthma han't been a problem for years, and you are well controlled on preventive medication, there should be no problem. If you have significant asthma that is not well controlled, you shouldn't be doing that job at the moment. If you are not honest with the company, and they later find out, they might have good grounds to dismiss you, regardless of how well your asthma is controlled.

Cheers,

BM

[EmiratesCCMad]

I was thinking that too, but after your words of confidence I feel I should just ring them on Sunday, and tell them. It's well controlled so maybe...thumbs up!!

I'll tell you how it goes...

Thanks so much

[lineupandwait]

Check out a method called Buteyko, I discovered it from this forum and it has helped my Asthma greatly, you may become medication free.

[EmiratesCCMad]

Hey!
Thanks for the suggestion
I just Google'd it and it's apparently a Russion breathing technique.
I'll try it.

I really hope it works however my asthma is really good now

:ok::ok:

Edit: Just had a pop on the site. It looks great! AND ITS IN MANCHESTER!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

I am going to have a proper read, ask my Dr., and go for it.

Thanks soooooooooooooo much:ok:

[EmiratesCCMad]

How much does this course cost?
How many lessons did you do?
I dont mind paying a fortune, if the outcome is that I can be a fit cabin crew and enjoy my life to a full!

[lineupandwait]

I did a course that ran over five days, 2 hours a day. I did a course run by people in the official Butekyo association. This is the association and locations in the UK: http://www.buteyko.info/fap_buteyko_region.asp?grpcode=UnitedKingdom
From what I can remember the cost was 100-200 pounds. You should be able to go along for an information sesssion for free which is also the first session. Just make sure you go to a professional practitioner, this method is amazing and it would be a lost opportunity if you didn't get anything out of it. I'll add that it requires a reasonable amount of dedication for at least 6 weeks to get any benefit.

Edit: Doctors a cautious of the method as it goes againts there way of treating people, that is with medication, so let your doctor know but don't let them steer you away.

[EmiratesCCMad]

Great stuff!

I'm going to contact the Company for info on the MAN sessions.

Ill let my Dr know but won't let him steer him away from my only chance!:cool:

Thanks so much,
Help is appreciated


Emirates__Mad

[JerryB12]

Hey, about the asthma issue. Many grow out of asthma as the airways increase in size over the years. If your asthma is controlled just with singulair and your peak flows are normal, you are in good shape. You may try and taper out of the singulair and avoid triggers such as cats. Big problem cats, they have an enzyeme on their fur that attacks the nose and resp system. Get some pulmonary function tests that a re normal and you are good to go...

[Cdn F/A]

Hi there...I have asthma as well and like you, it only really bothers me in the winter...I did have a incident in training while doing firefighting...I had to put on the PBE (smoke hood with concentrated O2) and "fight" a fake fire...I was running up the aisle with the PBE on and started gasping for breath and had a full blown asthma attack...I think it was the combination of stress, running and the fact that I had on a PBE (with limited O2) right in my face- I had never had an attack like that before or since...My company hadn't known about my asthma before this but they were great...At my new company (been here 3 yrs) I told them upfront and they have been excellent...I would be honest since you never know what the situation will bring, particularly in a stressful situation! Good luck!

Cdn

[EmiratesCCMad]

Hey guys,
Thanks for your replies.
Well, I havent updated you on this thread so I will now.
Im flying out 12 Oct.
I did ring Emirates, and they told me that they would discuss this more indepth when I get in Dubaim but it shouldnt matter unless if it's like walking 10 m and then getting out of breath, which it is definetly not me.
I use Singulair or Montelukast, and it drastically improved my health.

My biiiiiig trigger is cold weather,pets, and dust mites so them bloody a/c must be clean!

Thanks ever so much, I feel much better now.:ok:

I'll keep you posted,
EKCCMAD

[Shamrock274]

Brilliant, all the best with your Dubai meeting

Quick question(s)

How long since youve been hospitalised because of your asthma attack? and any admission to intesive care unt coz of your asthma?

[EmiratesCCMad]

Thanks loads
Last time I was hospitalised was when I was 15/6, lot of years back that was.
Not I.C.U just Childrens Ward lol!
Ta Again

[HomerJay]

- What medication is acceptable to the CAA.

I would be very interested to see if anyone ever got this list from the CAA? Or any feedback?
I have emailed them but they want me to send a letter instead, which might take a few weeks.

[kpd]

Peak flow is in fact related to height but this fact is sometimes missed by occupational physicians. Asthma in childhood is common in fact the quoted figure is 10 to 15 per 100 children. The vast majority either grow out of their symptoms or are well controlled by inhalers. Can the CAA seriously stop that number of people becoming pilots?- I doubt it. Asthma starting as an adult is usually more significant and people do not grow out of it. It seems incredibly common in top athletes and I have no reason why that is!!!!

[Kiev23]

Are these two inhalers accepted by the CAA for people wanting to obtain a class one medical?

Clenil Modulite "Preventer"
Salamol "Reliever"

[gingernut]

You're taking two of the most popular treatments (UK) for asthma, and past posts suggest that these meds are acceptable.

I should imagine that the AME will be more interested in your asthma control, (symptoms, hospital admissions, time off work etc), rather than the meds.

Good luck:)

[Kiev23]

Hi guys,

I went to A and E back in 2004 and the minimum limit for the last hospital admittance that the caa require for asthma is 5 years however when i rang they said if u send a medical report of when i went in then they will consider letting me this summer. I was wondering if anyone else has had anything like this and what do u think my chances are of getting it done this summer?
I was only in there for an hour and was discharged without having to go back in.

[SNS3Guppy]

Kiev23,

I'm an ATP and an asthmatic. My personal counsel is don't admit nor discuss what doesn't show up on the medical. I'm not advising you to conceal, but also not advising you to volunteer. Are you looking at the first class because you intend to fly for a living?

[Kiev23]

yehh i am looking to fly for a career

[ksa]

I am an asthmatic as well, and i will soon take the med class 1. I dont think they will ever find out about my asthma, undless i tell them about it.

I am not happy about lying to the test. Isn't there a question where i have to answer if i have asthma or not?

[ksa]

Do they have to see my medical journal at the med class 1?, and do they have acces to it afterwords?

What if they find out about my asthma later on, can they cancel my med class then?

[gingernut]

The term "Asthma" seems to bounced around quite liberally, sometimes in the abscence of a firm diagnosis.

A kid with a single episode of viral wheeze sometimes gets labelled as being asthmatic, with a resultant negative effect on their future career.

We'll always be willing to help straighten this situation out, but Kiev, I'd advise against concealling an episode which required a hospital admission.

Sounds like the authorities are trying their best to get you through. I'd imagine that they'd be interested in how your asthma has affected you, (control, affect on activities etc), since 2004.

[Kiev23]

thank you for all the help guys the CAA rang me up and said i can go for the class one.

Cant wait......

[HEATHROW DIRECTOR]

Be totally honest. I knew a young controller who died from asthma very suddenly so it's a serious matter.

[Kiev23]

yehh i am being totally honest, wouldnt dream of lying to them.

thanx again for replies

[Loose rivets]

Importantly, I'm talking about one type of Asthma. The one were you're okay one moment, and heaving against a reaction the next. Chronically inflamed tubes I know nothing about.

Some attacks are dangerous. Yes, people do die of the problem...but most don't, and to many it becomes a distant memory. You need to know what category you fall into. Tough to do without paperwork being generated.


I had asthma when I was a kid. I was excused all school sports, and had dozens of broken nights lying in my cat-hair coated bed. All the heaving against the restriction seemed to do nothing but give me a powerful lung/diaphragm. Swimming and rowing didn't phase me, and saved my bacon strength-wise I suppose.

Running suddenly into cold air was a no-no. And some types of smoke - solder flux I think would be tricky. Mostly it was at night...and I bet a modern bed and a dust free room would have cured the problem right away.

I sort of grew out of it. Smoking the world's strongest cigars and a pipe seemed to make my reactive circuits just give up. ( mean this seriously, but there must be less dangerous ways of achieving this effect.)

By the time I was 18, I was a judo enthusiast, and don't recall a reaction doing that. 3 years later I was taking the first medical. I don't recall any questions in those days. If there were, they weren't very searching.

By the time I had been a pilot for some years, I had to go the Praed St for the 5 yearly. I gathered a crowd round the old cast iron pen machine as I blew into the tube time and time again. They wanted to see if I could blow the needle off the disc. I didn't, but I got to the edge of the paper.

I'll never know if that flow was improved by all the nights of fighting against restriction. There is no doubt in my mind that they made me able to puff harder once the pipes had stopped reacting.

The point about all this is a/ that you can grow out of asthma. Never call it My Asthma...just b:mad:y asthma. Don't make a friend of it.


b/ Those nights of heaving away against the restriction. Look as them as a work-out period.

Keep an ace card up your sleeve until you are quite sure that your days of reacting are over. I carried Brovon for a couple of years without needing it.

[BlueDiamond]

Had a problem recently where I had to deal with a woman in severe respiratory distress from an asthma attack. Luckily, one of Perth's main ambulance bases is a mere two minutes away and they were on the scene very quickly so the problem was solved.

However, it occurs to me that it would be a very difficult thing to deal with if no expert assistance was nearby and I'd like to know what is the best thing to do (in case of future incidents) while waiting for the ambulance.

The woman had self-medicated with ventalin to no effect
and was severely distressed, shaking and turning distinctly bluish. I need to know what is the appropriate action in these cases when asthma gets to this severe stage, so your advice would be appreciated.

[rsuggitt]

I think this is something you need to ask a paramedic, or a qualified first-aid instructor....

[BlueDiamond]

Good idea, rsuggit ... I thought I might find one here, hence posting in this arena rather than my usual haunt, JetBlast.

[Is-Sur Belti]

If Ventolin did not work, it is definitely a case for a medic (not even para-).

[Pilot Pete]

There's nothing you can do if Ventolin doesn't work. They need treatment from a healthcare professional, usually admitting to hospital, so, what you can do is call an ambulance ASAP if the attack is that bad.

PP

[obgraham]

"Status asthmaticus" is a true medical emergency. Airway management, oxygenation, circulatory support -- the whole bit. As such it requires emergency hospital care, and so transport by the fastest available route is apprpriate.
It won't be handled well up in the air, be it my 172 or your A380.

Graham, MD

[redsnail]

I suffer from very mild asthma so fortunately it's well under control.

Firstly, don't panic. Yes, unbelievably hard to do when someone can't breathe. Reassure them that medical help is on the way. Call for an ambulance ASAP. Do not delay this action.

However, it seems to be a natural thing for people to want to pat people on the back if they can't breathe. Believe me, this is one of the worst things you can do. Their lungs are already in spasm and to irritate them will just make it worse.

Bluey,
Since you're often in a stressful environment, that can trigger first time attacks. Attacks will look like wheezing or coughing. The cough won't let up and it's a real hassle trying to breathe. Again, if it's the first time, the victim will be very stressed and panicking about not being able to breathe.

Ask if any one has some ventolin and see if that works.. if it's apparent it's not helping, call an ambulance.

[gingernut]

DR ABC

It sounds like you actually followed this rule, (and maybe saved this persons life;)}



It's quite easy to differntiate between what's life threatening, an what is not, if you've seen it many times before, but if in doubt, get'em seen as soon as poss:)'speically if your worried about someones breathing.

(2000 people a year (in the UK) die of uncontrolled asthma)

[BlueDiamond]

Thanks for the replies everyone. It looks like there was no more that could have been done in practical terms and calling the ambulance was the only option.

You're right, reddo ... watching someone struggle to breathe to the point where they're turning blue is very scarey, especially when it's at the point where you're mentally revising resuscitation procedure.

Thanks again for the help and advice everyone, much appreciated. :ok:

[Loose rivets]

If there is no help available, and I mean no help whatsoever for hours, what are the chances of forcing air into the patient?

I'm aware that sometimes it's the discharge of air that is more difficult, but even so, I would try very hard to force air in and out while monitoring pulse.

Surely, even the most dire seizure would allow some air past.

During this time I would try to tell the patient that nomatter how bad it gets, I'm not going to let them die. I might just have a couple of fingers crossed while I was saying this.

[gingernut]

The routine would be the same- DR ABC (or ABCDE!!) http://www.resus.org.uk/siteindx.htm

As obs says, this ill patient needs the works, and lots of drugs to save their life.

[cats_five]

There is specific advice here:

http://www.asthma.org.uk/all_about_asthma/what_to_do_in_an_asthma_attack/index.html

If the patient doesn't have their reliever medication with them (usually in a blue inhaler) or is a poor colour, call 999 immediatly.

[Mac the Knife]

Oxygen
Salbutamol nebuliser
Big whack of iv steroid
Consider titrated iv aminophylline/theophylline
Adrenaline as a last resort

Good article in eMedicine - http://www.emedicine.com/med/TOPIC2169.HTM

:ok:

[gingernut]

Of course, prevention is better than cure........ (people shouldn't die of asthma in this day and age.)

Go and see ya'asthma nurse, it's likely she'll give you good advice.:)

[BlueDiamond]

Thanks again, everyone ... all advice has been read and absorbed. :ok:

[tope kayode]

i want to find out if someone with an history of asthma can work as a pilot, i have applied for my class 1 medicals which i passed,but i want to be very sure.thanks

[SNS3Guppy]

A pilot living in Lagos, Nigeria, has passed his medical exam and been issued a certificate, but still isn't sure?

I was recently in Lagos, and don't remember seeing a flight school on the field.

How is it that you want to be "sure" after you've already taken the exam and passed, again?

[Rugbyears]

As long as you have provided the medical examiners with all the correct relevant information and passed, you have absolutely nothing to worry about, they obviously deem you sufficiently capable of flying. However, if you have retained such details, I would strongly suggest you obtain a medical opinion before flying, as Asthma can be a serious life threatening condition if it is not controlled appropriately with the correct medication. That said I’m sure as long as you are able to demonstrate that it is controllable thorough medication you will be ok.

[gingernut]

Try a search tk.:)

[tope kayode]

sure You right that there is no flying school here in lagos, but my sponsors requested me taking the medicals before heading to Mid Rand, South Africa for my training.

[MrBrightside]

Went to the doctors recently due to slight weezing after exercise. I have been given a ventolin evohale inhaler and a peak flow meter to record my peak flow results over a period of time. From reading previous posts on here I have become slightly worried as to the results I have been getting. My highest peak flow is 570 with my lowest being 540. Just wonderiing if anyone on here could shed some light on this? Is there anyone who has had similar results and falied the C1 medical?

Any methods on how I could perhaps improve this? .. I currently am an active person.

Thanks in advance
MB

[gingernut]

Hi MrBrightside.

The variation in your peak flow rate is marginal, but don't fall into the trap of placing too much emphasis on the figures alone. We have to look at the bigger picture.

A couple of points:

Asthma can sometimes be quite difficult to diagnose with any certainty.

Doctors (and nurses:), and sometimes surgeons) can sometimes be a"prickly" lot and resent being told what to do, but I do think that it is important that you stress the importance of an accurate diagnosis to your GP- does he realise the implications of labelling you as "asthmatic", on your future career.

He may even be aware of the newly released guidelines to managment and care of asthma.... http://www.sign.ac.uk/pdf/qrg101.pdf , although I'd resist the temptaion to print him a copy!

I know more about asthma than I do about aviation medicine, but from experience of these pages, it'd seem that mild asthma doesn't seem to be a problem for aviation medicals. (Try a search)- although the RAF seem to be stricter.

I expect the quack will be interested in the severity of your symptoms, how it affects your day to day life, and hospital admissions due to asthma.

Keep us posted.

[redsnail]

G'day from one very mildly asthmatic person and a holder of a Class 1 medical and an ATPL.

Asthma is a condition that needs to be monitored and controlled to have the least amount on impact on your life.

If the doc didn't explain, take 2 readings of your peak flow per day. One in the morning (first thing ideally) and one in the evening. What the doc is looking for is a bench mark for yourself and to see if there's a 25% or greater difference between the readings. The morning one should be the worst.

Being active is good. You may find you'll need to take a puff before exercise.

My version is a cough and it took several trips to the docs and changing doctors to get it diagnosed.

[Loose rivets]

An anti-inflamatry drug for me back causes really quite bad asthma. Couldn't get through the night without a puffer. Stopped taking it, and back to blowing nearly off the scale.

[cats_five]

Some variation in peak flow is normal. Take it when you get up, and in the early evening and plot the results as a graph. If your morning reading is a lot lower that suggests asthma, but modern treatment guidelines suggest that inhaled steroids are the drug of choice for most asthmatics rather than relieves, which is what Ventolin is.

However, if you only get symptoms after exercise then pre-treatment with a reliever might be all you need - if indeed you have asthma!

The Asthma UK website is very good, plus they have a phone number that will let you speak to an asthma nurse:

http://www.asthma.org.uk/

[MrBrightside]

Thanks for the replies. Greatly appreciated.

I have been recording my peak flow readings three times a day, morning, afternoon and before I go to bed. I do seem to find that my morning readings are slightly worse than my afternoon/evening readings but do not vary dramatically. I have been using the reliever twice after i take my readings.

I have managed to increase my peak flow to a maximum of 630 and I feel as if I may be able to improve upon this through time. What I would like to know is that if I was to stop using my ventolin evohale inhaler would my readings begin to drop substantially? Will this benefit me in the long term?

Thanks
MB

[timelapse]

www.peakflow.com is quite useful too :)

[redsnail]

I am not sure why you want a higher peak flow reading?

Sift through those links and educate yourself about what asthma is and how it's best managed. Then you can discuss it with your doctor as chances are, you'll know yourself better than s/he will. I spent a fair bit of time wading through the British Medical guidelines on asthma and it's well worth it.

Any way. How I understand the "reliever" eg Ventolin, it works when your bronchiols are playing up or as a temporary "preventer" if the asthma's exercise induced.

As I found out, as an adult you don't get cured, your condition is managed. Since I hadn't used my puffer for ages the asthma crept up and sidelined me for a week. Back to the preventer (steroid puffer) for 2 weeks to settle it down and also had to take the ventolin as well. Lesson learned. So, back to taking a puff before exercise.

It's not a crime or shameful to have to take a puff. Plenty of world class athletes are asthmatic eg, Kieren Perkins (Aussie swimmer) and Paula Radcliffe (http://www.asthma.org.uk/what_you_can_do/running_events/london_marathon_team_zone/living_with.rma).

[cats_five]

<snip>
As I found out, as an adult you don't get cured
<snip>

Neither do child asthmatics as there is not cure - all that can be done for any of us is management, and the better it's managed the less it's impact on your life. However, some shildren literaly 'grow out' of asthma as their airways enlarge. A fair percentage of those that grow out of it age back into it...

[gingernut]

Went to the doctors recently due to slight weezing after exercise.

Doesn't everyone?

I think we're all in danger of labelling you with a disease which hasn't yet been formally diagnosed.

Go see the quack rather than diagnosis by internet. This is important- it may affect your future career.

Pre and post ventolin peak flows may be useful- remember that when recording peak flow readings, it's the "best of three" which counts.

[gingernut]

It sounds like he did do it right.

If you look at the SIGN guidelines, you'll see that "getting it right" isn't always an exact science, and sometimes a trial with inhalers is the correct thing to do.

Cough medicines don't work. Full stop.

But I guess they're sometimes useful for placating the odd wimp with a sore throat and a sniffle, who probably doesn't know his gluteus maximus from his olecranium:)

[AMEandPPL]

The fact that I know what those mean

You know what "olecranium" means ?

I'm all ears . . . . . . . . .

[AMEandPPL]

Actually, one part of the elbow joint is the OLECRANON


this might be of interest: http://en.wikipedia.org/wiki/Olecranon

[davo31]

Hello all,

Is Asthma a problem for pilots??

I have mild asthma, never had an asthma attack or been hospitalised. Civil aviation have asked for a spirometry reading and status from a gp after passing the class 2 medical. Is this something to be concerned about considering I can only blow 350 on the peak flow and have a return reading of a moderate obstruction from the spirometry reading?

[AMEandPPL]

I can only blow 350 on the peak flow

An initial JAR class 1 at Gatwick would be seriously in doubt if a
candidate could not manage a PEFR greater than 350 l/min.

Just imagine a temporary WORSENING of that, for whatever reason at
all, and then combine that with the reduced oxygen content of a cabin at the equivalent of 8000 feet.

Still capable of dealing with any in-flight emergencies ? I don't think so.

[davo31]

Yes true this could become a problem in the case of low oxygen.

Thanks for your response I think I will have to reconsider my options.

Is there a training method that can improve lung capacity? After exercise I have blown >400. Also I have passed respritory testing and have gained a scuba diving licence.

[SNS3Guppy]

Short of having an asthmatic attack at altitude, it's probably not going to be an issue operationally. Getting past the paperwork, however, could very well be. I don't know what Australia provides with respect to Asthma, but in the US it's considered childhood asthma if it hasn't been repeated since the age of 12. If the paperwork reflects a statement that asthma hasn't been experienced since the age of 12, that may well do the trick. If you tell the examining physician you have asthma...then you're opening up a can of worms.

I'm an asthmatic. I grew up at density altitudes in the summer of well over 10,000'. I have more problems breathing at sea level than at higher elevations, and I've found that I tend to handle an oxygen deprived environment better than most; I spent much of my early life in that condition. I worked as a firefighter in the smoke for years, and I have regularly been above FL180 doing parachute jumps without any difficulty. Don't assume that being asthmatic automatically pushes you out of the running, or disables you at altitude. I've experienced on decompression at altitude without any ill effects. A much bigger concern would be a sinus block at altitude, which has nothing to do with asthma, and is something to which everyone is subject.

Truth be told, if one is truly a severe chronic asthmatic, an oxygen deprived environment is familiar territory. I know.

[AMEandPPL]

Short of having an asthmatic attack at altitude

And if that DOES happen ? For example, induced by the great stress of a mid-air emergency ? The name asthma covers a wide range of levels of disability. Admittedly, some can be pretty trivial, and lived with easily. Let it not be forgotten, though, that at the other end of the spectrum asthma can be life-threatening.

Bad news if you are at the controls of an aeroplane in flight.

[cats_five]

A PEF of 350 is *very* low, especially if it's on the old scales for a Mini-Wright, for women of most ages let alone men. Somewhere in the region of 600 would be more normal, depending on your height & age, and AFAIK to a degree on your ethnic group.

That leads me to wonder if 1) your technique for producing it is flawed and 2) are you undertreated?

Technique isn't hard - stand up straight, take the deepest possible breath & blow like crazy.

Being undertreated is another issue. You don't mention your current regime but I assume it includes an inhaled steroid. Have you taken PEF morning & evening to see if they are pretty much the same? If not, I'd say that you are almost certainly undertreated. Also, have you had a trial of Singulair or similar drugs? They didn't do anything for me, but I'm told they make a considerable difference to 1/3 of asthmatics, they help another 1/3 and for the final 1/3 (including me!) they make no difference.

[gingernut]

I wouldn't get too hooked up on the numbers, at this stage. (A peak flow of 350lmin-1 is on the low side, but is normal for an 85 yr old female midget!)

It does have to be said, that with the info. you've supplied, your asthma is far from "mild" at this stage.

It's likely that the authorities will take into account the facts you've mentioned. Hospital admissions, exascerbations, time off work school, affect on normal activities, need for emergency doses of steroids etc.

Reading between the lines, as my learned friends note, your control is not yey optimal. The "asthma" component of your underlying problem should be reversible and usually responds well to treatment.

I'd suggest an expert opinion, - seeing a GP with a specialist interest, or respiratory nurse may be a useful starting point.:)

[davo31]

"You don't mention your current regime but I assume it includes an inhaled steroid"

My current regime is 2 puffs of seritide (morning and night) which is a corticoid steriod. After exercise i can blow 400 PFR. This is so frustrating becuase I am about to start a PBL and am not sure whether to submit my current reading or seek advice and testing from a specialist (re: new medication as you have suggested).

Should I go to a respirtory specialist and ask them to run some tests? Is the issue here whether I will have an asthma attack in flight and can this be tested in a lab?

[davo31]

'You don't mention your current regime but I assume it includes an inhaled steroid'

2 puffs in the morning and 2 at night (seritide 250) which is a corticoid steriod. Yes i think you have all suggested i should reconsider my medication. I have booked an appointment with my respirtory specialist. I havent seen him for 7 years since I was approved for scuba diving. He actually suggested I start using seritide. Its strange, it never occurred to me that I suffer from chronic asthma. I have always played compeditive sports and run half marathons (on a regular basis) and never thought i could have been performing at a higher level if my lungs were functioning as they should.

In the end if I've never had an asthma attack requiring hospitalisation then this should be ok? Can they test this in a lab so that I can be cleared??

[gingernut]

I'm not sure what your national asthma guidelines say, but here in England, you'd be seen as being about 3 steps up the asthma treatment ladder.

(Seretide is a long acting bronchodilator+steroid).

There is probably some scope for improving your figures, but this may depend on what has been tried before.

In all honesty, at this level, it's probably difficult and unfair to offer such specific guidance on this forum.

I would have thought a good starting point would be to discuss the specific requirements with your aviation medical authority and work backwards from there.

I can't think of a test designed to test whether you are going to konk out in the air, but if this hasn't happened in the past, and you're running marathons, then this is a good start.

Previous posts regarding asthma seem to suggest that piots can fly with well controlled asthma, but it looks like the objective readings your doc. has obtained, have caused some concern.

As I've stated, there may be room for improving these readings- that's where the specialist comes in.:)

[cats_five]

Seven years is an awful long time to not see your specialist. I get called to the asthma nurse every year, and she checks that I'm OK, my technique is OK and also measures my peak flow - which has hardly changed in the 12 years since I developed asthma.

Do you know if your peak flow has altered since diagnosis? That it goes up after exercise implies to me it could be better all the time.

And is your diagnosis asthma, or ashtma plus something else?

BTW thought you might find the UK guidance interesting:

http://www.nice.org.uk/nicemedia/pdf/TA138Guidance.pdf

The interesting stuff starts at paragraph 2.5.

[saucy jack]

Am mildly asthmatic myself and, after leaving school in the 80s was initially turned down flat for a class 1 medical on these grounds. Around 2000 I found out that the CAA requirements were relaxing and decided to go for (and indeed passed) a class 1 check. Like you I had never had a major attack and always did plenty of sport, but with an inhaler to hand if necessary.

My goal was to be able to run round the CAA carpark at gatwick for 15 minutes and then pass a peak flow test (that is/was the criterion) and to do this I followed a simple plan of nothing more than running each morning for 15 mins for about 3 months followed each time by a self-tested peak flow until my re-found fitness and breathing technique left no ill effects such as wheezing, instead a positive attitude and a generally healthy feeling.

As it happens the test on the day of the exam proved to be a non-event after my preparation, easily achieving the required level (550-650 if I recall).

Incidentally my Dad (a GP) consistently reminded me that the technique for the peak flow test is not to blow.....rather to Huff with a very hard "H" for best results....could this explain the low readings you are experiencing?

My own AME tells me that many pilots (including me) carry a ventolin in their flight-bag so you are certainly not alone.

[redsnail]

I carry a ventolin in my nav bag. I got a really cool Bart Simpson cover for it. :ok:

[davo31]

Thanks all for your thoughts. I think I should be fine once I speak to the respiratory specialist next week. Cheers again :)

[davo31]

That link was interesting cheers for that 'Cats 5' :ok:

[PintofT]

Hi Pprune!

Does anyone know what one should be hitting on a peak flow meter to be confident of passing the CAA spirometry test? :8

I plan on booking my medical later this summer and would appreciate having a ball park figure to work with.

Many thanks,

PoT

[alphamikeecho]

This will give you a rough idea of Peak Flow - but Spirometry is a bit more than a quick blow ;)

Peak Flow - Normal Values (http://www.peakflow.com/top_nav/normal_values/index.html)

Good luck with the medical!

[gingernut]

your readings will depend on a number of factors including race, age, sex and height.

Try a search-discussed recently.

more here... Guideline 101: British guideline on the management of asthma (http://www.sign.ac.uk/guidelines/fulltext/101/index.html)

[PintofT]

Thanks for the pointers, guys! Much appreciated.

[Kiev23]

Hello,

Any advise on how to increase your peak flow will be much appreciated.
I know about like technique and all but i want to physically exert more air quickly. ?

[gingernut]

Obtain a meter from your friendly nurse/gp/pharmacist,

and practice your technique.

Try a search using the term "asthma" or "peak"

[LiverpoolFC]

Hello! I'm a 14 years old boy. And of course i want to be a pilot in a A380 ,a B747 or somthing like that. But i have asthma and i wonder if I can be a pilot or if the asthma would stop me from that....
//Swedish Gurra

[redsnail]

This is the answer you may not want,

"it depends".

It depends on how bad it is, how it's managed and so forth. If it's mild and under control, there's no problem (I have mild asthma and I fly a jet, not an Airbus though).

It's up to you and how you respond to your treatment. Do your best to keep yourself healthy and in good shape, listen to your doctor and most importantly, work hard at school. Have a chat with your doctor, make sure he/she is familiar with the medical requirements for flying. (They are less strict than for scuba diving)

Good luck.

[LiverpoolFC]

Okey thanks I'm not sure but I think I just have mild asthma so I think it´s ok...thanks any way....I don't take medecin often...

[uklocations]

try a search lfc, this has been covered a few times in the last year.

It seems many pilots fly with mild asthma, as redsnail states, it depends on severity, time off school, exascerbations requiring hospital admissions, history of collapse/use of steroids (tablets) etc.

The odd puff on a blue inhaler prior to footy probably 'aint gonna make a difference.

Good luck.:)

[Bad medicine]

Gday all. I'll be putting most of the recent info on asthma etc into an easy to find and search thread.
Cheers,
BM

[HomerJay]

Thanks Bad Medicine, useful for searching.

I have a quick question before my class 1 renewal in Dublin next month. I started taking Singulair tablets once a day, the doctor said I might as well as they help with allergy induced asthma and they work well. I still take the seretide which the medical people know about but I'm wondering wether I should tell them about the Singulair.

They might wonder why I am taking additional medication? My asthma has not worsened in any way. My fear is there might be new EASA standards which throw a spanner in the works and I could be sent to a specialist. Basically I don't want to rock the boat. I have my class 1 and I'm fit to fly.

Any advice about this very much appreciated.

Thanks,
HJ

[gingernut]

I think you're duty bound to tell them homer.

Singulair does seem to work extremely well, I suspect the boys in the white coats would be more interested in this, rather than the drug itself.

Good asthma care invovles prevention of problems, rather than sticking a plaster on an exascerbation, so it sound like your GP's acted correctly in this case, but for future reference, it's worth informing him of the why's and wherefores of the dark art of aviation medicals next time he wants to fiddle with your regime.

Try pming AMEandPPL, he seems to know the ins and outs better than most.

And let us know how you get on for future reference.:)

[HomerJay]

Thanks very much Gingernut, I'll send a pm.

The doctor couldnt get a sentence out without me reminding him of my situation so he definitely knew. The key thing was that Singulair is not a steroid tablet which is what the caa do not allow.

Thanks again, I will update once I do the renewal.

HJ

[RemotecUK]

Yes, Singulair is acceptable as I had my class 1 issued when I was using it. I dont use it now because it didnt make any difference to my symtpoms which are very mild anyway. As you have said its not a steroid so thats one of the reasons why its accepted.

[billabongbill]

I underwent the lung function test for the ANA B767 recruitment and failed miserably. Blew with all my might until I turned blue but no luck, just hit 68% capacity. Despite all the encouragement and coaching from the guy administering the test, I could not make the required 80%. Was advised to see a pulmonary/sleep specialist. Did the required testing with CO gas and more blowing...got cleared of any lung problem ( specialist said I was born that way, gotta live with it. A capacity of 60 to 70 % is no big deal; he fail to see why the JCAB requirement is such for 80% )

Someone told me that passing the test require the correct technique. Trolled through various threads, only found some vague thingy about taking really small breaths and then big blow. Well that didn't work for me; IS THERE MORE TO THIS? Thanks.

[CommanderRiker]

billabong..........sorry about your predicament. I have only this suggestion; do lots of deep breathing exercises using your diaphragm and stomach muscles, not the pectoral muscles. During the test, have 2 initial shallow breaths followed by a huge inhalation using your diaphragm and abs and a forceful exhalation using the same said muscles. It worked for me and I sincerely hope it does for you too.

[122.85]

One thing that may be useful to all is a breathing resistance trainer. I have just ordered one as all info have read / rewiewer comments said that they found a positive improvement and in a lot of cases reduced / removed need for medication. I doubt that it will help a massive degree but any training of the lungs couldn't do any harm. I personnaly went for a Powerbreathe Sport device. Will let you all know in a few weeks if helped me get through Class 1 initial :-) Fingers crossed!!

[Babablackship]

Just a thought.........would having a few puffs of ventolin or any of the other puffs asthmatics use help in the lung function test?

I am sure there are guys who on puffs and can confirm if they can help in the lung function test, not amounting to cheating of course!

[De_Vlegende_Student]

Very interesting topic guys!! I've got exactly the same, had my initial class 1 in Amsterdam and they told me to go to a specialist due to low FEV1 and FEV1/FVC (Tiffenau index) readings. Now i'm going a lot to the gym and have seretide/ventolin and singulair to prevent any reaction from cats and dust, hope it will work for the next time. Just a question, are the examiners at Gatwick just looking at the FEV1 numberand peakflow or also to the FVC and FEV1/FVC? Thanks a lot!

Greetings Alexander

[CommanderRiker]

Baba raises an interesting question; will AMEs allow these puffs to be used prior to a pulmonary function test?

I guess if the puffs are prescribed for asthmatic conditions, they are probably legit for the lung function tests. Anyone willing to share their experiences?

[Mach086]

My experience with regards to asthma on my initial:

I'm 6'2 so naturally I would have a lower capacity than the less tall guys.
I Use the Brown Inhaler (morning and night)
I Use the Blue Inhaler (when req)
I take Singulair once a day.

Passed the initial.

[De_Vlegende_Student]

My AME said the asthma must be stable, with or without your puffs so you may use them before you have to do the test (and with puffs i mean ventolin/seretide)

Alexander

[122.85]

I got through my Class 1 initial last week with no problems I told AME about my condition and that I had previously used Beclazone. He reviewed my lung function results and was perfectly happy with these.

Good luck to all in same boat, I worried about it before hand as am sure many do. My advice is lots of running, lung training and be honest at medical.

[De_Vlegende_Student]

Nice to hear 122.85!! Congrats!! I was waiting to hear the result of you because of the power breath sport device, convinced it helped so i'll give it a try too!:ok: Keep you all informed!

Alex.

[122.85]

Fingers crossed for you!
I do think the power breathe helped but in conjunction with CV training. When I was going for a run I used to use the power breathe to 'warm up' as you then start running with your second wind so to speak and that seemed to help.

Good luck!
Matt

[De_Vlegende_Student]

Allright then, just for the info which power breathe do you use, the wellness, fitness or sport performance?? And is that the classic one or the plus version? Just curious :)

Greetings Alexander

[122.85]

I am using the sport version and its plus not claasic.

Cheers
Matt

[Sparelung]

First post!

Just some replies to some of the things I've read on here if I may, from someone who works with respiratory disease every day, and with an interest in aviation medicine (which is why i came here in the first place...)

The Powerbreathe will not increase your lung function dramatically, they are useful for those under physiotherapists because their respiratory muscles have wasted due to disease. Put simply, this is because the majority of the lung function values we look at such as PEF (Peak Expiratory Flow) and FEV1 (Forced Expiratory Volume in 1 second) to diagnose airway obstruction are not down to respiratory muscle strength, but a function of the air-carrying capacity of your airways, which stands to reason will be lower if they are narrower, such as in an asthma patient. If your airways are narrowed and your numbers reduced, no matter how hard you are able to blow you will always get the same numbers because there is a maximum rate at which air can travel through a small tube . This can only be increased by increasing the diameter of the airway by reducing long-standing inflammation (brown inhaler) and reducing muscle constriction by way of medication (blue inhaler)

To billabongbill: Even if your lung function values are reduced, you may be what we refer to as a 'normal variant'. Everybody has predicted values based on age and height, but that number will be within a normal range that depends on which guidelines you read. Occasionally we will see patients that are outside the normal range, both high and low; it just means that their lungs are smaller/larger than average, but that those lungs are working properly. Your specialist took a look at your full results and came to that correct conclusion, passing that on to the relevant authorities who should pass you fit. 'Passing' has no technique apart from blow as hard as you possibly can! People (mainly people with a little bit of knowledge of lung function) become too fixated on the patient's 'normal' peak flow readings and forget that there is a large variant in the population that have the same age and height as you!

For those who get wheezy on cold days and when exposed to dust, I find that a lot of my patients who report this have PEF and FEV1 within normal ranges and would pass any medical on these numbers alone. These patients require 'provocation tests' like running around the car park! It's an excellent test, especially on a cold day, although treadmill running indoors will give you a similar effect. Exercise induced-asthma is categorised by a fall in FEV1 of 15% after 6 minutes running. If you have an allergic type asthma we can induce airway constriction with chemicals such as methacoline or histamine - the amount needed to drop FEV1 by 20% will categorise the severity of your illness.

Regarding asthmatics taking inhalers to 'pass the test': if the person doing the test is only looking at PEF and FEV1 then it may work, but if they are experienced and look at other things on the test then they will still see that you have distinct characteristics on your results and flag it up regardless of recent ventolin use - I can spot a controlled asthmatic a mile off. I always ask that patients don't use any inhalers prior to testing, because it then allows me to perform a 'reversibility' assessment, ie how much the inhalers can reverse the airflow limitation, and whether their treatment is optimal.

Sorry for the long post - If anyone has any specific questions please ask away.

[De_Vlegende_Student]

Hi Guys!
Just to let you know, i've also got my Class 1 medical certificate!!:} Had to come back for the renewal (because i already had the initial and then the asthma problem occured), the AME just looked to my fysical health, eye check etc. the usual and told him what medication i take (seretide qvar and singulair) and asked if i do any exercise (fitness, rowing, running). He send it to the Authorities and it's fine according to JAR-FCL 3.160 b appendix 2 paragraph 2. Finally:D!!! So just for the info for other asthmatic (allergic) (student) pilots, asthma is not a big deal IF it is stable, the medication is approved to fly with (ask AMC) and your pulmonary graph is sufficient (FEV1/FVC >70% FEV1 > 70% and Peakflow >80%). And the keyword for me was...do a lot of exercise/sport, practise on a Peakflow indicator and never let you tell it is mission impossible;). I want to thank all people on this site/forum for all the info and support, because this was the first site where i personally found out it is possibly to fly and make your dream come true, even with asthma!! All the best to the fellow asthmatic pilots!

Greets Alexander