Fainting whilst at work following a crash diet

[spitfire747]

A friend of mine at work, male 26, went onto a diet to lose some weight, which involved eating just protein such as chicken, tuna, meats and vegetables, nuts, seeds and pulses. NO carbs such as rice, potatoes or dairy products were consumed.

After a couple of months and a slight weight loss, he subsequently fainted whilst at work in the cruise and subsequently put on a no fly.

After exhaustive ECGs and various tests the CAA have pulled his JAA Class one for a period of 6 months and stated he must complete a full head up tilt test prior to consideration of re-instating the medical.
He has told me in confidence that there is no way he can pass the tilt test as the thought of the needles and intrevenous lines makes him feel faint thinking about it, I agree with this not everyones cup of tea.

Failing or not doing this test means no medical, no job.

Is there anyone with experience of this and knows whether following a single episode of fainting, if a tilt test can be avoided?
JAR FLC is very specific but says a tilt test "may" be required, but not "must" be required.

Thanks
Spit

[Loose rivets]

As a (retired) pilot, I have to say I feel the medics are right in treating this seriously. His 'health diet' doesn't sound too radical.

Having said this, even when I was fit, (judo 3 nights a week.) trying to 'crash' away those annoying few pounds would sometimes leave me greying out if I stood from crouching suddenly. It almost always was the case, and a small amount of sugar fixed the problem on a temporary basis. Normal diet, and it never happened.

Some 30 years ago there was a flurry of concern about lorry drivers in the UK fainting at the wheel. They were advised to carry sweets/candy just in case they felt feint.:ugh: An odd kind of logic.

I think anyone up the pointy end should be able to steel themselves to have any kind of procedure. But, now I come to think of it, I have a pal - 40years on Boeings - that can not look at a needle going into his arm. Difficult.

If I was in that position, I'd go for full fitness training...be able to cope with anything they'd throw at me. If I couldn't manage that at that age, I'd have to concede their concerns were valid.

[gingernut]

"Fainting" is quite a subjective term, and means different things, to different people. It'd be interesting to hear about his exact symptoms.

He'll probably have to jump through the hoops, which, from a passengers point of view is quite reasonable. (Bit of a :mad: if it's your job though.)

CBT may help with densensitisation of his needle phobia.

The 6 months suspension sounds like a "watchful waiting" strategy.

PS: essential to rule out a family history of young sudden deaths in the family.

[AvMed.IN]

Please check out this article on single episode of loss of consciousness (ingentaconnect Algorithm for Evaluation and Disposition of a Single Episode of L... (http://www.ingentaconnect.com/content/asma/asem/2005/00000076/00000009/art00008)). May be it is of some help!

[MR.X99]

Thats Normal.
As an athlete we see that frequently in the Gym. Ladies feeling faint/fainting and Muslim men during Ramadan also. Low blood sugar I guess.
If you wish to loose weight stop the carbs. White bread,rice,potatoes, French fries...eat meat and salads.etc.It will just melt off you.You are producing to much estrogene....males breasts soon:)

Good Luck.

In my opinion your medical should not have been pulled until the FAA or whoever received three agreed opinions one of which should of been a dietitians report.It sounds like you were starving yourself and coupled with stress your bodies reaction was fainting.
Currently it should be regulated that it takes more than one opinion three at least to invalidate a medical(grounding a pilot/end of income).That is a very ,very serious action.The power of these decisions leans to far over to the medical side and some doctors,not all, do make mistakes and at the end of the day ,are only human.Many will disagree ,but there are plenty of doctors who should have there licenses revoked as well and have.It is a debate we should have.Of course there are obvious reasons for invalidation,but some are dubious.

[AnthonyGA]

Of course there are obvious reasons for invalidation, but some are dubious.

Fainting on the flight deck is an excellent reason to remove someone from flying status.

In people who are in normal health, merely not eating or exercising will not produce fainting. There's more to the story, and without finding out exactly what else is going on, it would not be safe to return this person to flying status.

[MR.X99]

I completely agree.What I don,t agree with is the six month term. Perhaps two weeks until blood tests are conclusive etc. Then a further decision can be made. But to ban operations for 6 months "is not justified".

It does not take 6 months for a conclusive diagnosis. In fact a diagnosis and remedy could be achieved within 72 hours.

This a point for regulatory reform, a closer examination of the authority of medical practitioners and questioning the unrestrained authority in our industry and society in general.

At the end of the day the guy fainted.If he earning $10,000 a month and holding a seniority position we have allowed 1 medical examiner to end all that for 6 months for what? What are you going to do in 6 months exactly ?

[AnthonyGA]

I completely agree.What I don't agree with is the six-month term. Perhaps two weeks until blood tests are conclusive etc. Then a further decision can be made. But to ban operations for 6 months "is not justified".

It does not take 6 months for a conclusive diagnosis. In fact a diagnosis and remedy could be achieved within 72 hours.

There isn't a deadline or time limit. The pilot must remain on non-flying status until a clear diagnosis can be made AND the cause of the incapacitation can be eliminated. If it takes five years, it takes five years. If it takes 72 hours, it takes 72 hours. However, these two criteria must be met in order to return the pilot to flying status. Without knowing the cause already, one cannot be sure that a diagnosis and treatment will be found and successfully carried out in 72 hours, or even six weeks or six months. It's unfortunate if the diagnosis and treatment require two years, but there's really no other option than to prohibit him from flying for that period.

There's no telling how long diagnosis will take. It depends on the cause. It's possible that no diagnosis might be possible, in which case the removal from flying status may be indefinite. And even once the diagnosis is established, the cause must be something treatable, and it must be successfully treated. That might also take some considerable time. If it can be diagnosed but not treated, well, it's time for a career change.

This is all the more true because incapacitation is not merely a suspected risk in this case, it's an established fact. This pilot actually did become incapacitated while on flying duty.

Things like hypoglycemia, neurological or cardiovascular problems, blood or metabolic disorders can take a long time to fix. This pilot cannot fly until the fix is complete.

I do have reservations when someone is suspended because he has a condition that might theoretically incapacitate him (but hasn't actually done so). But when it's a condition that has actually caused a problem already, and right on the flight deck, one can no longer afford to give the benefit of doubt.

[AvMed.IN]

While I agree with AnthonyGA, a case of fainting, invariably is a diagnosis of exclusion. More interestingly, loss of consciousness due to fainting is found in 12 to 48% of healthy young adults. Common faint, also called as vasovagal syncope, is reported amongst 3 to 37% of the general population.
A study at USAF School of Aerospace Medicine had a referral of 47 cases of loss of consciousness over a period of 8 months, including 34 cases of fainting, of which 24 were found to have common faint.
As far as commercial aviation is concerned, if any pathological cause is ruled out (except in a rare or unpredictable case, which may be missed even on most exhaustive investigations), it can be safely assumed there is no life threatening risk of death. Therefore, there is no reason to prevent an aviator from flying in the event of a single episode of fainting, if exhaustive medical evaluation have ruled out any disease state.
The time for observation 72 hours to 6 months is discretion of the AME or the regulator. If they can define their reasons for the chosen period of non-fliying status, it is prudent to respect the same for it is not just the individual health but the larger issue of aviation safety at stake.
PS: Some of the figures quoted in the mail is taken from an article: http://www.ingentaconnect.com/search/download?pub=infobike%3a%2f%2fasma%2fasem%2f2005%2f00000076% 2f00000009%2fart00008&mimetype=text%2fhtml