Unfair?? Help!

[N2740RPettinato]

Hello,

I'm an F/O for a commercial airline.
Approximately 2 months ago I got sick on a flight (on duty) coming from SYR going to ORD. It was overcast when we took off from SYR and it was my leg, and everything was normal. We were climbing and after we got above the overcast clouds, something started happening to my vision. something like a dot of light was in the middle of my sight. I thought it was caused buy the very bright light coming from the sun so I didn't pay too much attention about what was happening. We cruised along and we started our descent to ORD and it was my time to brief the approach. I took out my approach plate and I was about to start talking but I couldn't. The only thing I was able to say to the cpt was:" take the plane, I am confused". He asked me what was happening to me and one again, I couldn't say much. I got worried and asked me if he had to declare emergency and I couldn't really answer so he did.
As soon as the airplane's door open I was completely fine. No vision distortion, no speech problem. I got off the airplane and they took me to the hospital with the ambulance and I stayed there for 2 days. While I was there I did all different kind of tests, to make sure that it wasn't a TIA(stroke). Every single test was negative. I have been diagnosed with Migraine with Aura. I must say that I did have previous episodes of Aura before. I had them since I was 10 or so but the where very, very rare like, one a year. They started to get more frequent the week before I got sick on the plane. The cause could be:stress, tiredness, lack of sleep, bad diet, bright lights.. so a bunch of factors.
I would like to say that I commute from SEA to ORD. It is a very difficult commute. Two days before I got sick, it took me 8 hrs to find a flight from SEA to ORD and I ended up going from SEA to DFW, got there at 11pm and I took one of the firs flight of the day to go from DFW to ORD and then I flew to SYR. 8 hrs to find a flight, going up and down, from terminal to terminal, from gate to gate, just to find an open seat.

I have been prescribed Propranolol from my Neurologist here in Seattle and I have been taken one pill every morning for the past 2 months

Now, I have been working with ALPA and they have been very helpful. They helped me gathering all my medical records that needed to be sent to the FAA and they have been dealing with the FAA as well.

The FAA came back with this:
By virtue of your migraine headaches with visual changes and aphasia, it has been determined that you are not qualified for any class of medical certificate at this time[...] ..you may wish to voluntarily surrender them for cancellation[...] ...you may request reconsideration after a 12-month observation period from the day of the event.

The ALPA doctor thinks that the FAA has been unfair with the 12 months stop period and he said that the usual "observation" period for migraines is 6 months which would mean 3 and a half more months to go without flying. ALPA gave me a doctor's number that could help me with my case but so far I was not able to contact him. I actually called him but I only got to speak with his secretary.

I'm pretty sure that I'm not the only pilot with this problem. I'm 26 years old, I studied in an aeronautical high school in Italy and I came to the States in '06 to become a pilot. So I have been studying airplane stuff for the past 10 years and flying a plane is pretty much the only thing that I can do. I applied for different kind of jobs since I got sick but with no luck.

I am wondering if anyone can help me find a way to get back in the air. So far the company has been waiting for me but I don't think that they are gonna wait for 10 more months.

Thank you all.

[DX Wombat]

The ALPA doctor thinks that the FAA has been unfair with the 12 months stop period and he said that the usual "observation" period for migraines is 6 months Count yourself lucky, I'm pretty sure that the CAA insists on a five year migraine-free period before they will even begin to consider returning any type of licence. The vision distortion and aphasia are particularly worrying. I know it is a remote-ish possibility, but what on earth would have happened if the captain had become incapacitated too? That is where the real worry lies and is probably the reason you have to wait so long for a review.

[fernytickles]

Are you a member of AOPA & have you talked with them? They have an extremely good system set up for cases such as yours.

Definitely contact them & join if you aren't already a member. If they can help you, they will.

Good luck! & if you get your medical back you may want to consider trying a shorter commute? That sounds like an awful way to live your life.

[Loose rivets]

I'm a retired pilot, not a doctor.

It looks as though their assumptions may well be correct. It's incredibly bad luck being young and having achieved your ambitions, only to find you may well suffer from Classical Migraine.

I've written a lot about this on PpruNe medical forum over the years, and most of it not too encouraging. Indeed, it used to be a license loser, but these days I understand there is the possibility of regaining your medical, but being limited to a multi-crew operation.

I'm not sure which countries accept this malaise while flying multi-crew.


It's encouraging to note you did not suffer a severe attack. The aphasia is something that is frightening, but very normal as a secondary symptom/phase of the attack. So often, that part of it will not continue into later life, but the vision problems may well be a normal part of the attack as long as they last.

Very often the symptoms lessen with age. Indeed, you may well grow out of them altogether.

The most important thing is to get well. Quit cheese and chocolate for an experimental period. This will need to be for months, not weeks. However, it is my unqualified opinion that while some things may be a very definite trigger to migraine, and they are the main two I hear about all the time, the prime cause is deep underlying worry. This is quite different from stress.

An example might be the stressful time you have with simply getting to work, but deep down and more importantly, you are wondering about the long term problems of a career that leaves you having to do this desperately difficult commuting. I emphasize this is only an example of one thing being two quite different things in the mind.

You are right about other pilots being affected. Over the years, while spending long hours with crews in hotel bars etc., I gradually realized several of them were describing migraine attacks. I had watched someone I cared about having them, and I knew very well what they were talking about. It's all about timing. I'm sure some go on for years without it coinciding with a flight.

Everyone I've questioned about the problem give the same impression. During exciting and fun times, they don't have an attack, but during long boring and worrying times, they are beset with the problem, just at a time they need it least.

Take best advantage of the enforced rest period, and tackle the problem head-on and with determination.


Good luck.

[N2740RPettinato]

Thanks, everyone, for the reply!

What really gets me is the fact that multiple doctors have passed all my medical records to some other doctor, because they were unsure of what decision to make. Finally the last doctor specified that I had to wait 12 months (I don't blame him for this decision) but the ALPA doctor let me know that it seems unfair, as migraines have a 6 month period observation.

I would like to add that I haven't had any headache or migraine since the accident. Seems like the medication is working.

Loose rivets-

I agree with everything you said, especially this part:

During exciting and fun times, they don't have an attack, but during long boring and worrying times, they are beset with the problem, just at a time they need it least.

I read on MayoClinic.com too something like you said:

The aphasia is something that is frightening, but very normal as a secondary symptom/phase of the attack. So often, that part of it will not continue into later life, but the vision problems may well be a normal part of the attack as long as they last.


I am working on my diet and exercising when I can.

Funny thing is: I was about to move to Chicago so I didn't have to commute anymore but right now, since I'm not working, I can't afford to move there.
I guess I was in the wrong place at the wrong time.
Im just mad at myself and at my Italian doctor who told me, years ago, that I couldn't do anything about my aura.

Once again, thanks everyone!

I hope to get back in the sky at some point.

[gingernut]

Good on you for displaying such good airmanship.

And to self report focal symptoms say's a lot about your character.

Unfortunately, this has left you on the ground. I'd hazard a guess that you've been given some degree of leniency with a 12 month "watchful waiting" period. Interestingly you've been able to identify a "trigger" for your symptoms, which hopefully you should be able to avoid in the future.

We've probably all got our trigger's, it sounds like over-tiredness is yours.:) (Mine is lime pickle and/or coffee.)

The scotoma, confusion and aphasia have likely worried the authorities,

[N2740RPettinato]

Gingernut-

Thank you!

lime pickle? ahah
A friend of mine cure herself with bread and butter. Crazy but seems to be working for her.

Im gonna fight. I really wanna go back to do what I love. It seems impossible to me that my career it's already over.

Thank you really much , mate!

Stefano