alcohol and dead reckoning

[instructor-pilot]

Could anyone say if this person is fit to fly :

AST 50 NORMAL: 0-38
ALT 68 0-48
LD 218 125-243
GGT 121 11-55
ALP 70 26-42

SODIUM 135 LO 136-145
POTASSIUM 3,4 LO 3,6-5,2
CHLORIDE 95 LO 98-108
CHOLESTEROL 7,3 HI 3,1-5,2
TRIGLYCERIDES 5,85 HI 0,11-1,70
GLUCOSE 6,5 HI 3,3-6,1

[Radgirl]

No nobody could

This is just a set of blood tests. Meaningless without a proper history and examination

[John R81]

Taking your title into account.


GGT enzyme can be high as a result of liver damage due to ingestion of toxins, including alcohol. It can also result from other causes, like gall bladder problem or obstructed bile duct.

Raised AST and ALT can arise from liver damage but there are other causes - heart attack raises AST for example. Both being raised is more typical of liver damage than damage to other muscle or organs, like the heart. In particular the concentration of ALT is high in the liver compared to other organs and so ALT is considered to be a more reliable indication of liver damage but that includes hepatitis.

So nothing conclusive. As Radgirl says, history and examination are required.


Oh, and cholesterol means little unless your body makes platelets from it. My own score is high, but an arteriolar scan shows Zero platelet formation- I don't make the stuff. So my cholesterol level is unimportant to healthy living and that kind of heart attack is not how I am going to check out of this world.

[Adroight]

I think testing for diabetes is due.

[cavortingcheetah]

Suppose the OP's question is approached from a slightly different track.
Had that set of blood results been provided by an adult male at a UK CAA medical, for either an initial or a renewal, would a medical certificate of any class have been issued by the relevant authority? Would the human with such sanguinary nectar flowing through his veins be classified as fit to fly?

Here's a UK CAA flow chart for alcohol abuse. It's interesting to see that the CAA has implemented hair analysis testing in certain cases and of course, alcohol abuse can also be tested using a hair sample. Blood readings will often return to normal following alcohol abstinence for several weeks prior to blood sample. This is not the case with a hair sample.

http://www.caa.co.uk/docs/2499/Alcohol%20and%20Substance%20Misuse%20FC.pdf

[Radgirl]

Cc

There are many possible scenarios for these results. Luckily doctors don't just jump to conclusions. The answer to your question is that a blood result isn't just provided. A history is taken and bloods requested as needed. So there is inadequate information to tell whether a medical would be issued. I can think of cases where it would be issued

[cavortingcheetah]

I would have thought that these blood results are the work up on a case history referred for follow up pathology. That being an assumption, since the patient is unlikely to have authorised the tests on himself, then there is already some concern in the mind of the physician who requested the bloods. There are multiple possibilities for these results and of course alcohol abuse is perhaps the least of them in that, were it the cause then the cure is relatively easy. Abstinence will cause a reduction in irregular readings. A problem though can arise when sudden withdrawal from heavy alcohol consumption leads to seizure. This can happen some considerable time after abstinence has commenced, say within a twenty four to forty eight hour period. This is not what one wants to have happening with a pilot, especially if the operation is a single crew one, such as with a PPL holder.
No doubt the sample donor is under medical attention and a diagnosis will soon be made. Let's hope that any appropriate suitable licence action has been taken and that treatment is successful.

[DX Wombat]

I think testing for diabetes is due. Why? That is a random glucose level (reports here usually state if it is a fasting one) so may have been taken after ingestion of food and therefore perfectly normal.

[mad_jock]

After reading the title I was going to reply

"In my experience oestrogen has a more marked effect on the ability for navigation"

Then found its about something completely different.

And will now get my legs slapped by granny DX.

[DX Wombat]

A little good humour is acceptable M-J but I don't do violence so I'll have to find another method of getting my own back. I'm off to do some thinking. :E

[mad_jock]

Not the nurses "does this hurt" finger squeeze.

Please please slap my legs.

[DX Wombat]

You big wimp! :)

[gingernut]

It's a "one off" result, bit like taking a snapshot of a high speed train, sometimes difficult to judge the direction of things.

If you were my patient, the first thing I'd ask would be around alcohol consumption, if the answer was positive, then I'd suggest abstinence and then retesting in 4-6 weeks.

If alcohol isn't a factor, then perhaps the quack may look into other causes (hepatitis / liver disease etc )

Sometimes good to read between the lines.

Your results aren't that deranged:)but they have thrown up an issue that you and the doc will have to deal with.

I think I'm right in saying that in the UK, we ask for repeat Drink Drive Offenders (? two convictions in 10yrs) to have normal liver function tests before we re-issue them their licence.

[Ulster]

I think I'm right in saying that in the UK, we ask for repeat Drink Drive Offenders (? two convictions in 10yrs) to have normal liver function tests before we re-issue them their licence

Must admit I wasn't aware of that, Gingernut. Seems to me it might be a bit harsh on some people ! For example, someone whose GGT and ALT are sky-high due to haemochromatosis, rather than to alcoholic excess. Presumably that rule could only be applied to anyone whose LFT's were known to have been normal prior to their convictions !

[gingernut]

Don't shoot the messenger, but I suspect the "The two drink drive convictions in 10 years," probably turns the focus round a bit.

Raied ALT and GGT in itself, isn't incompatible with driving, but being p*ssed in front of the wheel twice in ten years could be.

Amazingly, I have met people who "Game" the system......

[cavortingcheetah]

DVLA Medical Standards - Fitness to Drive - Drink Driving (http://www.drinkdriving.org/drink_driving_information_DVLA_medical.php)

[White Knight]

Alcohol and dead reckoning...

I saw the title of this thread and thought it was a discussion about how the hell we can find our way back to our hotel room when p1ssed out of our skulls:}
It's amazing navigating...

[flarepilot]

alcohol and dead reckoning....only the whiskey in the compass